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Patient Voice Program and Citizen Voice and Action: Leaders’ responsiveness to RMNCH gaps raised by citizens through community scorecard meetings in Rwanda: A cross-sectional study
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  • Christian Mazimpaka,
  • Dieudonne Ndatimana,
  • Betty Murerwa,
  • Celine Hirwa,
  • Amedee Fidele Ndibaza,
  • Christelle Mutuyimana,
  • Benjamin Kulaaza
Christian Mazimpaka
IntraHealth International Inc
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Dieudonne Ndatimana
IntraHealth International Inc

Corresponding Author:dndatimana@gmail.com

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Betty Murerwa
IntraHealth International Inc
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Celine Hirwa
IntraHealth International Inc
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Amedee Fidele Ndibaza
IntraHealth International Inc
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Christelle Mutuyimana
IntraHealth International Inc
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Benjamin Kulaaza
IntraHealth International Inc
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Abstract

Background: The Patient Voice Program and Citizen Voice and Action models use scorecard meetings for community-provider-government dialogue to improve health services. This study evaluates the responsiveness of leaders and providers to concerns voiced by citizens through these scorecard meetings at the health center and district office levels in Rwanda. Methods: We conducted a cross-sectional study from July to September 2022 in 325 Rwandan health centers across 20 districts. Responsiveness was measured by comparing resolved issues to raised issues. Logistic regression identified predictors of issue resolution, with a p-value less than 0.05 considered significant. Median responsiveness turnaround time was also analyzed. Results: In total, 59.4% (1,163) of the identified gaps were resolved. Facility-level issues experienced a higher resolution rate (65.9%) than district-level issues (35.4%). Gaps at the facility level were 3.24 times more likely to be resolved than those at the district level (OR: 3.24, p<0.001, 95% CI: [2.48,4.25]). Integrated gaps had 1.46 times higher odds of resolution compared to issues stemming from reproductive, maternal, newborn, and child health services (OR: 1.46, p<0.05, 95% CI: [1.13,1.88]). The median responsiveness turnaround time for resolving a gap was approximately 15.4 months (IQR: 6.7-25.8). Conclusions: The study shows that Patient Voice Program and Citizen Voice and Action models are effective in addressing healthcare service gaps. By promoting collaboration among communities, healthcare providers, and governments, these models facilitate targeted, locally-supported solutions that significantly improve the resolution of health service delivery issues.
07 Jul 2023Submitted to Public Health Challenges
07 Jul 2023Submission Checks Completed
07 Jul 2023Assigned to Editor
16 Jul 2023Reviewer(s) Assigned
27 Mar 20241st Revision Received
29 Mar 2024Review(s) Completed, Editorial Evaluation Pending
06 Apr 2024Editorial Decision: Revise Minor