By Mihret Aschalew
In Negelle Arsi Woreda, around 10:00 AM, community members gathered under the shade of a large tree. Organized by the clients’ council, they are here to help design health programs.
On this morning in Negelle Arsi, the facilitators welcomed all and gave instructions. They asked participants about their health service experiences like access to medication availability of ambulance service, and care from health extension workers (HEWs). Participants began raising their color-coded cards.
It has been two years since the Gates Foundation-funded JSI Improve Primary Health Care Service Delivery (IPHCSD) project initiated the implementation of CSC. This initiative, a growing practice in public health to inform health services of community experiences, gives communities like Negelle Arsi an opportunity to participate in service provision. The client’s councils, HEWs, and community health program unit coordinators plan and coordinate CSC activities in each community quarterly. A discussion facilitation guide was developed by the IPHCSD project and is used to help structure these discussions and monitor scoring. Caring, respectful, and compassionate care; waiting time for provision of health care service; availability of medicines; diagnostic services and medical supplies; availability and management of ambulance services; and cleanness and sanitation of health facilities are among indicators regularly discussed at these meetings. Mothers are highly encouraged to participate to ensure CSC are answering to care and service provision in maternal and newborn health.
Amanueal Naremo, CSC clients’ council member at Murago Kebele in Bensa Woreda elaborates “The clients’ council helps communities identify problems and raise awareness to address them. It has allowed us to educate communities about their rights and given them the opportunity to use those rights and have a say in how they receive care. We have made improvements based on their voices, such as enhanced provision of ambulances and availability of HEWs.”
Client councils collect and compile scores for the health facility they are responsible for and send those scores to the health facility. The health facility or primary health care unit aggregates scores for their catchment health post/kebele. The woreda health office will collect those scores for primary health care facilities and aggregate woreda scores. The scores are shared with staff, health facility management teams, and governing boards to ensure adequate attention and preparations for action.
In addition to CSC, the IPHCSD employed village health leaders strategy, optimized the existing Women Development Army structure, and introduced health post open house sessions- all to strengthen community engagement.
Improve Primary Health Care Service Delivery , a five-year project launched in 2022, is funded by the Gates Foundation. It is being co-implemented with Amref Health Africa, and operationalized with local partners and national organizations. Learn more about this project.
