Community Participation in Planning, Implementation, Monitoring and Evaluation n Health Service Delivery in Mbarara City, Uganda

Abstract

This study examined the contribution of community participation to Health Service Delivery Mbarara City. Specifically, it assessed how community involvement influences planning, implementation, and monitoring and evaluation of health services. The study was guided by Representative Democracy Theory and Stakeholder Theory and employed a cross-sectional design incorporating both quantitative and qualitative approaches. A sample of 210respondents, including community members and key health officials, was selected using a combination of simple random and purposive sampling, with a response rate of 206. Data were collected via questionnaires for community members and interviews for key informants. Quantitative data were analyzed using descriptive and inferential statistics, while qualitative data were analyzed through content analysis using NVIVO software. Findings indicate a weak positive but significant relationship between community participation in planning and health service delivery, a strong positive influence during implementation, and a moderate positive effect in monitoring and evaluation. The study further found out that active and well-structured community participation in both the planning and implementation of health service delivery enhances the relevance, utilization, and effectiveness of interventions. Engaging residents in identifying priorities and decision-making ensures appropriate resource allocation, fosters ownership, strengthens transparency and accountability, and builds trust between the community and service providers. Adequate training, clear roles, and empowered community representatives are essential for effective engagement, while limited involvement can result in misaligned priorities and reduced service impact. Overall, integrating community voices and supporting their participation is critical for responsive, coordinated, and high-quality healthcare delivery in Mbarara City. The study recommends establishing volunteer health committees, participatory feedback mechanisms, and community scorecards to enhance accountability, resource allocation, and overall quality of health services. These measures can strengthen community ownership and improve the responsiveness of health programs.