Citizens committees and local elites: Elite capture, captured elites, and absent elites in health facility committees

Mainstream development policies often promote citizens committees to oversee basic social services. Such committees require influence over, and legitimacy among, service providers and citizens to perform their roles, which local elites can help or hinder. Using a mixed-methods approach, we analyse the situation in 251 health facility committees in Burundi, part of which benefited from interventions designed to bolster their relationship with local leaders. Interviews and focus groups reveal that leaders’ support is essential for committees to access citizens and work with nurses, but the failure of the interventions show it is hard to nurture. The local socio-political elites (politicians, faith leaders) bypass and ignore the committees. In a ‘fragile’ context such as Burundi’s, the lack of political elite capture attempt suggests a largely vacuous committee system. The committees remain a façade participatory institution. Understanding and engaging with local everyday local politics is crucial for committee-based development approaches.