Social Accountability in Health Governance: A Conceptual Analysis Publisher



Nejatian A ; Arab M ; Takian A ; Ashtarian K
Source: Avicenna Journal of Nursing and Midwifery Care Published:2026

Abstract

Background and Objective: Social accountability, a crucial dimension of governance, significantly impacts people’s satisfaction and the overall performance of health systems. Despite increased attention to this concept in recent years, a common understanding of its dimensions within health governance remains elusive. This research aims to analyze social accountability in the context of health governance, identifying its prerequisites and outcomes. Materials and Methods: The present study was conducted using the concept analysis method based on the Walker and Avant model. A total of 25 scientific articles related to social accountability in health governance, spanning the period from 2010 to 2023, were reviewed. Results: Social accountability in health governance can be defined as a technique or strategy in which citizens actively participate and receive information—either directly or indirectly—about the actions or inaction taken by health system officials. Citizens pose questions, and these officials respond within their authority. Based on their judgment, people can either encourage or punish them. To effectively implement social accountability at the governance level, several prerequisites deserve attention. Social accountability yields positive results across various levels of Service Providers, Society, and Governance. Conclusion: Social accountability in health system governance depends on the demands of the general public. Increasing health literacy and empowering the community to exercise its rights will improve social accountability in the health system. Therefore, it is suggested that health policymakers, in addition to making officials accountable, pay attention to creating skills and opportunities for public demand. © 2025 Avicenna Journal of Nursing and Midwifery Care.