~~ ~~ uKaid from the British people Governance, Accountability, Pa1ticipation and Performance (GAPP) Program

Voices From The Field

A Collection of short stories on improved service delivery in through systems strengthening and increasing citizen participation in local governance

September 2017 Table of Contents

I. Strategic Engagements Improve Access to Education in Patwol village, district ...... 7

2. Duty bearers embrace accountability dialogues ...... 9

3. Enabling Citizens to Effectively Engage in Local Government Budget Processes ...... 10

4. Citizen Involvement in Improving the Quality of Water in Nebbi distric ...... 12

5. Improving Community Services Through Joint Ef...... 14

6. Grassroots Communities Mount Pressure for Better Services ...... 15

7. CSO Mounts Pressure on School to Construct Ramps for Children with Disabilities ...... 17

8. Government Improves Health Services Following Pressure From Community ...... 18

9. Reducing Teacher Absenteeism through Provision of Accommodation Facility ...... 20

I 0. Strategic Collaboration results in Safe Drinking Water for Ruchuko Primary School...... 22

I I. Bridging the Service Delivery Gap between Communities and Governments ...... 23

12. Stakeholder Collaboration Improves Health Services in Butiaba Sub-county ...... 25

13 . Combined Efforts Improve Health Service Delivery in Masindi ...... 26

14. Fifty Persons With Disabilities Aided to Benefit Directly from Wealth Program ...... 28

15. Increased Local Revenue Improves Services In Lower Local Governments ...... 31

3 Acknowledgements

The Governance, Accountability, Participation and Performance (GAPP) Program extends gratitude to all those who have, in one way or the other, enabled it to partake of the stories contained herein. Appreciation is extended to all participating grantees, the communities, institutions, and local governments that are contributing to positive change in service delivery. Gratitude is further extended to USAID and DFID for supporting the program and to RTI International for providing the opportunity for the GAPP Program to be implemented. Thank you, as well, to all the teams that were engaged in implementing, documenting, compiling, editing, and generally putting this piece of work together. With concerted effort it is possible to improve service delivery in Uganda from one level to a higher one.

5 Voices From The Field

A Collection of short stories on improved service delivery in Uganda through systems strengthening and increasing citizen participation in local governance

6 I. Strategic Engagements Improve Access to Education in Patwol village,

The village is the lowest administrative unit in Uganda's decentralized system of governance. Once services improve at the village level, chances are that this will be reflected at the higher levels.

For a very long time, pupils who come from Patwol village had challenges in accessing Palaro Primary Seven School in time especially during raining seasons. The road would get clogged with water due to the poor drainage system around. Rain water had no outlet. This would make the road impassible by pedestrians, riders and drivers. Pupils and their teachers would spend some days not going to the school. They would later opt for alternative ways, like passing through the nearby bushes, of getting to the school.

With support from the GAPP program, A4D, a civil society Community members working on the organization based in Gulu district, mobilized the road community and its leaders to address this problem. First .______, A4D trained selected community members - dabbed Community Development Monitors (CDMs) to track the work being done on different social service related needs.

In one of their monitoring activities, the CDMs raised the issue of inaccessibility of Palaro Primary Seven School. A4D then followed it up by organizing a stakeholders meeting to deliberate on the matter. The meeting was attended by the community around the school, the school management, opinion leaders, the area Local Council I Chairperson (who is also the highest elected political official at that lower local government level) and some authorities from the sub county (another lower local government level).

During this meeting, it was agreed that a proper road would be constructed with culverts to aid the drainage of running water to stop it from clogging and rendering the road impassable. The

7 sub-county would approach the district for the culverts because this was beyond their scope of intervention. The sub county would then provide the marram and the LC I of the area (Patwol village) would mobilize the community members to fix the culverts.

After the meeting, A4D followed up with the sub-county authorities and maintained the communication with the community on progress on the road. Indeed the sub­ county provided the marram, the district provided the culverts and the youths in the community were mobilized to work on the road.

In September 2016, the improved r oad was completed. It is now being used by the entire community of Patwol Village to smoothly connect to Palaro Primary Seven School and beyond.

[REDACTED] (inset), a P.7 class pupil who comes from Patwol village explains: "previously when it rained, we could stumble on the muddy and water logged road, our uniforms and shoes would get really muddy and dirty. When it got unbearable we would have to follow Lukwiya road which is far, in order to get to school. Now with the improved road, I arrive at school early, when I am smart. Other pupils also report to school early and clean".

As a result, the fixing of the culvert, the pupils now report to school o time. There is also easy movement of vehicle, motorcycles and community members to the school and neighboring villages to conduct different activities.

This goes to show that organized partnerships amongst communities and their leaders can result into great improvements in service delivery.

8 2. Duty bearers embrace accountability dialogues

Community Awareness and Response on AIDS (CARA) with funding from the GAPP program is implementing a two years project entitled "Enhancing good governance, accountability and transparency for improved health services in district" The project is addressing issues that hinder citizens' participation in planning, implementation and accountability and monitoring of health sector. One of the models that CARA is applying in this project is the Facility Based Dialogue meetings.

Facility Based Dialogue meetings are held at health centers as a platform for citizens to dialogue with their leaders about issues of accountability. The end users of a particular health center are mobilized to deliberate on the issues affecting that particular center. On the other hand the duty bearers are also called to respond to these issues. This is The In charge Busaana HC/11 addressing done to promote collaboration between the masses and citizens during a Facility Based Dialogue their leaders in finding workable solutions to the things that meeting affect them. Specifically, the meetings are held to address concerns about factors hindering accessibility to health services and possible solutions to address these factors.

One of the recurring issues is the indifference of health workers in giving accountability to the citizens, especially those who needed services from Busaana HCIII in Busaana sub county.

To resolve this issue, CARA initiated the Facility Based Dialogue meetings to create an interface between the concerned communities and their duty bearers (the leaders).

Initially duty bearers perceived the intervention as harassment in the public eye. The community openly expressed their frustrations at the poor services from health centers and this did not go down well with their leaders.

9 However as the duty bearers turned up for more of these meetings, they began to appreciate the concerns raised and also used the meetings to explain why things were the way they looked. In a way, they became more accountable to the citizens. They now look forward to these meetings and turn up prepared for them. This is usually the only opportunity they have to defend their work and take positive actions on the issues raised.

"We have held internal meetings amongst ourselves at the health center and we are improving on the way we render services to the masses. The negative publicity was not doing us well" says [REDACTED], the in-charge, Busaana HCIII.

"During, one of our feedback meetings, we agreed that we should fully utilize the Facility Based Dialogue meetings as a platform for accountability, issue generation and creation of actionable way forwards" Said [REDACTED] - a midwife at Lugasa HCIII.

CARA has so far conducted 24 facility based dialogue meetings in the sub-counties of , Galiraya, Kayonza and Busaana reaching 1,232 citizens. It is reported that at each of these government aided health facilities, services have improved.

3. Enabling Citizens to Effectively Engage in Local Government Budget Processes

Effective citizen engagement is important for ensuring that budgets address the needs of the people, especially the poor.

However, the capacity of the majority of citizens to effectively engage in budget processes is largely wanting. Lack of information and uncoordinated efforts among CSOs and citizens contributes to the passing of local government budgets that do not foster the implementation of pro-poor services.

10 With support from the Governance, Accountability, Participation and Performance (GAPP), the Civil Society Budget Advocacy Group (CSBAG) started organizing and mobilizing Civil Society Organizations (CSOs) in April 2016 in selected districts for a collective voice and activism on budget accountability at local government level.

Ten CSO budget coalit ions with 97 CSO representatives were formed in the districts of Masindi, Agago, Kagadi , Oyam, Amuru, Nwoya, Lira, Mubende, Gulu and Apac. These were trained in budget performance monitoring and advocacy. They have since utilized the new knowledge and skill to effectively engage in key budget events. They, for the first time monitored budget performance in 21 I health centres and UPE schools, This information was compiled and formed part of the quarter 4 Budget Performance Monitoring Report for FY 2015/ 16 that CS BAG submitted to Ministry of Finance, Planning and Economic Development on 30t h September 2016.

With the coalitions that CSBAG has formed at the different Local Government levels, there is increased recognition of Civil Society engagements in budget processes by the different Local Governments. For many of these CSOs, they are engaging in the budget processes for the first time and they have started realizing the value addition to their existing budget advocacy efforts as illustrated by

Amuru District CSO Network delibearting during the training on Budget [REDACTED] CSO Budget Performance Monitoring and Advocacy on 14th July 2016 coalition Network Coordinator: "Before CSBAG training, we used to focus on monitoring service delivery effectiveness, however with technical support from CSBAG, the coalition began assessing financing and accountability challenges in the sub counties. One

11 such example is Agung HC Ill which had delayed to submit Quarter FY 20 I SI 16 accountabilities to the district. We raised this issue with the health center and as a result, the health centre finally collected this information. This concern was generic across all health centres. We are grateful for the capacity building provided by CS BAG."

4. Citizen Involvement in Improving the Quality of Water in

Many communities in Nebbi district do not have access to water. Beyond the basic availability, water scarcity in rural communities is increasingly raising questions about the quality of the already scarce water. In general, access to safe water and sanitation is constrained by a range of economic and social factors, including; the lack of funds to meet safe water demands to match increased numbers of users, inadequate community ownership, and ineffective approaches to routine operation . and maintenance of water facilities.

Community Uplift and Welfare Development (CUWEDE) with funding support from Governance, Accountability, Participation and A water point at Pajuer Parish, Er ussi sub--county, Nebbi district Performance (GAPP) Program has been working to remedy this situation in ten ( I 0) water points in Nebbi district, scattered in different communities. Working with the user communities, sub-county and district level local governments, CUWEDE has been able to secure safe water points for the communities in Erussi (2 water points), Nyaravur (3 water points), Alwi (3 water points) and Panyimur (2 water points) sub counties.

12 These communities, which are also the project areas, had their water points repaired and fenced off to protect them from animals and misuse. However, in Nyaravur, the water point at Nyaravur Center "A" was decommissioned following CUWEDE recommendation because of the poor quality of the water which could easily become a health hazard. An estimated 15,000 people are benefiting from these water points.

CUWEDE's advocacy and capacity building has also led to more effective participation of Water User Committees (WUCs) in terms of management of minor repair and maintenance of water facilities, and providing accountability for user fees collected. All the nine water points now have new water and sanitation committees. They have the responsibility to collect user fees and to operate and maintain safe water supply and sanitation facilities at each water point.

Presently, water points rarely break down and when they do, they are repaired in a timely manner. Water users are now willing to pay user fees as they perceive both service level and quality to be adequate.

When it comes to accessing safe water in Nebbi district, one of the critical lessons demonstrated is that while there is general recognition for the importance of improving the governance of water systems, there seems to be some inadequacy in commitment and ownership among actors responsible for the different roles within the Water and Sanitation sector.

Therefore there is need to strengthen the oversight role of civil society in relation to community level service delivery. Interventions ought to focus on building the capacity of communities to demand, develop and maintain water, sanitation and hygiene facilities as a decisive element in improving water governance.

And all this is possible through working in partnerships amongst the citizens, civil society organizations and the local governments.

13 5. Improving Community Services Through Joint Effort

Eco Agric is working with communities to dialogue amongst themselves and with their leaders to improve the quality of education in Kidoma parish, Kiziranfumbi sub-county, . The organization has trained community monitors and is in regular contact with them to identify issues that can be resolved through strategic engagements and dialogue.

In the education sector, one of the key issues that affects most schools is habitual absenteeism and late reporting by teachers of primary schools. Most of these teachers first attend to their personal businesses - gardens, entrepreneurial entities - before reporting to their respective schools. For a long time, although the communities were aware of this, they did not know how to handle it.

The community monitors who are trained by Eco Agric have provided a means through which matters affecting the community can be forwarded to the relevant authorities for redress. When the monitors visited Kidoma parish, they held dialogues with the community and documented their findings which Eco Agric forwarded to the District Inspector of Schools (DIS).

Through various dialogues facilitated by Eco Agric amongst the community, schools and education authorities, the following positive changes have been registered: • Teachers are now attending school more regularly and they don't leave school before time. This followed massive sensitization of parents, teachers and pupils by the community monitors, on the importance of following regulations provided by the DIS • At least 80% of the parents in the schools of Pupi ls of Kabaale Primary School Kiziranfumbi sub-county having lunch after a community agreement to provide Buhimba and Kiziranfumbi are packing lunch meals for children for their pupils.

14 • There is improvement in both school attendance and retention of children since the beginning of 2016. For example in Kihangi Primary School, no pupil has dropped out of school as compared to the previous year where over fifty pupils did not complete the primary cycle.

Through Eco Agric, GAPP is able to engage with lower level local governments to improve services to those communities. Considering that budget allocations and other funds are often tagged to community services, it is important that these communities speak out and are not left behind.

6. Grassroots Communities Mount Pressure for Better Services

Lapeta HCII, in Pakwelo parish, Unyama sub-county, Gulu district serves a population of five thousand (5,000) patients. It has been in existence for more than 8 years since its establishment. Located about 3km from the Gulu-Kitgum road, the facility has a challenge of accessibility. It is not easy for its users to access it because of lack of a proper road leading to it.

Users complained of the narrow, bushy footpath. Some opted to access health services from private facilities like St. Mauritz Health Center where users had to pay for the services. Others travelled to Unyama HCII and Angaya HCIII which are a distance away.

Drug stock-outs were common at other health facilities but Lapeta HC II always had drugs because of the few people who Lapeta Health Centre II in Unyama could access it. sub-county Community monitors who were trained by the Human Rights Activists and Monitoring Organization (HU RAMO) raised the issue of accessing Lapeta HC II to the authorities of Unyama sub-county. Unyama sub county authority noted that they had

15 planned for the road in FY 2014/ I 5 but there were no funds. However during the FY 20 I 5/ 16, some funds were allocated for the road, following continuous engagements by communities of Lapeta, Pongdwongo and Akonyi-bedo villages.

The road has since been opened and this has eased accessibility to the facility. [REDACTED] the Community Development Officer of Unyama appreciated the community for the vigilance, commitment, involvement and for putting pressure on them to follow up with the District leaders to release road fund to work on the road.

"Without the road, the health services from Lapeta HC II were A patient being attended to at compromised. Social services complement each other because Lapeta HC II now we have a better road and accessible health services" says [REDACTED]. Through the GAPP program, HURAMO has been able to engage with communities at the grassroots level to enable them to demand for better services from the duty bearers. The duty bearers on their part also appreciate a vibrant community that makes them respond to their needs.

"Because of the pressure mounted on us by these three villages, we were able to respond fast. They are the ones who made us do our work" says [REDACTED].

16 7. CSO Mounts Pressure on School to Construct Ramps for Children with Disabilities

A number of government aided schools still do not have facilities for Children With Disabilities (CWDs).

According to the Disability Act (Uganda), the UN Convention on the Rights of Persons with Disabilities (CRPD) and the Building Control Act (Uganda), government is mandated to ensure that all public facil ities including schools are accessible to all Persons With Disabilities (PWDs). With support from the GAPP program, Mubende Women with Disabilities Association (MUDIWA) has carried out a number of activities to ensure that PWDs benefit from government programs and services.

When MUDIWA visited Kibyamirizi Primary School in Kabyuma parish, Kitenga sub-county they found the school without ramps, although one of the classroom blocks was new. The school serves all the nine (9) villages that surround it. It has 4 CWDs enrolled but with difficulties in mobility while at school.

MUDIWA engaged the school management committee (SMC) members who are responsible for overseeing the new building which was constructed in the school. This engagement was made during the co-ordination meetings which are held at sub county level and in LCI training meetings. It was realized that some of the SMCs did not fully understand their roles.

MUDIWA subsequently organized a training for the SMC of Kibyamirizi Primary School where they were sensitized on their roles in monitoring the new building to ensure quality The new building at Kibyamirizi Primary School with a ramp and also that there were CWDs/PWDs accessibility provisions on the buildings.

17 The school had an SMC which was not fully composed and their roles in ensuring accessibility provision in the school were being under performed. However, when MUDIWA held the LCI training on inclusive service delivery for Kibyamirizi parish, the SMC of Kibyamirizi Primary School were invited to attend the training. The members realized what they needed to do to advocate to improve PWD/CWD accessibility in their schools.

The SMC vigilantly supervised the construction work which was still going on at the school. They reali;zed that the contractor had not put any ramps; instead he had put only steps that could not be used by the CWDs. Due to the knowledge that they had obtained during the trainings, the SMC Chairperson and other three (3) members raised this concern to the Head teacher and the area councilor at the sub county.

These leaders called back the contractor to finalize his incomplete work by putting there some ramps. The contractor accepted to construct the ramps by substituting the ladders with ramps. Currently the new building has well laid ramps with an accessible latrine fo r CWDs.

The experience at Kibyamirizi Primary School shows that when the community is informed of its roles in improving service delivery, it will be possible to create the desired changes.

8. Government Improves Health Services Following Pressure From Community

In a bid to improve service delivery at community level in , GAPP is working with Kiboga NGO Forum to enhance community engagements with the local government to improve service delivery.

Kiboga NGO Forum trained forty (40) community monitors from Bukomero, Lwamata, Kapeke, and Dwaniro sub-counties. Ten ( I 0) participants were selected per sub-county. They

18 were trained in how to engage with communities on issues of service delivery and how to advocate for improved services from the sub-county.

After the training, some participants grouped themselves together and formed the Dwaniro Social Accountability Organization which they have since registered with the district authorities. This group of ordinary citizens is advocating for improved service delivery in their communities.

Katwe HC Ill is one of the facilities that was found wanting in delivering health services. The group petitioned the sub-county leadership about the state of health services delivery at this facility. During one of the dialogues which was held at Dwaniro sub-county, the chairperson of the Dwaniro Social Accountability Organization presented issues around the lack of housing for health workers at the facility, lack of a fence, lack of security and t he need for replacement of the latrine doors. Some of the officials from the sub-county who participated in the dialogue included the Community [REDACTED] (Chairperson of Dwaniro Social Development Officer, the Finance Officer and the sub­ Accountability Group) addressing a di91ogue county chief. meeting at Dwaniro Sub-county.

The sub-county officials received the petition and pledged to act on those which were within their mandate. One of the petition items were the dilapidated latrine doors of the health facility. They were in very sorry state with some barely hanging on their hinges. The sub-county took this up and the latrine doors have now been replaced with stronger and firmer ones. The sub-county pledged to address the other concerns during the financial year 2017/2018.

As a result of this intervention, the community use of the facility has increased and there is greater appreciation of the services offered by the health centre by the communities.

19 9. Reducing Teacher Absenteeism through Provision of Accommodation Facility

Lack of accommodation for teachers, is one of the challenges that has longer term negative effects on primary education in Uganda. Although the government boasts of close to one thousand primary schools (under the universal Primary Education - UPE), most of these schools do not have accompanying staff quarters. Teachers in these schools travel long distances to the schools and this has resulted into habitual late coming and absenteeism.

Okol Primary School is a government aided school in Okol parish, Mucwini sub-county . The school has Nine hundred and fifty nine (959) pupils (492 males 466 females) and fourteen ( 14) teachers - eleven ( I I) males and two (2) females. Of these, thirteen ( 13) are on the government payroll while one (I) is being paid for by parents. The parish is approximately six (6) kms away from Mucwini sub-county headquarters. The school does not have teachers' quarters so the teachers spend more of their time walking to school and back to their homes.

To lessen the time spent commuting to and from school, one of the classroom blocks was gazetted to be a teachers' quarters. The teachers use some simple materials to demarcate their respective "spaces". A former library was also gazetted to accommodate some teachers. Of the thirteen ( 13) teachers at the school, five (5) now reside in the gazetted buildings, including one (I) female. Before: A classroom block gazetted to accommodate teachers. Kitgum Concerned Women's Association (KICWA) is a civil society organization based in Kitgum and supported by the GAPP program to carry out a number of activities to improve services in the education sector. One of the approaches that KICWA uses is to train monitors who engage with the communities regularly and are able to identify service delivery gaps that need and can be addressed at the local and lower local government levels. During one of the monitoring activities, the situation at Okol Primary School was identified.

20 KICWA shared this finding with the district officials during a stake holders' meeting that took place at the Kitgum district headquarters in June, 2016. The meeting was attended by the district inspector of schools, district planner, district water officer, community development officers (CDOs), the deputy speaker of Kitgum district and selected staff of KICWA

After the meeting the CDO, the sub-county chief and councillors of Mucwini sub-county resolved to write to "Food for the Hungry," a child focused international organization that works in Kitgum, to ask for assistance. In subsequent meetings between Mucwini sub-county and Food for the Hungry, it was discovered that the organization's geographical scope of operation included the entire sub-county where Okol Primary Seven School is.

Working with Mucwini sub-county through participating in various follow up activities, Food for the Hungry accepted to construct one block of teacher's house comprising four (4) single rooms which will accommodate four (4) teachers in total. The community contributed 30 bricks per household that had a pupil or pupils in the school. Construction started in August, 2016. The block has since been completed and once commissioned by government, the teachers will occupy it.

The combined effort of the community, KICWA as a CSO, Mucwini sub county and the collaboration with other organizations like Food for the Hungry Aher: The new teachers' accommodation block at resulted into this positive change at the lower local Okol Primary Seven Schoo l government level. The moment KICWA identified the problem, it advocated for re-dress and worked with other stakeholders and now, Okol Primar Seven School has the problem of teacher accommodation reduced. It is envisaged that the school's performance will show a marked improvement now that the teachers can spend more time at school.

21 I 0. Strategic Collaboration results in Safe Drinking Water for Ruchuko Primary School

Community participation in identifying service delivery issues and engaging with duty bearers has resulted into construction of a borehole at Ruchuko Primary School in Abuku Sub County, district.

In 2015, Governance, Accountability, Participation and Performance (GAPP) in partnership with Koboko Civil Society Network (KOCISONET) started implementing the Strengthening Democratic Governance Accountability and Participation for Improved Service Delivery in

Ruchuko Primary School is located at Metino The borehole as a result of constructive collaboration amongst parish and lies in a hilly terrain where water communities, LGs and non-governmental organizations becomes a problem for the community, especially during the dry season. During the rainy season, the pupils and the community get water from a running stream which has been the only savior water-wise for this community.

During a community meeting (Baraza) held on 16th November, 2015 at the Sub County headquarters, the community raised the issue of lack of water. The officials from the Sub County who were in attendance pledged to have this sorted out by drilling a protected well near the school.

Routine follow up meetings conducted at the Sub County on the same issue, among others, did not materialize. The Koboko District Water Engineer was engaged to respond to this need, since Sub County Health Assistant had also expressed concern about diseases related to lack of water.

22 KOCISONET used the copy of the letter to lobby other stakeholders for a safe water source for the school. The community held meetings with the Associazione Centro Aiuti Volontari (ACAV) , an Italian NGO operating in Koboko and other West Nile Districts implementing water and sanitation programs.

ACAV was able to respond positively and constructed a bore hole near the school. The Borehole is now serving four villages of Mungoyo, Yaya and Ruchuko and part of Jomoni in Metino Parish, Abuku Sub County. An estimated I 02 households and a population of approximately 650 people and Ruchuko primary school is now being served by the borehole.

This borehole has changed the lifestyle of the community including the school children from drinking running stream water to using safe water from clean source for drinking and other for other domestic usages.

I I. Bridging the Service Delivery Gap between Communities and Governments

Goya Primary School in Kechi parish, Ludara sub-county had a staggering latrine stance pupil ration of I: I I 0. The school is government aided but its management and administration had not been able to address this hygienically sensitive issue.

The school management committee and the head teacher of the school remained adamant after the original four stances latrine which was constructed in 2013 sunk and a 5 stances latrine was condenmed for use. This made the school of over 900 pupils to use a 4 stances latrine.

In 2015, Governance, Accountability, Participation and Performance (GAPP) in partnership With Koboko Civi l Society Network (KOCISONET) started implementing the Strengthening Democratic Governance Accountability and Participation for Improved Service Delivery in Koboko District.

23 While carrying out its duties, KOCISONET engaged with the Head Teacher of the school and the issue of the latrines was discussed. The situation in the school needed urgent attention.

KOCISONET took up the matter and engaged with the District Education office and the District Health Inspector to intervene to address the challenge of latrines at the school.

Discussions commenced at the district level to construct a latrine for the school. Finally the district planner and the engineer were tasked to make some funds re-allocations to construct a 3 stance latrine for Goya Primary School. Further discussions at the district level, looking at the different priorities and allocations, led to a three (3) stance latrine, which was earlier allocated to Nyarilo Primary School, being now re-allocated to Goya Primary School.

The latrine was constructed in July 2016 by BIG Stores and Construction Company limited. It has now reduced the original stance pupil ratio of I: I IO to I :76.

The Deputy Head Teacher of Goya Primary School says "at least we are fair with latrines now, though we still needed more. I thank KOCISONET for supporting us to convince the district to bring the latrine to Goya because we were already defeated"

Working with district based civil society organizations like KOCISONET has enabled the GAPP program to make vertical interventions that reach down to the lower level communities up to the grassroots. Such interventions also create space for dialogue between communities and their leaders to improve service delivery.

24 12. Stakeholder Collaboration Improves Health Services in Butiaba Sub-county

On 21 March 2016, residents of Butiaba sub-county, woke up to the shock of seeing Butiaba HC Ill with a seriously damaged maternity ward and out patients department (OPD). The office and waiting space had also been seriously damaged by strong winds coupled with rain.

Lake Albert Children Women Advocacy and Development Organization (LACWADO), with support from the GAPP program visited the scene, did a quick survey and realized that there was urgent need to mobilize resources to help restore the health facility to aid the Butiaba community. A campaign was launched to make sure the damaged buildings were repaired as fast as possible.

Various radio talk shows were aired on Bunyoro Broadcasting Services (BBS) in and Biiso FM in Buliisa district, calling for aid to restore the facility. During the talk shows, the Buliisa District chairperson Agaba Simon Kinene and the Buliisa district Deputy Chief Administrative Officer Mr. Agondwa Rhoney led the discussions around the fate of Butiaba HC Ill if action was not taken to rescue it.

To amplify the need for support towards the damaged health facility, LACWADO petitioned the leaders of Buliisa district to pull resources and act fast. To this end LACWADO wrote to the Buli isa district chairperson and copied it to the area Member of Parliament and the Buliisa Resident District Commissioner, and other stakeholders expressing the urgency to overturn the situation.

LACWADO further worked with community leaders to mobilize the community to deliberate on ways of restoring the Butiaba HC Above: Butiaba HC before. Below: Butiaba HC new block Ill. A community dialogue was held where participants included

25 Buliisa district officials - the Vice Chairperson, Health Officer, Secretary for Hospital Administrator and the Community Development Officer among others.

Infectious Disease Institute (IDI) responded positively and repaired the OPD. The community around volunteered casual labor to ensure that the structure was up and running. Patients who seek services from the health facility can now be attended to in the new block which also has ample space for waiting to see the doctor and being treated. In addition, part of this new block is being used as a maternity wing, as more resources are being mobilized to expand on the health facility.

One of the patients, [REDACTED], says "After the storm had destroyed the building, we there was nowhere to sit as we waited to see the doctor. Now, this is much, much better."

The collaboration amongst the community, civil society organizations, local government leaders and the media was key in restoring Butiaba Health Center Ill. It is this combined effort and participation that was able to improve the health services that had been affected by a natural disaster. The vigilance displayed by the different stakeholders in addressing a common problem is what has improv_ed service delivery in Butiaba sub-county.

13. Combined Efforts Improve Health Service Delivery in Masindi

Users of services offered at Kibyamba Health Centre II in Nyangahya division, Masindi Municipal Council have been agitated by being treated from the staff quarters of the health facility because the building where they are supposed to be getting these services has never been commissioned. The staff quarters were small with very little space to give ample treatment to. patients.

26 Kibyamba Health Center II had an incomplete and uncommissioned outpatient department (OPD) for more than two years. During a community dialogue held in October 2015, the community complained of the way the facility was giving services. They complained bitterly about the limited space. In attendance at this dialogue were the Nyangahya division leadership, notably the LC Ill chairperson, councilors and the Assistant Town Clerk.

During that meeting, it was disclosed that the building had not been commissioned because some works on it were still pending. The community then formed a group dabbed the Community Development Forum whose major task was to follow up with the relevant authorities to ensure that the building was completed and commissioned.

Several follow ups and engagements were made by the forum and other individual community members with [REDACTED] Ag. Principle Medical Officer the Nyangahya division officials. Progress was slow, so Masindi Municipality Commissioning the OPD the forum approached Masindi NGO Forum (MDNF) to of Kibyamba Health Centre II take on the task.

With support from the GAPP program, MDNF wrote a letter to the Town Clerk in May 2016 about the concerns of the community and copied this letter to the relevant leaders and stakeholders in Masindi. This prompted the Masindi Resident District Commissioner (RDC) to go at the site to find out what exactly had stopped the building from being commissioned.

The RDC later held a meeting with selected stake holders and MDNF, where it was resolved that the OPD should be completed and commissioned as soon as possible.

Indeed works on Kibyamba Health Center II OPD were completed and the facility was commissioned in July 2016. It is now operational.

MDNF with support from the GAPP program played a crucial role in mobilizing the stakeholders to address the issue of improving health services to the community through a

27 functional health facility. With such continued collaborations and engagements, it is possible to create enabling environments for the improvement of service delivery at community level.

14. Fifty Persons With Disabilities Aided to Benefit Directly from Wealth Program

In 2013, the President of Uganda (GoU) initiated the Operation Wealth Creation (OWC) intervention with the main goal of Enhancing household participation in commercial agricultural production through community mobilization, equitable and timely distribution of agricultural inputs, and facilitation of agricultural production chains.

Like any other intervention, this too, has its challenges, one of which is to ensure that among the beneficiaries, there are Persons with Disabilities (PWDs). The coordinators of this intervention argue that when they are receiving applications for the agricultural items, it is not easy to identify PWDs. Thus, these PWDs have often missed out on the opportunity to benefit from this intervention.

GAPP has supported the Mubende Women with Disabilities Association (MUDIWA), to carry o ut various activities that specifically involve PWDs in MUDIWA project Officer (Kintu Richard) in follow up government programs and interventions. meeting for LCI Chairpersons of Ka longa parish in Kitenga Sub County MUDIWA works in in the sub- counties of Kitenga, Kalwana, Kasambya and Manyogaseka. These sub-counties hold meetings with OWC coordinators and the sub county leadership (Chairperson LCIII and the executive, the sub-county chief, Community Development Officer [CDO] and Parish chiefs).

28 Each time an issue around PWDs benefiting from the OWC intervention, the coordinators said that it was not easy to identify a PWD from the applicants to receive the agriculture items. And because PWDs are not as many as the rest of the applicants, they often missed out unintentionally.

In one of the co-ordination meetings where local government Heads of Departments (Agriculture, education and health) at sub county level met and shared their experience, it was resolved that village chairpersons should be trained in filling the OWC forms properly indicating the disability status of applicants.

This training was conducted by MUDIWA in co-junction with the sub-county CDOs and parish chiefs on Inclusive Service Delivery by the LC/ Chairpersons. The training also included showing the LCI Chairpersons on how they can include the disability status on the names of PWDs while filling OWC forms.

MUDIWA trained a total of two hundred and eighty six (286) LCI Chairpersons, where twelve ( 12) were female and two hundred and seventy four (274) were males from Manyogaseka, Kitenga, Kalwana and Ksambya sub- counties. The trainings were organized according to sub counties and thereafter parish level follow up meetings on the agreed action plans were held. Among the key resolutions from the meeting was to put an identification mark on the names of PWDs whenever they were filling OWC forms.

As a result LCI Chairpersons were able to submit Application lists for OWC, with names of PWDs properly indicating their disability status. The submitted PWDs' names were followed up by the PWD councilors and the Disability structure leaders at the sub county. The follow up reached up to the sub county level to ensure that the OWC Coordinators do not omit the names of the submitted PWDs.

The community members and PWDs themselves would make phone calls to the respective leaders and the sub county staff in charge of the programme to find out progress. MUDIWA would also make phone calls to the PWDs leaders to find out whether follow up was being done and update the leaders on the dates for distribution of agriculture inputs by OWC staff.

29 In addition, continuous mobilization and registration of PWDs who wish to access OWC agriculture inputs has been done by the LCI Chairpersons, councilors and LCIII Chairpersons during community meetings.

In Kitenga sub-county there was a bit of a scuffle for the agriculture inputs by beneficiaries. To control the distribution and ensure that the PWDs got their allotted lot, the parish chief, CDO and PWDs councilors kept aside items for the PWDs. Thus, the PWDs would not line up with the rest of the people and be saved from the scuffle.

This new approach proved successful and fifty (50) PWDs were able to receive OWC items from the project sub-counties as follows: twenty (20) in Manyogaseka, eight (8) in Kitenga, fourteen ( 14) in Kasambya and eight (8) in Kalwana.

MUDIWA has continued to train the LCI Chairpersons and to sensitize the different leaders (chairpersons LCIII, councilors, PWDs councilors and the technical teams - CDOs, Parish chiefs, Agriculture Officer) about the need to target the PWDs to access agriculture inputs. This has formed part of the agenda for the community meetings where leaders continue to mobilize PWDs to participate in many more government programs like Community Driven Development, Youth livelihood Program and Women Fund.

The vigilance shown by MUDIWA, the leadership of the communities at the different levels and the staff of OWC to enable PWDs to benefit from the presidential intervention greatly commended. It is through such vigilance and participation of the different stakeholders that PWDs can also be enabled to participate and benefit from government services.

30 I 5. Increased Local Revenue Improves Services In Lower Local Governments

The GAPP program believes that if locally generated revenue increases, services will improve, especially at the LG levels. When local governments generate revenue, they can decide on how to spend this revenue according to their own set criteria, practices or needs.

Collaborating with various local governments, the GAPP program has made interventions that have resulted into not just increase in local revenue but also improvement in service delivery. A case in point is the Railways Division Council (a lower local government), which is one of the four divisions that make up Lira Municipal Council (a local government).

When the division was created, it had no administrative offices. Operations were conducted in a rented building. With time, Railways division was able to allocate some money to the setting up of a permanent structure to serve as administrative offices. It took quite some time and finally in 2014 the administrative block was completed to the tune of UGX 198 million, all got from the local revenue collections in the division.

Having their own administrative block made it easier for the staff to conduct business. They were able to provide ample space for the different departments within the division, store their documents more securely and attend to their clients.

31 The money that would have otherwise paid for rent was invested in constructing the Ayago­ Temogo road joining the two wards (Ayago and Temogo) which are in Railways division. Construction of this road costed UGX I 13 million.

The two wards were separated by a swamp called Okole swamp. Originally there was no road to join the two wards which made administration costly as alternative routes to reach these wards covered longer distances. In 2014/ I 5 Railways division used local revenue to open up the road with the support from the community and later on gravelling was done by Lira Municipal council under the road fund.

This Ayago-Temogo has stimulated economic activities in the two wards, improving livelihoods and enhancing local revenue base for Lira Municipal Council.

Increased local revenue does actually result in improved service delivery as further exemplified by the construction of the maternity ward at Ayago Health centre 11, which led to upgrading it to Health Centre Ill. The maternity ward costed UGX 30 million. The health center reaches out to a wider community since it now attends to pregnant mothers and their babies. Besides the antenatal, delivery and postnatal services, it also carries out immunization of children and has widened its out patients department.

"I am having my third pregnancy and it is such a relief to come here. I am a resident of Ngetta and I used to walk for five and a half kilometers to Lira main hospital because it was the nearest. Now Ayago Health Centre Ill is just two kilometers so I come, they check me and I can still work in my gardens and do other work" says [REDACTED] (in the middle of mothers) a 25 year old expectant mother.

According to [REDACTED] the Nurse in charge of the health center, the center attends to 5, 172 patients in a month and this way above the estimated number.

With the various interventions of the GAPP program, which include training tax enumeration and assessment committees (both at division and municipal council levels), updating the business registers, and continuous mentoring of the different staff, there is better performance in revenue mobilization and management. Through the Embedded Technical Specialist model,

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