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Second generation plant health clinics in Uganda

Research output: ResearchWorking paper

Documents

Solveig Danielsen, Frank Matsiko, Emmanuel Mutebi, Gabriel Karubanga

The purpose of the present study was to assess the performance of plant clinics in Uganda and to identify system factors that are conducive or constraining to clinic performance. Our analytical framework was derived from the health system model of World Health Organisation (WHO), designed to measure performance and health outcomes. The modified plant health system model was based on six system components: Service delivery, Plant health workforce, Plant health information, Input supply, Finance, and Policy, governance and leadership. As plant clinic performance indicators we used Clinic coverage, Regularity/timeliness and Quality of plant healthcare.
Field work was carried out over 15 months between July 2010 and September 2011 in 13 districts in the eastern, central and western parts of Uganda. A total of 205 plant clinic sessions were held in the period. The plant clinics received 2,598 queries from 2,069 clients during the study period. The clients came from 20 districts, 107 sub-counties, 392 parishes and 851 villages. Despite the short period the plant clinics have been running in Uganda and the modest funds put into them, our findings clearly point out the potential of clinics to enhance the coverage of existing extension services.
Many factors influenced the performance of plant health clinics, from practical, everyday concerns of clinic staff to the policy framework that shapes public sector activities and relationships with the NGO and private sectors. While the basic aspects of clinic operation were well understood by all organisations, there were no common standards for record keeping, data management, monitoring and reporting, either internally in the clinic organisations or externally from the backstopping institutions. There was also no functional system to refer samples from the clinics to diagnostic laboratories.
Although the plant clinics have become part of Ministry policy and districts showed increasing interest and commitment, there are some structural barriers that made it difficult for the districts to institutionalise the clinics and for the Ministry to play their leading role. A mismatch between institutional mandates/authority and allocated resources limited the scope of the actions both at district and national level. The plant clinics risk ‘falling between the two chairs’ of extension and pest and disease control. Finding a solid institutional base for the ‘orphaned’ clinics will be a major challenge.
The plant clinics experienced a noteworthy revival in the study period. Wider stakeholder engagement created momentum for a new generation of the plant clinic initiative with more focus on expansion, consolidation and integration with key actors in plant health. Ownership was strengthened and clinic management improved with stronger local leadership. It was nonetheless evident that the clinic initiative expanded in a loose and unregulated way. It was not always clear who was leading the activities and providing the overall championship to guarantee that basic standards and procedures were in place and followed up on. Many of the observed clinic weaknesses were products of missing coordination, follow up and communication. The sustainability of plant clinics is still uncertain. Funds are limited and skilled human resources to man the clinics have yet to reach a critical mass. Nevertheless, the recent expressions of commitment from the major players suggest that the evolution of stronger links between components of a plant health system is a real possibility.
The use of a plant health system framework derived from human health to analyse events, enabled us to organise the issues and identify key features that affect plant clinics and their surroundings. The initial results are encouraging since the framework gives a structure to the analysis of human behaviour and outcomes and to the identification of interventional needs. The preliminary results presented here help understand what works and why. In general we found a good correlation between plant health system attributes and clinic performance.
Original languageEnglish
PublisherDepartment of Veterinary Disease Biology, University of Copenhagen
Number of pages76
StatePublished - 2012

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