Kotido — District leaders pledge action on staffing, infrastructure, patient confidentiality, sanitation, and service quality following community feedback.
Kotido District leaders have committed to strengthening healthcare delivery following the presentation of findings from a Community-Led Monitoring (CLM) exercise conducted by Nakere Rural Women Activists (NARWOA) in partnership with TASO and CUAMM with funding from the Global Fund
The commitments were made during the Kotido District CLM Feedback Meeting held at Ateker Hotel, where district leaders, health managers, development partners and community representatives reviewed findings gathered through focus group discussions across health facilities in the district.
The Community-Led Monitoring initiative assessed the accessibility, availability, acceptability, equity and quality of health services, giving community members an opportunity to share their experiences and recommend practical solutions for improving healthcare delivery.
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Opening the meeting, NARWOA Executive Director Atta Jessica Ruth said the feedback forum was intended to create an open platform where communities and duty bearers could jointly identify solutions to challenges affecting health service delivery.
"This is our space. Let us be free and discuss openly. Let us come up with tangible resolutions that will improve health services for our people," she said.
Atta emphasized that Community-Led Monitoring is not intended to fault health workers but to strengthen accountability by generating evidence from communities and supporting government efforts to improve health services.
Government welcomes community monitoring
Assistant Resident District Commissioner Lokwii Peter Abarahams praised the initiative, saying Community-Led Monitoring complements existing government monitoring mechanisms by giving citizens a direct voice in evaluating health services.
He noted that the Government continues to invest heavily in the health sector but urged communities to embrace preventive healthcare through proper hygiene and responsible health-seeking behaviour.
"So many people go to the General Hospital while forgetting the lower health facilities closer to them. Communities should also pay attention to primary healthcare, personal hygiene and regularly monitor their own health status," he said.
Lokwii said his office had received complaints from residents who claimed they had been turned away from health facilities because of poor personal hygiene, underscoring the need for continued community sensitization.
He also urged health workers to improve communication with patients.
"Patients want to understand their illnesses. Health workers should explain medical issues in a simple and respectful manner. Community-Led Monitoring is adding value to the work of traditional monitoring systems, and the feedback should be received positively."
District pledges action
Kotido Chief Administrative Officer Fredrick Nyanga commended NARWOA for extending monitoring to health facilities that district officials are often unable to reach because of limited resources.
"We appreciate NARWOA because you reached more than ten health facilities, yet even as a district we sometimes manage to monitor only about six," he said.
Nyanga acknowledged several concerns raised through the monitoring exercise, including the deteriorating general ward at Kotido General Hospital, poor conditions at Panyangara Health Centre III, inadequate patient confidentiality, understaffing at several facilities including Kamor Health Centre, and the need for nutritional support for people receiving Antiretroviral Therapy (ART).
He pledged to continue lobbying for additional health workers, especially for lower-level facilities such as 405 Health Centre II, while advocating for increased wage allocations.
The CAO revealed that funding had already been secured to renovate the maternity ward and construct a modern outpatient department housing all key service units.
"By September, we expect the challenge of inadequate space to have been addressed through the ongoing construction works," he said.
On medicine availability, Nyanga explained that high consumption rates and National Medical Stores distribution schedules sometimes create supply challenges but noted that electronic medicine management systems have strengthened accountability.
He also appealed for continued government investment in road infrastructure, saying poor road networks continue to affect access to healthcare services in remote communities.
"We shall take these recommendations seriously, share them through the CAO's office and engage partners where additional support is required."
DHO highlights progress
Kotido District Health Officer Dr. Achar Severino thanked NARWOA and its partners for supporting community engagement and strengthening accountability within the health sector.
He said the district has made significant progress over the last decade.
"When I first came to Kotido ten years ago, sanitation was one of our biggest challenges. We deliberately recruited health assistants to improve sanitation and public health."
According to Dr. Achar, the district's health workforce has increased from 124 staff to 314, while Kotido General Hospital alone now has 125 health workers.
He said the district has also expanded specialist healthcare services, including orthopaedic, dental and mental health care, supported by senior nursing cadres and six medical officers.
Several infrastructure projects are underway, including construction of a new outpatient department, expansion of the maternity ward, establishment of a dedicated neonatal ward and maternal theatre, construction of a mortuary, installation of a larger incinerator and placenta pit, and plans to build a larger general ward.
Dr. Achar also announced plans to upgrade Kacheri Health Centre III to Health Centre IV, including the establishment of a nutrition unit for the treatment of malnourished children, although insecurity in the area remains a challenge.
He further disclosed that the President has pledged to upgrade five Health Centre IIs within the district.
Responding to concerns about medicine management, Dr. Achar defended health workers, saying electronic medicine tracking systems have greatly improved accountability.
"My staff do not steal medicines because every medicine is tracked through our electronic system," he said.
He acknowledged concerns about poor attitudes among some health workers and said disciplinary measures are being taken where necessary.
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Partners call for collaboration
CUAMM representative Mary Kodet thanked the district leadership for embracing Community-Led Monitoring and supporting stronger collaboration between health facilities and communities.
She called for continued cooperation among government, partners and communities to mobilize additional resources and sustain the gains already achieved.
"We appreciate the support we have received in linking us to communities. Together we can mobilize more resources and continue improving health services."
Commitment to continuous improvement
Closing the meeting, Dr. Achar assured participants that the district would act on the recommendations emerging from the Community-Led Monitoring exercise.
"We are taking your feedback positively. Where mistakes happen, please consider human error, but continue giving us feedback. Soon we shall install suggestion boxes in our health facilities so that communities can continue sharing concerns."
He called for continued teamwork between communities, health workers, district leaders and development partners.
"We are committed. We shall not let you down. Together, we shall make health services better for everyone."
The meeting concluded with stakeholders agreeing that Community-Led Monitoring has become an important platform for strengthening accountability, improving dialogue between communities and health providers, and ensuring that health services respond more effectively to the needs of the people they serve.
