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Champions of change: Sensitized citizens determined to reverse maternal health situation in rural Uganda

  • Although Uganda is popularly known as one of the worst places to be a mother on planet earth, a rural community deep in the countryside is set to defy this negative perception. What makes such a community exceptional is a story worth telling. This rare community is located within Kyankwanzi district in mid central Uganda.

    Following sensitizations in Rights Based Approaches (RBA) to health and other social services delivery among communities of Gayaza Sub County, Kyankwanzi district, community members embarked on demanding for their rights from various categories of duty bearers and decision makers starting in October 2014. Among the demands made were improvement of roads to ease access to health facilities, construction of maternity wards, improvement of health workers’ attitudes toward pregnant mothers and adequate equipment of health facilities to support the implementation of the RBA in health centers.
    As a result of the demands made to the respective decision makers, Kyanga/Gayaza road was improved by the district works department in January 2015.
    Furthermore, an interface meeting was held between the communities and the health workers in November 2014. This meeting addressed the issue of poor health workers’ attitudes towards patients. Presently, health workers’ attitudes have greatly improved which encourages community members especially expectant mothers to use the health care services.

    The Local Council III chairperson of the sub county made a strong appeal to the district and other partners including civil society to urgently support construction of a maternity ward at Kiyuni Health Centre III. One of the civil society organizations operating in the area pledged to construct the maternity ward by the end of 2015. Finally, the district health office supplied Kikubya health centre II with two delivery mattresses to aid in child delivery.

    The above achievements would not be possible were it not for the support of civil society institutions such as Action for Rural Women’s Empowerment (ARUWE) and Open Society Initiative for Eastern Africa (OSIEA).

    The interventions have taught ARUWE a number of lessons. ARUWE has learnt that empowering communities to spearhead their health and social advocacy activities creates ownership and sustainability of advocacy initiatives; some of the methodologies used such as the Community Score Card are an important tool in improving working relations between duty bearers and rights holders; building community capacity to monitor health services is key in ensuring that rights holders access qualitative and quantitative service deliverables. This provides communities with capacities to influence, engage and demand for services from duty bearers; interface meetings between health workers and community members improve knowledge regarding management of the health centre, the existing national health policy and health care system; community monitoring of health services promotes accountability in health care management leading to improvement of service delivery; monitoring of health service delivery provides evidence to support health related advocacy initiatives for improved services; involvement of duty bearers including health workers and local government leaders in health monitoring activities helps duty bearers to identify gaps in their services that require improvement; increasing awareness of human rights and responsibilities among community members empowers communities to claim their rights and entitlements; and training and equipping duty bearers including Health Unit Management Committees (HUMCs) with skills and knowledge in their roles and responsibilities empowers them to effect improvement in health service delivery

    In spite of the progress made towards improving maternal health services in the sub county, significant challenges still remain. Among these are: ignorance of roles and responsibilities among some duty bearers, poor road infrastructure in other areas of the sub county hindering transportation of pregnant women to health facilities, limited funds to scale up activities, cultural and traditional barriers hindering behavioral change among communities, increased teenage pregnancies and cover up of maternal deaths that occur in residences of Traditional Birth Attendant (TBA).
    The above observations reveal that improving the maternal health situation in rural Africa is indeed possible and can be achieved at lower costs through local civil society institutions working in partnership with rural communities and their leaders.

    Compiled by
    Susanne Muwazi
    20th April 2015


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