Table of contents
The Role of Non-Governmental Organizations
(NGOs) in Social Development
A study of Health Sector NGOs in Mbale and Mubende
Districts, 1997
Nafuna Wamai, Ismail Walera and Gimono Wamai
Creative Research and Evaluation Centre
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Table of contents
(Correct pages to be filled during final laying of the book)
Table of Contents
Table of Contents ………………………………………………………………………… ii
Executive Summary ……………………………………………………………………… iii
Abbreviations …………………………………………………………………………
iii
Acknowledgements ……………………………………………………………………… iv
Introduction …………………………………………………………………………
Objectives of the Study ……………………………………………………………………4
Methodology …………………………………………………………………………
6
Findings and Implications ………………………………………………………………
11
District Profiles ………………………………………………………………………… 11
Main NGO Activities …………………………………………………………………… 12
Effects of NGO Activity …………………………………………………………………18
Constraints to NGO Activities ……………………………………………………………22
Criteria for Assessing NGOs Contribution ………………………………………………26
Monitoring NGO Activities …………………………………………………………… 30
Conclusions ………………………………………………………………………………38
Recommendations on NGO Activities …………………………………………………
The Way Forward for NGOs in Uganda ………………………………………………… 41
Appendices …………………………………………………………………………
Appendix 1 References ……………………………………………………………
Appendix 2 List of NGOs……………………………………………………………… 46
Appendix 3 Central and District Level Key Informants……………………………….. 48
Appendix 4 NGO Key Informants…………………………………………………….. 48
Appendix 5 Local and Opinion Leaders and Elders …………………………………. 50
Appendix 6 Community Group Discussants ………………………………………….
51
Appendix 7 Key Informants guide for NGO Officials ……………………………….
51
Appendix 8 Group Discussion Guide …………………………………………………
52
Appendix 9 Research Team …………………………………………………………… 54
Appendix 10 Map of Mbale District …………………………………………………..
55
Appendix 11 Map of Mubende District ……………………………………………….
55
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Abbreviations
ACAO ........................………………...Assistant Chief Administrative Officer
CAO ...........................………………..Chief Administrative Officer
CBO ...........................………………..Community Based Organization
CBR ……………….…………………Center for Basic Research
CDO ............................……………….Community Development Officer
CHDC……………………………….. Child Health Development Centre
CRC…………………………………..
DENIVA ……………Development Network of Indigenous Voluntary Organizations
DHT ...........................………………..District Health Team
DLC............................………………..District Local Council
DMO ………………..District Medical Officer (also called DDHS – Director of District
Health Services)
IMF ............................………………..International Monetary Fund
KCC ...........................………………..Kampala City Council
LC ..............................………………..Local Council
MISR………………………………..Makerere Institute of Social Research
NGO ...........................……………….Non-Governmental Organization
NURRU…………………………...Network of Ugandan Researchers and Research Users
SAPs........................... ……………….Structural Adjustment Programs
UNSCT ......................………………Uganda National Council of Science and Technology
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Acknowledgements
This work would not have been possible without the assistance of the following people:
community members, elders and local and district leaders in Mbale and Mubende district who
accepted to be interviewed. We thank officials of the various NGOs, NGO networks,
National NGO Board and government ministries, for all their co-operation and
accommodating our interviews despite their busy schedules. The NURRU Secretariat is
appreciated for the financial support, and the officials of UNCST for granting the permission
that enabled this work to be accomplished. Our gratitude to Tom Barton of CRC, Kampala,
for his technical assistance. And, lastly, but certainly not least, we thank the research team
who worked tirelessly despite the difficult field conditions.
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Dedication
In recognition of his important contributions and conscientious concern for doing a job well,
we want to dedicate this report to our long-time friend and colleague, Ismail Walera, who
passed away before this report was able to be finalized.
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Background to the Study
Since 1986, there has been a rapid proliferation in Uganda of both indigenous and
international Non-Governmental Organizations (NGOs). The Ministry of Internal Affairs had
registered more than 1,200 NGOs registered by 1995. Both these local and external NGOs
have played an essential role in social and economic development, including efforts against
poverty in Uganda. The contribution of the NGO sector to national development is
sufficiently important to justify measures aimed at reinforcing and promoting the NGO
sector, but there are limitations.
These include:

How to assess NGO contribution to development;

Planning and co-ordination of NGO activities; and

Criteria to use for assessing development.
Objectives of the Study
General Objective
To assess the contribution of NGOs in Mbale and Mubende districts to social development in
Uganda.
Specific Objectives
1. To establish the range of activities and effects of health sector NGOs in development.
2. To find out criteria used for assessing NGOs’ contribution to development.
3. To document the processes currently used to monitor effects of NGO activities and their
indicators.
4. To explore factors constraining measurement of NGO contributions to social
development.
Methodology
This was a descriptive, qualitative and exploratory study carried out in Mbale and Mubende
districts. NGOs operating in the two districts have, therefore, had the opportunity for a
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development orientation as opposed to a relief/emergency orientation. Mubende was selected
as an area of low NGO presence and Mbale as an area of high NGO activity.
Sources of Information
In total, 142 individuals and 30 NGOs participated in this study.
Category of Respondent
National Level/Kampala
Mbale
Mubende
(7)
District Officials
6
8
NGO Representatives
20
7
Local, Opinion Leaders and
16
15
30
33
Elders
Community Members
Key Findings
Background

The majority (more than three-quarters) of NGOs were local NGOs and CBOs.

More than half (56.7%, 17/30) of NGOs visited by the research team were indigenous.
In Mbale district, where there is a longer history of NGO activity, there were many more
NGOs as compared to Mubende. However, there was an equal distribution of NGOs in all
the six counties. For Mubende district, the majority of NGOs were based in Mityana, the
most urban of the four counties.
Activities and Effects of NGOs

NGOs were engaged in a broad range of activities beyond the narrow definition of health.
NGOs have multiple areas of activity, e.g., health services, economic, educational,
religious, and development support. Health services ranked highest for health sector
NGOs in both districts.

The format of registering NGO areas of work by district, county or even sub-county can
be misleading and suggest greater coverage than actually exists in the field.

NGOs' target groups were mainly vulnerable groups - those prone to poverty and ill
health. Gender, age, and socio-economic status were the criteria used to determine
vulnerability. In Mbale where there are more NGOs, and with a longer history of NGO
activity, a broader range of vulnerable groups has been included. While NGOs were able
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to mention the type of groups they target, they were less clear about the size of the target
group. Lack of specific information on size of target groups is a limitation on the extent to
which this variable can be used to assess NGO contributions.

By targeting marginalized groups especially women, NGOs give them a greater
opportunity and role to participate in development activities. There are also increased
opportunities for capacity building and skills development.

Enthusiasm and other positive effects generated by association with one NGO, e.g.,
strengthening local leadership, mobilizing local development committees, and capacity
building have the potential to spread and in the long term be cultivated within the
community.

To some extent, communities have been involved in planning, implementation and
monitoring of NGO activities although levels of involvement vary between NGOs. There
are also varied perceptions on involvement between communities and NGOs.
Participation in implementation is the commonest form of community involvement.
NGOs that are orientated towards capacity building and not just provision of materials
and relief have realized better community participation and ownership.
Monitoring NGO Activities and Assessing their Effects
The criteria for assessing NGOs' contribution to development that were identified during the
study include human resource capacity of NGOs, duration of operation, geographical areas of
operation, and type and size of NGO target groups.
Current strategies for monitoring of NGO activities were through various channels:
 Report writing and information sharing meetings – monthly, quarterly, annually;
 Meeting with target communities; and
 External monitoring and evaluation.
Benefits from these strategies have affected poor documentation and limited information
sharing by NGOs. In the absence of a clear and consistent policy on reporting and
accountability, many NGOs acted as if they had relatively little reporting or information
sharing obligations to the various stakeholders.
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Indicators for Measuring Change of NGO Activities
Indicators mentioned cut across sectors and are mostly quantitative (output and effect level).
The sectors were:

Health (occurrence of disease, quality of services, water and sanitation);

Economic (access to income generation activities);

Education (availability of facilities, enrolled school age children in school, female
education); and

Infrastructure (quality of housing and roads).
The indicators commonly mentioned by communities, NGO and district respondents were
those that were easily observable and tangible and, therefore, more quantitative than
qualitative.
Constraining Measurement of NGO Contributions to Development

While NGOs were working to facilitate development, sometimes they worked in isolation
to district leadership and concerned communities. There was some lack of co-ordination
between the NGOs and district authorities. District officials had limited information on
what NGOs exist in their areas and what they do among the community. There was no
clear policy of location on NGO activity within districts. There was also lack of a clear
and consistent policy (especially at district level) on reporting and accountability
obligations of NGOs.

Concerns about monitoring and attention to specific indicators require quality
documentation including information gathering, processing and sharing. These are
essential prerequisites to the operation of these NGOs. They were, however, found to be
lacking.

Even when assessment of change of development is possible, attribution of this change to
NGOs may be difficult. It may be difficult for NGOs, district officials and communities
to distinguish between achievements attributable to their respective activities and personal
efforts.

Monitoring and supervision of NGOs by districts is weak in part due to lack of a
standardized format (details, how often collected), poor quality of information and
reluctance to share.
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Other Limitations on NGO Contribution to Development

Inadequate funding of NGO activities and dependence on external donor funding;

Non-sustainability of NGO activities;

Unmet community needs and expectations beyond the scope (geography and sectoral)
from an NGO; and

Low involvement of communities in NGO planning resulting in lack of ownership of the
NGO activities by the communities.
“The community is not fully assimilated in some of these projects. People are
hesitant for fear that these NGOs are self-seeking and have their own agenda
and objectives.” (Head-teacher and Community Elder, Bukigai, Mbale)
“Their plans often overrule our needs; even before we request for something
or even need it, we find when they have already given it to us.” (LC I
Chairman, Bulambuli, Mbale)
Recommendations and Way Forward
Improve Community Participation in NGO Activities

Promote community involvement at all stages, i.e., planning, implementation and
monitoring. Enable bottom–top involvement and capacity building of the communities
and ensure sustainability of activities when the NGO completes its life span.
Improve Accountability and Transparency of NGOs

Improve accountability and transparency of NGOs to the community they serve, to
district and national authorities through submission of regular reports to them.
Improve Policy Environment for NGOs

Improve government policies relating to NGO operations both at district and national
level. This would ensure less bureaucracy in the process of NGO registration, equity of
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service, access to services (both physical and economic) and reconciliation between
planned NGO activities and community needs.
Networking

Form and strengthen NGO networks.
Improve Monitoring of NGOs

Establishment of an NGO desk at every district to enable NGOs receive the necessary
guidance from the districts, e.g., on selection of geographical areas, target groups, and
activities to be done.

By-laws that strike a balance between an NGO being semi-autonomous from the district
leadership but at the same time ensuring transparency of the NGO. For example, balance
on funding (amount and source), human resource and target groups (size, location and
special needs). By-laws that guide the registration of an NGO in a district and that enables
a district to de-register an NGO that does not comply with district needs.

Districts should directly involve NGOs in their plans and budgets with integration of
NGO plans in district strategic plans. Districts should systematically increase the
monitoring of NGO activities in a participatory manner that involves all stakeholders
including the community.

Establishment of district/NGO/community information systems that enable the flow of
information from communities to the districts and vice versa.
Existing Opportunities for Further NGO Activity
Presence of a national NGO Board and national NGO networks, e.g., National Association of
Women Organizations in Uganda (NAWOU) and Development Network of Indigenous
Voluntary Organizations (DENIVA).

Government policies that have favored development of the private sector.

Existence of district leadership structure through the LC administrative structure (LC I to
V) that provides an opportunity for levels of community participation.

Existence of community development committees, e.g., Parish Development Committees
through which NGO activities could be channeled.

Unmet community needs that require assistance from NGOs.
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NGOs have contributed to the wellbeing of the communities they serve. Orientation to
capacity building and greater commitment to participation (from NGOs, communities and
district leadership), better documentation and information management, will strengthen and
make it possible to measure NGO contribution to development.
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Introduction
Chapter 1.
Background to the Study
1.1 Background of NGOs in Uganda
During the colonial period, most NGO activity in Uganda was restricted to humanitarian and
missionary causes. There was, however, a formalization of voluntary services led by
churches, primarily in education and health care. During the early post-colonial era,
indigenous NGOs were not very active. This was reflective of the repressive political
situation as well as the socio-cultural climate in the country at the time. Churches, however,
remained significant during the Amin regime when most managers of NGOs either fled the
country or cancelled services. In the virtual disintegration of the state under the governments
of Milton Obote and Idi Amin, it became necessary to incorporate autonomous self-help
organizations and NGOs to fill in the vacuum (Dicklitch, 1998).
Since 1986, there has been a rapid proliferation of both indigenous and international NGOs in
Uganda (Kwesiga and Ratter, 1993). By 1995, more than 1200 NGOs had been registered
with the Ministry of Internal Affairs (Barton and Bizimana, 1995). NGOs include locally
constituted agencies, locally based international agencies, and external organizations. NGOs
provide many forms of support to communities, including religious, educational, literary,
agricultural, social or charitable. NGO contributions can also be classified as technical
(capacity building, skill and knowledge); resources (equipment, supplies and funds);
liaison/linkages with other agencies and advocacy. In the period of relative peace since 1986,
there has been a shift in focus of the NGO activity from relief to development (Kwesiga and
Ratter, 1993).
1.2 Statement of the Problem
It is now over a decade since Uganda adopted the World Bank and the International
Monetary Fund (IMF) sponsored Structural Adjustment Policies and Programs (SAPs).
Although economic growth has been registered at a national level during this time, poverty is
still a critical issue in much of Uganda (Lore, 1993). Local NGOs and external organizations
have played an essential role in social and economic development including efforts against
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Introduction
poverty and toward alleviating some of the negative impacts of SAPs. The contribution of the
NGO sector to national development is sufficiently important to justify measures aimed at
reinforcing and promoting the sector. There are, however, some limitations.
The main ones are:
How
to assess this contribution;
Criteria
for assessing NGOs and development are varied; and
Planning,
coordination of and documentation by NGOs is inadequate.
1.2.1 How to Make Assessments
The specific contributions of NGOs to development are difficult to assess. There is limited
information on NGOs, it is difficult to find out what NGOs are doing and where they are
operating. Indicators for measurement vary between different NGOs, between NGOs and
government and between NGOs, government and communities. Efficiency, effectiveness and
measurement of achievements against set objectives are difficult to assess. Lack of
information leads to lack of understanding, competition, or even conflict between
government and NGOs or between NGOs.
The ability to measure NGO contributions to development and to make comparisons between
different NGOs is complicated because of the varied activities in which they are involved.
Social development programs encompass a broad range of activities designed to improve the
quality of life. This is done through improving people's capacity to participate fully in social,
economic and political activities at the local and national levels. Programs may focus on
improving physical well-being, providing access to services, protecting vulnerable groups,
providing education (and/or literacy), employment and income generating activities (Valadez
and Bamberger, 1994). This range adds to the complexity of comparing contributions by
different NGOs. How, for example, does one compare between an NGO that is providing a
service (health or education) with one involved in advocacy and lobbying or even one
providing technical support and capacity building?
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1.2.2 Criteria for Social Development Vary
Social development, the aim of many NGOs, typically crosses sectoral boundaries and thus
sits uncomfortably with the efforts of many line ministries or sectorally specialized agencies.
Criteria for assessing NGOs are varied, and there is no standard way to measure social
development. Recognition that development is cross-sectoral and multi-faceted leads to a
search for indicators of achievement that cut across sectoral divides (Marsden et al, 1994).
A case study of CARE (Uganda) and its contribution to development identified three
categories of indicators that could be used to measure development including: economic,
social and demographic indicators. Of recent, the effect of projects on the environment is also
considered as an indicator of development (Asea, 1993).
Robinson (1990) identified four criteria, which could be used to measure the qualitative, noneconomic impacts of poverty alleviation programs, as follows:

Effectiveness - the degree by which NGO program or project objectives are being
achieved and measured against the resource costs incurred in achieving them.

Efficiency - the rate at which inputs are converted into outputs in the form of program or
project impact.

Impact - is associated with the broader consequences of a development project and goes
beyond the direct benefits arising from the intervention itself, for example, economic,
social, technical, and environmental.

Sustainability or viability - the long-term continuation of a project following withdrawal
of external support.
In assessing development activities of NGOs in developing countries, Barnett (1988) has
pointed out some additional concerns in measurement. Assessments should not assume that
only one pattern of development (particularly the Western type) is recognized. The indicators
must not assume that the values of ‘development’ are the same in all societies. The criteria
should measure results, e.g., how many people can read and write rather than inputs, i.e., how
much has been spent on education. The criteria must reflect the distribution of social
benefits. It should not use mean averages, which may disguise serious mal-distribution of
benefits. (Barnett, 1988).
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1.2.3 Inadequate Planning and Co-ordination of NGOs
NGO planning has been haphazard and often lacking government input about equity of
coverage, both in focus of activity and geography (Barton and Bizimana, 1995). There is no
adequate policy framework for co-ordination of NGOs in Uganda, including systematic ways
to link NGO efforts with government plans, policies and programs. Government has not yet
established a coherent, comprehensive set of rules and guidelines for the NGO sector or for
government in dealing with the NGOs (Kwesiga and Ratter, 1993). The only formal policy is
the NGO Registration Statute of 1989, requiring registration with the Ministry of Internal
Affairs.
NGOs are expected to present their financial plans to the Ministry of Finance and Economic
Planning (but it has no database), and review their projected activities with the NGO Desk in
the Prime Minister's Office (which also has no database) (Barton and Bizimana, 1995).
Another government agency involved in monitoring NGOs is the Ministry of Gender, Labor
and Social Development. This large number of agencies involved in regulating and
controlling NGOs tends to hinder and further bureaucratize NGO activity in social
development rather than help them (Dicklitch, 1998). Although NGO Co-ordination Boards
have been proposed at district level, there is no written policy about it yet.
Linked with limited controls, NGOs can have negative effects. Among the difficulties
associated with NGOs have been verticalization of programs, isolation and lack of coordination, lack of integration, top-down approaches and alien agendas.
1.3 Objectives of the Study
1.3.1 The Research Questions
This study explored the following questions:
1. What are perceptions of key stakeholders about potential variables for assessing the
contributions of NGOs to social development at district level?
2.
How can NGO contributions be assessed (especially in ways that permit comparisons)?
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The study focused on health-related NGOs and aimed to yield suggestions from multiple
stakeholders about how to assess, and improve co-ordination of NGO/government
interactions.
1.3.2 General Objectives
To assess the contribution of NGOs in Mbale and Mubende districts of Uganda to social
development and explore how this contribution can be measured.
1.3.3 Specific Objectives
1. To establish the range of activities and effects of health sector NGOs in development.
2. To find out the criteria used for assessing NGOs’ contribution to development.
3. To document the processes currently used to monitor effects of NGO activities including
indicators.
4. To explore factors constraining measurement of NGO contributions to social
development.
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Methodology
Chapter 2
Methodology
This was a descriptive, qualitative and exploratory study.
2.1 Study Area
The study covered Mbale and Mubende districts. The two districts have enjoyed periods of
relative peace with no large-scale civil insecurity/instability. NGOs operating in the two
districts have, therefore, had the opportunity for a development orientation as opposed to a
relief/emergency orientation. The rationale for selecting Mbale and Mubende was also to
assess whether the ability to measure contribution to development varies between districts
having many NGOs or few NGOs. Variations in perceptions of equity and quality between
the two districts were also assessed. Based on a recent review of NGOs in the health sector
by district, Mubende was selected as an area of low NGO presence and Mbale as an area of
high NGO activity.
2.2 Study Population and Sources of Information
The study population included all NGOs addressing health-related issues (including locally
constituted agencies, locally-based international agencies, and purely external donor
agencies) in Mbale and Mubende districts, and the communities they serve. Out of the
inventory of NGOs operating in the districts, specific information was collected from and
about NGOs providing the following services:

Improving health, promotive and preventive as well as curative services (health, nutrition,
mental, reproductive).

Providing access to services (housing, water, education, and literacy).

Protecting vulnerable groups from any adverse consequences of socio-economic reforms,
e.g., providing employment and income-generating opportunities.
The research team visited a total of 30 health sector NGOs (23 for Mbale and 7 for
Mubende), see Appendix 4 for full listing.
In total, 142 individuals participated in this study. For a full listing of respondents and
NGOs, see Appendices 3, 4, 5 and 6. The table below summarizes the respondent categories.
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Methodology
Table 1: Study Respondents
Category of Respondent
Number
Central Level/Kampala District
7
Officials
District Officials
- Mbale
6
- Mubende
8
NGO Representatives
- Mbale
20
- Mubende
7
Local, Opinion Leaders and Elders
- Mbale
16
- Mubende
15
Community Members
- Mbale
30
- Mubende
33
2.3 Variables, Information Needs and Tools for Data Gathering
Information for the study was collected according to the following variables and information
needs.
Table 2: Variables and Information Desired
Variable
Information Desired
Activity and
NGOs activities vs. district priorities; influence of activity by the
Geography
presence of other NGOs; NGO plans and activities compared to
district plans; NGO participation in district planning.
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Impact
Social and cultural impact: perceptions of change in income
distribution, health, education, gender roles and community
participation. Economic impact: perceptions of change in
consumption, savings, and asset levels.
Performance of
Criteria used by NGOs, districts and communities being served.
NGOs
Equity
Equity of activity vs. need; geographical equity within the district,
and equity for various population groups, for example, by age,
gender, disability or other aspects of marginalization or
vulnerability. Perceptions of greater social equality, existence of
non-hierarchical relationships among people.
Quality
Quality (and its measures) was explored from the different
perceptions of the district leadership, beneficiary communities and
from the NGOs.
Sustainability vs.
NGO contribution was assessed, i.e., whether it was encouraging
NGO Self-
sustainability or ensuring demand for the services provided;
propagation
flexibility and adaptability to prevailing needs in the target area or
population.
Policy
Existing policy guidelines/regulations, effect of guidelines on
NGO activity, facilitation or inhibition. Perceptions of
government, district and NGOs about policy needs.
2.3.1 Data Collection Tools
Data was collected using qualitative methods and tools, which included the following:

An assessment form/checklist about the study NGOs

Key informant interviews

Focus group discussions with community persons

A review of documents produced by or about the study NGOs were reviewed, e.g.,
project documents, needs assessments, routine reports, etc.
(See Appendices 7 and 8 for copies of data collection tools.)
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Involvement of the Community and other Research Users
In-depth study involved selections of NGOs in consultation with the district leaders who were
aware of the activities of NGOs (guidance was sought from the CAOs in both districts). The
NGO board and members of the National NGO Forum were also consulted and interviewed
during this study.
The research assistants were selected from the participating districts of Mbale and Mubende.
In selecting the research assistants, an attempt was made to get a balance between
government departments, NGOs and community persons. Research assistants also
participated in the preliminary analysis of data.
At the end of the data collection exercise, seminars were held to disseminate the preliminary
findings of the study. The participants in these seminars included district leaders and
community and NGO representatives in each of the two districts. This served as a strategy to
validate the findings and to allow immediate use of the study findings in the respective
districts. It is expected that the final report will be circulated at the national level, district
level and to the participating NGOs. The study report will also be made available to research
institutions e.g., Center for Basic Research (CBR), Makerere Institute of Social Research
(MISR), CHDC, CRC.
Ethics
At the national level, the research protocol was cleared with the UNCST. In each district, the
district leadership was informed of the study and their approval sought. The right of NGOs
and individuals to participate or not as key informants was also respected.
Study Limitations
Every effort has been made to reflect accurately on what the research team was told and to
protect confidentiality. The data and views in the report are those of the staff and community
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Methodology
members interviewed. The conclusions drawn are the authors’ and any inaccuracies,
therefore, remain the responsibility of the authors.
Quality Control and Data Management
Training: Seven research assistants were recruited on the basis of maturity, open-mindedness
and previous experience in interviewing. After selection, a two-day training session was held
in Mubende to familiarize the interviewers with the study instructions and update them on
interviewing skills, recording of answers, translations, etc.
Pre-testing: Pre-testing of the data collection instruments was done at Buwaata Primary
School and Ntungamo village in Kasambya sub-county, Mubende district. This exercise
helped to ensure clarity and appropriate sequencing of the questions.
Data Cleaning At the end of each interview, the interviewer checked to make sure all
questions had been asked and answers clearly recorded. The research investigators checked
all the completed questionnaires at the end of each day.
Coding open-ended responses in the NGO record retrieval sheet were coded before data
entry. This was done based on the range and frequency of observed responses. Responses
from the KI interviews and group discussions were coded according to emerging themes.
Data Entry and Analysis: Open-ended responses on the NGO record retrieval sheets were
entered and analyzed with the ASKSAM database software package. Data validation for the
questionnaires was done by a program in-built system.
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Findings
Chapter 4
Findings and Implications
4.1 District Profiles
4.1.1 Mbale District
Mbale is one of the eastern border districts of Uganda located about 240 Km to the east of the
capital, Kampala. The district shares borders with Kenya to the east and with the districts of
Kapchorwa to the Northeast, Moroto to the north, Kumi and Pallisa to the west and Tororo to
the southwest. Mbale comprises six counties of Bulambuli, Budadiri, Bungokho, Manjiya,
Bubulo and Mbale Municipality. The six counties in turn comprise 30 sub-counties (See
Appendix 10 for a map of Mbale district).
4.1.2 Mubende District
Mubende district is located about 140 km to the west of the capital, Kampala and covers an
area of 5237 square kilometres. It borders the districts of Kiboga to the north, Luwero and
Mpigi to the east, Masaka to the south, Hoima and Kabarole to the west and Kibaale to the
northwest (See Appendix 11 for a map of the district).
This district comprises four counties of Buwekula, Busujju, Mityana and Kassanda that in
turn comprise 18 sub-counties. The district has two town councils (Mityana and Mubende),
the latter housing the district headquarters. Mubende is predominantly an agricultural district
with 62.2% of households depending on subsistence farming as a principle source of
livelihood.
Table 3: District Profile of Mbale and Mubende
Characteristic
Mbale
Mubende
National
District
District
District Population (1991 census)
710, 908
497,500
16,671,000
Population Density (people per sq.
283.9
84.2
85
11
19
291
km)
Number of Government Health Units
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Number of NGO Health Units
11
12
Population within 5 km of Health
81%
30%
49%
Population per Health Unit
30,913
55,667
24,754
Infant Mortality Rate (IMR)
129
119
122
Under-five Mortality Rate
216
198
203
AIDS Cases per Million Population
619
1689
23,141
Latrine Coverage
30%
60%
47.6%
Rural Water Coverage
26.4%
14.4%
26.4%
Unit
(Source: Barton and Wamai 1994)
4.2 Main NGO Activities
Categories of NGOs:
Of the 30 NGOs visited by the research team, more than half, (56.7%, 17/30) were locally
based. The majority was based in Mbale district, 65.2% (15/23) as compared to Mubende
district with28.6% (2/7) (See Appendix 4 for details).
Most of the NGOs focussed on health. In addition, some NGOs are involved in economic,
educational, religious, and development support.
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Table 4: Main NGO Activities
Mbale
Main NGO Activity
Number of
Mubende
Rank
NGOs
Number
Rank
of
NGOs
Health Services
14
1
7
1
12
2
3
2
10
3
3
2
Evangelism
8
4
-
4
Education (Formal, Informal)
8
4
3
2
Provision for Needy Groups (Shelter, Food,
7
5
-
-
5
6
2
2
5
6
-
4
5
6
3
2
(Curative, Maternal and Child Health, Family
Planning Health Education, Water and
Sanitation)
AIDS activities
(IEC, Treatment of PWAs, Social Support to
PWAs, HIV Testing and Counselling
IGA/Credit/saving (Education, Provision of
Loans)
Clothing)
Agriculture/Nutrition/Environmental Services
(Education, Provision of Seeds, Food
Supplements
Rehabilitation/Resettlement Displaced
Persons
Infrastructure Development/rehabilitation of
Health Units, Schools, Roads
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4.2.1 Health-related Activities
4.2.1.1 General Health Services
NGOs are involved in the provision of general health services, including the provision of
drugs and sundries, training health workers, and health education of communities on
domestic hygiene, water and sanitation.
Often, the presence of NGOs improves access to health care through construction of NGO
health units and stocking these with drugs. Some NGOs have further enhanced physical
access through the construction or repair of roads, as one respondent said:
“We appreciate because the services have been brought nearer to us the
community. Instead of going to Mbale Hospital, we are saved the expense of
transporting ourselves”. (Community Member, Mbale)
For example, at Walanga Dispensary (Mbale district), patients receive treatment at subsidized
rates, have credit facilities exits and they no longer have to travel all the way to Mbale
Hospital for simple ailments. Some respondents further observed that there were now fewer
patients attending the clinic, which was attributed to a reduction of preventable disease
episodes following health education activities by NGO staff.
4.2.1.2 Maternal and Child Health Services
The Private Midwives Association and Namunsi Birth Attendants Association of Mbale are
involved in improving the health of mothers and children through mobilizing pregnant
women to attend antenatal and postnatal clinics. At these units, family planning services are
provided and high-risk patients are screened for referral. Also provided are immunization
and health education services, education on nutrition for mothers and their children, personal
and domestic hygiene, water and sanitation activities and control of diarrhoeal diseases
through the preparation of oral rehydration salts (ORS).
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Respondents in Mubende said that NGO-related health education efforts had mobilized and
sensitized the community on the importance of preventive behaviors such as immunization
and family planning. A key informant in Mubende explained that mothers regularly attend
clinics; more mothers give birth in the NGO-supported health unit, while those who are not
able to come to the health unit have been assisted by Traditional Birth Attendants (TBAs) as
observed below:
“These people found us in a poor state but today the TBAs assist women in
labour instead of women walking all the way to Mubende or Kasambya.
Women used to die in labour but now each LC1 has at least two TBAs.”
(Local NGO Person, Mubende)
4.2.1.3 AIDS Activities
At least 15 NGOs are involved in various AIDS activities, including preventive education on
HIV transmission, provision of condoms, care of People With AIDS (PWAs) (treatment,
counseling and home visits) as well as support to AIDS orphans. Some of the NGOs in both
Mbale and Mubende districts that are involved in AIDS activities are doing so in
collaboration with other NGOs working in the same geographical location, as one local leader
observed:
“They have taught us how to use condoms and they supply us with them. They
give them to people they have trained. Each LC 1 has a number trained to
counsel others on AIDS and this member distributes condoms to the society.”
(Local Leader, Butawata, Mubende)
4.2.1.4 Water and Sanitation Activities
There were two main forms of assistance for water and sanitation – construction and health
education. In Mubende, Action AID Buwekula is assisting communities with spring
protection. The NGO is providing external resources (corrugated iron sheets and money),
while communities provide other locally available resources, such as sand, bricks and labor.
In Mbale, Water AID has worked with Bubulo on community water improvements by
providing water storage tanks, water pumps and pipes. Members of the communities then
provide labor to set up these tanks. MADZI, another Mbale NGO, has constructed a gravity
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water scheme and some VIP latrines at health centres that are used for demonstration
purposes.
As an example of health education, the Ntungamo Women’s Club in Mubende is involved in
sanitation and hygiene education to mothers, e.g., boiling drinking water and domestic
hygiene.
4.3 Economic Activities
Although the sampled NGOs were chosen principally for their work in health, many of them
were involved in various activities to assist communities with improving their economic
status. Some economic benefits have been direct, for example, Salem Brotherhood has
provided employment to community members (clinical officers, nurses, teachers and
watchmen are employed at the NGOs health units and schools).
Another relatively common approach favored by NGOs and communities is the use of small
loan schemes. Community members, especially women, are sensitized on possible income
generating ventures, provided with information on costing and savings, and then given small
loans. NGOs are promoting venture involvement in handicrafts, poultry and livestock
farming and running of retail shops. Some women have been involved in planting and selling
agricultural products including timber after receiving loans through NGOs (FOCCAS and
Salem Brotherhood). There are women in Mbale who have received heifers under the
Uganda Women Concern Ministry (UWCM) and Christian Children Fund (CCF).
Indirect economic benefits have also come about because of NGOs activities. Participants in
Mbale said that some youth who had been redundant before the establishment of the NGO
dispensary at Namaitsu are now earning a living by transporting people to and from the
health unit (boda boda cyclists). In Mubende, adult literacy classes provided for the
community by Action AID Buwekula have enabled better savings by members when they
receive loans.
Also, community members, especially women, in Mbale believe that NGO-related efforts
toward economic improvement have raised the standard of living for their respective families.
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They can now afford to send their children to school and provide them with nutritious meals.
Key informants in Mubende cited improved education infrastructure both in number and
quality (from none at all or mud and wattle to brick/ iron sheets structures) as one respondent
observes thus:
“Many of us are contented with the education facilities that have been
provided. In fact, when a child goes to school, he is likely to come back with
fairly clean clothes since he now has somewhere to sit.” (LC3 Secretary for
Information, Buyaga, Mbale)
4.4 Orphan Support Activities
A local leader in Mbale said orphan support, especially to AIDS orphans, is provided by
NGOs through orphanages or support to foster parents in the form of school fees and
scholastic materials. Older orphans are sometimes supported in vocational training schools
through provision of fees and supply of equipment, and are assisted in acquiring jobs after
completion of courses.
4.5 Agricultural/environmental Activities
Some NGOs are involved in environmental protection activities, especially tree planting of
fast growing trees such as eucalyptus. The timber is subsequently sold and the proceeds
shared or used by members in the construction of their own homes. One local leader observed
thus:
“They also help in teaching the community about environmental protection,
e.g., soil conservation through contour stripping and mulching. They also
teach the community about the advantage of zero grazing of the local stocks.”
(Local Leader, Bubulo, Mbale)
Furthermore, Ntungamo Bakyala Twekambe, a community based organization (CBO) in
Mubende, has mobilized women in agricultural activities that involve rotational cultivation of
each other’s gardens. Part of the produce is saved for home consumption while the rest is
sold and the money shared out amongst group members.
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4.6 Infrastructure Development
Several NGOs have been involved in the construction of schools and health units, as in the case of
Action AID Buwekula (Mubende) and Walanga (Church of Uganda Dispensary, Mbale). These
NGOs provide some construction materials (especially corrugated iron sheets, cement and transport
for materials), while the communities provide sand and labor. In some situations, the community also
provides the land on which the buildings are erected. Community members in Mbale said that these
infrastructure projects have sometimes been the seed for further development, citing the mushrooming
of small trading centres around NGO dispensaries, e.g., Namaitsu where permanent commercial
buildings have been erected.
NGOs are also involved in several other areas of construction, such as provision of
construction materials for housing. Action AID Buwekula (Mubende) and ADRAA (Mbale)
are using this approach in providing improved low cost housing to the rural communities and
urban poor (for example, in municipal slum areas of Namatala, Mbale). NGOs are also
involved in the improvement of water and sanitation through spring protection, construction
of drainage systems, and provision of hygiene education to communities. Roads have also
been constructed or repaired through the efforts of Action AID Buwekula in Mubende and
Uganda Red Cross in Mbale, thus improving access to markets, health units and other
services.
Implications
The NGOs visited in both districts are engaged in a broad range of activities beyond the
narrow definition of health. Their activities aim at solving specific problems as well as
improve the health, social and economic wellbeing of individuals, families and communities.
4.7 Effects of NGO Activity
4.7.1 Community Cohesion
NGO activities have bred enthusiasm among people and groups who work together during
community activities as one respondent noted:
“Under the Buwekula Women Development Association (BWDA), groups have
realised the importance of working together, keeping records, accountability
and having a focused vision.” (BWDA Co-ordinator, Buwekula, Mubende)
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Action AID Buwekula staff members further explained that the community capacity to
identify, prioritize and plan to solve their own problems had been enhanced through
involvement with the NGO. They said that the spirit of voluntarism among the community
had improved community members' view the project and activities as their own and do not
wait for coercion to participate.
4.7.2 Community Involvement in NGO Activities
According to NGO representatives in Mbale and Mubende, communities have been involved in
planning, implementation and monitoring of NGO activities.
4.7.3 Points of Entry
LCs provide an important functional and rapid link between NGO and the community. The
LCs are often the entry point for NGOs into the communities. Respondents explained that
NGO staff first sensitized the LCs about their objectives and the LCs in turn mobilized the
communities. In other instances, NGOs have established community links through existing
resource persons in the community, for example, traditional birth attendants (TBAs), CHWs,
elders and opinion leaders.
In Mubende, community members explained that NGOs had facilitated establishment of
Parish Development Committees (PDCs) and sub-committees at parish and village levels.
These committees act as a link between the NGOs and the communities, and are responsible
for the dissemination of information both to and from the community.
The LCs and development committees are also responsible for calling community meetings
that solve any problems that may arise, and ensure smooth operation of the projects, as one
respondent observed:
“They picked the locals of the area who were trained in various capacities
and these always supervise the activities of the project”. (Group Discussant,
Ntungamo, Mubende District)
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4.7.2.2 Community Involvement in Planning of NGO Activities
In Mubende, respondents were satisfied with the plans of Action AID Buwekula, which they
considered to be in line with local plans and activities. However, they explained that this was
not the case at the inception of the NGO’s activities in the area. At inception, the NGO
simply imposed its plans on the community
Action AID Buwekula staff explained that at the beginning, the NGO was more forceful and
imposing, but later changed to more community participation. This was done through
formation of local committees and direct involvement of communities in planning,
implementation and monitoring of the project activities. This change of strategy enabled
communities to appreciate the NGO activities as their own. One LC1 Secretary in this respect
observed thus:
“The NGO creates awareness amongst the community through seminars. The
people get to understand their status, problems and resources at their
disposal. This enables the community to welcome such an NGO and work with
it.” (LC I Secretary for Women, Buswabulango, Mubende)
In Mbale, respondents were similarly satisfied with NGO plans fitting with their own local
plans and activities, especially for Uganda Women Concern Ministry and Kiseyo Women
Association. Respondents in Buyaga, Mbale explained that they are involved in budgeting
and planning with the NGO staff. The NGO staff members usually go through the problem
identification process with the community, after which community members are asked to
prioritize their problems before joint planning is then carried out. This process was described
for SIDA, BBYA, Uganda Red Cross Society and Namaitsu in Mbale and Action AID
Buwekula in Mubende thus:
“We identify our problem and then consult the organisation for discussions.
Meetings are convened to consider the priorities of the area. We thus have a
close linkage with the activities of the organisation.” (Community Member,
Bulambuli, Mbale)
In Buyobo, Mbale, however, community respondents explained that they are involved in only
a small part of the planning process, e.g., in identification of areas where activities are to be
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located. Most of the NGOs' activities are reportedly imposed with little or no involvement of
the target communities. Community members in both Mbale and Mubende also cited secrecy
and lack of transparency with some NGOs in budgeting and funding, leaving the relationship
between NGO staff and the communities strained, as one LCIII councilor explained:
“The planning process comes from the NGO; they just inform us of their
agenda and then bring it to the committee for approval or disapproval. The
committee to some extent has a say on the major decisions of the project
although it comes while already designed from above.” (LC III General
Secretary, Buhugu, Mbale)
4.7.2.3 Community Involvement in Implementing of NGO Activities
Participation in implementation is the commonest form of community involvement. The
community in Action AID Buwekula area explained that they are directly involved in the
construction of schools and health centres. Communities contribute by providing land and
building materials such as sand, stones and bricks while the NGO provides cement,
corrugated iron sheets and transport for these materials. In Mbale district (Bududa Subcounty), community members contribute to development through monthly subscriptions,
which are determined by the community and are affordable to the majority. The NGO
provides the extra funds required in completing a project.
Implications
Enthusiasm and other positive effects generated by association with one NGO could always
spread and be used on other developmental activities, and in the long term, be cultivated
within the community. Using the existing local leadership systems helps to strengthen them.
It also improves the confidence of the community in their local leadership. If successful and
useful, committees are mobilized by one agency, they could also be used for other activities
in their communities.
The level of NGO commitment and expertise in involving communities is varied. For some,
it comes after realising that communities are not merely passive recipients but prefer a more
active role in activities that are supposed to benefit them. Thus, NGOs that are oriented
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towards capacity building and not just provision of materials and relief have realised better
community participation and ownership.
4.7.3 Gender-related Benefits
The involvement of women in NGO activities has empowered them on both economic and
social fronts. Key informants in Mbale said that women as a group have had significant
improvements in their economic status through proper utilization of grants for IGAs. Women
who are able to earn a living from such IGAs are not only able to improve the standard of
living in their families, but they have also become less economically dependent on their
husbands, as one woman councilor observed:
“There is a general improvement in incomes in villages. Here a woman can
easily buy the domestic needs other than wait for her husband to provide
everything.” (LC I Women Representative, Bungokho, Mbale)
Respondents in Mbale also said that economic empowerment had improved the awareness
and assertiveness of women who are now earning an income. Increasing numbers of women
are participating in community activities because they are no longer held back by their
husbands, since the men have themselves realized the benefits of the activities of the
respective NGOs.
Due to capacity building and establishment of IGA projects, respondents are confident about
the sustainability of their IGA when NGOs close, as observed below:
“We shall be able to sustain ourselves because many of the families have tried
to invest. Some have shops, land, trees and animals.” (LC3 Secretary for
Information, Buyaga, Mbale)
“When the project closes, we shall be able to sustain ourselves because many
of the families have tried to invest. We have acquired shops, land, trees and
animals.” (Local Leader, Bubulo, Mbale)
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Implications
By targeting marginalized groups, especially women, NGOs give them a greater opportunity
and role to participate in development activities. There are also increased opportunities for
capacity building and skills development.
4.8 Constraints to NGO Activities
4.8.1 Unmet Community Needs and Expectations
Key informants in both Mbale and Mubende explained that the community has several
problems most of which cannot be addressed by a single NGO. Among the problems
mentioned include high prevalence of disease, especially malaria, with a high mortality and
morbidity among infants, lack of safe water, poor social infrastructure, poverty and low
literacy. NGO staff said that communities often expect NGOs to solve all their problems and
in so doing often get disappointed on learning that this is not possible. This often leads to the
community getting dissatisfied with the NGO and declining to effectively support its
activities.
4.8.2 Inadequate Mobilisation and Involvement of Communities by NGOs
Respondents in Mbale explained that often NGOs do not fully involve the communities in
planning, implementation and monitoring of activities (see earlier section of this report).
This leads to lack of ownership of the NGO activities by the community since the community
and NGO's plans do not tally, as observed below:
“The community is not fully assimilated in some of these projects. People are
hesitant and fear that these NGOs are self-seeking and have their own agenda
and objectives.” (Head-teacher and Community Elder, Bukigai, Mbale)
“NGO's plans often overrule our needs, even before we request for something
or even need it, we find when they have already given it to us.”(LC I
Chairman, Bulambuli, Mbale)
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4.8.2 Non-Involvement/Low Involvement of Communities in NGO Plans
There were mixed opinions on the level of community involvement. For example, in Mbale,
some community key informants were concerned that NGOs like Salem Brotherhood do not
work with the community in anyway apart from the few locals who are employed as
members of staff. NGO staff, however, explained that communities often have very high
expectations from NGOs. Some community members are against payment of user fees and
expect free treatment and even employment, despite lacking the necessary qualifications.
Respondents in Mbale explained that they are not consulted during the preparation of NGO
plans because these NGOs depend on donors who dictate what activities the NGOs should
perform. Respondents further explained that when they realize that NGOs have “pre-set” or
"foreign” plans and activities, then they just carry along or abandon the NGO’s activities
altogether. They observed thus:
“This organisation is timely and it addresses the needs of the day only that
they never consult us. They set up their activities according to their own plan
designed by them but does not even incorporate the LC plan.” (CDO, Mbale)
“How do they expect the community to monitor when we are not involved in
prior plans? We can only lament at their work and since it is a private
organisation, we do not have much to say.” (Local Leader, Mbale)
NGO staff also cited negative publicity of NGO activities by unscrupulous politicians and
other members of the society who instead tarnish the image of NGOs. This happened
especially during election time (parliamentary and local council representatives), where
politicians wanted to attribute the work of NGOs to their own effort. NGOs that did not carry
along with such plans were then termed “anti-development.”
“Some local leaders are like presidents in their areas and often become
barriers to the NGO’s objectives.” (NGO Co-ordinator, Mbale)
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4.9 NGO-Related Problems
4.9.1 Physical Location and Activities of NGOs
Key informants at district level explained that some NGOs have in the past not been screened
at district level and find their way into districts, and decide on their own where to work.
Often, these NGOs offer services that people do not need or duplicate those of already
existing agencies.
Secondly, community respondents in Mbale said that some NGOs are reluctant to operate in
the most needy areas, many of which are under-served rural areas far from district
headquarters. One respondent in this respect observed thus:
“Geographical factors have hindered the feasibility of Action Aid’s projects in
areas where they are much needed and yet the same services have been set up
elsewhere in the neighbourhood. The disgruntled section of the target
community looks at the NGO as practising favouritism and partiality”. (Local
Leader, Buwekula, Mubende)
Some national and district level key informants observed that there are briefcase type NGOs,
with no physical address. They solicit for and receive funds, which are finally not used on
the intended beneficiaries, as one councilor observed:
“Personally I have problems with NGOs that appear on those lists and yet are
not present on the ground. Some of these NGOs are not addressing
community needs but serving their own personal problems.” (LC3 Councillor,
Maluku, Mbale)
4.9.2 Organisation and Staffing
Some NGO coordinators reported lack of adequate staff, equipment and supplies to run their
activities. This reportedly results in creating little or no impact on the intended beneficiaries.
4.9.3 Lack of Transparency of NGOs
Key informants at district and national level explained that NGO staff members are
occasionally secretive about their functions in a given area, especially about funding sources
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and amount procured. This often leads to inadequate planning and co-ordination of the NGO
in district /national plans, as observed below:
“Some NGOs are not open. It is not easy to get all the information on what
they are doing.” (Welfare and Community Services Secretary, Kampala City
Council (KCC))
Key informants at national and district level further explained that NGOs sometimes falsify
records in order to be seen to be working, but often do not represent a true picture of the
actual activities, as observed:
“Sometimes they give you figures and numbers of people they are helping but
they often exaggerate.” (Welfare and Community Services Secretary, KCC)
4.9.4 Inadequate Funding of NGO Activities and Dependence on External Donor
Funding
Many NGO staff in both Mbale and Mubende explained that some of their activities are not
carried out as expected due to inadequate funding. This arises from delayed funds, less than
expected release of funds from donors, or the absence of alternative donor sources. These
financial problems arise from poor planning of activities and, therefore, inadequate support
from both the communities and other agencies in the region. Community members in Mbale
said some NGOs and CBOs have a donor dependency syndrome and are unable to sustain
their activities when funding from these donors ceases.
4.9.5 Non-sustainability of NGO Activities
One community member observed thus:
“When the project ceases to operate we shall realise that many of the families
will stand to lose because we have been propelled into a situation where we
are provided with everything. When the NGO goes, we will be at a
loss.”(Community Member, Bulambuli, Mbale)
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Respondents expressed the problem of several NGOs not preparing their communities for
sustainability of activities at the end of their project periods, i.e., from relief provision to capacity
building.
4.9.6 Unaccomplished NGO Objectives
Both central level and community respondents said some NGOs come to communities
promising certain activities for them but these are not always fulfilled. Yet communities are
not always given an explanation as to why the objectives are not met, as explained below:
“In the case of ACET, it does fulfil its purpose. It does education and training
of communities but not caring for those infected with and affected by AIDS.
This is wrong because we are told the initials stand for AIDS Care Education
and Training.”(Community Member, Bulambuli, Mbale)
4.10 Government/District Related Problems
Community members mentioned lack of a government policy guiding the establishment and
activities of NGOs, both at central and district level. Secondly, one NGO coordinator
mentioned that district leaders often take advantage of the existence of NGOs in their areas to
satisfy their personal political motives. This he said tarnishes the image of the NGOs.
4.11 Criteria for Assessing NGOs Contribution
4.11.1 Human Resource Capacity of NGOs
Human resource capacity (size and skills) was one of the criteria that emerged as a potential
for assessing NGO contributions. The size of NGOs in terms of human resources (both paid
staff and volunteers) was not established for all NGOs as some NGO coordinators were
unable to (or were unwilling) to disclose these numbers. Only one NGO in Mbale, (ACET)
and one in Mubende, (Action Aid) enumerated their workers precisely. For example, the
ACET co-ordinator mentioned that one manager, an administrator, a training supervisor, four
facilitators and three volunteers operate the NGO. This lack of specificity on numbers is
complicated further by the fact that some paid NGO staff were reported to be working as
volunteers for the good of their communities and/or religious gatherings.
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On the other hand, some NGO coordinators explained that they implement some of their
activities through established district offices, e.g., the District Medical Office (DMO) and it
was, therefore, difficult for them to ascertain their human resource capacity. For those NGOs
coordinators who were able to mention their staff numbers, there was still some uncertainty
in the numbers, for example responses such as, “this NGO is run by a project director and a
team of assistants,” or “ the personnel, the executive committee and the general community.”
4.11.2 NGO Budgets and Funding
While it is acknowledged that NGOs contribute to development, in many instances, it is
unspecific and difficult to assess or quantify this contribution. In both Mbale and Mubende,
district officials were aware that NGOs are making a contribution and are grateful for it,
however, they could only give the amount of resources used for this. They also felt they had
no authority to ask for this information, as one district official noted:
“We are grateful for what they (NGOs) are doing for our communities. We
cannot, therefore, put them to task to explain their funding sources or
amounts. You cannot beg for services and at the same time choose. These
people may decide to pull out and go and serve in areas where their work will
not be interfered with.” (District Official, Mbale)
For example, in Mbale district, officials were not aware of the contribution of NGOs to the
annual district budget. This was because various NGOs did not channel their funds through
district departments since there was no district regulation requiring them to do so. In
Mubende district, the Three-year District Development Plan (1995 to 1998) pointed out the
need for closer collaboration between the district leadership and NGOs in terms of planning,
implementation and monitoring of district development activities. Furthermore, the exact
roles and responsibilities of districts, vis-à-vis NGOs with regard to implementation,
monitoring and evaluation of NGO activities is not clear.
It is not surprising, therefore, that some district officials in both Mbale and Mubende were of
the view that a district NGO board should vet all NGO activities. Such a board would set preconditions for all NGOs intending to operate in the district, including submission of project
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documents such as long term plans, organization and staffing, as well as transparency about
their respective budgets.
Implications
Poor documentation and information sharing limit the use of human resources as a criterion
for NGOs' capacity to contribute to development. It is further constrained by the variety of
ways that human resources are categorized and used by NGOs. There is need to clarify the
roles and responsibilities, and for transparency of plans, activities and funding in order for
NGOs to participate in district planning and to involve districts in their planning process.
While NGOs have been working to facilitate development, they have worked largely in
isolation from the district leadership and concerned communities.
4.11.3 Duration of Operation
The health sector NGOs in Mbale had been operational for a longer period as compared to
those in Mubende. In Mbale duration of existence ranged between 1 and 45 years, with an
average duration of 11 years as compared to Mubende with a range of 2 to16 years and an
average duration of 8 years. Most NGOs that have been in existence for more than ten years
were either church-related or had international linkages. Locally based NGOs or CBOs had
generally been in existence for less than ten years. These findings are in line with the
national intensification of NGO activity mentioned by other authors (e.g., Dicklitch, 1998)
since the NRM came to power 13 years ago.
4.11.4 Areas of Operation of NGOs
NGO staff members were requested to mention the geographical areas of operation of their
respective NGOs. These are summarized in the tables below.
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Table 5: Areas of Operation of NGOs in Mbale (N=23)
Mbale District
Mubende District
County
Number of NGOs
County
Number of NGOs
Bubulo
17
Busunju
2
Budadiri
18
Buwekula
3
Bulambuli
19
Kassanda
3
Bungokho
17
Mityana
5
Manjiya
18
All counties plus
1
neighbouring districts
Municipality
17
All counties plus
5
neighbouring
districts
There was an almost equal distribution of NGOs in all the six counties of Mbale district. For
Mubende district, the majority of NGOs were based in Mityana, the most urban of the four
counties. It was not clear, however, whether more equitable distribution in Mbale was
because of having many more NGOs in Mbale with a longer history of operation or because
of due to better coordination from the district officials.
The format of registering NGO areas of work by district, county or even sub-county can be
misleading and suggest greater coverage or greater equity than actually exists in the field.
Although an NGO could be registered as operating in a particular county, its staff members
are often working in a much more limited area, i.e., a particular village in a particular parish
of a particular sub-county.
Implications
This variability of assignment puts limitations on the use of geographical coverage to assess
NGO contributions to development.
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4.11.5 NGO Target Groups
While some NGOs target the community as a whole, the majority of NGOs target specific
‘vulnerable groups’. Gender, age, and socio-economic status are the criteria used to
determine vulnerability. Most NGO staff hold the view that NGOs target the “poorest of the
poor” (as summarized by a social worker with Action Aid, Mubende). A few NGOs base the
selection of their target groups on religion. In Mbale where there are more NGOs, and with a
longer history of NGO activity, a broader range of vulnerable groups has been included.
Table 6: NGO Criteria for Selection of Target Groups1 (N=30)
Criteria
Mbale
Mubende
NGOs
NGOs
- Women in general
6
3
- Widows
2
-
- Women of childbearing age
1
-
- Female children
1
-
- Children under 5 years
2
1
- Orphans
5
1
- Street children
1
-
- Vulnerable to negative peer pressure
2
-
- Unemployed
4
-
- Elderly lacking extended family
1
-
- Homeless, displaced
2
1
- Chronically ill, PWAs
2
2
Vulnerability
1. Gender
2. Age
3. Adolescents
4. Other needy categories
1
Note: Some NGOs had more than one criterion for selection of target groups.
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Religion
- Islamic
3
-
- Christian
-
1
Whole community
4
2
4.11.6 Size of NGO Target Group
While NGOs were able to mention the type of groups they target, they were less clear about
the size of the target group. Only one NGO in Mbale, the Christian Restoration Outreach
(CRO), put a specific size to their target group – they reported caring for 150 displaced
children and orphans (some attending school), and 30 who have been resettled in their home
villages. The other NGOs sampled in this study were not able (or willing) to precisely
mention the size of their target groups, although they explained that they served the target
population in their respective areas of operation.
Implications
Lack of specific information on size of target groups is a limitation on the extent to which
this variable can be used to assess NGO contributions. As the majority of the identified
target groups were those mostly prone to poverty and/or ill health, an emerging question is to
what extent does targeting of these groups contribute to development? Are we improving the
coping capacity of the specific groups or are we contributing more generally to development?
Another emerging question is whether there is a minimum size of target group in order to
cause a significant development change in an area.
4.12 Monitoring NGO Activities
4.12.1 Current Strategies for Monitoring of NGO Activities
NGO staff explained that they monitor progress of their activities through various channels:

Report writing and information sharing meetings – monthly, quarterly, annually;

Meeting with target communities; and

External monitoring and evaluation.
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4.12.1.1 Mbale NGOs
In Mbale district, 12 of the 22 (55%) sampled NGOs reported that they share their reports
with the DMO of Mbale district at intervals ranging from monthly to annually. Eight of the
22 (36%) said they have submitted their reports to their respective regional/national offices
and donors. Four of the 22 (18%) reported that they share with the communities during
meetings while only one NGO reported sharing its report with other NGOs. However,
reporting and sharing is not always done. Four NGOs reported that they neither prepare nor
share reports.
4.11.1.2 Mubende NGOs
The staff of all 8 NGOs in Mubende district reported sharing their reports with their
respective communities at least quarterly; 5 out of 8 (63 %) reported sharing with the DMO
annually and 3 out of 8 (38%) said they share reports with their regional/national offices and
donors.
However, sharing is not a guarantee, for example, NGOs which submit their reports only to
their regional or national offices and donors were not willing to share their reports with the
researchers. This could only happen with the written permission from the respective offices.
There were good examples from Action AID in Mubende and Bubulo Walanga Church of
Uganda Dispensary in Mbale. In addition, Action AID had prepared and provided copies of
their plans and budgets for 1995 to 1997. These plans had clearly laid down their strategies
for communication with the communities through the Local Councils (LC I to III), the PDCs
and Project Committees (PCs). There was, however, no mention of the strategies for
communication with the higher district leadership (LC IV and V) and copies of these plans
had not been availed to district officials.
Several NGOs further reported visits from district officials, especially members of the
DHMT who make follow up visits to static NGO health units to monitor supply and use of
essential drugs as well as MCH/FP activities.
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Implications
In the absence of a clear and consistent policy on reporting and accountability, many NGOs
act as if they have relatively little reporting or information sharing obligations to the various
stakeholders. This is a constraint to the monitoring process as it allows, or even encourages
NGOs to be secretive about their activities.
4.12.1.3 Community Involvement in Monitoring NGO Activities
The communities in Mbale and Mubende are involved in monitoring NGO activities through
committees. For example, in Bubulo, Mbale committees were set up to monitor schools,
water sources and health units, as observed by one councilor:
“They picked the locals of the area who were trained in various capacities.
Committees have been set up to look at these various projects to ensure that
they are running well.” (LC III General Secretary, Buhugu, Mbale)
However, secrecy and lack of transparency about sensitive issues like budgeting and funding,
still inhibit the community from fully contributing to NGO monitoring and evaluation.
4.3 Indicators for Measuring Change of NGO Activities
Study respondents suggested a number of indicators2, which to them would be used for
determining change in development. The indicators that were mentioned fall under the
following categories:

Health,

Economic

Maternal and Child Health,

Social

Water and Sanitation,

Education

AIDS,

Infrastructure

Access to Quality Health Services
2 These indicators are presented in descending order of importance derived from
the frequency with which both community and NGO respondents mentioned them.
The respondents did not, however, mention these indicators in numerical terms.
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4.13.1 Health

Decreased burden of disease in the community; and

Reduced number of illness episodes amongst the general population, as observed:
“On the side of health, there is observable change in that many people used to
visit these clinics, but over time, the number has reduced.” (Community
member, Bukuya, Mubende)
4.13.2 Maternal and Child Health

Reduced maternal and child mortality rates due to improved MCH services, as
observed:
“TBAs now assist women in labour instead of these women walking all the
way to Kasambya; women used to suffer or even die but now each LC 1 has at
least to TBAs.” (Local leader, Butawata, Mubende)
4.13.3 Water and Sanitation

Percentage of population with access to safe water;

Percentage of population with access to safe waste disposal systems; and

Percentages of homes with ideal environment, i.e., having plate racks, separate
living quarters for animals, ventilation, and latrines, as one woman councilor
explains:
“Health education has helped to improve the hygienic conditions of the
community. There are fewer reported cases of diarrhoea, springs and wells
have been protected and the community now has access to safe drinking
water.” (LC IV Women Representative, Mbale Municipality)
4.13.4 AIDS
Behavior change amongst the community, thus:
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“People’s sexual behaviour has changed. They now practice safe sex; for
example using condoms.” (Local Leader, Mbale)
4.13.5 Access to Quality Health Services

Percentage population within walking distance (not specified) of a health unit

Number of health personnel trained; and

Equipment and supplies available in health units, as observed by one respondent:
“We appreciate as the services have been brought nearer to us, the people.
Instead of going all the way to Mbale Hospital, we have been saved all those
expenses and other inconveniences.” (Community Member, Bududa, Mbale)
4.13.6 Economic

Number of women having income generation activities in their homes and changes
resulting from having an IGA;

Rate of loan recovery amongst beneficiaries; and

Type and rate of asset acquisition.
4.13.7 Social

General outlook or appearance of the community: Nutrition status, dressing; and

Number of orphans supported in school by NGOs, and type of support provided.
4.13.8 Education

Number of schools built or renovated;

Number of school-age children in schools; and

Number of female children in school, as observed by one local leader:
“More children were enrolled in school when this NGO started operating
here, even before the coming of UPE. Apart from the large number, better
quality education is also provided.” (Local Leader, Bubulo, Mbale)
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4.13.9 Infrastructure
Improved housing; and
Improved roads.
“The social infrastructure has improved. The road connecting the centre to
other areas has been constructed, permanent houses have been built, some
used as shops and stores, and others as offices.” (Community Member,
Mbale)
The range of indicators were linked to improved health and wellbeing, access to health care,
affordability of services and infrastructure.
The indicators commonly mentioned by communities, NGO and district respondents are
those that are easily observable and tangible. The indicators under the health sector and
especially under the general health status and water and sanitation areas were in use because
some NGOs routinely collected these.
Implications
Concerns about monitoring of specific indicators require attention to quality of
documentation, including information gathering, process and sharing. These should be
essential prerequisites to the operation of these NGOs. However, this was found not to be the
case. In selecting indicators, attention needs to be given to the ease of collection and
processing (in terms of time, cost and skills) and the outputs to be meaningful to NGO staff
and the community for which they are collected.
Another observation is that study respondents are more inclined toward quantitative
indicators of measuring change as compared to qualitative. This could also represent a need
for capacity building to better appreciate the nature and utility of qualitative indicators.
Even when assessment of change is possible, attribution of change may be difficult. It may
be difficult for NGOs, district officials and communities to distinguish between achievements
attributable to their respective activities and efforts.
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4.14 Constraints to the Monitoring Role of NGOs in Social Development
NGO respondents mentioned various factors constraining their monitoring of activities.
Table 7: Constraints to the Monitoring NGO Role in Social Development3
Mubende
Mbale
Constraint
Number
Rank
Number
Rank
Shortage of resources
19
1
5
1
Lack of community support for NGO activity
5
2
1
3
Lack of established means of monitoring role
2
3
2
2
1
4
-
-
Shortage of funds, Transport, Manpower
Large areas covered
No document detailing monitoring process
No provision for monitoring in activity plans.
Lack of a policy guiding the various
stakeholders
Poor or no networking with other NGOs
Bureaucracy in national and district offices
Long, tedious process registration of NGOs.
Lack of supporting documents and other
logistics
(Source: NGO Co-ordinators, Mbale and Mubende, 1997)
Shortage of funds for transport and staff salaries, as well as large areas covered by the NGO
were the most important constraints to monitoring the role of NGO activity in both districts.
District officers in both Mbale and Mubende explained that their biggest constraint to
monitoring the role of NGOs in social development was the fact that in some cases they did
not know what the NGOs were doing nor where they are located within the districts thus:
3
Note: Four NGOs (2 in Mbale and 2 in Mubende) did not mention constraints to monitoring their role.
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“It is really very difficult to determine the change brought in by some of these
NGOs, especially where they do not have a specific area of operation within
the district. Many of them do not exist but are the briefcase type.” (DMO
Mbale)
Secondly, one district official in Mbale said that the functions of the NGOs are not mutually
exclusive and cannot, therefore, be assessed in isolation. He explained that many NGOs
complement the work of government agencies and even private practitioners. He further
explained that establishing of a health bill, formation of a national NGO coordinating body
and enforcement of registration of all NGOs operating in the district would enable the
relevant district offices to monitor the role of NGO activities.
4.14.2 Poor Documentation and Information Sharing
Evaluation and assessment of a given NGO is a difficult undertaking by all stakeholders (the
NGO itself, the policy makers and by the community it serves). NGO staff members were in
many instances not precise about the domain of their respective NGOs. The poor record
keeping among NGOs worsens this situation. There were hardly any statistics that were
availed to the research team because either some NGO records were poorly kept or not kept
at all.
In addition, although records did exist in some NGOs, there was reluctance on the part of
some NGO officials to share them. There appears to be no policy on information sharing
and, therefore, no obligation on the part of the NGOs.
On the other hand, another Mbale district official explained that useful indicators for
assessing NGO contribution to social development are those laid down in the project
documents of the respective NGOs. She, however, added that some NGOs have no such
documents and operate in a haphazard manner, making it difficult to monitor them.
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Conclusions
Chapter 5. Conclusion, Recommendations and Way Forward
5.1 Conclusion
5.1.1 Objective: To Establish the Range of Activities and Effects of Health Sector NGOs
in Development
 NGOs are engaged in a broad range of activities beyond the narrow definition of health.
Activities are aimed to solving specific problems as well as improving the health status
and coping ability, e.g., by increasing income.
 Enthusiasm and other positive effects generated by association with one NGO, e.g.,
strengthening local leadership, mobilising local development committees, and capacity
building, have the potential to spread and in the long-term, be cultivated within the
community.
 By targeting marginalized groups, especially women, NGOs give them a greater
opportunity and role to participate in development activities. This also increases
opportunities for capacity building and skills development.
5.1.2 Objective: To Find out Criteria used for Assessing NGOs’ Contribution to
Development
Potential criteria for assessing NGOs' contribution that were identified during this study are:

Human resource capacity of NGOs;

Duration of operation;

Areas of operation of NGOs;

NGO target groups; and

Size of NGO target group.
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5.1.3 Objective: To Document the Processes Currently used to Monitor Effects of NGO
Activities Including Indicators
Current strategies for monitoring of NGO activities are through:
 Report writing and information sharing meetings – monthly, quarterly, annually;
 Meeting with target communities; and
 External monitoring and evaluation.
The poor documentation and limited information sharing of many NGOs affect benefits
accruing from these strategies. In the absence of a clear and consistent policy on reporting
and accountability, many NGOs act as if they have relatively little reporting or information
sharing obligations to the various stakeholders.
5.1.4 Indicators for Measuring Change of NGO Activities
The range of indicators were linked to improved health and wellbeing, access to health care,
affordability of services and infrastructure. Indicators commonly mentioned by communities,
NGO and district respondents were those that are easily observable and tangible, and tend to
be more quantitative than qualitative.
Concerns about monitoring of specific indicators then requires that quality documentation
including information gathering, process and sharing are essential prerequisites to the
operation of these NGOs. This was found not to be happening thus affecting the potential for
attribution.
5.1.5 Objective: To Explore Factors Constraining Measurement of NGO Contributions
to Social Development
Assessment of a given NGO’s contribution is a difficult undertaking by all stakeholders. This
is mainly due to the wide range of indicators used; poor record keeping and documentation as
well as limited information sharing. Even when assessment of change is possible, attribution
of change may be difficult. It is often quite difficult for NGOs, district officials and
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communities to distinguish between achievements attributable to their respective activities
and efforts.
5.2 Recommendations
5.2.1 Improve Access of Services to Target Communities
 Physical
access should tally with local demand and needs for services, location and
equity; and
 Economic
access should take into consideration the affordability of services to the
majority of target population.
5.2.2 Improve Community Participation in NGO Activities
 Promote
community involvement at all stages, i.e., planning, implementation and
monitoring, as observed:
“They should involve local leaders like us in monitoring of these
organisations since one must have an external audit to ensure that one is
performing to expectation.”(LC I Chairman, Manjiya, Mbale)
 Enable
bottom–top involvement and capacity building of the communities to ensure
sustainability of activities when the NGO completes its life span.
 Promote
effective community participation and involvement at the grassroots level
where the NGO operates. This was explained thus:
“The community should understand the aims and objectives of the NGO. The
local leadership should be included in the administrative line of the NGO.”
(Elder and Opinion Leader, Bukigai, Mbale)
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5.2.3 Improve Accountability and Transparency of NGOs
To improve accountability and transparency of NGOs to the community they serve, to

district and national authorities through submission of regular reports to these categories
of stakeholders.
5.2.4 Improve Policy Environment for NGOs

Improve government policies relating to NGO operations both at district and national
level to ensure less bureaucracy in the process of NGO registration, equity of service,
access to services (both physical and economic) and reconciliation between planned
NGO activities and community needs. Thus:
“Districts should clarify the entry point of NGOs into their areas. NGO activities
must also tally with the needs identified by the district.” (District Official, Kampala)
5.2.5 Networking

Form and strengthen NGO networks.
5.2.6 Sustainability of NGO Activities
Provide for sustainability

“They should change their method of operation such that when the project
ceases to operate, we will be able to stand on our own.”(Local leader and
teacher, Bukigayi, Mbale)
5.3
The Way Forward for NGOs in Uganda
NGOs have contributed a great deal to the wellbeing of the communities they serve despite
the various shortcomings highlighted in this report since they have always come to the rescue
of the masses. Because some NGOs are oriented towards capacity building and improved
community participation at all levels of activity, the future of NGO contribution to social
development will be further enhanced. Improved policies on registration and monitoring of
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NGOs at central and local government as well as community levels will also improve the
impact of NGOs.
NGOs have further contributed to the wellbeing of the communities they serve. Orientation to
capacity building and greater commitment to participation (from NGOs, communities and
district leadership), and better documentation and information management, will strengthen
and make it possible to measure NGO contribution to development. As government
withdraws more from social services delivery, NGOs certainly find themselves taking up a
more assertive role in community development. Possible areas of consideration include the
following:
5.3.1 NGOs and Districts

Establishment of an NGO desk at every district to enable NGOs receive the necessary
guidance on selection of the most under-served areas, target groups, and submission of
work-plans to the district development committees.

Districts should directly involve NGOs in their plans and budgets with integration of
NGO plans in district strategic plans.

Districts to systematically increase the monitoring of NGO activities in a participatory
manner that involves all stakeholders including the community.

Establishment of district/NGO/community information systems that enable the flow of
information from communities to the districts and vice versa.
5.3.2 Policies and Guidelines
(These policies and guidelines could be developed by district development committees with
guidance from organizations such as the National NGO Board, concerned government
ministries, e.g., Ministry of Finance and Economic Planning, Ministry of Internal Affairs and
Ministry of health)

By-laws that guide the registration of an NGO in a district and that enable a district to deregister an NGO that does not comply with district needs.

By-laws that ensure the flow of information from the community, and served to the
district on a regular basis, e.g., monthly, quarterly or annually.
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
By-laws that protect communities from a self-seeking NGO, especially the ‘brief-case’
type that may be out to exploit the community. This could be avoided by involving
communities (through their leaders) in all stages of the NGO's work process, i.e.,
planning, implementation and monitoring.

By-laws that strike a balance between an NGO being semi-autonomous from the district
leadership but at the same time ensuring transparency of the NGO in terms of funding
(amount and source), human resource and target groups (size, location and special needs).
5.3.3 Existing Opportunities for Further NGO Activity
5.3.3.1 National Level

Presence of a national NGO Board and national NGO networks, e.g., NAWOU, DENIVA

Government policies that have favored development of the private sector, retrenchment
that provides an opportunity for NGOs to play a greater role in community development
as government pulls out.
5.3.3. 2 District Level

Presence of district NGO desks in some districts.

Existence of a district leadership structure through the LC administrative structure (LC I
to V) that provides an opportunity for levels of community participation
5.3.3.3 Community Level

Unmet community needs that require assistance from NGOs.

Existence of community development committees, e.g., Parish Development Committees
through which NGO activities could be channeled.
5.3.4 Areas of Further Research Beyond this Exploratory Study
This study has highlighted some of the areas of further research, both nationally and at
district level. For example, comparing national, district and community needs versus NGO
resources and interests to further refine the possible role of NGOs in development.
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References
Action AID Buwekula, Project Plans and Budgets, 1995, 1996 and 1997.
Action AID Uganda (1994); Management Summary.
Anonymous (1995); Bugisu Muslim Women’s Association Constitution.
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Anonymous (undated); Salem Brotherhood, Mbale (Brochure).
Asea, G.A. (1993); The Role of Non-governmental Organizations (NGOs) in the
Development of Uganda: A case Study of CARE International. Dissertation, B Stat, ISEA,
MUK.
Barton, T. and Bizimana, D. (1995); Health Sector Review. OXFAM-Uganda.
Barton, T. and Wamai, G. (1994); A Situation Analysis of Women, Adolescents and
Children in Uganda. UNICEF and NCC-Uganda.
Dicklitch, S. (1998); The Elusive Promise of NGOs in Africa: Lessons from Uganda.
International Political Economy Series. Macmillan Press Ltd.
Kemigisha, M. (1993); Self-help Organizations in Uganda: A Study of Selected
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Community groups in Uganda. GoU/MoFEP.
Lore, A.C. (1993); Effects of Structural Adjustment Policies and Programs (SAPs) on
Women's Marginal groups, Particularly Adolescent Pregnancy. Paper at 7th International
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Marsden, D.; Oakley, P.; and Pratt, B. (1994); Measuring the Process: Guidelines for
Evaluating Social Development. INTRAC.
MoFEP, Statistics Department (1992); The 1991 Population and Housing Census, Mbale
District Summary Series.
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MoFEP, Statistics Department (1992) The 1991 Population and Housing Census, Mubende
District Summary Series.
Mubende District Local Council (1996); Plan of Action for Nutrition, 1996 to 1999.
Mubende District Local Council (1996); Three-year Development Plan, 1995/6 and 1997/8.
Obbo, C. and Southall, A.; Social Dimensions of Adjustment. [Source?]
Robinson, M. (1990); Performance Criteria in NGO Poverty Alleviation Programs. Cited in:
Marsden, D. and Oakley, P. (1990); Evaluating Social Development Projects, Development
Guidelines No.5. OXFAM.
Swift, A. (1991); Development Against the Odds: OXFAM at Work in Uganda. Perry-Swift
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The New Vision (1993); Mubende: A Study of Underdevelopment.
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in Developing Countries: A Handbook for Policymakers, Managers, and Researchers.
Economic Development Institute of the World Bank.
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Appendices
Appendix 1- List of NGOs
Mbale District
1. Salem Brotherhood of Kolonyi
2. Mbale Foundation of the Blind and
Physically Handicapped Persons
3. Christian Child Care Project (CCR)
27. AIDS Counseling Education and
Training
28. Uganda Teachers Christian
Association
4. Child Restoration Outreach (CRO)
29. Uganda Bible Society
5. Uganda Women Concern Ministry
30. Buyaga Project
6. Uganda Women Action Trust
31. Sabino Child and Family Association
7. Tasha Mission
32. Gangama School for the Mentally
8. United Nations Development Program
Handicapped
9. Nabitshika CCF
33. CARE
10. Nyanza Integrated Guild
34. National Adult Education of Uganda
11. Uganda Women Lawyers
35. Mbale Foundation for the Disabled
12. Tata Foundation
36. TASO
13. Christian Hope Ministry
37. St. Kizito Babies Home
14. Bushikori Christian Centre
38. Butiru Vocational Rehabilitation Home
15. Muslim Supreme Council
39. Mothers Union
16. Church of Uganda Diocese
40. Lumasaba Language Academy
17. Roman Catholic Church (Tororo
41. Islamic Medical Association of
Diocese)
Uganda
18. Islamic University in Uganda
42. YCA
19. Young Women Christian Association
43. Bugusege Child and Family Programs
20. Young Men Christian Association
44. Sironko Valley integrated Project
21. Red Cross
22. Rotary Club
23. Mother’s Union
24. Catholic Women’s Guild
25. Uganda Community Based Association
for Child Welfare
26. Uganda Women’s Effort to Save
Orphans
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(Source: Mbale District Planning Unit, 1997)
Note: These NGOs are listed in the order in which they were registered at the District
Planning Unit, 1996.
B) Mubende District
1. Action AID, Buwekula
2. Action AID, Mityana
3. Buwekula Women Development Association
4. Voluntary Service Team
5. World Vision, Kikandwa
6. African Education Fund, Bukuuya
7. Kiyinda Mityana Diocese
8. Uganda Muslim Supreme Council
9. Kolping
(Source: Mubende District Officials, 1997)
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Appendix 2 - Central and District Level Key Informants
a) Central Level Officials in Kampala
Name
Position
Organisation
Dombo R.
Co-ordinator
NGO Desk
Kalete D.
Co-ordinator
DENIVA
Kyarimpa R.
Administrator
National NGO Forum
Mubiru M.
Medical Officer of
Medical Officer (KCC)
(Dr)
Health
Mukasa L.
Secretary
Welfare and Community Service Department
(KCC).
Odochi
Director
NGO Desk at the Prime Minister’s Office
Zedriga R.
Co-ordinator
National NGO Forum
b) Mubende District Officials
Name
Position
Kalanzi L.
Assistant CAO and Clerk to DLC
Lyagoba P.
District Health Inspector
Mawejje E. (Dr)
Chairman LC5 Mubende DLC
Mureeba B.
District Planner/Statistician
Muwanga J.
Assistant District Health Inspector
Nsubuga F.
Assistant CDO
Wamala G.
District Health Visitor.
Zziwa S.
District Sports Officer
c) Mbale District Officials
Name
Position
Kihika G.
ACAO
Madete R.
District Population Officer
Okujja S.
ACAO
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Othieno R. (Dr)
DMO
Siango Apreku S.
District Economist
Auma R.
CDO
Appendix 3 - NGO Key Informants
a) Mbale District
NGO
Category of
Person
Position in the
NGO
Interviewed
NGO
1. Ahamadiya Muslim Medical Centre
International
Dr. Fazal
Co-ordinator
2. AIDS Care Education and Training
Local
Tibamwagaine P.
Supervisor
3. AIDS Information Centre (AIC)
Local
Magombe J.
Manager
4. Bubulo Walanga COU Dispensary.
CBO
Wafula P.
Administrator
5. Bukigai Seventh Day Adventist
CBO
Wakhonya W.
Chairman
Local
Hajati Wambede
Chairperson
(ACET)
Clinic/Dispensary.
6. Bugisu Muslim Women’s
Association
Z.
7. Buyaga Project
CBO
Masaba C.
Social Worker
8. Child Care and Family
Local
Nangendo J.W
Executive
Rehabilitation (CCFR)
9. Child Restoration Outreach (CRO).
Director
Local
Kamiti C.
Admin.
Manager
10. Christian Child Care Project
Local
Kidulu J.
Administrator
11. Christian Children’s Fund (CCF)
Local
Masaba C.
Social Worker
12. Chrisco Hospital
Local
Wasige M.
Registered
(UCOBAC).
Nurse
13. FOCCAS
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Local
NGO Study 1997
Wanzira B.W
Programme
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Appendices
Manager
14. IMAU
Local
Wathategi A.
Trainer,
Member
15. Mission Moving Mountains
Local
Mayeku J.
Project Leader
Local
Wasubile L.
President,
(MMM)
16. Mother’s Union
Diocese
17. Revival Mission In Uganda
International
Wambedde M.
Pastor
18. Salem Brotherhood
International
Bartl H.
In charge-child
Home
19. SIMU Corner Maternity Home
CBO
Mukoota K.
Co-ordinator
20. TASO
Local
Siango C.W
Chairman
21. Tororo Diocese
Local
Fr. Masayi J.B
Episcopal
Vicar
22. Uganda Red Cross, Mbale Branch
International
Masaba A.
Executive
Officer-Branch
Secretary
23. Uganda Women’s Concern
Local
Watulasu J.
Ministry (UWCM)
Women
Welfare
Co-ordinator
b) Mubende District
NGO
1. Action Aid Buwekula
Category of
Person
NGO
Interviewed
International
Busingye C.
Position in the NGO
Area Co-ordinator
Manager
2. Action Aid Mityana
International
Kintu F.
Training Officer
3. Buwekula Women
CBO
Tumwesigye
Co-ordinator
Development Association
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(BWDA)
4. Kajoji Project
CBO
Masembe D.
Project Manager
5. Kitokoro Health Project
CBO
Zawedde R.
Social Worker
6. UMSC Mityana Health
Local
Katende M.
Sister- in- Charge
Local
Nanyanzi P.
Coordinator (Busunjju
Centre.
7. Window
County)
Appendix 4- Local and Opinion Leaders and Elders
a) Mbale District
Name
Position
Area
Kawuta G.
Opinion Leader
Bunghokho, Kolonyi area
Kisolo J.
LC3 General Secretary
Buhugu
Kitongo M.
Opinion Leader
Bubulo, Butiru
Kutosi T.
LC1 Chairman
Manjiya
Kyayeba B.*
LC1 Women representative
Bulambuli, Muyembe,
Bunyakwa Village.
Mare A.
LC 1 Youth
Bubulo, Walanga.
Masaba M. *
LC 1 Women
Bunghokho
Maswere K.
Vice Chairman LC3
Bududa
Matsatsa Z.
Headmaster, Bukigai Primary School,
Bukigayi
Elder
Mukuma A. *
Chairperson, Uganda Private
Nakaloke Branch
Midwives Asso and LC4 Women Rep
Mbale Municipality
Wakamwai B.
Opinion Leader
Bubulo, Bugobero
Wambedde R.
LC4 Chairman
Mbale Municipality
Wambede R.
LC3 General Secretary
Municipality, Industrial
Area
Wayaba T. W.
Elder
Manjiya, Budaka
Wazikonya M.*
LC5 Women Secretary and Teacher
Budadiri, Busulani.
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Wepukhulu S.
Opinion Leader
Bubulo, Bugobero
Note: * represents female respondents
b) Mubende District
Name
Position
Area
Batinako F.
Headmaster Buwata Primary School
Buwekula, Kigando,
and Opinion Leader
Buwata.
Bigumira Y.
Opinion Leader
Butawaata, Kasambya
Bukonya P.
Sub County Chief
Mityana
Kakinda F.C.
LCIII Chairman
Mityana
Kateregga K.
Sub County Chief
Kagoma, Kitenga,
Buwekula.
Kawalya E.
LCIII General Secretary
Bukuya
Kebilungi B.*
Opinion Leader
Mugolodde, Village
Luwazo M.
LC1 Secretary for Women
Buswabulango, Mityana
Mabira L.
Elder
Kajoji, Mityana
Malabira G.*
Member PDC
Mugolodde Village
Masaba S.
LCIII General Secretary
Kalongo, Buwekula
Mbawadde C.*
LCI Secretary for Defence
Kakindu Malwa, Busunjju
Nakiyemba Z. *
Opinion Leader
Kajoji, Mityana
Serunjogi E.
LC I Chairman
Kitokolo, Kassanda
Wamala L.
LC III Secretary for Mass
Mawanda, Vuumbe,
Mobilization
Busunjju.
Note: * represents female respondents
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Appendix 5 - Community Group Discussants
a) Mbale District
Area
Number
1. Bulambuli, Muyembe, Bunyakwa
8
2. Manjiya, Bududa, Namaitsu
15
3. Bungokho, Nakaloke, Kolonyi
15
b) Mubende District
Area
Number
1. Kassanda, Bukuya, Kalata
12
2. Mityana, Busimbi, Kabuwambo
13
3. Kassanda, Buwaata
8
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Appendix 6 – Key Informant Guide for NGO Officials
Form Number ---------------- Interviewer ------------------Date of interview ------------ Interview complete -------- 1. YES 2. NO
Introductory Remarks
To be created by the research team and to include: Name of interviewer, agency working
for, purpose of information, confidentiality and approximate length of the interview.
This NGO is one of the health sector NGOs selected.
1. NGO Identification
a) Name of NGO -----------------b) Person interviewed -----------c) Position in NGO ------------d) Duration of operation of the NGO ---------e) Where in the district does the NGO operate? (County, Sub-county, village).
f) How was this area(s) selected?
g) What are the main activities of this NGO? (Probe for exact nature of activity,
e.g., if the NGO is involved in spring protection, does the NGO provide
materials, health education or community mobilization).
h) Who is (are) the target group(s)? (Probe size, characteristics, and distribution).
i) What are the strengths that the NGO brings in order to achieve its purpose?
j) What are the weaknesses, if any, that the NGO brings in order to achieve its
purpose? What is being done to overcome these weaknesses?
2. Change as a Result of NGO Activity
a) What are the perceptions of change as a result of the NGO activities?
b)What indicators are used to measure the change?
(Probe both qualitative and
quantitative indicators)
c) What are the constraints for the NGO to monitor its role in social development?
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3. NGO Relationships
a) What is the relationship between this NGO and other NGOs doing similar work?
(Probe: influence on activity by other NGO, i.e. co-ordination, collaboration,
duplication; who else is involved in similar activities in the district)
b)What is the relationship between the NGO and the community? (Probe: is the
community involved in decision making? What are the strategies to enhance
community participation in the monitoring? What is the perceived role of the
NGO in developing the community? )
4. Resources and needs map for the District
a)How do NGO plans link with district plans and vice versa? (Probe: within policy
framework and policy guidelines. What is the participation of NGOs in district
or sub-county planning? NGO versus district priorities, project activities and
location versus need and targeted group )
5. Accountability of the NGO
a. How often does the NGO provide feedback in terms of reports or otherwise to the
community,
district and central government?
b. What is the future of NGOs (involved in health) in this district?
c. What are your recommendations for NGOs to measure their role in social
development both qualitative and quantitative
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Appendix 7 - Group Discussion Guide
The Role of NGOs in Social Development: How can it be measured? A Study of Health
Sector NGOs in Mbale and Mubende districts
Introductory Remarks
Moderator greets participants, introduces him/herself and the rapporteur and the purpose
of the discussion. The moderator explains the procedure of the discussion including the
importance of note making and/or tape recording. Requests self-introduction of
participants. Moderator guides the discussion. Rapporteur MUST take verbatim notes
and make a record of general observations during the group session. Time of start and
end of the meeting, note nature of group, participation and interaction, dominance and
submissions of some of the members and general trend of discussion
(Group participants to come from the community where NGO operates)
Knowledge About NGO Activity
 What NGOs are working with any aspect of health in this area?
 Who are they working with?
 What are they doing?
Perceptions of Change as a Result NGO Activity
 What is/has changed as a result of the NGO working in this area? (Probe: as far as local
health and social development is concerned? Ask for both negative and positive
changes)
Community-NGO Collaboration
a) In what ways if any do the NGOs work with the community? (Probe: community
involvement in decision making, monitoring etc)
b)How do the NGOs plan? Do activities and priorities fit with local plans and needs?
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c) How does the community monitor the contribution of the NGO to development?
d)What are the recommendations for the future in monitoring NGOs in social
development?
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Appendix 8 – Research Team
Principal Investigators
 Nafuna
Wamai
 Gimono
Wamai
Co-investigator
 Ismail
Walera
Research Assistants (Mbale District)
 Richard
 Juliet
Madete
Siango
 Micheal
 Herbert
Magumba
Mulekwa
Research Assistants (Mubende District)
 J.
Ssempiki;
 J.
Nnalunkuuma;
 Irene
Nsaagi
Technical Assistance
 Tom
Barton, Creative Research and Evaluation Centre (CRC)
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