Can transparency and accountability programs improve health? Experimental evidence from Indonesia and Tanzania

• We assess the impact of a transparency & accountability program on health outcomes. use randomized controlled trials involving 400 villages across Indonesia and Tanzania. On average, no evidence treatment effect maternal newborn healthcare. The causal paths from planning actions to tangibly improving healthcare were complex. Overall, few communities able traverse these complex paths. designed improve (MNH) outcomes in Co-designed with local partner organizations be community-led non-prescriptive, sought encourage community participation address barriers access high quality care for pregnant women infants. evaluate this through (RCTs), 100 control each country. find that did not have statistically significant or content services, nor perceptions civic efficacy among recent mothers where it was offered. These findings hold both countries set prespecified subgroups. To identify reasons lack impacts, we mixed-method approach combining interviews, observations, surveys, focus groups, ethnographic studies together provide an in-depth assessment linking improvements MNH Although meetings substantial sustained most communities, attempted at least some what they had planned, only minority achieved tangible improvements, fewer still saw more than one such success. In our assessment, main explanation is accomplishing their care.