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Social accountability in practice: Breathing and weaving together to build relationships

Social Innovations Journal
Authors: Ray Markham, Scott Graham, Megan Hunt, Georgia Betkus, Bob Woollard, David Snadden, Daniel Harper, Kim Williams
Publication Date: August 2022


Rural and First Nations populations bring valuable lived experiences and perspectives to health reform efforts that serve as a powerful form of specialized insight and grassroots knowledge. To address the issue of inadequate and inconsistent inclusion of these populations in health reform planning and decision-making processes in British Columbia, Canada, the Rural Coordination Centre of BC (RCCbc) has adopted Boelen’s (World Health Organization 2000) Partnership Pentagram model for socially accountable health systems. This article illustrates Markham and colleagues’ (2021) innovative adaptation of the model—the Partnership Pentagram Plus (PP+)—in practice, through the design and delivery of a provincial-level dialogue and deliberation gathering that centered rural and First Nations voices for health system change. In doing so, it highlights four key features: Co-creation, honouring Indigenous ways of knowing and being, appreciative inquiry, and ‘breathing and weaving’. It also reports on the key outcomes of the meeting: Relationship formation and long-term commitments to change.

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