Challenges of accountability in resource-poor contexts: lessons about invited spaces from Karnataka's village health committees

Abstract

Invited spaces have been discussed by development scholars and policymakers as a new and important means of promoting accountability in primary healthcare. Although numerous experiments have been initiated to establish such spaces in resource-poor contexts, we still have little understanding of how they are used and their effectiveness. Based on our longitudinal study of the Village Health Sanitation and Nutrition Committees in Karnataka, we trace changes that have occurred in the frequency and quality of interactions between state, political and civil society committee participants as they come to understand the possibilities afforded to them, work out tactics and develop a set of practices that make them accountable to each other for improving village health. Our findings suggest that strengthening accountability within invited spaces can form an important basis for improving the primary healthcare system with implications for research and policy.