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
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Date
2016
Journal Title
Journal ISSN
Volume Title
Publisher
Trials
Abstract
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
Description
Keywords
Child survival, Management tools, Bottleneck analysis
Citation
Waiswa, P., O’Connell, T., Bagenda, D., Mullachery, P., Mpanga, F., Henriksson, D. K., ... & Peterson, S. S. (2016). 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, 17(1), 1-8. DOI 10.1186/s13063-016-1241-4