| Community of Practitioners on Accountability and Social Action in Health |
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Information Communication Technology for Improving Maternal
Health in Local Communities
Health in Local Communities
SMS-based platforms complemented with suggestion boxes, community radios and community advocates structure have now emerged as popular social accountability monitoring tools in developing countries.
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Robinah Kaitiritimba
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Background
Information Communication Technology (ICT)-based social accountability monitoring tools have become increasingly popular in developing countries. With the increasing popularity, accessibility and coverage (70.7 percent) of mobile technology, more and more people are using it to raise their concerns. Most ICT solutions are based on simple messages through mobile SMS (poll questions, results and useful information) service designed to strengthen communityled development and citizen engagement. The tool allows citizens to engage more actively in civil society issues by monitoring service delivery and helping keep governments accountable. In essence, they facilitate social accountability a single SMS leads to a bigger discussion involving all citizens registered on the SMS platform. |
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Uganda National Health Consumers’ Organisation (UNHCO) is among the pioneers in using SMS-based social accountability platforms in Uganda. UNHCO with support from Catholic Organisation For Relief and Development Aid (CORDAID) is implementing a project in three districts namely: Luweero, Kamuli and Lyantonde. The project aims at “reducing maternal mortality using the rights based approach through increased communication and information sharing”. The project is using the text messaging approach to raise awareness on maternal health and also to solicit feedback from the community. Both men and women are registered to receive maternal health information through text messages. Once registered, community members are able to send feedback to the platform on the status of service delivery and hence demand accountability.
It is interesting that community members have found this platform very useful and secure to raise their concerns and currently there are more than 2,168 beneficiaries who receive and send feedback. UNHCO has been able to handle the emerging issues with the help of Village Health Teams, district and local governments and the “Text to Change” tool. Aggregated data from the project districts is shared quarterly with the Ministry of Health through its Quality Improvement Taskforce and the Maternal Health Cluster where UNHCO represents other civil society organisations. The Ministry then mandates its various implementation arms to address issues during the subsequent quarters.
The ICT platform is complimented by suggestion boxes, community radios and community advocates structure to improve health services. A case in point is Kalagala health centre IV in Luweero district of central Uganda where the suggestion box is managed by the Health Unit management committee chairman who organises community dialogue meetings. Issues from the suggestion box and radio talk shows are presented and discussed for improved healthcare. In one of the meetings at Kalagala health centre IV on an issue pointed out through the suggestion box, the community informed about the lack of a resident doctor. The issue was discussed and the message was forwarded to the district administration. Resultantly, a resident doctor was appointed at the health centre.
The community is using the SMS service to report situations such as cleanliness, availability of medicines and health worker absenteeism at health facilities. These issues are compiled and recorded in a register, which is then reviewed by the Health Unit Management Committee (HUMC). The community is then informed through SMSs, radio broadcast and community dialogue meetings. In Lyantonde district of Kaliiro Sub County, the community held its leaders as well as the health officers accountable through a community dialogue where they brought to light the behaviour of the officer-in-charge of Kaliiro HCIII. The officer-in-charge used to abuse patients and force them to pay for mama kits that is supposed to be given free of cost to pregnant women. The authorities responded to the community’s complaint, transferred the health worker and brought in new workers. Since then the community has not faced any problem with regard to accessing health services. Tumusiime, a boda bode cyclist says, “Thank you for helping us. I had stopped coming to this health centre as the health workers were never present. Once when I was not well and came here at midday, I found the facility closed. But since the time they have brought in new health workers, I easily get the services I need whenever I come here.”
It is interesting that community members have found this platform very useful and secure to raise their concerns and currently there are more than 2,168 beneficiaries who receive and send feedback. UNHCO has been able to handle the emerging issues with the help of Village Health Teams, district and local governments and the “Text to Change” tool. Aggregated data from the project districts is shared quarterly with the Ministry of Health through its Quality Improvement Taskforce and the Maternal Health Cluster where UNHCO represents other civil society organisations. The Ministry then mandates its various implementation arms to address issues during the subsequent quarters.
The ICT platform is complimented by suggestion boxes, community radios and community advocates structure to improve health services. A case in point is Kalagala health centre IV in Luweero district of central Uganda where the suggestion box is managed by the Health Unit management committee chairman who organises community dialogue meetings. Issues from the suggestion box and radio talk shows are presented and discussed for improved healthcare. In one of the meetings at Kalagala health centre IV on an issue pointed out through the suggestion box, the community informed about the lack of a resident doctor. The issue was discussed and the message was forwarded to the district administration. Resultantly, a resident doctor was appointed at the health centre.
The community is using the SMS service to report situations such as cleanliness, availability of medicines and health worker absenteeism at health facilities. These issues are compiled and recorded in a register, which is then reviewed by the Health Unit Management Committee (HUMC). The community is then informed through SMSs, radio broadcast and community dialogue meetings. In Lyantonde district of Kaliiro Sub County, the community held its leaders as well as the health officers accountable through a community dialogue where they brought to light the behaviour of the officer-in-charge of Kaliiro HCIII. The officer-in-charge used to abuse patients and force them to pay for mama kits that is supposed to be given free of cost to pregnant women. The authorities responded to the community’s complaint, transferred the health worker and brought in new workers. Since then the community has not faced any problem with regard to accessing health services. Tumusiime, a boda bode cyclist says, “Thank you for helping us. I had stopped coming to this health centre as the health workers were never present. Once when I was not well and came here at midday, I found the facility closed. But since the time they have brought in new health workers, I easily get the services I need whenever I come here.”
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ABOUT AUTHORS
Robinah Kaitiritimba, is the regional coordinator-COPASAH east and southern Africa and UNHCO executive director. She contributed to development of a module for social accountability published by World Bank institute, which is now used globally. She spearheaded development and adoption of patients’ charter, a legal and policy frame work for observance of patients’ rights. She is: member of national health policy advisory committee, national health insurance task force, Makerere University College of Health Sciences Institutional Review Board and patient safety champion for WHO.
Robinah Kaitiritimba, is the regional coordinator-COPASAH east and southern Africa and UNHCO executive director. She contributed to development of a module for social accountability published by World Bank institute, which is now used globally. She spearheaded development and adoption of patients’ charter, a legal and policy frame work for observance of patients’ rights. She is: member of national health policy advisory committee, national health insurance task force, Makerere University College of Health Sciences Institutional Review Board and patient safety champion for WHO.