Empowering districts to target priorities for improving child health service in Uganda using change management and rapid assessment methods

Background: Local health system managers in low- and middle-income countries have the responsibility to set health priorities and allocate resources accordingly. Although tools exist to aid this process, they are not widely applied for various reasons including non-availability, poor knowledge of th...

Full description

Bibliographic Details
Main Authors: John Odaga, Dorcus K. Henriksson, Charles Nkolo, Hector Tibeihaho, Richard Musabe, Margaret Katusiime, Zaccheus Sinabulya, Stephen Mucunguzi, Anthony K. Mbonye, Joseph J. Valadez
Format: Article
Language:English
Published: Taylor & Francis Group 2016-05-01
Series:Global Health Action
Subjects:
Online Access:http://www.globalhealthaction.net/index.php/gha/article/view/30983/pdf_287
_version_ 1828464988176515072
author John Odaga
Dorcus K. Henriksson
Charles Nkolo
Hector Tibeihaho
Richard Musabe
Margaret Katusiime
Zaccheus Sinabulya
Stephen Mucunguzi
Anthony K. Mbonye
Joseph J. Valadez
author_facet John Odaga
Dorcus K. Henriksson
Charles Nkolo
Hector Tibeihaho
Richard Musabe
Margaret Katusiime
Zaccheus Sinabulya
Stephen Mucunguzi
Anthony K. Mbonye
Joseph J. Valadez
author_sort John Odaga
collection DOAJ
description Background: Local health system managers in low- and middle-income countries have the responsibility to set health priorities and allocate resources accordingly. Although tools exist to aid this process, they are not widely applied for various reasons including non-availability, poor knowledge of the tools, and poor adaptability into the local context. In Uganda, delivery of basic services is devolved to the District Local Governments through the District Health Teams (DHTs). The Community and District Empowerment for Scale-up (CODES) project aims to provide a set of management tools that aid contextualised priority setting, fund allocation, and problem-solving in a systematic way to improve effective coverage and quality of child survival interventions. Design: Although the various tools have previously been used at the national level, the project aims to combine them in an integral way for implementation at the district level. These tools include Lot Quality Assurance Sampling (LQAS) surveys to generate local evidence, Bottleneck analysis and Causal analysis as analytical tools, Continuous Quality Improvement, and Community Dialogues based on Citizen Report Cards and U reports. The tools enable identification of gaps, prioritisation of possible solutions, and allocation of resources accordingly. This paper presents some of the tools used by the project in five districts in Uganda during the proof-of-concept phase of the project. Results: All five districts were trained and participated in LQAS surveys and readily adopted the tools for priority setting and resource allocation. All districts developed health operational work plans, which were based on the evidence and each of the districts implemented more than three of the priority activities which were included in their work plans. Conclusions: In the five districts, the CODES project demonstrated that DHTs can adopt and integrate these tools in the planning process by systematically identifying gaps and setting priority interventions for child survival.
first_indexed 2024-12-11T03:24:14Z
format Article
id doaj.art-ab74b527629445de869275212f3e56ab
institution Directory Open Access Journal
issn 1654-9880
language English
last_indexed 2024-12-11T03:24:14Z
publishDate 2016-05-01
publisher Taylor & Francis Group
record_format Article
series Global Health Action
spelling doaj.art-ab74b527629445de869275212f3e56ab2022-12-22T01:22:34ZengTaylor & Francis GroupGlobal Health Action1654-98802016-05-01901910.3402/gha.v9.3098330983Empowering districts to target priorities for improving child health service in Uganda using change management and rapid assessment methodsJohn Odaga0Dorcus K. Henriksson1Charles Nkolo2Hector Tibeihaho3Richard Musabe4Margaret Katusiime5Zaccheus Sinabulya6Stephen Mucunguzi7Anthony K. Mbonye8Joseph J. Valadez9 Liverpool School of Tropical Medicine, Kampala, Uganda Health Systems and Policy (HSP) Research Group, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden Liverpool School of Tropical Medicine, Kampala, Uganda ChildFund International, Kampala, Uganda ChildFund International, Kampala, Uganda ChildFund International, Kampala, Uganda ChildFund International, Kampala, Uganda ChildFund International, Kampala, Uganda Ministry of Health, Kampala, Uganda Liverpool School of Tropical Medicine, Kampala, UgandaBackground: Local health system managers in low- and middle-income countries have the responsibility to set health priorities and allocate resources accordingly. Although tools exist to aid this process, they are not widely applied for various reasons including non-availability, poor knowledge of the tools, and poor adaptability into the local context. In Uganda, delivery of basic services is devolved to the District Local Governments through the District Health Teams (DHTs). The Community and District Empowerment for Scale-up (CODES) project aims to provide a set of management tools that aid contextualised priority setting, fund allocation, and problem-solving in a systematic way to improve effective coverage and quality of child survival interventions. Design: Although the various tools have previously been used at the national level, the project aims to combine them in an integral way for implementation at the district level. These tools include Lot Quality Assurance Sampling (LQAS) surveys to generate local evidence, Bottleneck analysis and Causal analysis as analytical tools, Continuous Quality Improvement, and Community Dialogues based on Citizen Report Cards and U reports. The tools enable identification of gaps, prioritisation of possible solutions, and allocation of resources accordingly. This paper presents some of the tools used by the project in five districts in Uganda during the proof-of-concept phase of the project. Results: All five districts were trained and participated in LQAS surveys and readily adopted the tools for priority setting and resource allocation. All districts developed health operational work plans, which were based on the evidence and each of the districts implemented more than three of the priority activities which were included in their work plans. Conclusions: In the five districts, the CODES project demonstrated that DHTs can adopt and integrate these tools in the planning process by systematically identifying gaps and setting priority interventions for child survival.http://www.globalhealthaction.net/index.php/gha/article/view/30983/pdf_287LQASBottleneck analysispriority settingCODES
spellingShingle John Odaga
Dorcus K. Henriksson
Charles Nkolo
Hector Tibeihaho
Richard Musabe
Margaret Katusiime
Zaccheus Sinabulya
Stephen Mucunguzi
Anthony K. Mbonye
Joseph J. Valadez
Empowering districts to target priorities for improving child health service in Uganda using change management and rapid assessment methods
Global Health Action
LQAS
Bottleneck analysis
priority setting
CODES
title Empowering districts to target priorities for improving child health service in Uganda using change management and rapid assessment methods
title_full Empowering districts to target priorities for improving child health service in Uganda using change management and rapid assessment methods
title_fullStr Empowering districts to target priorities for improving child health service in Uganda using change management and rapid assessment methods
title_full_unstemmed Empowering districts to target priorities for improving child health service in Uganda using change management and rapid assessment methods
title_short Empowering districts to target priorities for improving child health service in Uganda using change management and rapid assessment methods
title_sort empowering districts to target priorities for improving child health service in uganda using change management and rapid assessment methods
topic LQAS
Bottleneck analysis
priority setting
CODES
url http://www.globalhealthaction.net/index.php/gha/article/view/30983/pdf_287
work_keys_str_mv AT johnodaga empoweringdistrictstotargetprioritiesforimprovingchildhealthserviceinugandausingchangemanagementandrapidassessmentmethods
AT dorcuskhenriksson empoweringdistrictstotargetprioritiesforimprovingchildhealthserviceinugandausingchangemanagementandrapidassessmentmethods
AT charlesnkolo empoweringdistrictstotargetprioritiesforimprovingchildhealthserviceinugandausingchangemanagementandrapidassessmentmethods
AT hectortibeihaho empoweringdistrictstotargetprioritiesforimprovingchildhealthserviceinugandausingchangemanagementandrapidassessmentmethods
AT richardmusabe empoweringdistrictstotargetprioritiesforimprovingchildhealthserviceinugandausingchangemanagementandrapidassessmentmethods
AT margaretkatusiime empoweringdistrictstotargetprioritiesforimprovingchildhealthserviceinugandausingchangemanagementandrapidassessmentmethods
AT zaccheussinabulya empoweringdistrictstotargetprioritiesforimprovingchildhealthserviceinugandausingchangemanagementandrapidassessmentmethods
AT stephenmucunguzi empoweringdistrictstotargetprioritiesforimprovingchildhealthserviceinugandausingchangemanagementandrapidassessmentmethods
AT anthonykmbonye empoweringdistrictstotargetprioritiesforimprovingchildhealthserviceinugandausingchangemanagementandrapidassessmentmethods
AT josephjvaladez empoweringdistrictstotargetprioritiesforimprovingchildhealthserviceinugandausingchangemanagementandrapidassessmentmethods