Assessing Performance of Health Centre III in Reducing Maternal Mortality

Organization(s)

Action Group for Health, Human Rights, and HIV/AIDS (AGHA)

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Basic Project Information

AGHA sought to improve maternal health services in Uganda by assessing user experience and increasing community members’ capacity to monitor and engage in service delivery.

Sector

Sub-Sector

Project Summary

Objectives

  • Improve the quality and utilization of maternal sexual reproductive health services (MSRH)
  • Increase the capacity of community members to monitor and engage in the delivery of MSRH

Summary

In order to improve maternal health services in Uganda, AGHA conducted an assessment of users’ experiences and brought together community members and service providers to collectively determine solutions to identified problems.  The project had two phases:

  • A Citizen Report Card (CRC) was conducted to first assess the availability, access, use, and quality of MSRH to identify factors hindering utilization, and generate evidence for AGHA’s advocacy efforts
  • A Community Score Card (CSC) then empowered local community members to discuss the CRC findings with service providers via facilitated focus group discussions to collaboratively create an action plan to address any issues

The project’s findings revealed that although availability and access to services were generally good, the utilization and quality of select aspects of services ranged from moderate to poor. Through CSC discussions, AGHA uncovered underlying factors potentially contributing to these larger issues, including weak grievance redress mechanisms, inadequate medicines, long waiting times, understaffing, and additional fees for services. Based on these findings, AGHA coordinated advocacy efforts at the national level to raise awareness of issues and advocate for policy change, infrastructure development, and other technical issues beyond the mandate of local governments.  At the local level, AGHA disseminated findings and encouraged local governments to integrate CSCs into their programming to enhance planning and resource allocation.

Use of Information Communication Technology

None

Scale

CRC: 610 households and 16 health facilities across 2 districts

CSC: 640 service providers and community members across 2 districts

Target Population

Mothers and expectant mothers
Results

Results Methodology

Not applicable

Indicators Used

Not applicable

Reported Results

  • Increased awareness of health rights by community members
  • Improved delivery of equipment and medicines, resulting in the:
    • Reduction of drug stockouts from 24 to 5 days, and
    • Monthly delivery of essential health commodities for mothers compared to every 2-3 months
  • Increased recognition of and support for MSRH delivery by development partners, NGOs, and government
  • Target districts adopted CSC-like interface meeting approach for future service delivery planning and management
  • Ministry of Health committed to review policy of payment to ensure free health services for mothers
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