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Empowering districts to target priorities for improving child health service in Uganda using change management and rapid assessment methods
Univ Liverpool Liverpool Sch Trop Med, Kampala, Uganda..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH). Karolinska Inst, Dept Publ Hlth Sci, Hlth Syst & Policy HSP Res Grp, Tomtebodavagen 18A, SE-17177 Stockholm, Sweden..
Univ Liverpool Liverpool Sch Trop Med, Kampala, Uganda..
ChildFund Int, Kampala, Uganda..
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2016 (English)In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 9, 30983Article in journal (Refereed) Published
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Text
Abstract [en]

Background: Local health system managers in low- and middle-income countries have the responsibility to set health priorities and allocate resources accordingly. Although tools exist to aid this process, they are not widely applied for various reasons including non-availability, poor knowledge of the tools, and poor adaptability into the local context. In Uganda, delivery of basic services is devolved to the District Local Governments through the District Health Teams (DHTs). The Community and District Empowerment for Scale-up (CODES) project aims to provide a set of management tools that aid contextualised priority setting, fund allocation, and problem-solving in a systematic way to improve effective coverage and quality of child survival interventions. Design: Although the various tools have previously been used at the national level, the project aims to combine them in an integral way for implementation at the district level. These tools include Lot Quality Assurance Sampling (LQAS) surveys to generate local evidence, Bottleneck analysis and Causal analysis as analytical tools, Continuous Quality Improvement, and Community Dialogues based on Citizen Report Cards and U reports. The tools enable identification of gaps, prioritisation of possible solutions, and allocation of resources accordingly. This paper presents some of the tools used by the project in five districts in Uganda during the proof-of-concept phase of the project. Results: All five districts were trained and participated in LQAS surveys and readily adopted the tools for priority setting and resource allocation. All districts developed health operational work plans, which were based on the evidence and each of the districts implemented more than three of the priority activities which were included in their work plans. Conclusions: In the five districts, the CODES project demonstrated that DHTs can adopt and integrate these tools in the planning process by systematically identifying gaps and setting priority interventions for child survival.

Place, publisher, year, edition, pages
2016. Vol. 9, 30983
Keyword [en]
LQAS, Bottleneck analysis, priority setting, CODES
National Category
Pediatrics Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:uu:diva-299626DOI: 10.3402/gha.v9.30983ISI: 000377800200001PubMedID: 27225791OAI: oai:DiVA.org:uu-299626DiVA: diva2:949832
Available from: 2016-07-25 Created: 2016-07-25 Last updated: 2017-11-28Bibliographically approved

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Henriksson, Dorcus K.

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