Support Team - SPHIP presentations during the CHW symposium

Citizen’s research into adherence to tobacco regulations in Uganda

Moses Kirigwajjo Nsaire from the Uganda National Health Consumers Organisation presented a research carried out by members of the organisation into adherence to regulations with regard to restrictions on promotion for tobacco and sale of tobacco in the country.

The members visited in total more than 1,000 points of sale of tobacco (shops, supermarkets, kiosks, bars, etc.) and checked if there was any advertisement, display or sale to minors.  They received a short training via telephone, and used a mobile phone app to communicate information. In general, there was a good adherence to the ban on advertisement. Less than 10% of visited places had some type of advertisement (poster, banner, sticker). Adherence to ban on display of tobacco products was less: 27% showed tobacco products on sale, especially in shops and supermarkets.

Nevertheless, this research shows that there is reasonable adherence to regulations imposed by government to contribute to reduction of tobacco use.

The research also showed that it is possible to make use of citizens to collect relevant information for research. Member of the UNHCO were able to collect relevant data for monitoring implementation of government policies. 

Health information systems at community level. Experiences with the DHIS2 tracker in Kwale County, Kenya

Mr Omar from 4Kenya Trust in Kwale, Kenya presented experiences from the community health project. Health data collection is an important part of the role of Community Health Workers in Kenya. Presently, paper log books are used routinely to collect health data. DHIS2 is an electronic health information system using mobile technology for the collection, transfer and analysis of community health data.

In Kwale County, a pilot study is being done in 24 community units, using a uniquely designed DHIS2 tracker system, with 240 Community Health Volunteers (CHVs) collecting data on smart phones and uploading to a server. These data are analysed by the public health officer in the nearby health facility, who is supervising the CHVs. It potentially allows data to be analysed in real time, enhancing the value of data collected. Having actual information at hand, makes monthly evaluation, planning and priority setting of community health activities more direct.

However, for introducing electronic data collection a significant support system is needed. CHWs need appropriate knowledge and training to use the technology. Software development issues with DHIS2 tracker have created challenges in implementation and maintenance. Reliable internet is needed for uploading data. Interest and support from the Ministry of Health is important for sustainability and expansion of the project.

Analysis of financing healthcare in Uganda

Mr Ricard Ssempala from the SPEED project in Uganda presented a research into expenditure on health in Uganda. The research team analysed data over a 10-years’ period to analyse the funding for health in the country. The government budget for health is only around US$ 18 per capita, which much too low according to the WHO standard of US$ 84 per capita. The budgets of the government were mainly spent on capital investment (buildings) and salaries, leaving hardly any room for funding of service delivery, e.g. medicines and equipment. This seriously affects quality of the service delivery.

If government wants to reach universal health coverage by 2030, it has to increase the budget seriously. A National Health Insurance Scheme would be an option to increase income-generation for government. However, before citizens are ready to become member of an insurance scheme, government has to build trust and improve quality of service delivery, especially availability of medicines in health facilities.