Category: Blog

A Greater Calling

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It was yet another beautiful day after heavy downfall, the question ringing in Simon’s mind was whether or not he could go for health center visits; imagining the road condition, from nowhere he found strength to move and visit health centers; it was 9:00am that he reached Amach health center IV in Northern Uganda, however much he reached this health center, he still felt something missing “Oh my what is this that I feel someone else needs me to listen to their cry than where I am” surprisingly when Simon reached the first

Patients at Health centers in Northern Uganda

health center, there were over 20 patients waiting for health workers who were nowhere to be seen , now this was the time for him to take advantage of the situation, Simon went ahead to interact and sensitize community health users who constituted more of women compared to men, as Simon moved around with his camera to snap, the patients kept on wondering what this handsome young man was doing; some wondered “Is he a journalist, photographer or he just loves taking photographs?” “I always see him coming around this health center, it seems he is concerned with monitoring this facility” one of the patients responded. It was a moment they long awaited for!! Simon steps up and greets the gathering of patients who were by 10:15am 78 people in number yet no service delivery had started, Simon greeted “Ibutu wuno aberr” meaning “Good morning to you all”, “hey he even speaks our language”, one patient exclaimed. “I know most of you are wondering who I am and what I am here to do, well, my name is Simon Peter Ogwang, I work with Transparency International Uganda” Simon introduced himself. I am here to work together with you to monitor heath service delivery at this very health center, since you stay near this facility, “but how will you help us yet this health workers are always absent, they report late and even start working late, we have been here for nearly 2 and a half an hour and no health worker has attended to any of us, for sure we are disappointed!” said one of the patients. I believe now you realize the importance of working together to improve health services, we can make it because we are stronger as a community to send our voices out, demand that best practice is put in place, our rights are not violated. It’s amazing that health workers who were around ears dropping mobilized their other colleagues to begin working.

There is always a greater calling some ware; the next and final visit of the great day was Barr health center III; believe me you couldn’t stand what was on ground, challenges after challenges. Large number of patients seated waiting to be attended to, three health workers who were surprisingly supposed to be on duty were out attending workshop, other two in for meeting within at the health center “you tell us you are improving service delivery, as a matter of fact this happens here most time what can we do, we are helpless, our pain can’t wait, out patience dies off and our voices can never be hard” said Apio one of community women. Apio said that as a matter of fact they had many other responsibilities other than being at the health center without being attended to, “why can’t you leave some of the activities to your spouse?” Simon asked, “Hah don’t even ask about that, do you really think these men want to support us? They only know making babies, once we conceive, they are no ware to be seen!, when are pregnant, all antenatal care we ride bicycles to the health center instead of them carrying us ” Molly said “That is not our work to bring our wives to hospital, we have much bigger commitments” Ogwal responded. “Whether or not, less agree that family responsibilities are for everyone, let us all share responsibilities and ensure that we support women and children in accessing health service delivery, send and support women voices at local council community meetings; calling for all men to start supporting their spouse in health care accessibility, on the other hand we are going to provide you a toll free telephone line so that you will be calling and reporting challenges you are facing in health service delivery, therefore this demands us to work together for the good of our community ” this was a call from Simon; “oh yes I think this works out, our voices needs to be heard and we also need to actively participate in health center monitoring, together we can do this” Grace said. Indeed this was the greater calling, an interactive and participatory dialogue for change, feeling empowered and involved in health service monitoring.

Author: Ogwang Simon Peter

Project Coordinator; AT Transparency International Uganda

Contact: spogwang@tiuganda.org /+256 783256392

Incompetence of Support Staff (Porters and Watchmen) at health centers

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Transparency International Uganda

Porters and watchmen are employed at each health center in Uganda by Ministry of health. Porters are tasked to keep and maintain hygiene of surroundings of their respective health centers. Noticeably these support staff are recruited from the same locality of the health centers, none of them has ever experienced transfers. It has been noted that these individuals according to Health center in-charge at Agulurude Mr. Opio Daniel Patrick, have managed to draw the local community on their side to the extent at which when they are being urged or warned to improve their performance, they claim to the community that they are being witch-hunted; community members have ended up believing in them than acknowledging that the porters who are paid by the government have failed to perform their duties; failure to understand the roles of porters have made some patients’ care takers to participate in health center cleaning.

In Lira District Amach health center IV and Barr Health Center III are under poor hygiene due to outstanding indiscipline of porters, the porters want always to be seen as medical/health workers but not cleaners; they feel belittled to be cleaning the health center while community members see them; yet that wasn’t what they first considered when they first applied for the job. Mr. Okwir Joe according to the health center In-charge  (Michael) of Amach health center has continuously failed to change and perform his duties as expected.  The next step he/Michael together with health management committee are hoping for is to write a warning letter to Okwir Joe and copy it to District health officer, the chief administrative officer and Transparency International Uganda. TIU pledged to follow-up and see into it that action is taken by the relevant authorities.

In oyam district, Ameny Ambrose and Ojok Tonny who are both porters  together with Ayini Dickens (Watchman) at Agulurude health center III have repeatedly abandoned their duty, as a result the health management committee convened a meeting on 28th November 2011 and collectively wrote a letter to the DHO  (Dr. Owiny) complaining of “very poor work performances of support staff”, the letter was copied to the culprits, CAO and Sub County Chief Loro. TIU got reach of this document during health center visits and is engaging district health authorities to take actions.

TIU within its program activities is going to empower communities by conducting radio talk-shows in one of the local FM stations in Northern Uganda once every week. The talk-show will involve participation from community health users (calling in), district health officers, health workers, support staff, partner organizations and local leaders together with TIU to have joint contribution towards attaining results.

Empowering communities through ICT to demand for better health service delivery

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Transparency International Uganda (TIU) is empowering communities in Northern Uganda to demand for better health service delivery, Oyam and Lira districts are the project implementation area; a total of 6 sub counties were selected out of the 24 sub counties in the two districts. After nearly five years of insurgency in Northern Uganda, health care systems remains under dilapidating situation, with collective rehabilitation programs by civil society organizations to improve livelihood of the people, the project shares this goal of  contributing  towards improvement of health service delivery in Northern Uganda.  The project acknowledges that health service human resource is under staffed, and even the few are always absent from their duties but continues to get pay for what they have not worked for, this practice of absenteeism therefore besides being corruption puts the lives of health users at a risk and violates health rights.

Under the project; there is much effort being put in stopping health workers’ absenteeism so as to improve health service delivery, and this will be greatly achieved in the coming months (starting month of January and February 2012) when TIU deploys toll free call center and free SMS for community empowerment and involvement monitoring and improving health service delivery . Before deploying ICT tools the project underwent the processes mapping stakeholders, creating partnership, mapping health center accessibility, selection of voluntary accountability committee (VAC) members, training voluntary accountability committee members,

Patients at Barr health center III (Lira District -Northern Uganda)

The Left Photograph: Patients at Barr Health Center III (Lira district- Northern Uganda).

A young kid seating with her mother as they await to be attended to. It was clear here that the health users do not understand their rights, even if they did, they had no avenue of reporting, demanding and ensuring that delay in health services in their health center is dealt with.

The project will therefore provide them with tool free call center hot line to always report irregularities. The technology will be handled and managed directly by TIU. Telephone calls will be recorded and replayed to generate reports, reports are then shared with partners  and government (district health office) to demand for positive changes tailored towards improving health service delivery.

 

Patients at Amach Health Center IV (Lira District)

 Health center Visit conducted on 06th-12-2011 at Amach Health center IV
It was yet another day of field work, the project officer arrived at Amach health center IV at 9:15am and was welcomed by the security guard, no health worker had yet started working at the Outpatient wing, found 15 patients seated waiting for health service.

By 10:20am there were 78 patients had lined-up, The project officer shared and empowered patients about their health rights and need for better health service delivery; sensitized patients on the need to jointly help Transparency International Uganda to monitor and report late arrival and absenteeism of health workers. Patients could not hide their disappointments on how they felt in delay of accessing health service.

At 10:25am, the health educator Ogwang Ray of Amach health center arrived joined the project officer in sensitizing patients on issues concerning primary health care and stopping health workers absenteeism. The health educator was requested by the project officer to help in stopping late arrival of health workers and also be the voice of patients at the health center. It was at 10:30am that actual process of attending to health needs of patients started by Ogwal Vincent who is the clinical officer.

The success story here is that, Health workers were briefed about the need to stop absenteeism and late coming, work together as a team and improve service delivery. By TIU actively involving health center in-charge and health workers to ensure early reporting and serving the patients, the following day the health center opened early with early commence of patience treatment.

M-Governance Exploratory Survey

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After a comprehensive literature review and an informative workshop conducted last month (October 2011), the iHub Research team ventured into the field to find out whether wananchi’s (Swahili for citizens) reality on the ground matched the theory and rhetoric. The team conducted a brief exploratory survey from November 1st – 4th, 2011. The survey was conducted to better understand Nairobi citizens’ point of view on governance in Kenya and to have a clearer picture of avenues of service delivery and government-citizen interactions that are currently occurring. This initial information will help to formulate the indicators to be studied as part of the larger M-Governance field research that is scheduled to begin January 2012.

Four locations in Nairobi were chosen for the exploratory survey based on factors such as sampling variety, ease of access, and targeted respondents: the Bishop Magua Building, the Central Business District (CBD), the Kibera slum and the University of Nairobi main campus. Two members of the team visited the sites on each of the four days with a minimum target of 15 respondents per location. The brief questionnaire contained seven open-ended questions on perceptions of governance and service delivery as well as existing and preferred channels of communication between the government and citizens. One interesting feature of the survey was that the team piloted Open Data Kit (ODK) mobile data collection software. ODK allowed the field researchers to input the questionnaire responses while in the field using a mobile phone running on Android. As soon as the phones were on Internet, the field team was then able to send the data back to a cloud server, which is accessible in real time from the office using a laptop computer. Therefore, researchers in the office were able to begin seeing and analyzing the results while the field team sent the data from various locations around Nairobi!

A major obstacle encountered was unwillingness to be interviewed, seen in all locations, but especially in the CBD. The unwillingness to give consent to be interviewed might be attributed to mistrust of strangers and fear of reprisals on talking ill about the government. This mistrust had been anticipated by the team, who, in order to counter it, worked hard to establish a rapport with interviewees and make it clear that anonymity was guaranteed. Another challenge was language translation, with most of the interviews having to be carried out in Kiswahili although questionnaires were originally written in English. Some terms in English, such as governance, are difficult to accurately translate without losing the original or intended English meaning. This challenge revealed the fact that “governance” as we know it does not exist in the culture and lingo of most Kenyan people. The closest Swahili word to “governance,” is more closely translated to “rule”, “leadership”, or “government.” Thus, there is a need to continue to develop creative instruments to highlight what “governance” means to Ken

From the brief four-day exploration, the team managed to gather the ideas of over 60 “Nairobians” on governance matters. The insights from the exploratory survey will facilitate the construction of a more “customized” and “Kenyan” framework within which to conduct the wider field research. The data is currently under analysis and additional insights will be published here as soon as analysis is complete.

Launch of the Information Economy Report 2011 in Uganda

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What role are Information and Communication Technologies (ICT) playing in enabling private sector development in developing countries? And what are countries in Africa and other developing regions doing to enable ICT play a greater catalysing role in national development? These were some of the questions discussed at the launch in Kampala of the Information Economy Report 2011, themed ‘Information and Communication Technologies as an Enabler for Private Sector Development (PSD).

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Gender, Youth and Digital Democratic Processes in East Africa

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The Arab Spring has demonstrated a couple of things namely the power and importance of social media, the ability for technology to unite crowds of people in the shortest amount of time no matter the location, and the increased blurriness between the local and global entities with the use of tools like Twitter and Facebook. The role social media have played in the revolutions in countries such as Tunisia, Egypt and Libya is well documented. That youth in particular are recognized as the major players behind the use of these platforms is largely undisputed.

In this article the composition of youth is scrutinized to acquire an understanding of which youth actually have the opportunity to partake in democratic and public fora. The concept of youth and their use of social media for democratic processes is not sufficiently discussed with regards to heterogeneity. The complex layers comprised of the term ‘youth’ is an important point of consideration so as to ensure that all youth are engaging in democratic processes. This article considers differences among youth from a gender perspective, specifically the differences between young men and young women with regards to digitally mediated democratic processes.

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How ICT Could Drive Open Government in Africa

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Information and Communications Technologies (ICT) could be a key enabler of open government in Africa, in the wake of the September 20, 2011 launch of the Open Government Partnership (OGP), a multilateral initiative that aims “to secure concrete commitments from governments to promote transparency, empower citizens, fight corruption, and harness new technologies to strengthen governance”.

The African countries currently eligible to join the OGP are Kenya, Liberia, Ghana, South Africa, Tanzania, and Uganda – and of them, by September 20, 2011, only Tanzania and Uganda had not indicated their plans to join the OGP. These countries derived their eligibility from their “demonstrated commitment to open government” in the key areas of budget transparency, access to information, asset disclosure by politicians and officials, and citizen engagement.

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