Abstract: Background: Despite a growing body of literature on social accountability in health systems, many questions remain unanswered about how community actors interact with health workers and demand accountability. Social accountability is viewed as an empowerment process and a social practice in which communities actively participate in changing the conditions that affect their health. Local factors, such as the role of community actors, influence the effectiveness of social accountability. The purpose of this research was to assess empirical evidence on the role of community actors in social accountability.