Author:
Kiracho Elizabeth Ekirapa,Aanyu Christine,Apolot Rebecca Racheal,Kiwanuka Suzanne Namusoke,Paina Ligia
Abstract
Abstract
Background
Planning for the implementation of community scorecards (CSC) is an important, though seldom documented process. Makerere University School of Public Health (MakSPH) and Future Health Systems Consortium set out to develop and test a sustainable and scalable CSC model. This paper documents the process of planning and adapting the design of the CSC, incorporating key domains of the scalable model such as embeddedness, legitimacy, feasibility and ownership, challenges encountered in this process and how they were mitigated.
Methods
The CSC intervention comprised of five rounds of scoring in five sub counties and one town council of Kibuku district. Data was drawn from ten focus group discussions, seven key informant interviews with local and sub national leaders, and one reflection meeting with the project team from MakSPH. More data was abstracted from notes of six quarterly stakeholder meetings and six quarterly project meetings. Data was analyzed using a thematic approach, drawing constructs outlined in the project’s theory of change.
Results
Embeddedness, legitimacy and ownership were promoted through aligning the model with existing processes and systems as well as the meaningful and strategic involvement of stakeholders and leaders at local and sub national level. The challenges encountered included limited technical capacity of stakeholders facilitating the CSC, poor functionality of existing community engagement platforms, and difficulty in promoting community participation without financial incentives. However, these challenges were mitigated through adjustments to the intervention design based on the feedback received.
Conclusion
Governments seeking to scale up CSCs and to take scale to account should keenly adapt existing models to the local implementation context with strategic and meaningful involvement of key legitimate local and sub national leaders in decision making during the design and implementation process. However, they should watch out for elite capture and develop mitigating strategies. Social accountability practitioners should document their planning and adaptive design efforts to share good practices and lessons learned. Enhancing local capacity to implement CSCs should be ensured through use of existing local structures and provision of technical support by external or local partners familiar with the skill until the local partners are competent.
Publisher
Springer Science and Business Media LLC
Subject
Public Health, Environmental and Occupational Health,Health Policy
Reference47 articles.
1. Agarwal S, Heltberg R, Diachok M. Scaling-up social accountability in World Bank operations [Internet]. The World Bank; 2009 May [cited 2019 May 23] p. 1–12. Report No.: 51469. Available from: http://documents.worldbank.org/curated/en/423211468164948681/Scaling-up-social-accountability-in-World-Bank-operations.
2. World Bank. World Development Report. 2004: Making services work for poor people - Overview [Internet]. The World Bank; 2003 Sep [cited 2019 May 23] p. 1–36. Report No.: 26886. Available from: http://documents.worldbank.org/curated/en/527371468166770790/World-Development-Report-2004-Making-services-work-for-poor-people-Overview.
3. Rabbani F, Lalji NS, Abbas F, Jafri SW, Razzak AJ, Nabi N, et al. Understanding the context of balanced scorecard implementation: a hospital-based case study in Pakistan | Implementation Science | Full Text. Implementation Science [Internet]. 2011 [cited 2019 May 21];6(31). Available from: https://implementationscience.biomedcentral.com/articles/https://doi.org/10.1186/1748-5908-6-31.
4. Blake C, Annorbah-Sarpei NA, Bailey C, Ismaila Y, Deganus S, Bosomprah S, et al. Scorecards and social accountability for improved maternal and newborn health services: A pilot in the Ashanti and Volta regions of Ghana. Int J Gynaecol Obstet. 2016 Dec;135(3):372–9.
5. Peters HD, Noor AA, Lakhwinder PS, Kakar KF, Hansen MP, Burnham G. A balanced scorecard for health services in Afghanistan A balanced scorecard for health services in Afghanistan. Bull World Health Organ. 2007;85:146–51.
Cited by
1 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献