Training of Health Units Management Committees (HUMCs) and Performance of Health Centers in Eastern Uganda.

Abstract

Community participation has been emphasized internationally as a way of enhancing accountability, as well as a means to enhance health goals in terms of coverage, access and effective utilization. As a result, countries have embraced and supported introduction of Health Unit Management Committees in rural health facilities (Goodman and Apwora, 2011). This study was conducted to establish the relationship between training of Health Unit Management Committees (HUMCs) and performance of health centers in Eastern Uganda. This study employed a mixed methods approach within a pre-post randomized community trial study design to explain how training of HUMCs triggers improved performance of health centres. The unit of analysis in the study was the response of the performance of Health Centres to training of the members of HUMC. Clinical outputs like Out-Patient Department (OPD attendances, deliveries in health facilities, immunization coverage). Twelve health centres were selected for in-depth intervention study in the experimental arm and twelve health centres were selected in the control arm for this study on training of HUMCs to stimulate productivity of the health centres. This study, established that training increases level of trust between HUMCs and health workers thereby leading to a highly motivated workforce. Their motivation was shown in the significantly high level of dedication to their duty; positive correlation values despite the myriad challenges facing their facilities such as drug stock-outs, high demand for services against a thin workforce, and limited facility resources. The study recommends that for effective performance of Health Unit Management Committees, the central government, through Ministry of Health should organize training sessions at District levels so that each year, there are new skills they receive.