Improving the effectiveness with which health services are delivered has continued to be a major concern especially in low- and middle-income countries. The ills from poor quality services have now exceeded those from non-utilization of services, with about five million deaths attributed to poor quality services. FHS Uganda Country Coordinator Elizabeth Ekirapa-Kiracho, blogs about the session that she attended at the Fifth Global Symposium on Health Systems Research in Liverpool, which focused on improving quality to promote equity and effectiveness in the SDG era.
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At the upcoming Global Symposium on Health Systems Research, we will be running a participatory session that builds on research from Uganda, Bangladesh and Nepal, entitled Amplifying Marginalised Voices: Towards Meaningful Inclusion in Social Accountability Mechanisms for Health. This session applies an intersectional lens to accountability mechanisms, asking about the inclusion of specific, marginalised categories within communities in mainstream accountability initiatives.
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Currently, thanks to the sustained campaign by the Ugandan government and development partners, more women deliver in facilities than ever before. However, without concerted efforts to ensure that facilities are well equipped to handle these increased numbers, more women will continue dying to give life.
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Moses Tetui, FHS Researcher, writes for the Daily Monitor about the messages Ugandan children are receiving in schools about gender roles, and the need for gender mainstreaming to reach gender parity.
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World Health Day has come and gone this year, but nevertheless, it is very important for us to continue to remember our commitments towards health care delivery, such as equitable health systems. Most efforts to improve Maternal and Newborn Health (MNH) outcomes in Uganda have focused on access and quality of care for women in general, paying no attention to special populations such as women with walking disabilities who have a high likelihood of poor MNH outcomes.
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Moses Tetui, FHS Researcher, writes for New Vision about the FHS Community Score Card Project being undertaken in eastern Uganda by Makerere University School of Public Health to improve maternal health.
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For World Health Day 2018, Elizabeth Ekirapa-Kiracho, Makerere University School of Public Health, Uganda, calls on Africans to hold their politicians accountable for meeting the health care needs of their people, and delivering on the commitments they made in the Abuja Declaration 17 years ago.
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Helping improve health systems for disadvantaged and marginalised populations is an important value motivating health systems research in low and middle-income countries (LMICs). However, simply undertaking health systems research in LMICs does not necessarily generate the knowledge needed to achieve that goal.
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Caroline Namugwere (not real name) is a 27 year old disabled woman and resident of Kibuku District in Eastern Uganda. Her pregnancy experience was laden with challenges right from attending antenatal clinic appointments to delivery. Inquiry into the plight of the marginalised is part of what the Community Score Cards study of Makerere University School of Public Health in partnership with the Future Health Systems Research Consortium intends to explore over the coming months in Kibuku District in Eastern Uganda. Specific to the case of Caroline and other marginalised groups, the following research question is being pursued: To what extent does a community scorecard process incorporate and address the maternal and newborn service related needs of marginalized populations?
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We had three days. That was it. We had three days: to gather, to share ideas and experiences, to make new connections, to strengthen existing ones, and to wrestle with the conceptual beast that is “accountability.” The aim? To bring sharp minds, creative problem-solvers and pragmatic innovators together under one roof so that we might get a few steps closer to our common goal of greater health equity. Did it work? Yes. With caveats. You can be the judge.
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Stefan Peterson, Chief of Health, UNICEF, highlights the contribution of a maternal and newborn health implementation project in Uganda led by Future Health Systems partner, the Makerere School of Public Health, to improvements in early antenatel care attendance, facility deliveries, newborn care practices, birth preparedness, and awareness of obstetric danger signs.
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Last week, between 80-90 researchers, practitioners, advocates and policymakers gathered for a three-day workshop organised by the IDS Accountability for Health Equity programme. Entitled Unpicking Power and Politics for Transformative Change: Towards Accountability for Health Equity, the event was hosted in collaboration with Unequal Voices, Future Health Systems, the Open Society Foundations, the Impact Initiative, and Health Systems Global. In this blog, Tom Barker and Karine Gatellier share their reflections from the event.
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Makerere University School of Public Health recently concluded a four-year intervention aimed at sustainably improving maternal and neonatal health outcomes, implemented in the Eastern Ugandan districts of Kamuli, Pallisa and Kibuku. The intervention - the Maternal and Neonatal Implementation for Equitable Systems Study or MANIFEST - employed a participatory action research approach that has been lauded for increasing sustainability chances. This blog post examines lessons learned from the performance review meetings which were part of the approach.
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How sustainable is your intervention? If someone wanted to replicate it, how easy would it be? What happens when the study ends? Will the communities be able to continue with this initiative after the implementers have gone? Ayub Kakaire, FHS PIRU Officer for Uganda, blogs about what working on the Maternal and Neonatal Implementation for Equitable Systems (MANIFEST) study has taught him about how to ensure an intervention is sustainable.
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On Universal Health Coverage (UHC) Day, Elizabeth Ekirapa-Kiracho, FHS Uganda Country Coordinator, reflects on what Uganda needs to do in order to finance universal healthcare in Uganda.
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Inspired by the power of networks to strengthen capacity in health systems research, colleagues at Johns Hopkins Bloomberg School of Public Health convened a panel titled “The network approach to strengthening health systems research capacity: experiences from the Global South” for the Global Forum for Health Research (Forum 2015) held in Manila, Philippines from 24-27 August. Four networks engaged in capacity building for health policy and systems research (HPSR) were showcased. Here are the reflections of the Chair (NJ) and the panelists (CM, EE, RR and SG).
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Future Health Systems and Africa Hub partners will be participating at the ResUp MeetUp Symposium and Training Exchange in Nairobi from 9 to 12 February 2015, which will bring together members of the ResUp MeetUp community to share learning and best practice, and build capacity for research uptake
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Every day, health service leaders face challenges like working with limited resources while delivering results, managing change, and keeping staff motivated. Decentralisation adds to these challenges, as many health workers have both clinical and managerial responsibilities.
However, little attention is paid to leadership and management skills during their health training.
In partnership with the districts, who select the candidates, the Makerere University School of Public Health is training health workers in three areas: planning and management of health services, improving management of logistics and improving management of labor and newborn care.
A six-month distance health services management certificate course, targeting district and health facility managers, caters for the first two thematic areas, the focus for this article. In the first phase, 30 health service delivery personnel were drawn from the three study districts (10 from each), and another 30 are attending the second phase of training. The results have been tremendous, with beneficiaries already registering significant improvements back at their work places.
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Households and individual community members are being educated and encouraged to join or start financial social networks, like saving groups, which offer financial protection. In addition to the business funds, the networks are advised to have a separate fund to cater for maternal and newborn health needs. Members can access these funds to cater for emergency transport to and from the health facility for pregnant women, mothers and newborns. The fund is also meant to provide funds to cater for birth items. Saving groups are similarly encouraged to enter into partnership with transporters.
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Deciding to seek care from a skilled health worker by a woman at the time of delivery is highly encouraged in order to improve health outcomes for both mother and baby. When a woman delivers under skilled care, it is easier to detect and attend to any emergences that arise.
Under the community mobilisation and sensitisation component of the study, around 1,691 community health workers (CHWs, also known as village health teams or VHTs), were trained across the three study districts of Kamuli, Pallisa and Kibuku. The training focused on early detection of emergencies, birth preparedness and care for mothers who just delivered and their newborns. During the visits, CHWs provide households with information needed to ensure mothers have a safe delivery and remain healthy with their babies. Two home visits happen during pregnancy and two after delivery.
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