ANTI CORRUPTION COALITION UGANDA Project Evaluation Report Citizen Action Platform (CAP) Submitted on 18th January, 2016 By Harriet Namisi, Tel: +256 392944674/772-672259, [email protected] /[email protected], Plot 49/51, Bukoto Street – Kamwokya, P.O BOX 9460, Kampala This report highlights an evaluation of the project expected results its contribution to the expected development outcomes. 1 Acknowledgments This evaluation was as a result of support from the Apac Anti Corruption Coalition (TAACC), Apac Local Government, and citizens that participated in the implementation and evaluation process of this project. This work attracted a considerable amount of hard work and dedication from government, organizations, and individuals. We therefore extend our appreciation to all of you. We would like to thank the Partnership for Transparency Fund (PTF) for the financial support towards the project and for the technical backstopping provided during the implementation phase. We are also grateful to Apac District Local Government, The Apac Anti-corruption Coalition and Transparency International in Uganda for accepting to partner with us during the implementation of this project without which, it would have been impossible to get this far. Our sincere thanks go out to the technical team which includes Lilian Kaweesa, Evaline Ayugi and Roy Mukasa for their technical expertise, input and tireless support during the implementation of this project. Finally, our appreciation goes to Harriet Namisi for carrying out this evaluation exercise and putting together this report. Ms. Cissy Kagaba Executive Director 2 Table of Contents Acknowledgments ....................................................................................................................................2 LIST OF ACRONYMS ......................................................................................................................4 CHAPTER ONE .................................................................................................................8 1.0 INTRODUCTION .......................................................................................................................8 1.1 Background to the Citizens Action Platform (CAP) Project ..................................................8 1.2 Methods Of Evaluation .........................................................................................................8 1.3 Citizen Action Platform (CAP) Project Design ..............................................................10 1.4. The Use of ICT in Awareness Raising, Monitoring and Communication .....................11 1.5. The Programme Delivery Mechanism ..........................................................................................11 CHAPTER TWO .................................................................................................................13 2.0. CAP PROJECT FEASIBILITY ........................................................................................................13 2.1. Project Thematic Approach ........................................................................................................13 2.1.2. Awareness Raising, Monitoring and Communication ...............................................................13 2.1.3 Complaints Raising, Analysis/Processing ...........................................................................................15 2.1.4 Aggregation, Verification and Analysis of Grievances ................................................................15 2.1.5. Response to Citizens .......................................................................................................................15 2.2. Overall Impact of Technology .........................................................................................................16 2.2.1. Citizen reporting (what worked/didn’t work) ..............................................................................16 2.2.2. Overall Management by ACCU/TAACC (What worked well/didn’t) .....................................17 2.2.3. Promoting Government Responsiveness ..............................................................................17 2.2.4 Improved Service Delivery .........................................................................................................18 2.3. CAP Project Exit Strategy (Sustainability) ..............................................................................18 CHAPTER THREE .................................................................................................................20 3.0 CAP PROJECT OUTCOMES AND RESULTS .............................................................................20 3.1. Medicines and Clinical Care Provided Corruption – Free and at an Appropriate Level of Quality and Accessibility ....................................................................................................................................20 3.2. Fewer Bribes Solicited/paid .........................................................................................................22 3.3. Reduced Absenteeism among Doctors and Nurses and Mandated Hours of Operation ................................................................................................................................................................23 3.4. Improved transparency and Communication between Service Providers and Citizens .........24 CHAPTER FOUR .................................................................................................................27 4.1 LESSONS LEARNT ......................................................................................................................27 4.2. CHALLENGES ....................................................................................................................................28 4.3. RECOMMENDATIONS ......................................................................................................................29 5.0 CONCLUSION ......................................................................................................................30 CHAPTER FIVE .................................................................................................................31 Appendix 1: Terms of Reference .........................................................................................................31 Appendix II: Quantitative Questionnaire ...........................................................................................34 Appendix III: Qualitative Questionnaire ...........................................................................................36 Appendix V: List of Persons interviewed using Quantitative Questionnaire ....................................37 Appendix VI: List of Participants who took part in the Qualitative Interview ....................................39 3 LIST OF ACRONYMS ACCU Anti-Corruption Coalition Uganda ADLG Apac District Local Government CAO Chief Administrative Officer CAP Citizen Action Platform CSO Civil Society Organisation DHO District Health Officer DISO District Internal Security Officer DLC District Local Council DPC District Police Commander HC Health Centre HUMC Health Unit Management Committee IBM Independent Budget Monitors IEC Information Education and Communication materials ICT Information Communication Technology LC III Local Council Three Chairperson LC V Local Council Five Chairperson OPD Out Patients Department PAF Public Accountability Forum PHC Primary Health Care fund PTF Partnership for Transparency Fund RDC Resident District Commissioner TAACC The Apac Anti-Corruption Coalition TIU Transparency International Uganda VHT Village Health Team 4 Executive Summary This end of project independent evaluation report has been prepared for the Anti-Corruption Coalition Uganda (ACCU) on the Citizens Action Platform Project (CAP Project) in Apac District of Uganda. The two-year pilot project was implemented by ACCU in collaboration with The Apac Anti-Corruption Coalition (TAACC) with financial support from the Partnership for Transparency Fund. The CAP project sought to amplify citizens’ voices through technology to demand for improved service delivery in the health sector. At the heart of the project was its Information and Communications Technology (ICT) platform for citizens and civil society organizations (CSOs) to easily gather information provided by citizens at the grassroots level to inform policy makers and the media, ultimately improving health service delivery, thus contributing to the attainment of the Millennium Development Goal (MDG) 6. The evaluation considered both qualitative interviews with 37 people participating in the Focus Group Discussions at the health centers and 42 quantitative interviews. Six sub counties were visited including: Abongomola, Chawente, Apac, Aduku, Ibuje and Akokoro. On provision of corruption free services, medicines and clinical care through an appropriate level of quality and accessibility, the project has realized a 19.6% improvement from 42.4% at baseline to 62% in the people who reported an improvement in the quality of service delivery. There are current efforts in the visited hospital and Health Centres to ensure that patients access the required services where possible, except in circumstances where drugs may not be available or any other supplies. This is due to the service provider’s knowledge that any poor handling of the patients will be reported via CAP or on radio or maybe discussed in a Public Accountability