Delegation of the European Union to Eswatini
Community Score Cards (CSC) is a model for structured dialogue between service providers and users. It is a way to define needs and execute action plans at a grassroots level.
The objective of the project is to improve accessibility and satisfaction at health clinics. Eight clinics, each covering 3 communities, participated in the three year pilot project.
One CSC cycle took 8 months. During the first 3 months, patients and medical staff had focus group discussions. These resulted in a list of priorities. Patients, staff and local authorities worked together with World Vision to make the improvements. One example is the construction of ramps for wheelchair users. Finishing the 8 month cycle, the measured satisfaction about the improvements was high. This cycle was repeated 4 times in all 8 clinics.
Total Cost (EUR): 1 155 741.08
EU contracted amount (EUR): 1 155 741.08
Duration: January 2015 - January 2018
Implementing organisation: World Vision Austria
Funding Instrument: European Development Fund (EDF)
Benefitting zone: Eswatini
Patients enjoy better service at health clinics in rural Eswatini after the Community Score Cards process, a model for structured dialogue.
Agrippa Sukati (29) participated in the focus group discussions.
CONTEXT
Focus group discussions in the 8 clinics defined 36 priorities. The most important ones are: shortage of clinic staff, poor hygiene and sanitation, lack of maternity services, insufficient maintenance of infrastructure, shortage of staff and equipment, long waiting times, unfriendly and inadequate attendance by medical staff, and inaccessibility for people living with disabilities. Staff would improvise a ‘treatment area’ with sheets around the disabled patient, outside near the queue, lacking all sense of privacy.
OBJECTIVES
RESULTS
TESTIMONY
Agrippa Sukati (29) participated in the focus group discussions.
When Agrippa was five months old, doctors discovered complications. Born a paraplegic, his family had difficulty to accept him at first. Agrippa:"The first years of my life I went from hospital to hospital. I also stayed with traditional healers on and off for about three years. Therefore I only started primary school at the age of nine instead of six." In spite of this delay in his education, Agrippa got a higher degree in Office Management and Technology. "Even with my diploma, and despite countless job applications, I couldn’t find a job. That’s why I opened my own shoe repair shop at the bus station in 2016. Business is not great, but I’m keeping my head above the water".
Agrippa’s life has not been easy, but at least now he has easy access to his health clinic: "I participated in the focus group discussions where I could let my needs be heard. I wanted access for wheelchair users and better availability of medication. For the first time, we as a community were given a platform to say what we needed. Before, we didn’t even know where to start. Thanks to the dialogue model of CSC, we were given the opportunity to express our demands and act upon them."
Before the ramps were built, Agrippa had to wait outside the door to the waiting room: "I had to shout for help until someone would come and lift me and my wheelchair up and into the waiting room. This was not pleasant. I am so grateful I can move freely in and out of the clinic now." The construction of the ramps isn’t the only improvement coming from the CSC programme. "Nobody at the clinic used to pay attention to me. Now, everyone greets me when I arrive. The staff makes everyone feel welcome at any time of day. This is a great improvement in atmosphere at the clinic."
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FACTS AND FIGURES
PARTNERS