Accountability in the Reproductive Health Sector

This project, funded by the Results for Development Institute under William and Flora Hewlett Foundation support, aimed to better understand and overcome problems with public spending and service delivery in reproductive health in Tanzania.

The project generated evidence-based information through the use of Citizen Report Cards to persuade local government authorities to allocate funding for family planning during stock outs. The project also influenced the contraceptive supply chain management system to address stock outs at the district level, and strengthened the capacity of two local organizations and women’s and youth groups in the use of the Citizen Report Card for accountability.

The project engaged beneficiaries and health workers to measure access to contraceptives, identify inefficiencies and gaps, and develop appropriate solutions to respond to the public's contraceptive needs. Training of community-based organizations and meetings with women of reproductive age, health workers, and district and regional authorities culminated in a national stakeholders' forum to produce a joint strategy to ensure family planning supplies are available at all facilities.

Through the use of the Citizens Report Card, Pathfinder obtained feedback from FP clients in the regions of Dodoma, Shinyanga, and Dar es Salaam on the quality of FP services they received through public health facilities. Pathfinder worked on a three-level dissemination plan to distribute reports with findings and analyses from the Citizen Report Cards: a national level plan targeting key Ministry of Health and Social Welfare officials and Family Planning partners; a district level plan targeting district officials and health facility level service providers; and a community level plan which targeted community members. The dissemination meetings presented specific findings of FP client feedback and suggested actions.



Your support is critical to ensuring our work can continue. Your gift of $25 or $50 helps women and families access contraception, maternal and newborn care services, and a range of other reproductive health services.

Related Publications

October 2013

Use of the Citizen Report Card to Assess Local Family Planning Need in Tanzania

This technical update discusses Pathfinder International and partners’ experience implementing the Citizen Report Card to support the government in understanding local experience of contraception and family planning services.

Related Projects

African Youth Alliance

PAST PROJECT: This project worked to improve, scale up, and institutionalize HIV and AIDS prevention and youth-friendly sexual and reproductive health services. Institutional capacity building was a key component of the project.

Community Scorecards in Tanzania

PAST PROJECT: Pathfinder was awarded a second grant from the Results for Development Institute to implement activities that are complementary to those of the Citizen Report Cards.

Community-Based Family Planning Program in Papua New Guinea, Tanzania, and Uganda

PAST PROJECT: This project provided technical assistance and support to local organizations in Papua New Guinea, Tanzania, and Uganda, with the goal of improving each grantees organizational capacity to affect health and community systems strengthening.


HoPE for Sustainable Development: Results From an Integrated Approach in East Africa

Supported by Pathfinder International, the MacArthur Foundation, and the Packard Foundation, the Health of the People and Environment in the Lake Victoria Basin initiative, or HoPE-LVB, has employed the PHE model to address food insecurity, weak health infrastructure, environmental degradation, high maternal and infant mortality, and inadequate water, sanitation, and hygiene.

Tanzania Rejects Key Recommendations to Human Rights Council

Tanzania has rejected 72 recommendations including to duly safeguard the freedom of speech and the right to information as advised by Portugal via the Human Rights Council's Working Group on Universal Periodic Review (UPC).

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