Uganda- Care, Support and Treatment Project (CVA)

Bringing together different project stakeholders in a dialogue over the quality of services under the Citizens’ Voice and Action (CV&A) activities not only ‘awakened’ duty bearers on their important roles in service delivery, but also demonstrated the importance of community or service user empowerment. World Vision’s project facilitates the identification and training of CV&A lobby groups whose membership was drawn by service users. These groups were facilitated to conduct lobby meetings with different stakeholders for the support and availability of quality PMTCT services.

The CV&A as strategy was integrated in the project on the backdrop that inadequate service delivery is often a function of weak capacity by citizens (service users) to effectively influence government responsiveness to their needs. In Uganda, some past studies have shown that the inability of citizens to engage with local governments over the quality of service delivery is both a cause and consequence of weak local government capacity to deliver services.

Feedback from a group interview expressed that service delivery significantly improved as a result of World Vision’s programming and the inclusion of CV&A. One participant shared, “To me things have really improved. In the past, you would come to the facility and health workers would just look at you [like that], but now, once you come with any problem they attend to you well.... I wish they could continue working that way ... Pregnant mothers would go to a health facility but fail to get the kind of attention they now get.  Because of that, women always preferred to give birth from their villages with the help of traditional birth attendants but now because of the good services they deliver at health facilities.” Most (80.6%) of HIV positive mothers with recent deliveries, did so at a Prevention of Mother to Child Transmission (PMTCT) health facility. This is a 19.6% increase from the baseline performed in 2010. W