Poverty reduction programs and local collective actors: social accountability and public service delivery in São Paulo

This paper presents preliminary results from a research still in progress that addresses the forms of accountability activated by collective  actors over local level
service delivery in health and social assistance, focusing on two  Brazilian poverty reduction programs: the Family Health Program (PSF) and the Minimum Family
Income Program (Renda Mínima), in the city of São Paulo. The results show that societal accountability exercised by collective actors varies according to the specific
sector. It appears stronger and more present at the local level of the health sector, which has an older and more organized social movement. Health sector has as well as an
administrative and participatory structure, historically rooted in the local level,  and open for interlocution with civil society/stakeholders about health policy.
 The analysis points to the relevance of the historical social movement engaged with the sector as in health sector case, and that its absence (Dowbor1, forthcoming)
may explain much weaker local level societal accountability in the social assistance sector. The rooted structure of basic service delivery in health sector (406 Basic Health
Units), of administrative instances (three hierarchical levels) and of participatory spaces (more than 500 councils) may influence the intensity of societal accountability by local
collective actors. Last, it is  significant that there is a spreading effect on societal accountability exercise, as local active collective actors engage with other sectors that
lack a structure that promotes participation, going beyond a specific more structured sector such as health.