Q4 GEF PROJECT_BUKEDEA DISTRICT COMMUNITY DIALOGUE MP4

Описание: ACTIVITY DESCRIPTION & METHODOLOGY
1. Bukedea District Entry and Engagement Meeting
The Malaria Youth team had an initial engagement meeting with the Bukedea district health team. The meeting was aimed at providing feedback on the GEF project to the district team, reviewing and discussing the districts GEF Community Scorecard (Quarter 2 2025) at Nalugai Health Centre III, feedback on action points developed in July 2025, finalizing the plans, approach for the scheduled community dialogue and scheduling of a feedback meeting
The key burden highlights from earlier community scorecard were:
1. Barriers to the decision to seek healthcare inclusive of:
• Menstrual stigma
• Tribal bias evidenced at registration with the book system.
• Language barrier at the health facility between Gisu and Teso counterparts
• Family planning (Information gap, stigma, Fear to feedback on side effects, lack of spouse support)
• Clients for Family Planning not prioritized
• No formal consenting system
2. Long Waiting Time mainly at the Outpatient Department
Reasons:
• Understaffing with only 5 employees
• Large patient numbers as facility catchment area is inclusive of three sub counties
3. Safety and Security
• Lack of privacy in labor suite
• Shared toilets, no demarcations for separate genders
• Inconsistent security guard
• Overgrown compound grass
• Hostile community towards employees, not aware of services to be availed
• Theft and Lack facility fencing
4. Gaps in infrastructure
• Lack of kitchen
• Lack of refrigerator for vaccines
• Very few ward beds
5. Ambulance access challenges
• Variable costs of transportation for a service that ought to be free

2. Facility Tour
To assess the general conditions, improvement in services available and infrastructure, a repeat tour around Nalugai Health Centre III was conducted, for the youth and community members providing an infrastructure, security and service update about the facility e.g. cleanliness of toilets, number of beds, consultation rooms & waiting areas.

3. Nalugai Community Dialogues
A second set of dialogues were held in Kongunga Town Council, a community served by the Nalugai Health Centre III. The dialogue focused on malaria data from the Q1 2025 Malaria Scorecard (DHIS2). Kongunga sub-county is a high-burden area for the district, accounting for over 15% of all malaria cases.
Key performance indicators performing poorly include:
• Malaria prevalence: The percentage of outpatient visits due to malaria was 83%, ranking 1st in the district, with test positivity rate of 77%, below the national target.
• Malaria in pregnancy: Performance was poor across several indicators -
ANC attendance: Only 37% of pregnant women attend their firsts Antenatal Care (ANC 1) visit falling to 6% attendance for the fourth visit (ANC4) - -
IPTP uptake: Intermittent Preventive Treatment uptake was poor across trimesters.
i.e. IPTp1 and 2, were both at 50% with a significant decline to 36% for IPTp3
The data also indicated164% of pregnant women in the area are diagnosed with malaria.
Based on these poorly performing indicators for both general malaria burden and Malaria in Pregnancy (MIP), Kongunga was selected as a priority intervention area. This second dialogue was conducted to follow up on the key community challenges identified during the first dialogue.
The team held four focused group discussions with 4 separate categories representing the population majority. These were adolescents / young girls and boys as well as adult man and women with a group capacity of 10, facilitated by 2 trained MYCU Champions per category. Both qualitative and quantitative data was collected and scored as per the scale below. The scores ranging from 1 to 3 representative of either a poor/bad finding for 1 or excellent for 3.

A thirteen (13) indicator questionnaire was administered to best assess their experience with health care
delivery at the facility within the most immediate period of July to September 2025. Facilitators probed
into each indicator as
a. Decision Making
b. Home Visits
c. Accessibility of health Care services
d. Waiting Time for Provision of health care services
e. Caring, respectful and compassionate care
f. Availability of gender preferred health care services
g. Availability of health care services
h. Availability of medicines, diagnostic services and medical supplies
i. Ambulance management and services
j. Facility infrastructure
k. Cleanliness of the health facility
l. Safety and security of the health care facility
m. Responsiveness to community health needs