PHA-Exch> EQUINET PRA Report 10: Consolidating processes for community - health centre partnership and accountability in Zambia

[Rene Loewenson]

EQUINET PRA Report 10: Consolidating processes for community - health centre
partnership and accountability in Zambia,
C Mbwili-Muleya, M Lungu, I Kabuba, I Zulu Lishandu, R Loewenson
 
Cite as: Mbwili-Muleya C, Lungu M, Kabuba I, Zulu Lishandu I, Loewenson R
(2008) 'Consolidating processes for community - health centre partnership
and accountability in Zambia,'  EQUINET PRA project report 10. EQUINET:
Lusaka District Health Team, Equity Gauge Zambia, EQUINET: Harare.
 
Available online at:
http://www.equinetafrica.org/bibl/docs/PRAequitygauge2008.pdf
 
This report has been produced within the capacity building programme on
participatory research and action (PRA) for people centred health systems in
EQUINET. It is part of a growing mentored network of PRA work and experience
in east and southern Africa, aimed at strengthening people centred health
systems and people's empowerment in health. The report presents the work and
outcomes from the follow up action research building on a pilot in 2006 that
aimed to strengthen community-health centre partnership and accountability
in two districts in Zambia. The action research presented consolidated the
participatory approaches initiated in 2006 to further enhance the community
voice in planning, budgeting and implementation activities at HC and
community level; extended the process to two new health centres in Lusaka,
and built the capacity of the 2006 group to facilitate scale up of the work
to other centres. It explored through this the possibilities for scaling up
such processes at wider level. The project demonstrated that using
participatory approaches can de-mystify and remove suspicions surrounding
the district and health centre planning process, strengthen dialogue between
communities and health workers, increase community involvement in planning
and budget processes and resolve issues in the interface between health
workers and communities. If the processes are to be institutionalized the
lessons from the action research are that participatory processes take time
to have impact, need continuous mentoring and resource support in the early
stages, need to be integrated within routine work and supported by
authorities, with orientation of new health workers. Not investing in scale
up of the process, however, leads to persistence of disharmony between
health workers and communities caused by lack of communication and
information flow, undermining the functioning of health systems as envisaged
in policy.
 
December 2008
 
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are welcomed and should be sent to admin at equinetafrica.org 
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