Influence of community scorecards on maternal and newborn health service delivery and utilization
Abstract Introduction 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 del...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-11-01
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| Series: | International Journal for Equity in Health |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12939-020-01184-6 |
| _version_ | 1818210797399048192 |
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| author | Elizabeth Ekirapa Kiracho Noel Namuhani Rebecca Racheal Apolot Christine Aanyu Aloysuis Mutebi Moses Tetui Suzanne N. Kiwanuka Faith Adong Ayen Dennis Mwesige Ahmed Bumbha Ligia Paina David H. Peters |
| author_facet | Elizabeth Ekirapa Kiracho Noel Namuhani Rebecca Racheal Apolot Christine Aanyu Aloysuis Mutebi Moses Tetui Suzanne N. Kiwanuka Faith Adong Ayen Dennis Mwesige Ahmed Bumbha Ligia Paina David H. Peters |
| author_sort | Elizabeth Ekirapa Kiracho |
| collection | DOAJ |
| description | Abstract Introduction 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. Methods This was a mixed methods study that used both quantitative and qualitative data collection methods. It was implemented in five sub-counties and one town council in Kibuku district in Uganda. Data was collected through 17 key informant interviews and 10 focus group discussions as well as CSC scoring and stakeholder meeting reports. The repeated measures ANOVA test was used to test for statistical significance. Qualitative data was analyzed manually using content analysis. The analysis about the change pathways was guided by the Wild and Harris dimensions of change framework. Results There was an overall improvement in the common indicators across sub-counties in the project area between the 1st and 5th round scores. Almost all the red scores had changed to green or yellow by round five except for availability of drugs and mothers attending Antenatal care (ANC) in the first trimester. There were statistically significant differences in mean scores for men escorting their wives for ante natal care (ANC) (F(4,20) = 5.45, P = 0.01), availability of midwives (F(4,16) =5.77, P < 0.01), availability of delivery beds (F(4,12) =9.00, P < 0.01) and mothers delivering from traditional birth attendants (TBAs), F(4,16) = 3.86, p = 0.02). The qualitative findings suggest that strengthening of citizens’ demand, availability of resources through collaborative problem solving, increased awareness about targeted maternal health services and increased top down performance pressure contributed to positive changes as perceived by community members and their leaders. Conclusions and recommendations The community score cards created opportunities for community leaders and communities to work together to identify innovative ways of dealing with the health service delivery and utilization challenges that they face. Local leaders should encourage the availability of safe spaces for dialogue between communities, health workers and leaders where performance and utilization challenges can be identified and solutions proposed and implemented jointly. |
| first_indexed | 2024-12-12T05:22:19Z |
| format | Article |
| id | doaj.art-3235181fc26141dbb771281961bade2b |
| institution | Directory Open Access Journal |
| issn | 1475-9276 |
| language | English |
| last_indexed | 2024-12-12T05:22:19Z |
| publishDate | 2020-11-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal for Equity in Health |
| spelling | doaj.art-3235181fc26141dbb771281961bade2b2022-12-22T00:36:35ZengBMCInternational Journal for Equity in Health1475-92762020-11-0119111210.1186/s12939-020-01184-6Influence of community scorecards on maternal and newborn health service delivery and utilizationElizabeth Ekirapa Kiracho0Noel Namuhani1Rebecca Racheal Apolot2Christine Aanyu3Aloysuis Mutebi4Moses Tetui5Suzanne N. Kiwanuka6Faith Adong Ayen7Dennis Mwesige8Ahmed Bumbha9Ligia Paina10David H. Peters11Department of Health Policy Planning and Management, Makerere University School of Public HealthMakerere University School of Public HealthDepartment of Health Policy Planning and Management, Makerere University School of Public HealthDepartment of Health Policy Planning and Management, Makerere University School of Public HealthDepartment of Health Policy Planning and Management, Makerere University School of Public HealthDepartment of Health Policy Planning and Management, Makerere University School of Public HealthDepartment of Health Policy Planning and Management, Makerere University School of Public HealthDistrict Health Service, Kibuku Local GovernmentDistrict Health Service, Kibuku Local GovernmentDistrict Health Service, Kibuku Local GovernmentDepartment of International Health, Johns Hopkins Bloomberg School of Public HealthDepartment of International Health, Johns Hopkins Bloomberg School of Public HealthAbstract Introduction 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. Methods This was a mixed methods study that used both quantitative and qualitative data collection methods. It was implemented in five sub-counties and one town council in Kibuku district in Uganda. Data was collected through 17 key informant interviews and 10 focus group discussions as well as CSC scoring and stakeholder meeting reports. The repeated measures ANOVA test was used to test for statistical significance. Qualitative data was analyzed manually using content analysis. The analysis about the change pathways was guided by the Wild and Harris dimensions of change framework. Results There was an overall improvement in the common indicators across sub-counties in the project area between the 1st and 5th round scores. Almost all the red scores had changed to green or yellow by round five except for availability of drugs and mothers attending Antenatal care (ANC) in the first trimester. There were statistically significant differences in mean scores for men escorting their wives for ante natal care (ANC) (F(4,20) = 5.45, P = 0.01), availability of midwives (F(4,16) =5.77, P < 0.01), availability of delivery beds (F(4,12) =9.00, P < 0.01) and mothers delivering from traditional birth attendants (TBAs), F(4,16) = 3.86, p = 0.02). The qualitative findings suggest that strengthening of citizens’ demand, availability of resources through collaborative problem solving, increased awareness about targeted maternal health services and increased top down performance pressure contributed to positive changes as perceived by community members and their leaders. Conclusions and recommendations The community score cards created opportunities for community leaders and communities to work together to identify innovative ways of dealing with the health service delivery and utilization challenges that they face. Local leaders should encourage the availability of safe spaces for dialogue between communities, health workers and leaders where performance and utilization challenges can be identified and solutions proposed and implemented jointly.http://link.springer.com/article/10.1186/s12939-020-01184-6Community score cardsMaternal healthNewborn healthUtilizationAccountabilityUganda |
| spellingShingle | Elizabeth Ekirapa Kiracho Noel Namuhani Rebecca Racheal Apolot Christine Aanyu Aloysuis Mutebi Moses Tetui Suzanne N. Kiwanuka Faith Adong Ayen Dennis Mwesige Ahmed Bumbha Ligia Paina David H. Peters Influence of community scorecards on maternal and newborn health service delivery and utilization International Journal for Equity in Health Community score cards Maternal health Newborn health Utilization Accountability Uganda |
| title | Influence of community scorecards on maternal and newborn health service delivery and utilization |
| title_full | Influence of community scorecards on maternal and newborn health service delivery and utilization |
| title_fullStr | Influence of community scorecards on maternal and newborn health service delivery and utilization |
| title_full_unstemmed | Influence of community scorecards on maternal and newborn health service delivery and utilization |
| title_short | Influence of community scorecards on maternal and newborn health service delivery and utilization |
| title_sort | influence of community scorecards on maternal and newborn health service delivery and utilization |
| topic | Community score cards Maternal health Newborn health Utilization Accountability Uganda |
| url | http://link.springer.com/article/10.1186/s12939-020-01184-6 |
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