Perspectives of Local Government Stakeholders on Utilization of Maternal and Child Health Services; and Their Roles in North Western Uganda

Abstract

Active and systematic engagement of key stakeholders at all levels, from policy-formulation to health service delivery is crucial for success of any health system. In this study, we assessed the perspectives of Lower Local Government (LLG) stakeholders on utilization of Maternal and Child Health (MCH) services; and their roles in North Western Uganda. We conducted a qualitative study in four LLGs in North Western Uganda. In-depth interviews were carried out with elected LLG leaders, health center III in-charges, and midwives. Focus Group Discussions (FGDs) were held with Traditional Birth Attendants (TBAs).

Combined analysis of in-depth interviews (IIs) and FGDs followed predetermined themes that include; stakeholder views on utilization of antenatal care, facility delivery, postnatal care, and childhood immunization services and their roles in improving each of these services. All the stakeholders reported relatively high utilization rates for antenatal care and childhood immunization. They reported a low-level of uptake of health facility delivery and postnatal care services. They all saw themselves as key to effective domestication of internationally and nationally originated health care initiatives.

The stakeholders identified the following as barriers to maternal and child health services’ utilization; low capacity of local governments in localizing national polices and strategies as well as formulating local ones, inadequate interaction between the local stakeholders, inadequate resources, misconceptions, and continued belief in home-based service providers. The study showed that LLG stakeholders are aware of the status of utilization of MCH services, the challenges and their roles.

Deliberate, systematic and active engagement of LLG stakeholders at all stages of implementation of MCH services is critical; more so in a decentralized dispensation. This effectively fastens domestication and decentralization of global health initiatives.