CODES to improve reach of health services in rural areas

By Feliciah Kanyesigye

According to the Citizen Report Card produced by the Advocates Coalition For Development and Environment (ACODE), 4 out of 10 children between 12-13 are immunized before their first birthday.

The consultant, CODES project Doreen Lwanga, said during a press briefing on April 12 that the reduced numbers are due to the writing of immunization cards in english, a language most rural people donot understand.

Community and District Empowerment for Scale –Up (CODES) is a five year project aimed at ensuring that the government of Uganda attains the capacity,particularly at the district level to implement public policies and interventions that lead to quantitative and qualitative improvements in health outcomes, especially the control of malaria, pneumonia, diarrhoea in children.

CODES is spearheaded by the Ministry of Health in Partnership with District Local Governments, the Advocates Coalition for Development and Environment(ACODE), and Child Fund International(CFI). Makerere University School of Public Health(MUSPH), the Liverpool School of Tropical Medicine(LSTM), and Karolinska Institute(KI) provide technical assistance.

It is a two year UNICEF led project being implemented in 5 districts in the first wave. It has the potential of being scaled up to 25 districts for more than 3 years.

Between 2011 and 2012, CODES project undertook a baseline survey for households, Village Health Teams(VHT) and Health facilities in areas of Bukomansimbi, Masaka, Mukono Buikwe and wakiso.

Using community dialogues as a main communication tool, Lwanga says dialogues are an opportunity to provide communitues with public health education and to communicate important information about the perfomance of health services.

According to Lwanga, the CODES project is going into year two community dialogue due to take place between May and June with the hope of conducting 90 dialogues as compared to 45 in year one.

Dr Hector Tibeihaho, district health Supervisor, Child Fund says, “In a few months’ time, end line surveys will be conducted in the districts to document improvements.”despite the issues raised during year one dialogue that included poor facilitation for field work, lack of identification, lack of malaria RDTs among others.

“While the government promises free healthcare and universal coverage, it doesnt provide funds to facilitate the kind of outreach necessary to fufill these promises, especially in isolated communities. If health workers fail to engage in outreach, subcounty statistics on immunization and other metrics will remain alarmingly low in the short term.” says Doreen Lwanga, consultant, CODES project during a press briefing on April 12.