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Use of the RMNCAH Scorecard at District and Health Facility Levels:  Enablers, Deterrents, Lessons Learned and Recommendations

Principal investigator

Co-investigator

Description

Introduction

In 2013, Uganda developed the reproductive, maternal, newborn, child and adolescent health (RMNCAH) Sharpened Plan to accelerate interventions towards the reduction of preventable maternal and child mortality.  To monitor the performance, strengthen accountability and inform decision-making and actions in the delivery of RMNCAH interventions at various health facility levels, the Ministry of Health introduced a RMNCAH scorecard in 2014. This scorecard was automated in the second district health information system (DHIS2) and rolled out to relevant stakeholders in several districts and health facilities of Uganda. Since it was launched five years ago, no research has been carried out to understand the extent, factors, challenges, utility, outcomes and the lessons of its adoption and application. 

Aim

This study seeks to examine these issues to provide evidence which can be used to strengthen the implementation and institutionalization of the RMNCAH score card at district and health facility level in Uganda. The study will be conducted in selected districts and health facilities and shall specifically: (i) assess the extent to which the RMNCAH scorecard has been adopted and utilized in Uganda; (ii) examine the strategies and processes used to implement the RMNCAH scorecard; (iii) determine the perceived effects (both positive and negative) of implementing the RMNCAH scorecard; (iv) investigate the factors that enable or deter the use of the RMNCAH scorecard; and (v) propose practical recommendations on the design and use of the RMNCAH scorecard.

Methodology

This is a cross-sectional mixed methods study which will use document review, key informant interview and semi-structured interview methods to collect data at once from national and district health information system managers, health facility managers, data officers, service providers and stakeholders selected in eight districts of Uganda.

The data for this study will be managed, analysed, interpreted and presented qualitatively and quantitatively. Qualitative data will be entered into NVivo software program and analysed by identifying key content and merging it in relevant sub-themes and themes. Quantitative data from the semi-structured questionnaires will be entered into the Epidata template, cleaned, and labelled. Thereafter, descriptive statistics will be run through univariate and bivariate analysis.