Community perceptions of health accountability meetings with local politicians to improve healthcare quality: a qualitative study in Western Uganda

Abstract Background Lack of accountability within healthcare systems contributes to suboptimal healthcare quality and ultimately poor health outcomes, especially in low-income countries. In Uganda, our research team implemented a pilot project of quarterly health accountability meetings between comm...

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Main Authors: HaEun Lee, Neyat Fiseha, Jordan Bateisibwa, Cheryl A. Moyer, Joshua Greenberg, Elisa Maffioli
Format: Article
Language:English
Published: BMC 2024-12-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-024-21025-3
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author HaEun Lee
Neyat Fiseha
Jordan Bateisibwa
Cheryl A. Moyer
Joshua Greenberg
Elisa Maffioli
author_facet HaEun Lee
Neyat Fiseha
Jordan Bateisibwa
Cheryl A. Moyer
Joshua Greenberg
Elisa Maffioli
author_sort HaEun Lee
collection DOAJ
description Abstract Background Lack of accountability within healthcare systems contributes to suboptimal healthcare quality and ultimately poor health outcomes, especially in low-income countries. In Uganda, our research team implemented a pilot project of quarterly health accountability meetings between community members and their local political leaders to discuss healthcare needs and strategies for quality improvement. In this study, we examine the community members’ understanding and perceptions of the health accountability meetings, as well as the perceived impact of the meetings on local healthcare services and community life. Methods We conducted a total of 12 focus group discussions (FGDs), half with men and half with women, in November 2022 across six randomly chosen communities out of the ten communities where health accountability meetings were held. We audio taped, transcribed, and translated all FGDs into English. We collected data on demographics, understanding of the meetings, and perceived changes within healthcare services and the community from 111 participants. Two researchers analyzed the data using an inductive thematic approach, generating five themes. Results We found the following themes: (1) increased inclusivity and promotion of bidirectional communication; (2) increased understanding of patient rights and practicing of collective empowerment by the community; (3) improved provider behavior; (4) enhanced relationships among politicians, community members, and healthcare providers; and (5) identified needs for future improvements. Conclusion Through this qualitative study, we found that the community members perceived the accountability meetings as beneficial in improving the local healthcare services and community life. The study demonstrates the need to prioritize the voices of local communities in efforts to address the accountability gaps, as well as the potential for utilizing the relationship between community members and politicians to address accountability shortfalls in other governmental functions beyond healthcare. Trial registration N/A.
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spelling doaj-art-d09631a28b72402b85d28da3b1fc6c0c2025-08-20T02:40:15ZengBMCBMC Public Health1471-24582024-12-0124111010.1186/s12889-024-21025-3Community perceptions of health accountability meetings with local politicians to improve healthcare quality: a qualitative study in Western UgandaHaEun Lee0Neyat Fiseha1Jordan Bateisibwa2Cheryl A. Moyer3Joshua Greenberg4Elisa Maffioli5Department of Systems, Populations, and Leadership , University of Michigan School of NursingUniversity of Michigan Medical SchoolProgressive Health PartnershipLearning Health Sciences, Obstetrics and Gynecology, University of MichiganCenter for Global Health Equity, University of MichiganHealth Management and Policy School of Public Health, University of MichiganAbstract Background Lack of accountability within healthcare systems contributes to suboptimal healthcare quality and ultimately poor health outcomes, especially in low-income countries. In Uganda, our research team implemented a pilot project of quarterly health accountability meetings between community members and their local political leaders to discuss healthcare needs and strategies for quality improvement. In this study, we examine the community members’ understanding and perceptions of the health accountability meetings, as well as the perceived impact of the meetings on local healthcare services and community life. Methods We conducted a total of 12 focus group discussions (FGDs), half with men and half with women, in November 2022 across six randomly chosen communities out of the ten communities where health accountability meetings were held. We audio taped, transcribed, and translated all FGDs into English. We collected data on demographics, understanding of the meetings, and perceived changes within healthcare services and the community from 111 participants. Two researchers analyzed the data using an inductive thematic approach, generating five themes. Results We found the following themes: (1) increased inclusivity and promotion of bidirectional communication; (2) increased understanding of patient rights and practicing of collective empowerment by the community; (3) improved provider behavior; (4) enhanced relationships among politicians, community members, and healthcare providers; and (5) identified needs for future improvements. Conclusion Through this qualitative study, we found that the community members perceived the accountability meetings as beneficial in improving the local healthcare services and community life. The study demonstrates the need to prioritize the voices of local communities in efforts to address the accountability gaps, as well as the potential for utilizing the relationship between community members and politicians to address accountability shortfalls in other governmental functions beyond healthcare. Trial registration N/A.https://doi.org/10.1186/s12889-024-21025-3Political accountabilityGovernanceHealthcare serviceMeetingsCollective empowermentUganda
spellingShingle HaEun Lee
Neyat Fiseha
Jordan Bateisibwa
Cheryl A. Moyer
Joshua Greenberg
Elisa Maffioli
Community perceptions of health accountability meetings with local politicians to improve healthcare quality: a qualitative study in Western Uganda
BMC Public Health
Political accountability
Governance
Healthcare service
Meetings
Collective empowerment
Uganda
title Community perceptions of health accountability meetings with local politicians to improve healthcare quality: a qualitative study in Western Uganda
title_full Community perceptions of health accountability meetings with local politicians to improve healthcare quality: a qualitative study in Western Uganda
title_fullStr Community perceptions of health accountability meetings with local politicians to improve healthcare quality: a qualitative study in Western Uganda
title_full_unstemmed Community perceptions of health accountability meetings with local politicians to improve healthcare quality: a qualitative study in Western Uganda
title_short Community perceptions of health accountability meetings with local politicians to improve healthcare quality: a qualitative study in Western Uganda
title_sort community perceptions of health accountability meetings with local politicians to improve healthcare quality a qualitative study in western uganda
topic Political accountability
Governance
Healthcare service
Meetings
Collective empowerment
Uganda
url https://doi.org/10.1186/s12889-024-21025-3
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