Kapochorwa’s Kabeywa subcounty is awash with remarkable success stories that range from improved access to vaccination to increase first-trimester ANC uptake. “We see change in Kabeywa subcounty. In the past, getting children vaccinated was an uphill task .Most people would ran away to hide in the forest with their childen on vaccination days” attested Yusuf Twaha, DHE Kapochorwa during the USA regional implementing partners performance review meeting.
At the same meeting, Dr. Siraji Masai, the District Health Officer (DHO), highlighted the remarkable impact of USAID SBCA interventions in Kabeywa. Dr. Masai emphasized, “Kabeywa sub county is currently the lead even with the Result Based Financing indicators, and I would want to link this to the SBC interventions, especially the iDARE and Channels of Hope methodologies.” These methodologies empowered community gatekeepers to address various barriers, including those related to social economic factors, culture, and gender. Dr. Masai recommended that all partners embrace these SBC approaches.
The transformative journey began in March 2021 when USAID SBCA introduced various SBC approaches in Kabeywa sub-county, such as Channels of Hope and iDARE. Channels of Hope empowered faith leaders to tackle barriers related to community and faith-based health service uptake, while iDARE, a Quality Improvement (QI) methodology, identified local determinants of service uptake and collaborated with community influencers to tailor solutions. Kabeywa was chosen as a learning site due to its history of suboptimal performance in key health indicators.
In Mbale, a different success story unfolded through USAID SBCA. In August 2023, SBCA initiated the iDARE project with the USAID Mbale Regional Referral Hospital Strengthening Activity (G2G). The project aimed to increase first-trimester ANC uptake, which was at just 12% of the assigned targets. Through careful examination and guided by USAID/SBCA, the hospital conducted exit interviews and discussions with ANC clients.These revealed the hidden factors affecting service uptake, including late reporting and community opinions.
The insights led to the identification of community influencers who played pivotal roles in addressing these issues.The QI and ANC teams engaged in discussions that revealed restrictions on dresscode for pregnant women, and one specific day for first ANC (Monday) that discouraged service uptake.The increased understanding translated into greater empathy and improved the quality of care. In just six weeks, the hospital recorded over a 12% increase in ANC service uptake, with many clients referred by community influencers.
These stories underscore the impact of USAID SBCA’s initiatives in Eastern Uganda, emphasizing the potential for community-driven change and improved healthcare services. SBC performance score card sessions with the sub county and community leaders
Since we began iDARE at the hospital, our eyes have been opened to so many realities that actually affect ANC uptake, and now we can plan and care for the clients better. In the past, we limited dress code, mothers who were not dressed in loose dresses were reprimanded and those who came for first ANC on other days other than Monday were not attended to. Therefore, most of them went to a near-by facility – Municipal health center II, which is more congested and with fewer facilities. This is because they were received regardless of their dress code and day of the week. Since we dropped these restrictions, we have seen a tremendous increase in the numbers, from 13-25%, in a period of six weeks.”
Said Diana Twisa, clinical officer, Mbale