I Participate in Improving HealthcareIt’s My Responsibility and Yours Too!! – A story from Africa
Uganda National Health Users‘/Consumers‘ Organization (UNHCO) is implementing a three year project to ―Assess the Extent to which Resources Allocated to the Health Facilities Affect Access to Essential Medicines in Uganda.‖ The project is implemented in the south-western Bushenyi district. In the first two years of implementation, the Quantitative Service Delivery Survey (QSDS) and citizen report card methodologies were applied in the districts. Both reports of the studies can be accessed at www.unhco.or.ug. In the current year (3rd year), UNHCO is applying the community score card (CSC). The CSC targets 400 community members within a radius of five km of the health centers, and health workers of the four selected target health facilities are primarily involved in the community score card exercise.
Summary of key achievements during the six month implementation include:
Increased involvement of district and national level duty bearers in the advocacy points generated in the CSC through various committees at sub-county, district and national levels. At the district level, transactions involving redistribution of medicines between health centers were found to be abused and one such case of alleged pilferage of medicines and supplies was forwarded to the security authorities by the District Health Team (DHT) in Bushenyi district. The DHT is now pro-actively leading the excess medicine and health supplies redistribution with proper documentation as provided for in the policy guidelines.
There is increased knowledge of rights and responsibilities of health service users and HUMC roles through the monthly community sensitization meetings. This has resulted in positive relationships between health workers, health unit management committee members and community members with each understanding their roles at the health center.
Creation of platforms at the health center level through the CSC and the radio talk-shows at district level for participation and engagement between communities and duty bearers.
Improved security at one of the health centers called Swazi Health Center II: In response to the action plan drawn during the previous CSC, the community mobilized themselves to provide free labor and poles for the construction of the fence at the health centre. They also requested the HUMC and health workers to apportion part of the Primary Health Care (PHC) funds for purchasing barbed-wire. This fencing has now been completed, thus improving security at the health center.
Placenta pit was constructed at Swazi HCII in Bushenyi district through efforts of the community and the area Member of Parliament. During the CSC, it was noted that at level II, Swazi HC was one of the exceptions to be handling deliveries but unfortunately, it lacked a placenta pit. The community once again mobilized themselves though the community monitors to dig-up a pit and also requested for assistance from their MP to give the pit an appropriate cement finishing. This is also now in place.
The community voluntarily made proper pathways and signs in the compounds of the health centers to help patients locate the areas to visit. This was done in response to patient complaints from the suggestion boxes over lack of directions at the health centers.
The number of patients, as reflected by out-patient attendance (OPD) at the target health centers has increased. The health workers have attributed this to the improved relationship between them and the community.
Regular (quarterly) meetings of HUMCs are now held without fail. The HUMC members some of whom are also community monitors have made it a point to review all notes from the suggestion box and include all emerging issues in their meeting agendas. Thereafter, the responses to complaints and suggestions are displayed at the notice-boards. Before the project, the feed-back mechanism was adhoc and unsystematic.
Regular meetings of HUMCs are now held without fail. The HUMC members some of whom are also community monitors have made it a point to review all notes from the suggestion box and include all emerging issues in their meeting agendas. Thereafter, the responses to complaints and suggestions are displayed at the notice-boards.
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Frederick Okwi is a Programme Officer at Uganda National Health Users’/Consumers’ Organization (UNHCO). To know more about the work of UNHCO, please CLICK HERE