When Popular Participation Won't Improve Service Provision: Primary Health Care in Uganda

Golooba-Mutebi, Frederick

doi:10.1111/j.1467-7679.2005.00281.x

Cited by 45 publications

(45 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This finding is supported by Golooba-Mutebi’s discussion of similar experiences with the implementation of health unit management committees (HUMC) in Mukono District, Uganda [53]. Golooba-Mutebi found that HUMC were successful at a time when AMREF, implementing a World Bank project, paid allowances to members of HUMC to attend meetings and write reports but HUMC nearly grounded to a halt as they transitioned to the government formal structures [53]. While linking social capital espouses partnerships as an essential ingredient in the processes that involve connecting people to formal social services [33], this finding suggests that potential partnerships for effective linkages can be seriously hampered if other interested stakeholders become central players at a later stage in an intervention.…”

Section: Discussionmentioning

confidence: 64%

“…However, from AMREF to government structures, there was a transition failure , which culminated in “accusations” from community members and VHTs of government neglect, failure to equip the VHTs and sustain an incentive structure initiated by AMREF, which affected the linkages. This finding is supported by Golooba-Mutebi’s discussion of similar experiences with the implementation of health unit management committees (HUMC) in Mukono District, Uganda [53]. Golooba-Mutebi found that HUMC were successful at a time when AMREF, implementing a World Bank project, paid allowances to members of HUMC to attend meetings and write reports but HUMC nearly grounded to a halt as they transitioned to the government formal structures [53].…”

Section: Discussionmentioning

confidence: 87%

See 1 more Smart Citation

Linking communities to formal health care providers through village health teams in rural Uganda: lessons from linking social capital

et al. 2017

View full text Add to dashboard Cite

BackgroundCommunity-based programmes, particularly community health workers (CHWs), have been portrayed as a cost-effective alternative to the shortage of health workers in low-income countries. Usually, literature emphasises how easily CHWs link and connect communities to formal health care services. There is little evidence in Uganda to support or dispute such claims. Drawing from linking social capital framework, this paper examines the claim that village health teams (VHTs), as an example of CHWs, link and connect communities with formal health care services.MethodsData were collected through ethnographic fieldwork undertaken as part of a larger research program in Luwero District, Uganda, between 2012 and 2014. The main methods of data collection were participant observation in events organised by VHTs. In addition, a total of 91 in-depth interviews and 42 focus group discussions (FGD) were conducted with adult community members as part of the larger project. After preliminary analysis of the data, we conducted an additional six in-depth interviews and three FGD with VHTs and four FGD with community members on the role of VHTs. Key informant interviews were conducted with local government staff, health workers, local leaders, and NGO staff with health programs in Luwero. Thematic analysis was used during data analysis.ResultsThe ability of VHTs to link communities with formal health care was affected by the stakeholders’ perception of their roles. Community members perceive VHTs as working for and under instructions of “others”, which makes them powerless in the formal health care system. One of the challenges associated with VHTs’ linking roles is support from the government and formal health care providers. Formal health care providers perceived VHTs as interested in special recognition for their services yet they are not “experts”. For some health workers, the introduction of VHTs is seen as a ploy by the government to control people and hide its inability to provide health services. Having received training and initial support from an NGO, VHTs suffered transition failure from NGO to the formal public health care structure. As a result, VHTs are entangled in power relations that affect their role of linking community members with formal health care services. We also found that factors such as lack of money for treatment, poor transport networks, the attitudes of health workers and the existence of multiple health care systems, all factors that hinder access to formal health care, cannot be addressed by the VHTs.ConclusionsAs linking social capital framework shows, for VHTs to effectively act as links between the community and formal health care and harness the resources that exist in institutions beyond the community, it is important to take into account the power relationships embedded in vertical relationships and forge a partnership between public health providers and the communities they serve. This will ensure strengthened partnerships and the improved capacity of local people to leverage resources ...

show abstract

Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 87%

Linking communities to formal health care providers through village health teams in rural Uganda: lessons from linking social capital

et al. 2017

View full text Add to dashboard Cite

show abstract

“…While an absence of choice, and therefore an inability to exit, may on the one hand make the exercise of voice more pressing (Golooba-Mutebi, 2005) it may simultaneously undermine it.…”

Section: (Ii) Monopoly Tendencymentioning

confidence: 97%

The Politics of Public Services: A Service Characteristics Approach

Batley

Mcloughlin

2015

World Development

View full text Add to dashboard Cite

Politics is widely regarded as affecting and being affected by the performance of public services, yet little research differentiates between services in exploring these effects. The article addresses this gap by proposing a framework for understanding and comparing the politics of different services. It identifies how the nature of the good, type of market failure, tasks involved in delivery, and demand for a service-hitherto regarded largely as economic and managerial concerns-affect political commitment, organizational control, and user power. Policy responses can be targeted to address service characteristics where they present opportunities or constraints to better services.

show abstract

“…Escobar 2001; Escobar et al . 2002) and a range of empowerment‐oriented participatory approaches to development (see Mohan and Stokke 2000; Cooke and Kothari 2001; Simon et al 2003; Golooba‐Mutebi 2005). By contrast, the universalizing neoliberal‐inspired approaches imply or advocate global cultural convergence/homogenization through the assimilation of western capitalist consumer culture, and are thus very much metanarratives constituting latter‐day versions of modernization theory (Nederveen Pieterse 2004, 7–21).…”

Section: The ‘Cultural Turn’ and Postcolonialismmentioning

confidence: 99%

Separated by common ground? Bringing (post)development and (post)colonialism together

Simon

2006

Geographical Journal

View full text Add to dashboard Cite

The relationship between mainstream development policy (and perhaps also development studies) and postcolonial theorists has often been characterized as a dialogue of the deaf. Rather like in the old ‘debates’ between adherents of modernization and neo‐Marxist theories, the protagonists are often thought to be talking at or past one another, rather than with each other. This paper reassesses some firmly held views on both sides of the schism. On the one hand, many official development agencies appear to promote business as usual (often quite literally, as a recent War on Want report attests in the case of the UK's DFID using its aid budget to promote profitable opportunities for British corporations). On the other hand, some postcolonial purists rely on surprisingly modernist, totalizing discursive techniques while claiming post‐structural credentials, or baulk at the prospects of practical engagement. Discrepancies between theory, discourse, policy and practice are not the preserve of one side. However, the middle ground is firmer and better trodden than most believe. Considerable progress has been made and the paper assesses examples of productive engagement and concludes with suggestions for carrying forward the challenges.

show abstract

When Popular Participation Won't Improve Service Provision: Primary Health Care in Uganda

Cited by 45 publications

References 29 publications

Linking communities to formal health care providers through village health teams in rural Uganda: lessons from linking social capital

Linking communities to formal health care providers through village health teams in rural Uganda: lessons from linking social capital

The Politics of Public Services: A Service Characteristics Approach

Separated by common ground? Bringing (post)development and (post)colonialism together

Contact Info

Product

Resources

About