Browsing by Person "Kawooya, Vincent"

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Application of social network analysis in the assessment of organization infrastructure for service delivery: A three district case study from post-conflict northern Uganda
(OUP, 2017-06-16) Ssengooba, Freddie; Kawooya, Vincent; Namakula, Justine; Fustukian, Suzanne
In post-conflict settings, service coverage indices are unlikely to be sustained if health systems are built on weak and unstable inter-organization networks-here referred to as infrastructure. The objective of this study was to assess the inter-organization infrastructure that supports the provision of selected health services in the reconstruction phase after conflict in northern Uganda. Applied social network analysis was used to establish the structure, size and function among organizations supporting the provision of (1) HIV treatment, (2) maternal delivery services and (3) workforce strengthening. Overall, 87 organizations were identified from 48 respondent organizations in the three post-conflict districts in northern Uganda. A two-stage snowball approach was used starting with service provider organizations in each district. Data included a list of organizations and their key attributes related to the provision of each service for the year 2012-13. The findings show that inter-organization networks are mostly focused on HIV treatment and least for workforce strengthening. The networks for HIV treatment and maternal services were about 3-4 times denser relative to the network for workforce strengthening. The network for HIV treatment accounted for 69-81% of the aggregated network in Gulu and Kitgum districts. In contrast, the network for workforce strengthening contributed the least (6% and 10%) in these two districts. Likewise, the networks supporting a young district (Amuru) was under invested with few organizations and sparse connections. Overall, organizations exhibited a broad range of functional roles in supporting HIV treatment compared to other services in the study. Basic information about the inter-organization setup (infrastructure)-can contribute to knowledge for building organization networks in more equitable ways. More connected organizations can be leveraged for faster communication and resource flow to boost the delivery of health services. 2017 The Author.
Sub-national assessment of aid effectiveness: A case study of post-conflict districts in Uganda
(BioMed Central, 2017-06-13) Ssengooba, Freddie; Namakula, Justine; Kawooya, Vincent; Fustukian, Suzanne
Background: In post-conflict settings, many state and non-state actors interact at the sub-national levels in rebuilding health systems by providing funds, delivering vital interventions and building capacity of local governments to shoulder their roles. Aid relationships among actors at sub-national level represent a vital lever for health system development. This study was undertaken to assess the aid-effectiveness in post-conflict districts of northern Uganda. Method: This was a three district cross sectional study conducted from January to April 2013. A two stage snowball approach used to construct a relational-network for each district. Managers of organizations (ego) involved service delivery were interviewed and asked to list the external organizations (alters) that contribute to three key services. For each inter-organizational relationship (tie) a custom-made tool designed to reflect the aid-effectiveness in the Paris Declaration was used. Results: Three hundred eighty four relational ties between the organizations were generated from a total of 85 organizations interviewed. Satisfaction with aid relationships was mostly determined by 1) the extent ego was able to negotiate own priorities, 2) ego's awareness of expected results, and 3) provision of feedback about ego's performance. Respectively, the B coefficients were 16%, 38% and 19%. Disaggregated analysis show that satisfaction of fund-holders was also determined by addressing own priorities (30%), while provider satisfaction was mostly determined by awareness of expected results (66%) and feedback on performance (23%). All results were significant at p-value of 0.05. Overall, the regression models in these analyses accounted for 44% to 62% of the findings. Conclusion: Sub-national assessment of aid effectiveness is feasible with indicators adapted from the global parameters. These findings illustrate the focus on results domain and less on ownership and resourcing domains. The capacity and space for sub-national level authorities to negotiate local priorities requires more attention especially for health system development in post-conflict settings. 2017 The Author(s).