Effects of a community scorecard on improving the local health system in Eastern Democratic Republic of Congo: qualitative evidence using the most significant change technique

Conflict and Health
Lara S HoRuwan Ratnayake

Abstract

More than a decade of conflict has weakened the health system in the Democratic Republic of Congo and decreased its ability to respond to the needs of the population. Community scorecards have been conceived as a way to increase accountability and responsiveness of service providers, but there is limited evidence of their effects, particularly in fragile and conflict-affected contexts. This paper describes the implementation of community scorecards within a community-driven reconstruction project in two provinces of eastern Democratic Republic of Congo. Between June 2012 and November 2013, 45 stories of change in the health system were collected from village development committee, health committee, community members (20 men and 18 women) and healthcare providers (n = 7) in 25 sites using the Most Significant Change technique. Stories were analyzed qualitatively for content related to the types and mechanisms of change observed. The most salient changes were related to increased transparency and community participation in health facility management, and improved quality of care. Quality of care included increased access to services, improved patient-provider relationships, improved performance of service providers, and improved ...Continue Reading

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Nov 1, 2017·International Quarterly of Community Health Education·Emma SacksHenry B Perry
Jun 7, 2017·Journal of Health, Population, and Nutrition·Sandrine MartinHelen Counihan
Sep 7, 2018·BMC Pregnancy and Childbirth·Jennifer WessonPearl Kalimugogo
Oct 4, 2020·Global Health, Science and Practice·Nicole RendellEmma Field
Sep 20, 2019·Sexual and Reproductive Health Matters·Victoria BoydellRajat Khosla
Jan 3, 2021·International Journal for Equity in Health·Anthony SsebagerekaElizabeth Ekirapa-Kiracho
Nov 3, 2020·International Journal for Equity in Health·Elizabeth Ekirapa KirachoDavid H Peters
Jan 13, 2021·International Journal for Equity in Health·Elizabeth Ekirapa KirachoLigia Paina
Feb 10, 2021·Archives of public health = Archives belges de santé publique·Kendra TonkinNeil Andersson

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