Improving Social Accountability and Health Care Service Delivery in Public Health Facilities in Uganda: A Case of Mukono General Hospital

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Uganda Christian University
This study examined the social accountability mechanisms for improving health care service delivery in public health facilities in Uganda, using a case study of Mukono General Hospital. Specifically, the study assessed the various social accountability mechanisms for improving health service delivery at Mukono General Hospital; identified the factors affecting social accountability at Mukono General hospital; and assessed the role of social accountability practices in improving health service delivery at Mukono General hospital. A descriptive research design was adopted with a qualitative research approach. Data was collected from a sample of 15 Heads of department and Section at Mukono General Hospital using interviews. The study found that Public Tracking Systems participatory planning and monitoring through elected leaders and Village Health teams; community surveys, scorecards and social audits implemented by Civil Society Organizations (CSOs), Health Facility Management Committees and use of media are some of the social accountability mechanisms for improving health service delivery at Mukono General Hospital. Rigorous reporting standards, illiteracy among local populations, lack of adequate information tools, citizen’s limited knowledge about their rights and responsibilities, political interference and lack of funding were found to be barriers to effective social accountability and health service delivery. Findings also indicated that social accountability plays a significant role in improving health service delivery at Mukono general hospital. The study concluded that social accountability interventions are effective in improving health service quality delivery at Mukono General Hospital. The study recommended that: community – based monitoring should be strengthened and complemented with measures to sanction health officials and public service providers who do not perform according to expected standards; training of citizens to build their capacity in monitoring of health service provision in their areas; management of Mukono General hospital should consider relationship-building between community and health practitioners at the facility; and the Ministry of Health should build a strong institutional support in the form of resources, data, education, and citizen empowerment to facilitate social accountability in public health facilities.