Lack of effective communication between communities and hospitals in Uganda: a qualitative exploration of missing links.
Abstract
Background
Community members are stakeholders in hospitals and have a right to
participate in the improvement of quality of services rendered to them.
Their views are important because they reflect the perspectives of the
general public. This study explored how communities that live around
hospitals pass on their views to and receive feedback from the
hospitals' management and administration.
Methods
The study was conducted in eight hospitals and the communities around
them. Four of the hospitals were from three districts from eastern
Uganda and another four from two districts from western Uganda. Eight
key informant interviews (KIIs) were conducted with medical
superintendents of the hospitals. A member from each of three hospital
management boards was also interviewed. Eight focus group discussions
(FGDs) were conducted with health workers from the hospitals. Another
eight FGDs (four with men and four with women) were conducted with
communities within a five km radius around the hospitals. Four of the
FGDs (two with men and two with women) were done in western Uganda and
the other four in eastern Uganda. The focus of the KIIs and FGDs was
exploring how hospitals communicated with the communities around them.
Analysis was by manifest content analysis.
Results
Whereas health unit management committees were supposed to have
community representatives, the representatives never received views from
the community nor gave them any feed back from the hospitals. Messages
through the mass media like radio were seen to be non specific for
action. Views sent through suggestion boxes were seen as individual
needs rather than community concerns. Some community members perceived
they would be harassed if they complained and had reached a state of
resignation preferring instead to endure the problems quietly.
Conclusion
There is still lack of effective communication between the communities
and the hospitals that serve them in Uganda. This deprives the
communities of the right to participate in the improvement of the
services they receive, to assume their position as stakeholders. Various
avenues could be instituted including using associations in communities,
rapid appraisal methods and community meetings.
Citation
BMC Health Services Research (2009), 9:146 [doi:10.1186/1472-6963-9-146]