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Abstract
Social accountability is increasingly recognized as a critical factor in improving development outcomes. Exploring the situation of social accountability in primary health care. Assessing, the readiness of citizens to hold their service providers accountable, and the readiness of policymaker to be accountable. Health system research, exploratory, study. Clients’ attitude differs according to different factors like their residence and education. Clients who choose to ask the physician to fulfill their needs were more in urban than rural (p value < 0.001). While those who choose not to return to the unit again were more in rural (p value < 0.001). Educated have more knowledge that they have ability to hold the unit accountable more than non-educated (p value = 0.021).In-depth interviews with service providers and policy makers also showed that weak role of civil society organizations play a major role influencing citizens awareness about their role in the health system