In most rural settings, the HUMC roles are less well defined, undermining their legitimacy and functioning. This can combine with resource constraints, overworked and under resourced primary care services and health workers and lack of bottom up functioning that weaken their role and impact.
According to the 2012 Health Unit Management Committees (HUMC) guidelines issued by the Ministry of Health, every Health Centre is required to have a functional committee of nine for HCIVs and seven members for HCIIIs. They provide for participation in the functioning of the health centre and PHC activities, to involve communities in planning and implementing health services and health actions and to promote public accountability in health. Despite the restoration of the committee system, there have been bottlenecks in implementation.
Sunday Alioni, the in charge of Oleba HCIII says that before the HUMC trainings by Partners in Community Transformation (PICOT), health personnel did not have a clear direction of how the HUMC were to operate and what their role would be in the finance, budget, staff performance and attendance among others. “The training gave us confidence in handling facility issues through prioritization and joint meetings with staff. We were able to share our work plans with the sub county and lobbed from the council the prioritization of health issues in the sub county plans and budget,” says Ojaku Henry, HUMC Chair Oleba HCIII.
IDF partner PICOT is implementing activities aimed at increasing capacity of citizens to demand for the delivery of quality health services from duty bearers. Medical workers in Maracha and Koboko District breathed a sigh of relief when the Health Unit Management Committees (HUMCs) started producing results after training.
The struggle of putting up a kitchen in Wadra Health center III in Koboko district finally produced fruit after the Health Unit Management Committees were empowered through trainings. The efforts that started much earlier before PICOT’s intervention in Wadra, did not yield much said the health in charge Wadra HCIII Mr. Aciya Robert. “We learnt a great deal of knowledge and skills from the capacity building on the HUMC roles organized by PICOT in 2016 that helped us execute our mandate very well”. Partners in Community Transformation (PICOT) is an NGO supported by IDF in the West Nile Region.
Robert also explained on the plight of the communities as the women especially suffered erratic weather conditions that affected the attendants to patients admitted in the facility. “There has never been a kitchen in the compound of the health facility and our mothers and sisters suffer in preparing food especially during the rainy/windy seasons” He said. Amid such public outcry, they always felt disempowered because of the inadequate resources to help them address the challenges. The HUMCs have since the training been able to plan and come up with strategies that focussed on community sensitization; involvement and increasing their participation in ensuring quality service delivery in the health facilities. As a result, they were able to mobilise the community to lay bricks, raise the wall and timber for the kitchen project. Today the communities are eagerly waiting for the official launch to start enjoying the amenity.
Successes such as these are not only enjoyed by the communities in Koboko. In Oleba Health Center III, one of the busiest facilities in Maracha district also grappled with challenges as the in charge of maternity explained “We were facing a number of challenges without a functional HUMC including the lack of a placenta pit yet the number of deliveries was rising like in the month of March 2017, we delivered 97 mothers, this is a big number. Thanks to the HUMC, as result, we have achieved a lot including the demolition of the old Placenta Pit and built a new one, advocated for renovation of the Maternity word which was approved and renovations are on-going,” says, Asinduru Dorcus, midwife at Oleba HCIII Maracha.
Interactions with HUMCs at the various health facilities in Koboko and Maracha districts showed a team strengthened on their work by the timely intervention of PICOT with capacity building programs for the HUMC not only on their roles but also community engagement meetings with leaders.
The health in charge and secretary to HUMC Oleba HCIII Alioni Sunday elaborated on the great role HUMC had played and thanked PICOT and IDF for partnering with them in improving the health service delivery. “PICOT has made us see a lot of things we were not seeing, now we have been brought closer to the community through the HUMCs and they have been very frank with us during our joint meetings,” added Sunday.