Delivering Community-based Programming in Rural Uganda: A Qualitative Program Evaluation Pubblico

Abstract

Purpose/Problem: Uganda Village Project (UVP) is a grassroots community-based public health program in Iganga, Uganda, that unites international and national allied health students with Ugandan Village Health Teams (VHTs) every summer to implement the UVP Summer Internship Program with the objective of helping ease the health burden in Iganga. For organizations such as this to continue to be effective in their mission, regular program evaluations need to be completed incorporating feedback from their VHTs, community members, and program participants. 

Methods: I used qualitative methods to assess the interns’ and VHTs’ perspectives of the 2022 Summer Internship Program to provide UVP with a participant-based program evaluation. Focus group discussions (FGDs) and in-depth interviews (IDIs) were used to gain the interns’ and VHTs’ emic perspectives on the quality of the program, including as it relates to working with people from different backgrounds, the perceived benefits gained by the surrounding community, and the perceived personal and professional skills gained from working with UVP.

Results: Findings revealed four primary themes: The need for better alignment/understanding of UVP’s mission, structure, purpose, goals, activities, and definition of roles; community involvement in the program; the benefits and drawbacks of working with people from different backgrounds and how cultural sensitivity/ethics and equity relate to this; and the need for a more continuous and thorough M&E plan with sustainable ways to refine the program over time

Conclusion: To better align with the current literature outlining the necessary components of successful community-based public health programs, UVP needs to update its M&E program to include feedback from its participants and community members to create more sustainable and equitable health gains in Iganga District. 

Table of Contents

Chapter 1: Introduction ..................................................................................................... 1

           1.1: Introduction & Rationale ................................................................................... 1

           1.2: Problem Statement.............................................................................................2

           1.3 Purpose Statement..............................................................................................4

           1.4 Research Question...............................................................................................5

           1.5 Significance Statement.........................................................................................5

           1.6: Definition of Terms.............................................................................................5

Chapter 2: Literature Review...............................................................................................7

2.1: Importance of Community-Led Public Health Programs.................................................7

2.2: Interdisciplinary Teams in Global Public Health............................................................9

2.3: Community Benefit of this Approach: .........................................................................11

2.4: Facilitator Benefit of this Approach............................................................................13

2.5: Importance of Evaluation & Programming..................................................................14

2.6: Known Gaps, Challenges, and Limitations...................................................................16

Chapter 3: Methods..........................................................................................................19

           3.1: Introduction.....................................................................................................19

           3.2: Population and Sample......................................................................................19

           3.3: Focus Group Discussions................................................................................... 21

           3.4: In-Depth Interviews..........................................................................................22

           3.5: Plans for data analysis....................................................................................... 22

           3.6: Ethical Considerations.......................................................................................24

           3.7: Limitations and Delimitations............................................................................24

Chapter 4: Results.............................................................................................................26

           4.1 Results...............................................................................................................26

                       Theme One: Purpose of UVP............................................................................26

                       Theme Two: Intern & VHT Roles in the Village.................................................28

                       Theme Three: Perceived Community Experiences/Benefits................................32

                       Theme Four: Benefits of working with UVP for the Interns & VHTs...................37

Theme Five: Drawbacks of Working with UVP for Interns & VHTs.......................................40

Theme Six: Working with People From Different Backgrounds............................................41

Theme Seven: Review of/Advice for UVP............................................................................47

Chapter Five: Discussion, Recommendations & Conclusion................................................51

5.1: Discussion...............................................................................................................51

           5.1.1 Community Involvement in the Program........................................................51

5.1.2 The Benefits & Drawbacks of Working with People from Different Backgrounds.........53

5.1.3 The Need for Bette Alignment/Understanding of UVP’s Organization, Purpose, Goals, Activities, & Definition of Roles.........................................55

5.2: Recommendations & Conclusion..............................................................................58

References.....................................................................................................................60

Appendicies...................................................................................................................63

           Appendix A...........................................................................................................63

Appendix B....................................................................................................................66

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	African Studies Health Sciences, Public Health Education Health Sciences, Public Health
Parola chiave	Qualitative Research Community Health Worker-Based Programs Program Evaluation
Committee Chair / Thesis Advisor	Kate Winskell, Emory University

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