CoHeRe Project
Makerere University, School of Social Sciences, Kampala,
Uganda
Presentation by Denis Muhangi, PhD
Project Title: Developing Sustainable Community
Health Resources in Poor Settings in Uganda
•5 Year Project ( 2011 - 2015)
Aim: To contribute to the development of
sustainable interventions that will mitigate the
effects of the human resource deficit in healthcare
and contribute to the achievement of the healthrelated Millennium Development Goals (MDGs).
Focus of the Project
• Identifying locally existing resources (social, economic,
cultural, etc.) that can be used to promote better health
• Utilize existing community resources to:
– Spread health information
– Encourage health promoting behaviors
– Bring vulnerable community members into better contact with
existing health services.
• Develop local capacity for applied public health related
social science research.
• Generate lessons to promote low-cost community based
health approaches.
Focus of the Project -2
1. Exploratory Anthropological Research on:
i.
Indigenous
community
information
resources
ii. Social processes and spaces that generate
and sustain social capital as a health
resource
iii. Existence and functioning of informal social
support mechanisms
Focus of the Project - 3
2. Small-scale pilot interventions based on
the research findings on the above three
topics:
•“Social Groups for Health” Initiative – work with
pre-existing groups to improve household health
•Referral vouchers – to promote care seeking from
formal health facility
•The “grapevine” - spread health information
through informal channels
•Health Improvement Modelling – through support
towards a community latrine
Policy Relevant Questions
•
How can local/indigenous social roles, networks and
information processes be used to transmit health
information to communities, skills, and behaviours, and
link vulnerable community members to existing health
resources?
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What motivation mechanisms for voluntary behaviour in
the community can be harnessed for replication to
support health related interventions?
Progress
• Main data collection phase completed
• Data analysis and writing up on-going
• Small-scale interventions being
implemented
• Supplemental and monitoring data being
collected
Main stakeholders
Primary
stakeholders
Secondary
stakeholders
Tertiary
stakeholders
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Community members (men, women, youth, children)
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Community Leaders (LCs, Women ….)
Community groups (CBOs, SACCOs)
Traditional/cultural leaders (Buganda Kingdom officials, clan heads)
Religious leaders
Health workers
Village Health Teams (VHTs)
Traditional healers and TBAs
Schools
District local government (Health Department, Community
Development Department)
Ministry of Health (Directorate of Community Health,
Environmental Health, MIS)
Uganda National Health Research Organization
National Level Politicians (Area MPs)
Researchers
Academicians
The Media
NGOs, CSOs (AMREF, KOICA)
KTNet
Donor agencies
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Stages of the project at which
stakeholders been involved
• Project conceptualization and design
• Data collection
• Pilot intervention
Institutions with the responsibility of packaging
and disseminating research in Uganda
• Universities (departments and schools)
• Research institutes (MISR)
• Think tanks (Centre for Basic Research,
ACODE)
Stakeholder engagement strategies
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Meetings
Workshop
One to one formal and informal talks
Participation in on-going events
Through the pilot intervention
Newspaper article
Blog article
Key messages & the findings
• Individuals and households can play a key role in
supporting each other to address health problems Much use is already made of a strong underlying sense
of local reciprocity and solidarity during funerals,
weddings, farming, etc.
• Many perceived health problems could be solved by
strengthening linkage with formal health facilities – many
residents believe they have syphilis [kabotongo], though
they have never tested for it.
Key messages & findings
• There are numerous local groups/ processes/
venues that bring people together and serve as
sources of information and social influence.
These could be utilized, but this needs to be
‘from below’ as appropriation from outside has a
negative effect on local solidarity and
sustainability – Groups that have been formed
with strong external influence have fractured
pre-existing social relations or ended in conflicts
Key messages & findings
• Small motivations and inputs from external
agents can spark off far reaching effects and
changes – following construction of the
communal latrine, local leaders are demolishing
unhygienic latrines
KT related Challenges Encountered
• Our approach – subtle approach, intended to be
bottom-up and low–cost, so not keen to portray
ourselves as a project
• Primary researchers (PhD candidates) not on
ground most of the time – busy writing up their
papers/theses
• Still at data analysis and intervention stage –
results and lessons not yet concretized and
agreed
How has your project over come
these challenges?
• Tried to do more translation with the community
itself without involving so much the media
Opportunities to overcome the challenges
• Planning to use every opportunity with the PhD
candidates when in the country
KT Products
• One dissemination meeting with local
stakeholders in Luwero
• Presentation at conference in Tanzania
(November 2014)
• Newspaper article
• Blog article
Additional KT products and
activities for 2015 and beyond
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Dissemination meetings
More newspaper articles
More blog articles
Policy briefs
Media briefings
Support Needed
• Training in media engagement
• Training and editorial support in writing policy
briefs