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Table 3 Conceptual definition

From: Improving maternal health services through social accountability interventions in Nepal: an analytical review of existing literature

Social accountability: Social accountability is an approach that enhances accountability through civic engagement. The civic includes citizens and/or civil societies who directly or indirectly hold service providers accountable for their actions. This approach is commonly demand-driven; however, it can be supported by the state as well through the formal mechanism. In the health system, it ensures the quality of care by empowering citizen, protecting their rights, preventing corruption and improving governance [11, 16].

Social accountability interventions: In this review, social accountability interventions refer to the approaches, processes, tools, interventions, initiatives that involve community engagement and oversight to enhance health system responsiveness. This definition is adopted from the concept of Lodenstein et al. 2013 [17].

Health system responsiveness: Health system responsiveness signifies as an ability of health system (both health services and policymakers) to respond valid expectations of service users and to protect their rights to get adequate and timely care [19]. In this paper, the health system responsiveness refers to the health service providers’ and policymakers’ responses toward community voice and demand regarding quality maternal health services. The responses include a tendency to implement change in their behaviour and attitude, decision-making and management structure for quality services at the point-of-service-delivery which is adapted from Lodenstein et al. 2017 [13].

Quality of care: The QoC in maternal health services involves a proper use of effective clinical and non-clinical interventions, strengthen health infrastructure and optimum skill and attitudes of health service providers. Improved QoC results in women and service provider satisfaction and produces better maternal health outcomes [9, 20]. Furthermore, the perception of women, their family and community about the available maternal health services influence their health-seeking behaviour. Therefore, community engagement is the key to improve the quality of maternal health services [9, 10, 17]. In this review, we have adopted following indicators based on National health sector strategy (NHSS) (2015-2020) [6] and the Safe Motherhood Programme [2] to assess the quality of maternal health services. They are (1) Infection prevention practices at health facility/birthing center, (2) Availability of trained human resources at Birthing Center, (3) Attitude of health workers, (4) Availability of equipment and supplies, (5) Coverage of services: ANC, PNC, Institutional deliveries, (6) Client satisfaction, (7) Waiting time to receive the services and (8) Confidentiality.