The Community Score Card (CSC) is a participatory monitoring tool used to engage communities and stakeholders in assessing the quality of public services, identifying gaps, and recommending solutions. In Kayunga and Nakasongola districts of Uganda, the CSC was used to assess the availability and quality of HIV prevention and support services. This article highlights the key findings and action points that emerged from the CSC process.
Key Findings in Kayunga District:
The CSC process in Kayunga district revealed several issues that hindered effective HIV prevention and support services. One of the main issues was the lack of adequate information about pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) as HIV preventive tools. The district and implementing partners were recommended to popularize PEP and PrEP during community sensitization activities. Another issue that emerged was the inadequate social support and protection to people living with HIV (PLHIVs) and gender-based violence (GBV) survivors.
To address the issue of forced cervical cancer screening among PLHIVs, the district health officer (DHO) committed to organize refresher trainings for health workers and engage implementing partners that offer the service to ensure that they seek consent from women and plan with them prior to screening them.
Key Findings in Nakasongola District:
In Nakasongola district, the CSC findings were appreciated by the district authorities, who recognized the value of the exercise in improving the quality of services. The district committed to using the findings to reward excelling facilities since the exercise is independent.
Action Points:
The CSC process in both districts led to the identification of action points that aimed to improve the availability and quality of HIV prevention and support services. The key action points were:
Low utilization of PrEP and PEP services: The district and implementing partners were recommended to conduct facility health and education talks to increase awareness and uptake of these services.
Stockouts of diagnostic medicines: Redistribution within health facilities should be done to ensure that all facilities have the necessary diagnostic tools and supplies.
Including PEP, PREP, and GBV referrals in quarterly sensitization: ICWEA, the implementing partner, committed to including PEP, PREP, and GBV referrals in their quarterly sensitization activities.
The CSC process in Kayunga and Nakasongola districts provided valuable insights into the challenges facing HIV prevention and support services. The findings and action points identified provide a roadmap for stakeholders to improve the quality of services and increase access to HIV prevention and support services. Implementing these recommendations will require the commitment of all stakeholders, including the district authorities, implementing partners, and the community.
