Located in Western Uganda, eSociety Kasese is a resource centre that promotes ICT literacy and the use of ICT for transparency in the local government. As part of its iParticipate Uganda project, the Collaboration on International ICT Policy for East and Southern Africa (CIPESA) has provided to the centre equipment and connectivity support. In addition, we jointly conduct research and citizen journalism training.
Below is an introductory video to the Centre.
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In Northern Uganda “ICT 4 health service delivery” project used technological approach to empower the communities. Through the empowerment, the communities were able to engagement and participate in monitoring and demanding for better health service delivery. The main awareness media technological tools that were used included the local FM radio programs which informed, educated and empowered over 7000 people in and out of the target districts in a period of 12 months, TIU managed a Toll free call center that the communities used for reporting health centre irregularities, for onward action by duty bearers.
Health services remain a great need for many communities and the only facilities that most of them can afford are government health centers which provide free health care services. Most health centers like Ogur, Aromo and Anyeke in Northern Uganda are visited by patients from as far as 24 kilometers. In most cases they ride bicycles to and from the health centers. it is often disappointing for such a patient to reach the health center and find it still locked even by 10:00am. In most occasions, even when the health center is open, some health workers are absent while most drugs are lacking.
Read about how The Commission for Human Rights and Good Governance (CHRAGG) in Tanzania takes SMS to the citizens to strengthen human rights. The newsletter also includes articles on “Health Service Delivery”, “Empowering rural communities through ICTs”, and “Fostering community empowerment through ICTs for service delivery and community participation”, among other things. The Spider ICT4Democracy in East Africa Network is premised on the recognition that Information and Communication Technology (ICT) enhances communication and the right to freedom of expression, as well as the right to seek, receive and impart information.
In this respect, ICT has the potential to increase citizens’ participation in decision-making processes, thus strengthening democratisation. The network is facilitated by The Collaboration on International ICT Policy for East and Southern Africa (CIPESA), based in Uganda. Participating project partners come from Kenya, Tanzania and Uganda.
Download the Newsletter here.
Purpose: To promote transparency and accountability in health service delivery through ICT.
Goal: To Contribute towards improvement of health service delivery in Northern Uganda
Objectives
ICT 4 health service delivery pilot project (Funded by SPIDER) has been implemented by Transparency International Uganda (TIU) in two districts (Lira and Oyam) in Northern Uganda; specific health centers that worked directly with the project included health centers from Oyam which included Anyeke HC (Health Center) IV, Iceme HC II, Loro HC II, Agulurude HC III and four health centers from Lira that included Amach HC IV, Barr HC III, Ogur HC IV and Aromo HC III. The ICT project right from inception used technological approach of community empowerment and engagement/participation in monitoring and demanding for better health service delivery. The main awareness media technological tools that were used was the local FM radio programs which informed, educated and empowered over 7000 people in and out of the target districts in a period of 12months. The Toll free call center was the main platform that was and is still being used for active community reporting.
Through the call center TIU received 3267 calls from community members. The reports pointed out key challenges of Absenteeism, under-staffing, ghost workers, poor hygiene, inadequate accommodation facilities, drugs stock out uncoordinated health workers transfers without replacement. and corruption in Uganda police force. Other callers were requesting for project replication in their communities while others wanted to know more about the project. In response TIU managed to conduct health center verification visits to validate the reports. . Some of the problems were handled and resolved at the community level. The health management committees were able to address the challenges. Challenges that proved to be beyond respective health center management level like ghost workers, inadequate staff accommodation and drug stock out were shared with district health officers who were able to respond by first updating staff employment register at district level tallying it with staff numbers physically present at health centers. The district health department also managed to complete construction of staff accommodation at some health units.
Health workers absenteeism was reduced by 30%, the figure was derived by comparing staff attendance/arrival register statistics during inception and after empowering people and structures working together to stop absenteeism. As a commitment for continuous monitoring and provision of better health service delivery, stakeholders committed themselves through development pact signing which has improved working relationship between health workers and health users. Community volunteers have given testimonies to the positive results/changes realized at their respective health centers.
During the entire period of implementation the Local government district health offices of Lira and Oyam supported and participated in project implementation by providing government vehicles for on spot health center visits and also responded to recommendations from TIU in regards to challenges reported from the health centers.
Toll free Call Center:Community volunteers, health users, health workers and other used the facility to report cases to TIU, after receiving the call center reports, verification visits were conducted to spot check, verify and validate the issues reported. TIU frequently called back to seek for clarifications, remotely follow up on urgent challenges reported and giving feedback to callers.
Radio programs; The Radio programs were used to inform, educate and empower project beneficiaries and stakeholders towards collective efforts in promoting social accountability of health workers in health service delivery. Among presenters of the radio program included, CSO partners like Lira NGO Forum, Justice and Peace Center Lira and Voluntary accountability Committee members. They shared with communities the different ideas for improvement, key examples from of what happens on ground and provided recommendations for improving health service delivery. Radio talks-shows reached beyond Lira and Oyam districts. In order for the toll free number to be known to the different take holders, TIU ran spot radio jingles advertising the number and informing the communities on the reporting guidelines. Empowering people enabled TIU to receive reports from different health centers, pointing out challenges in healthcare accessibility. Due to this, health workers were alert at all times since their misconduct would be reported by just a call away.
Strategies used during Project Implementation
Key Results
Sustainability
Project has empowered communities to take up health service delivery monitoring beyond project implementation The community members themselves monitor and demand for social responsibility of health workers. The District local government structures are monitoring the health units and addressing any reported anomalies. TIU is currently ensuring that all pilot projects are up-scaled, proposals are being developed to fund raise and give the ICT 4 Health service delivery life after SPIDER funding.
The Democratization process of the East African Countries still remains elusive as Civil and Political actors of Governments and top leadership remains major impediments in addressing the underlying problems to social evils such as corruption, poor governance, a declining press freedom and lack of respect for fundamental rights and freedom of its Citizens.
The East African Countries of Uganda, Kenya and Tanzania is still bogged down by high levels of corruption, lack of transparency and accountability in the delivery of public service, poor civic participation by Citizens and lack of feedback mechanisms from leaders to citizens in addressing major concerns that directly affects the well-being of communities. This has created a situation whereby we live in a society in which people are less informed about government functions and systems typically breeding an environment in which corruption and poor service delivery can thrive.
WOUGNET with financial support from the Swedish Program for ICT support to Developing Countries (Spider) conducted awareness raising meetings in the District of Tororo and Busia in Eastern Uganda from the 23rd -27th of September 2013. The awareness meetings was aimed at introducing the new project to the district and mapping stakeholders and partners to be involved in the Project.
The Senior Program Officer, Gender and ICT Policy Advocacy, Ms. Goretti Z. Amuriat met a number of District leaders including the Resident District Commissioner (RDC) and the Chief Administrative Officer of Busia, Mr. Okumu Christopher and briefed them about the SPIDER Upscale project in their offices last week. Mr. Okumu said that he believes that it will be one of the best projects in his district and since it is targeting mainly women, he is so happy about it and welcomes it to Busia.
Spider ICT for Education Network Workshop held in Uganda, August 28-29 
Spider project partners at the workshop. From left John Sebaganwa (Open Learning Exchange Rwanda), Regina Monyemangene (Open University of Tanzania), Iryna Kuchma (EIFL), Tito Okumu (Makerere University), and Ulf Larsson (Spider). Raul Silveti (Fundacion LaPaz) participated via skype. Spider and five project partners within education has held a successful workshop in Kampala, Uganda where the Network for ICT in Education was formed.
WOUGNET with financial support from the Swedish Program for ICT support to Developing Countries (Spider) conducted awareness raising meetings in the District of Tororo and Busia in Eastern Uganda from the 23rd -27th of September 2013. The awareness meetings was aimed at introducing the new project to the district and mapping stakeholders and partners to be involved in the Project.
In its April 2013 publication, the ICT4Democracy in East Africa Network – of which CIPESA is a member – highlights stories and experiences from the field.
Download the full publication here.
The network is premised on the recognition that Information and Communication Technology (ICT) enhances communication and the right to freedom of expression, as well as the right to seek, receive and impart information. In this respect, ICT has the potential to increase citizens’ participation in decision-making processes, thus strengthening democratisation.
Project Progress Report: July-December 2012
Title: Empowering Communities through ICT for better Health Service delivery.
Project Abstract
Years after the end of rebel insurgency, Northern Uganda continues to face challenges in terms of health service delivery. This is manifested mainly in high rates of absenteeism of health workers rendering dysfunctional the few available health centers. Medical workers’ absenteeism which is caused by many factors remains key cause of poor health service delivery in the region.
According to World Bank, health workers in Uganda operate under de-motivating terms and conditions of service characterized by low pay resulting in either migration to other countries for better pay or absconding from duty to attend to their private clinics/businesses.
Other organizations like WHO have attributed absenteeism to inadequate number of qualified health staff. The high level of absenteeism of health workers has ramifications for the quality of service provision (MOH 2008b). In addition, practices such as receipt of bribes, extortion of money from patients for services that should ideally be free, the outside sale of drugs and other public facility supplies and misappropriation of user charge revenue (applicable to referral units) are also common (McPake et.al. 1999).
The project is therefore aimed at promoting transparency and accountability in health service delivery through ICT to reduce the rates on absenteeism of health workers, increase community participation in demanding for Transparency, Accountability, functionality of health centers and empower communities in reporting cases of absenteeism through ICT and promote Local government Advocacy in health service delivery.
Current status
The toll free call center is currently being used as a key platform for community involvement and participation in ensuring social accountability and transparency of health workers. TI Uganda in the past six months has widely used atoll free call center was installed in May 2012 as a key platform for community involvement and participation in ensuring social accountability and transparency of health workers. The call center in November received a new twist where the community health users have called to seek for medical consultation, this shows how much the technology can do for the community beyond reporting challenges.
The call center network has greatly improved because the telecom inaction service provider due to our request has conducted network maintenance which has reduced the rates of call drops. The community has greatly adapted to technological approach of improving health service delivery which has been realized through their participation radio talk shows and calling the toll free line, some have even gone to the extent of requesting that the project intervention should be replicated in their districts and community.
Radio Talk Shows.
The radio talk-shows which have been implemented in the last six months has fostered community empowerment and engagement in demanding social accountability from their respective leaders, the community members every Wednesdays would listen to and call-in the station live to contribute or comment on the subject matter; there has also been a lot of knowledge sharing through the technology.
Development Pact Signing
This activity was conducted in December from 17th to 20th 2012 in the sub counties of Amach, Ogur, Iceme , Acaba and Loro in the health centers of Amach, Ogur, Iceme, Anyeke, Agulurude and Loro respectively. The stakeholders district health officers, health workers, community volunteers, health center health management committees, HIV/AIDS focal person, sub county chiefs, voluntary accountability committee members, village health teams (VHTs), Radio Q FM, Radio unity FM, Radio Wa FM, youth drama group and community people from the respective sub counties. The health workers together with community leaders, volunteers and district health officers have pledged their roles play in improving health service delivery at the respective health centers
Advocacy Interface meetings
Meetings with the respective district health officers aimed at improving health service delivery and recommending the use of existing policy guidelines towards overcoming health challenges has paid off; for the first time in history Anyeke Health center IV became the first health center IV to recruit and employ a medical doctor, something greatly attributed to SPIDER health project. In Lira district, the district health office/local government has improved staff accommodation in Ogur and Aromo health centers as result of the meeting, this is important because as long as causes of absenteeism are not addressed it would be very difficult to stop absenteeism.
Collaboration and Networking
TI Uganda in the last six months has greatly collaborated with partner civil society organizations in community empowerment. As part of collaboration, Justice and Peace Commission Lira (JPC) participated in development Pact Signing by providing free power generator and public address system that was used in conducting development pact signing, JPC also provided youth drama group who also freely acted drama during the development pact signing. During collaboration with JPC, TI Uganda only provided lunch allowance, generator fuel and microphone battery which made the whole activity cost effective.
TI Uganda also collaborated with Lira NGO Forum and JPC in conducting Radio Talk-Shows where Lira NGO Forum took lead in mobilizing participants, presenting during radio talk shows and registering participants. Their participation in Radio Talk-shows helped in empowering communities by encouraging their respective community knowledge workers and volunteers to participate in health center monitoring and calling the toll free call center number 0800200188 to report challenges and positive results at the respective health centers.
Radio Wa (Local FM Station) has continued to collaborate with TI Uganda by offering 3 free Talk-show airtime for TI Uganda to empower their Radio listeners towards improving of health service delivery in Northern Uganda and from time to time TI Uganda has also been invited to participate in planning session for community empowerment using ICT.
Collaboration with District Health Officers, The district health offices offered government vehicle for activity implementation with continued embracement of project intervention as a great contribution towards improving of health service delivery in their respective districts.
Documentation and Communication
The project has continued to create public awareness and informing sharing through facebook (social media) which has help to draw attention from different internet users from across the world. Social media has helped the project to reach thousands of people where some requested for additional information to enrich their research/studies,
ICT 4 Democracy in East Africa website has also been used in the last six months for information sharing. Blog posts hosted by Transparency International Secretariat in Berlin have been used to post issues of community empowerment and engagement, this blog has also helped to make the project to be widely known.
TI Uganda involvement of media house in project activities and sharing of information has enabled the project results and activities appear in Local news which has also built both project and organization visibility in Northern Uganda.
http://jkornet.com/2013/01/22/can-technology-help-african-women-to-fight-corruption/
Sustainability
The signed Development pact in the target health centers and radio talk shows held have greatly helped in up scaling community participation and ownership of the intervention where the community are now more informed and engaged in health center monitoring. Efforts are being made to ensure that through development pact, communities are able to continuously ensure that social accountability of health workers is at par.
Risks and risk management
Transport still remains a challenge under the project, the field office only has one motorcycle which is normally used for health field visits, some of the roads become impassable when its rainy season.
Project Coverage, the project coverers a very small geographical area and health centers yet on the other hand community continues to request for the intervention to be introduced and implemented in their sub counties and districts; this continues to remain a big challenge because however much we are willing to stretch out to a wider community, we are limited by funding. Part of risk management taken to mitigate the Risk and challenges has been development and submitting of project concept notes and project proposal of which none of them has yet been successful.
Project Budget Revision
The previously revised budget does require additional adjustment to cater for reallocation balances realized from activities and also to complete the implementation of development pact signing.
9. Response to audit
10. Short Story (Attached separately)
Appendix 1 Project Story (http://www.ict4democracy.org/project-story-empowered-and-involved/ )
Appendix 2 Project Photographs (www.facebook.com/StopAbsenteeism )
11. Results Matrix – Activities, Results & Indicators
Departing from your original proposal describe the results of your activities by filling in the table below. Give special attention to any unexpected developments whether positive or negative and how they have been managed.
| Input(resources used in activity) | Activities(what has been done) | Outputs(what has been produced) | Short term outcomes(anticipated & unanticipated) | Medium term outcomes(anticipated & unanticipated) | Indicators |
| Toll free Call center operation | 1749 in coming calls received.1857Out going calls |
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| Challenges/constraintsICT infrastructure accessibility among women is minimal.
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Health Center Verification visits |
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| Challenges/constraints:ICT infrastructure accessibility among women is minimal.
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Radio Talk Shows |
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The number of people calling in during radio talk show. | ||
| Challenges/constraints:District civil servants being too reserved to participate in radion programms. | |||||
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Development Pact Signing |
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The number of community members leaders who have embraced development pact signing. | ||
| Challenges/constraints: | |||||
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Social Media and Documentation |
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The number of people/facebook users who have comented, viewed or liked post from the project facebook page. | ||
| Challenges/constraints: | |||||
Motorcycle fuel (Activity combined with health center verification visits) |
Advocacy Interface meetings |
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District Health officers have contined to requeste the project intervention be replicated in the remaining sub counties/health centers of their respective districts | Testimonies from distict health officers.Actions taken by district health office towards improving health service delivery. | |
| Challenges/constraints: |