“Something is really changing inside communities in Uganda. They are realising that their government has responsibilities to provide for their health that it is not fulfilling, They are angry”, says, Dorcas Amoding, with contagious conviction.
Amoding is from the Community Health and Information Network (CHAIN), a network of community based organisations that partners with the Alliance’s linking organisation in Uganda, Community Health Alliance Uganda (CHAU) in a Dfid-supported project to improve HIV-related maternal, child and newborn health (MNCH).
As part of the MNCH project, the CHAU is playing a pivotal role in the development of the Maternal Health Coalition, a campaign that demands an effective improvement in the delivery of maternal health care all along the health chain in Uganda, from the creation of health commissioners at the lowest level of local government, to increases in the national budget for maternal health.
The Maternal Health campaign was sparked by Petition 16 2011, a law suit against the Ugandan Government at the Constitutional Court for failing to provide basic maternal health for expectant mothers. The petition was lodged in March 2011 by the Centre for Health, Human Rights and Development (CEHURD) on behalf of the families of Sylvia Nalubowa and Jennifer Anguko, two mothers who died in government hospitals.
The campaign has attracted a growing number of health and non-health related non governmental organisations and all sorts of civil society actors nationally. But crucially, it has also involved communities at the grass root level thanks to CHAIN and other community-based organisations that partner with CHAU in the MNCH project.
“This is community campaigning as I have never seen in Uganda”, Dorcas says. “We are presenting the facts about the appalling state of our healthcare system, and the unacceptable numbers of women and children dying at pregnancy, deliver and post partum. We tell them about Petition 16 2011. Communities now know that what the government provides in terms of health is not a ‘gift’, it is an obligation.” HIV and maternal health are something everybody relates to in Uganda that could well explain how quickly communities are mobilising to claim their health entitlements.
But what is changing? “Our authorities are listening now” replies Dorcas, “At the national level, they are feeling the call for accountability and good governance that the Coalition is bringing to the fore. But the community campaigning is essential in all this. It is creating demand among local authorities who are now asking government at higher level to provide healthcare for their constituencies.”
In just a couple of months, the campaign for maternal health has made enormous progress. The national budget passed a few days ago includes for the first time a specific provision for maternal health, and the national government is promising more attention to maternal health. This is about how health is galvanizing communities to exert their essential role in securing accountability and transparency at all levels of governance.