The project helped established a sub-national RMNCAH coalition with GFF Accountability at Subnational level
The project main goal was improved delivery of Women, Children, and Adolescent Health (WCAH) services in Kasese District targeting hard to reach areas which are basically underserved communities. The activities included, developing a district scorecard, Facilitating bi-annual dialogues dissemination workshops, and trainings of CSOs on GFF processes, budget advocacy and expenditure tracking, social accountability, dialogues, documentation, review district advocacy strategy, in Kasese District on women, children and adolescent health services.
This project was a scale up of CSO engagement on GFF Accountability and roll out of the GFF framework of reaching the hard to reach and most vulnerable communities and case in point is the new District in the Toro cluster under Uganda Reproductive Maternal Child Health Project (URMCHIP).
Initial Proposal Objectives:
- To enhance the capacities of 160 technical, CSOs, and political representatives in Kasese Districts to fulfill their mandate in ensuring effective service delivery in health sector.
- To track GFF implementation through development of bi-annual district score cards.
- To build one RMNCAH+N district Coalition to support advocacy
- To Strengthen CSOs coalition in Kasese district to engage in RMNCAH+N activities by December 2020
- To strengthen engagement of CSOs coalition members in the Extended District Health Management Team by December 2020
The project strengthened capacity of 20 CSOs representatives,10 political representatives who are now engaging in health budget advocacy and expenditure tracking on women, children and adolescents health (WCAH) services, the trainings were delivered by consultants from Ministry of Finance Planning and Economic Development and Civil Society Budget advocacy group.
The project successfully generated two semi-annual scorecards, the scorecard worked as a tool to help CSOs develop the advocacy action plan for Kasese district, aimed at tracking specific indicators in maternal and child health, the scorecards are attached, they both show the swifts in the CSO meaningful participation in Global Financing Facility implementation at district level. Additionally, the project developed and published a position paper on CSO engagement on GFF accountability.
20 CSOs members and its steering committee, the members are active, participated in the nomination of the district health sector priorities on WCAH services, the coalition has continued to meet through zoom and in-person.
Two periodic scorecards were developed, printed and disseminated during CSOs meetings and in the Expended District Health Management Meetings, this has helped to equip CSOs with evidence to ask the district health officer and health centre in-charges to increase allocation to maternal and child health indicators performing poorly in the subsequent quarters, which resulted in allocation commitment by the district health office of more ugx4000,000 to family planning services, increased immunization coverage in the district
A CSOs Sub-national RMNACH coalition was successfully formed in Kasese district and currently consists a membership of 25 members and still growing, the Sub-national Coalition was also linked to the national RMNCAH coalition interms of representatives participation in the national events, presentation of district priorities into the national selection of priorities in the RMNCAH+N investment plan, implementation of scorecard at district level and share information on the national platform for use and continued advocacy. The elected two representative have been participating in the extended district health management team meetings.
The district was not conducting expanded district health management team meetings, the project facilitated the district to hold these meetings.
The district has not yet committed resources to conduct EDHMTs, the project has support the 2 sessions.
COVID-19 affected meetings of CSOs, the project subscribed for a zoom account where meetings were made possible to take place virtually, where CSOs were able to review and approve terms of reference for engagement in the expanded district health management team meetings.
Planned future engagements at sub-regional level
The scorecard implementation will consider collecting feedback from the community on the quality of services under results based financing compared to past years before the new health financing approach.
Continuing to support the Extended district health management Team meetings would be a potential platform for fruitful CSOs engagements with the district health stakeholders and the duty bearer (Chief Administrative Officer, District Planner, District Health Officer and health centre- in-charges) in the district.
The extend capacity building to district councilors at district and parish level, this would equip them with knowledge on how to track allocation on areas key to improving lives of women, children and adolescent including knowing their roles and powers on the district budget allocations.
Comparison of districts performance in the region will be good to network key players and learn from each other on the best practices in the districts, this significantly would lead to improved service delivery for women, children and adolescents in the district. A regional CSOs performance scorecard on MCH indicators covering 4 or more districts would create competitive among duty bearer in service delivery improvement.
Publishing the generated scorecard at all health centres and the district notice boards will increase awareness on the poorly performing health critical indicators in the district and call to action