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Publications

Filtering by Category: Community

Influence of community scorecards on maternal and newborn health service delivery and utilization

Future Health Systems

Kiracho, E.E., Namuhani, N., Apolot, R.R. et al. (2020) Influence of community scorecards on maternal and newborn health service delivery and utilization, Int J Equity Health 19, 145, https://doi.org/10.1186/s12939-020-01184-6

The community score card (CSC) is a participatory monitoring and evaluation tool that has been employed to strengthen the mutual accountability of health system and community actors. In this paper we describe the influence of the CSC on selected maternal and newborn service delivery and utilization indicators.

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Do community scorecards improve utilisation of health services in community clinics: experience from a rural area of Bangladesh

Future Health Systems

Hanifi, S.M.A., Hossain, A., Chowdhury, A.H. et al. (2020) Do community scorecards improve utilisation of health services in community clinics: experience from a rural area of Bangladesh, Int J Equity Health 19, 149, https://doi.org/10.1186/s12939-020-01266-5

The government of Bangladesh initiated community clinics (CC) to extend the reach of public health services and these facilities were planned to be run through community participation. However, utilisation of CC services is still very low. Evidence indicates community score card is an effective tool to increase utilisation of services from health facility through regular interface meeting between service providers and beneficiary. We investigated whether community scorecards (CSC) improve utilisation of health services provided by CCs in rural area of Bangladesh.

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Feasibility, Acceptability and Initial Outcome Of Implementing Community Scorecard To Monitor Community Level Public Health Facilities: Experience From Rural Bangladesh

Future Health Systems

Mahmood, S.S., Rasheed, S., Chowdhury, A.H. et al. (2020) Feasibility, acceptability and initial outcome of implementing community scorecard to monitor community level public health facilities: experience from rural Bangladesh, Int J Equity Health 19, 155, https://doi.org/10.1186/s12939-020-01265-6

Engaging communities in health facility management and monitoring is an effective strategy to increase health system responsiveness. Many developing countries have used community scorecard (CSC) to encourage community participation in health. However, the use of CSC in health in Bangladesh has been limited. In 2017, icddr,b initiated a CSC process to improve health service delivery at the community clinics (CC) providing primary healthcare in rural Bangladesh. The current study presents learnings around feasibility, acceptability, initial outcome and challenges of implementing CSC at community clinics.

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Maternal Health challenges experienced by adolescents; could community score cards address them? A case study of Kibuku District– Uganda

Future Health Systems

Apolot, R.R., Tetui, M., Nyachwo, E.B. et al. (2020) Maternal health challenges experienced by adolescents; could community score cards address them? A case study of Kibuku District– Uganda, Int J Equity Health 19, 191, https://doi.org/10.1186/s12939-020-01267-4

Approximately 34.8% of the Ugandan population is adolescents. The national teenage pregnancy rate is 25% and in Kibuku district, 17.6% of adolescents aged 12–19 years have begun child bearing. Adolescents mothers are vulnerable to many maternal health challenges including; stigma, unfriendly services and early marriages. The community score card (CSC) is a social accountability tool that can be used to point out challenges faced by the community in service delivery and utilization and ultimately address them. In this paper we aimed to document the challenges faced by adolescents during pregnancy, delivery and postnatal period and the extent to which the community score card could address these challenges.

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Photo voice as a participatory approach to influence climate related health policy in the Sundarbans

Future Health Systems

Ghosh U, Sen B, and Bose S (2019) Photo voice as a participatory approach to influence climate related health policy in the Sundarbans, The Lancet Planetary Health, Volume 3, Special Issue, S22, DOI: 10.1016/S2542-5196(19)30165-2

The IPCC Fifth Assessment Report highlights community-based strategies to drive effective and ecologically sustainable local adaptation strategies. A climate change hot spot, Sundarbans, India, needs collective action between communities and for local level health and non-health decision makers to find sustainable solutions to combat the impacts of climate change on child health.

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Understanding the role of community resilience in addressing the Ebola virus disease epidemic in Liberia: a qualitative study (community resilience in Liberia)

Future Health Systems

Alonge O, Sonkarlay S, Gwaikolo W, Fahim C, Cooper JL and Peters DH (2019) Understanding the role of community resilience in addressing the Ebola virus disease epidemic in Liberia: a qualitative study (community resilience in Liberia), Global Health Action, 12:1, DOI: 10.1080/16549716.2019.1662682

There is an increasing recognition that community resilience plays a significant role in addressing health shocks like the Ebola virus disease (EVD) epidemic. However, the factors that constitute community resilience, and how these operate dynamically with other health system factors are less understood. This paper seeks to understand key factors that constitute community resilience and their role in responding to the EVD outbreak in Liberia.

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Maternal newborn health community scorecards in Uganda: a story of change

Future Health Systems

Between June 2017 and December 2018, Makerere University School of Public Health (MakSPH), in collaboration with Future Health Systems, implemented a Community Scorecard project focusing on maternal and newborn health service delivery and utilization in six sub-counties in Kibuku district in Eastern Uganda. This short film highlights some successes from this pilot.

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Challenges and solutions to implementing MNH community scorecards

Future Health Systems

Between 2017 and 2018, the Makerere University School of Public Health (MakSPH), in collaboration with the Future Health Systems Research Consortium, implemented a CSC project focusing on maternal and newborn health service delivery and utilization in six sub-counties in Kibuku District, in Eastern Uganda. The implementation was led by stakeholders in the district and comprised of sub county chiefs, Local council chair persons, Health Unit Management Committee chairpersons, Village health team members, community development officers, sub county level councilors and volunteers. This short film is based on the challenges of implementing the project and also explains how these challenges were handled.

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How to do a maternal & newborn community scorecard

Future Health Systems

FHS partner Makerere University School of Public Health undertook a Community Score Cards study, which contributed to research on how leaders can work with the community and health workers to improve maternal and newborn health in Kibuku District. The use of the Community Score Card tool – a two-way and ongoing participatory tool for assessment, planning, monitoring and evaluation - aims to improve the performance of facilities and accountability by the different stakeholders who are responsible for improving the performance of facilities. This film provides an overview of how to undertake a maternal and newborn community scorecard.

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Accountability in Health Service Delivery: a Community Scorecard Exploration in Rural Bangladesh

Future Health Systems

Community clinics (CCs) were established by the Government of Bangladesh with an aim to extend primary health services to the grassroots population in rural areas. Currently there are 13,500 CCs throughout the country and each covers 6,000 population under its jurisdiction and are meant to provide maternal, child health, family planning and other primary health care services. However, challenges still remain in ensuring accountability, quality and equity in healthcare service at the local level. Voice and accountability mechanism are almost non-existent. There are gaps in logistics, quality assurance procedures and the facilities suffer from high staff absenteeism, unskilled staff and inefficient use of supplies. Stakeholders are not fully aware of clinics' purposes and there is weak communication and lack of involvement of local government institutions.

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The Ebola Virus Disease in Liberia: improving community awareness for disease surveillance

Future Health Systems

At the time of the 2014–2015 Ebola Virus Disease (EVD) outbreak, Liberia was still recovering from years of civil war and unrest. The country’s infrastructure was very poor, especially in rural regions, where people could not easily travel because of the lack of adequate roads. Liberia’s health system was also weakened by the civil war, leaving health facilities struggling to respond to the EVD outbreak effectively.

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Community scorecards: Engaging community and bringing in positive changes to health service delivery at community clinics in rural Bangladesh

Future Health Systems

Community clinics, a flagship programme of the Government of Bangladesh, are health facilities set up to deliver primary health care, family planning and nutrition services to rural people at the grassroots level. Currently there are 13,500 community clinics (CC) in Bangladesh, aimed to cover every 6000 rural population. Despite the widespread establishment of the community clinics, challenges such as shortage of supply, provider absenteeism, lack of properly defined roles and responsibilities of human resources, poor behaviour towards patients, weak accountability and governance, and absence of active participation from community in healthcare delivery restrict efficient use of these facilities and available resources.

To complement the monitoring mechanism of community clinics, the Future Health Systems (FHS) Bangladesh team at icddr,b aimed to implement a community scorecard (CSC) to ensure community participation and provider accountability in the local health system. This FHS Research Brief presents the learnings from the three cycles of community scorecard implementation in the intervention community clinics.

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Which contextual factors facilitate successful implementation of Community Score Cards in Uganda?

Future Health Systems

This issue brief describes the factors that facilitate the CSC implementation process, based on the lessons learnt from a CSC project on maternal and newborn health service delivery and utilization in six sub-counties of Kibuku district in Uganda. District and sub-county stakeholders led the implementation of the CSC, with support from Makerere University School of Public Health (MakSPH). Four rounds of scoring were undertaken between November 2017 and September 2018.

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How can political leaders help ensure Community Score Cards in Uganda are sustainable?

Future Health Systems

Beginning in June 2017, the Makerere University School of Public Health (MakSPH), in collaboration with Future Health Systems, has been implementing a CSC project focusing on maternal and newborn health service delivery and utilization in six sub-counties in Kibuku district, Uganda. As one of its exit strategies, the project carried out a qualitative study that explored ways of involving political leaders in the CSC process to ensure its sustainability.

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Reflecting strategic and conforming gendered experiences of community health workers (CHWs) using photovoice in rural Wakiso district, Uganda

Future Health Systems

Musoke D, Ssemugabo C, Ndejjo R, Ekirapa-Kiracho E and George AS (2018) Reflecting strategic and conforming gendered experiences of community health workers (CHWs) using photovoice in rural Wakiso district, Uganda, Human Resources for Health, 16:41, DOI: 10.1186/s12960-018-0306-8

Community health workers (CHWs) are an important human resource in Uganda as they are the first contact of the population with the health system. Understanding gendered roles of CHWs is important in establishing how they influence their performance and relationships in communities. This paper explores the differential roles of male and female CHWs in rural Wakiso district, Uganda, using photovoice, an innovative community-based participatory research approach.

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When Leadership Counts

Future Health Systems

FHS partner Makerere University School of Public Health is undertaking a Community Score Cards study, which is contributing to research on how leaders can work with the community and health workers to improve maternal and newborn health in Kibuku District. The use of the Community Score Card tool – a two-way and ongoing participatory tool for assessment, planning, monitoring and evaluation - aims to improve the performance of facilities and accountability by the different stakeholders who are responsible for improving the performance of facilities. This film provides an overview of the work and the use of community scorecards.

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What about us

Future Health Systems

This film, produced by FHS partner Makerere University School of Publich Health (MakSPH), highlights the challenges that women with disabilities face when seeking maternal health services in the Eastern Uganda district of Kibuku. To address some of these challenges, FHS partner MakSPH, in partnership with Research in Gender and Ethics (RinGs), is using the Community Scorecard methodology - a participatory tool for assessment, planning, monitoring and evaluation of services – with mothers living with disabilities, allowing their voices to be heard.

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Global framework on people-centred and integrated health services

Future Health Systems

Future Health Systems research into empowering communities to demand and shape health services has informed the development of a WHO strategy on service delivery. The strategy reflects a paradigm shift towards an increased emphasis on preventive public health, as well as curative strategies, to address current and future health challenges.

Experiences of using a participatory action research approach to strengthen district local capacity in Eastern Uganda

Future Health Systems

Tetui M, Coe A-B, Hurtig A-K, Ekirapa-Kiracho E and Kiwanuka SN (2017) Experiences of using a participatory action research approach to strengthen district local capacity in Eastern Uganda, Global Health Action, 10:sup4, 1346038, DOI: 10.1080/16549716.2017.1346038

To achieve a sustained improvement in health outcomes, the way health interventions are designed and implemented is critical. A participatory action research approach is applauded for building local capacity such as health management. Thereby increasing the chances of sustaining health interventions. This study explored stakeholder experiences of using PAR to implement an intervention meant to strengthen the local district capacity.

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‘Nurture the sprouting bud; do not uproot it’. Using saving groups to save for maternal and newborn health: lessons from rural Eastern Uganda

Future Health Systems

Ekirapa-Kiracho E, Paina L, Kananura RM, Mutebi A, Jane P, Tumuhairwe J, Tetui M and Kiwanuka SN (2017) ‘Nurture the sprouting bud; do not uproot it’. Using saving groups to save for maternal and newborn health: lessons from rural Eastern Uganda, Global Health Action, 10:sup4, 1347311, DOI: 10.1080/16549716.2017.1347311

Saving groups are increasingly being used to save in many developing countries. However, there is limited literature about how they can be exploited to improve maternal and newborn health. This paper describes saving practices, factors that encourage and constrain saving with saving groups, and lessons learnt while supporting communities to save through saving groups.

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