Browsing by Author "Mpanga, Flavia"

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    Community and District Empowerment for Scale-up (CODES): a complex district-level management intervention to improve child survival in Uganda: study protocol for a randomized controlled trial
    (Trials, 2016) Waiswa, Peter; O’Connell, Thomas; Bagenda, Danstan; Mullachery, Pricila; Mpanga, Flavia; Kiwanuka, Dorcus H.; Katahoire, Anne R.; Ssegujja, Eric; Mbonye, Anthony K.; Peterson, Stefan S.
    Background: Innovative and sustainable strategies to strengthen districts and other sub-national health systems and management are urgently required to reduce child mortality. Although highly effective evidence-based and affordable child survival interventions are well-known, at the district level, lack of data, motivation, analytic and planning capacity often impedes prioritization and management weaknesses impede implementation. The Community and District Empowerment for Scale-up (CODES) project is a complex management intervention designed to test whether districts when empowered with data and management tools can prioritize and implement evidence-based child survival interventions equitably. Methods: The CODES strategy combines management, diagnostic, and evaluation tools to identify and analyze the causes of bottlenecks to implementation, build capacity of district management teams to implement contextspecific solutions, and to foster community monitoring and social accountability to increase demand for services. CODES combines UNICEF tools designed to systematize priority setting, allocation of resources and problem solving with Community dialogues based on Citizen Report Cards and U-Reports used to engage and empower communities in monitoring health service provision and to demand for quality services. Implementation and all data collection will be by the districts teams or local Community-based Organizations who will be supported by two local implementing partners. The study will be evaluated as a cluster randomized trial with eight intervention and eight comparison districts over a period of 3 years. Evaluation will focus on differences in uptake of child survival interventions and will follow an intention-to-treat analysis. We will also document and analyze experiences in implementation including changes in management practices
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    Community Participation to Improve Health Services for Children: a methodology for a community dialogue intervention in Uganda
    (African Health Sciences, 2019) Muhwezi, Wilson Winstons; Palchik, Elizabeth Allen; Kiwanuka, Dorcus Henriksson; Mpanga, Flavia; Mukundane, Moses; Nanungi, Annet; Bataringaya, Denis; Ssesanga, Patrick; Aryaija-Karemani, Adelaine
    Like other developing countries, Uganda still struggles to meaningfully reduce child mortality. A strategy of giving information to communities to spark interest in improving child survival through inducing responsibility and social sanctioning in the health workforce was postulated. By focusing on diarrhea, pneumonia and malaria, a Community and District Empow- erment for Scale up (CODES) undertaking used “community dialogues” to arm communities with health system performance information. This empowered them to monitor health service provision and demand for quality child-health services. We describe a process of community dialoguing through use of citizen report cards, short-text-messages, media and post-dialogue monitoring. Each community dialogue assembled 70-100 members including health workers and community leaders. After each community dialogue, participants implemented activities outlined in generated community contracts. Radio messages promoted demand for child-health services and elicited support to implement accepted activities. The perception that community dialoging is “a lot of talk” that never advances meaningful action was debunked since participant-initiated actions were conceived and implemented. Potential for use of electronic communication in real-time feedback and stimulating discussion proved viable. Post-dialogue monitoring captured in community contracts facilitated pro- cess evaluation and added plausibility for observed effects. Capacitated organizations during post-dialogue monitoring guaran- teed sustainability.