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Empowering communities to hold governments to account

How we helped

Christian Aid’s partners have worked with communities in Nigeria, Malawi and Kenya to create an environment in which they can enjoy the right to access health services and hold governments and local health authorities to account.  

Kenya

In Kenya, our partner the National Council of Churches of Kenya has supported communities to engage their leaders and local government. Community members use simplified tools to track resource use and gather evidence to influence prioritisation of health service allocations from government funds designed to support local-level development and Ministry of Health projects.

Malawi

In Malawi, our ‘community scorecard’ approach enables communities to assess health service providers, rating their services and performance using a grading system.

Area Development Committees responded by providing temporary sanitary facilities. For example, bathrooms were provided at Nyungwe Health Centre, while community members were encouraged to contribute bricks, sand and labour towards the construction of permanent bathrooms and toilets.

Nigeria

In Nigeria, we have supported Community Development Committees to teach people about their rights and empower them to engage with local authorities to demand quality health services.

The committees were trained and supported to develop a Community Health Agenda - a list of priorities identified by all stakeholder groups.

The change in this time has been tremendous. There is now demand from the communities for health care. They mobilise their own resources to come up with structures, such as the [new] dispensary.

- Tom Opee, Field worker for Christian Aid partner TRDP - the Trasmara Rural Development Programme.

The impact

Communities are now aware of their rights and are holding local authorities to account for the provision of quality health services. This has led to greater access to and uptake of health services, which has in turn improved communities’ health and quality of life.

Kenya

In Kenya, our partners have worked with communities and local health authorities to strengthen health systems, including: medical infrastructure, greater availability of medicines and increased staff capacity.

These factors have improved uptake of and access to health services at a community level - including malaria, HIV, and mother and child services.

In one community, participation by community members in local health facility management resulted in the extension of the maternity wing of the health centre. 

Malawi

In Malawi, the number of health service personnel increased after community scorecard feedback. Improved community participation and social accountability led to local development funds being allocated to a health centre borehole, benefiting 9,724 women.

Nigeria

In Nigeria, we have supported Community Development Committees to teach people about their rights and empower them to engage with local authorities to demand quality health services.

The committees were trained and supported to develop a Community Health Agenda, a list of priorities identified by all stakeholder groups.

Lobbying of the government to challenge discrimination against people living with HIV (PLWHIV) contributed towards the enactment of the HIV and AIDS (Anti-Discrimination) Act 2014, potentially benefiting 3.4 million people (the number of PLWHIV in Nigeria in 2014 according to UNAIDS).