May 22nd and 23rd, 2014 Witnessed gallant efforts of Bundibugyo District leaders and Good Hope Foundation for Rural development staff in finding out problems still derailing service delivery in Health, Education and NAADS Sectors.
The District Vice Chairperson Hon.Kamabu Z.Blasio,District Health Officer Dr.Bagonza Majid, District Community development officer Mr.Olega Caesar, Senior inspector of schools Mr.Maate Charles, District Naads Coordinator Mr.Kisembo Light Godfrey,Deputy Chief Administrative officer, Deputy Resident District Commissionar,LCIII Chairpersons, Community process facilitators closed their offices and hit the ground in Nyahuka Town council,Ndugutu and Sindira sub counties to assess the delivery of services to the citizens. Health centers like Nyahuka Health centre IV, Butama Health centre III, Primary schools and Naads beneficiaries were visited.
|District team and Good Hope staff being addresses by District Vice chairperson before joining the subcounty team for joint monitoring.Looking on is the Deputy RDC|
Key findings were gathered that we believe are representative of the District service delivery status, and among others include;
• There are still high drop out/absenteeism rates in most primary schools, affecting the quality of education. This is caused by parents’ negligence, absence of lunch at schools, low teachers’ motivation levels that make them pay little attention to pupils. For example, at Bundimulinga P/S, Out of 1054 pupils as per close of First term, only 180(103 f and 77m) were present on 23/05/2014, meaning; 874 were absent or had dropped out of school, at Bundikahungu P/S, out of 670 as per close of First term, only 173 (110f and 63m) were present on 23/05/2014; 497 were absent, and at Bundimbere P/S, out of 271 pupils as per close of First term, only 15(09 f and 06 m) were present on 23/05/2014; 256 were absent.
• The National standard teacher pupil ratio is 1:49. In some schools however, it is far above the standard. For Mundimulinga P/s for example, the ratio above 1:65. This is so alarming and quality education can not be attained under such a condition.
|District Vice chairperson,Hon.Kamabu Blasio(in suit) interacting with pupils|
• The Sitting Capacity in the class rooms is generally on standard of 3-5 per sit in over 95% of the schools visited. However, there are still cases of pupils sitting on floor at some schools like; Bundimbere P/s in P1,P2 and P3.
• Schools still have a challenge of staff houses. For the three schools visited (Bundimbere, Bundimulinga and Bundikahungu), only Bundimulinga P/S has staff quarters.
• More than 50% of teachers walk 1-5kms to schools. This to some extent account for late coming and absenteeism.
• Poor academic performance .Bundimbere and Bundimulinga for example did not have any pupil pass in Division one(1) in 2009,2010 and 2011 caused by failure of teachers to prepare schemes/lesson plans, poor time management ,lack of intensified monitoring by inspectors of schools and failure to implement resolutions.
• All Naads Groups Visited in Sindira Sub County had Farmers’ lists, had signed MOUs except one in Kakuka Parish, Mutiti Village.
|A Focus group discussion(FGD) during a joint monitoring in Sindira Subcounty.|
• More than 90% of farmers had farm records and all farmers had received at least one training on Naads Programme.
|The RDC in blue shirt,with a farmer and Good Hope's team|
• All farmers had atleast been visited by a technical officer from the District.
• On average, a farmer earns over Ugx 200,000 in three months from sales.
• Most Farmers reported that; Lack of drugs, lack of transport means for their produce to markets, inadequate labor, limited ownership of Naads projects by group members, lack of adequate land for expansion were key challenges faced.
|A farmer sharing with the RDC how his enterprise has multiplied.|
• Farmers recommended that; more farmers training be organized on modern farming practices and disease control, need for farmers’ learning exchange visits and more funding for increased inputs to farmers.
• Generally, Naads seem to be doing well in Sindira Sub County and therefore need to replicate the successes to other sub counties that may need so.
|The DNC Mr.Kisembo Godfrey taking notes from a farmer|
• Diagnosis of patients done by talking, Blood pressure machine, stethoscope, laboratory tests and generally differs with patients’ complaints.
• Health centers have customer care attendants. However, Nyahuka HCIV uses an Ascari as the customer care attendant.
• Nyahuka HCIV is highly congested caused by high patients’ influx from the DRCongo.
• Most health workers were not found in Uniform which is against their ethical conduct.
• Supply of essential Drugs to Health centers is still limited. Only cheap drugs are supplied like panados, anti-biotics.
• Health centers still lack adequate staff houses. For Nyahuka HCIV with over 35 staff members, only 6 staff members are adequately accommodated, and all toilets are full.
• All Health centers have HUMC but not fully performing their expected roles because of their poor selection, political influence and others just interested in allowances .The Butama HCIII HUMC is not fully constituted, other members left.
• Limited outreach services are provided by the health centers. For Nyahuka HCV, the services are affected by limited funding and transport means. The Ambulance for example was found mechanically down.
• The surgery section at HCV is also affected by limited funding. The equipments NMS supplies to be used in 2 months, is for example used in just 1 week, and there is limited JIK,OMO and power bills are always high.
• Most causes of Illnesses are; Diarhea,Malaria,Hiv and AIDS, Malnutrition,Diabetes,TB ,sickle cells, warms, Respiratory track infections(RTI) and Drug abuse.
• Under staffing is still a challenge. Butama HCIII for example has only 5 staff members and Nyahuka HCIV has 19 health workers, and of these, the 4 comprehensive nurses are not appointed.
• There are still inadequate facilities and equipments at the Health centers visited. At Nyahuka HCV for example, the maternity ward is about to collapse, a laboratory is just a small room with a micro scope and testing kits, OPD is poorly set up, Very few dust-bins more over the town council does not collect the rubbish
• There are still long queues of patients for medication at Nyahuka HCIV.
• Many complaints about drug stock outs by patients and health workers. This according to them is affecting delivery of health services.
Complaints for key informants.
• Under staffing causes delays of health workers to work on patients.
• There has been poor management support to Nyahuka HCIV by the District.
• Selection of Health Units management Committees (HUMCs) is highly politicized to an extent of selecting a non former health worker as chair person HUMC (Nyahuka HCIV).
• The office of DHO has provided limited support to Nyahuka health centre.
• Inadequate equipments and building structures as well as inadequate staffing are affecting health service delivery.
All the above findings acted as a litmus paper for service delivery in the District and Good Hope Foundation and District Leadership planned for actions after this joint monitoring to address the challenges. Actions like District stakeholders meeting, Press briefing, Sub county meetings, radio talkshows, follow-up meetings were planned to seriously attack root causes of most of the problems.