How Does Evaluation Foster Accountability for Performance? Tracing Accountability Lines and Evaluation Impact within the World Bank and the Italian Local Health-Care Providers 1

Throughout the world, the political and policy context surrounding public accountability is changing. As Chelimsky (1997) put it, “the movement worldwide is toward reduced taxation, reduced deficits, reduced fund transfers from the rich to the poor, and reduced government size.” This movement puts greater emphasis on accountability. Yet, the notion of accountability is complex to grasp and operationalize. When we talk about holding people accountable, we usually mean accountability for finances, accountability for fairness, or accountability for performance. Accountability for finances and fairness are (relatively) straightforward as they reflect concerns for how government does what it does (Behn, 2001). But as Behn (2001) argues “we also care about what government does—what it actually accomplishes,” that is, accountability for performance.