As part of ISIS’s philosophy, we always listen to our community partners to provide the best and most appropriate services to them. We consult, collaborate, monitor and evaluate, and make evidence based decisions following that process. From May to July 2011, we conducted a baseline survey in Uganda in the community surrounding Kiwoko Hospital. The structure and content of the survey was similar to the baselines we have conducted in communities where we work in Humla. We were focused on building our understanding of three primary areas.
Our local data collection team was trained by Kiwoko Hospital’s Community Based Health Care Director, Moses Ssekidde and Dr Kimber Haddix McKay (ISIS’ Research Manager). The team interviewed members of 510 households in 15 villages in the region. The households surveyed ranged from settled cultivators to cattle keeping people in the northern reaches of Kiwoko Hospital’s catchment area. People from many different tribes and backgrounds were included.
Once all of the data was collected and aggregated it was sent to Kimber and a group of university research assistants to analyse. During the last quarter of 2011, ISIS’s research office analysed over 300 variables of interest. In addition to the primary areas of interest, we also collected basic demographic, educational, socio-economic and attitudinal information toward health and health-seeking behaviour. This was done to understand how to serve the communities around Kiwoko Hospital, and sub-populations within them better. We are especially interested in how tribe, socio-economic status or geographic region may play a role in health problems and treatments sought.
We have learned that people rank their community development needs in ways that are reminiscent of the rankings we have seen in the rural communities we work with in Humla, Nepal. People rank access to water, markets and education highest among their development priorities. We also see that there are larger-than-expected issues with food security in some communities, and that struggles with food security actually vary considerably within the region. This may be due to local variability in soil quality and subsistence systems.
Not surprisingly, ‘malaria’ was among the top health problems reported (this is a catch-all local term used for fevers, some of which are not due to malaria). Yet, usage of mosquito nets was low enough to indicate this is an important target area for future work in the community. We found that many people report that they do not visit clinics and hospitals and prefer home or herbal treatments. This is due in large part to distance and cost, though other reasons were listed, including lack of trust in government clinic staff and limited understanding between villagers and hospital staff creating a sense of reluctance to visit some facilities.
Interestingly, it appears from our analyses so far that traditional healers are more commonly visited in villages that are closer to Kiwoko Hospital. It appears that this is because traditional healers set up shop in the very same place they expect to encounter potential patients.
The full results of this survey will help to guide ISIS’ support in the community for years to come.