As the rapporteur for the MHTF Buzz Meeting, my job is really all about keeping track of what questions come out of the meeting, and as I look back at my notes on the first day of the meeting, I’m really struck by just how much of the meeting is about questions. The first question of the meeting, “Do we really know what works?” was posed by Wendy Graham. Within Wendy’s fairly brief question, “Do we really know what works?” the different underlined pieces really pointed to a series of often difficult questions, around the issue of accountability: who is accountable, to whom, for what and how are they held to account? And, further, this led to the question of what accountability looks like now vs. what it should look like.
Rather than a dry discussion of how different mechanisms might be used to establish accountability on the part of, say, health and finance ministers, the discussion that followed focused pretty quickly on the more difficult to answer – and more personal challenges. In most of the discussion, the answer to “who is accountable” was “us,” or, as Wendy put it, “the maternal health knowledge community.” From there, a consensus emerged pretty quickly around the to whom question: researchers, advocates and programmers are accountable to the donors who fund their work, a fact which sometimes obscures or creates tension that keeps them from being entirely accountable to the women, families, and health workers are the people who they should answer to. With the question of “for what,” the ultimate answer was clear: improving maternal health, but the steps along the way were not always so clear cut: for example, do next steps mean bringing in new voices to talk about priorities? To challenge policy makers or donors to set priorities that align with ours? Finally, the last question: how led to a huge range of personal reflections on how to make sure that the work we do every day has an impact, that we are open to new questions, or, as one person put it how to “be more of an outlier.”
At the same time, there was a lot of discussion of collective and mutual accountability: how do we as a community hold ourselves responsible? One of the questions that followed this seemed particularly apt for the first day of this particular meeting: “How do we make safe spaces for discussing challenges to our assumptions as a community?” I’ll certainly be paying attention to whether there is at least a partial answer to this question by Wednesday.