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Evaluation report

2000 Uganda: Documentation of the Community Capacity Building Experience in Uganda

Author: Wilcox, S.; Gaifuba, J.

Executive summary

For many years, organizations and development agencies have struggled with how to empower communities to manage their development processes. This paper documents how UNICEF and the Ugandan Ministry of Health have built the capacity of Ugandan communities to understand, document, prioritize and develop solutions for their problems. It describes how UNICEF and the MOH established Parish Development Committees (PDCs) at the parish or ward level, as the basic capacity building structure.

1. Document Uganda’s experience with community capacity building through the establishment of parish development committees.
2. Identify lessons learned from this process that may be useful in the 2001-2005 Country Program.
3. To share Uganda’s experience of CCB with other people.

In order to conduct this documentation, the consultants visited parish development committees in the four districts where the project was initiated: Jinja, Iganga, Mukono and Kiboga. The consultants also reviewed project documents and interviewed personnel at UNICEF, and the central and district offices of the Ministry of Health.

Findings and Conclusions:
PDCs were composed of members of local government, from parish councils as well as members from the communities in the parishes, with equal male and female representation. Trainers who worked at the sub-county level trained the PDC members, and district level trainers, in turn, trained them. The training consisted of topics that covered: community organization for development; decentralization; gender; behavior-change communication; adult-learning principles; report writing; planning; problem identification and solving; and how to develop a Community Based Management Information System (CBMIS). This training targeted employees from the district levels down to representatives at the village level and the purpose was to reorient their development strategy from a top-down to a bottom-up approach. The PDCs were also structured in a way that integrated them with the decentralized system of local governing councils, in order to encourage political support for their community-based development strategies.

As a first task, the PDCs were asked to collect data about each of the communities in their parish (CBMIS). These data generally included information about the populations, broken down by age and sex, numbers of children attending school, immunization levels, numbers of latrines and information about the quality of water sources. This information is then used to educate the communities about their general status and lead to discussions about solutions for the problems identified. The documentation process revealed that in addition to serving as a basis for community development activities, the CBMIS has also created a realistic basis for parish development plans. Because the PDCs are directly linked with the local governing councils, there is greater likelihood for their development priorities and plans to be accepted and funded.

Other accomplishments noted in the documentation included the strengthening of women’s roles in development activities. Because of the gender equity policy, women are well represented on the PDCs and those who are active tend to take on leadership roles in areas related to the home and children, such as food production, nutritional status, sanitation and child health. Generally, women’s participation in preventive health activities is much higher in the PDC communities. Examples include: infant nutrition meetings; growth monitoring sessions; immunization clinics; attendance at family planning and antenatal clinics.

Other interesting accomplishments include how the PDCs have interfaced between the service delivery system and the communities. In fact, the PDCs have become the entry point to the community. They are viewed by the district medical officers (DMOs) as their “first line health workers” and have been the key organizers for dynamic community participation in immunization campaigns, malaria control and cholera eradication. In fact, the major problem, according to district officials, has been in meeting the dramatically-increased demand for preventive services. Since the PDCs have become active, community data systems report immunization levels that have increased from coverage levels of 20% to 30%, to levels above 80%. District data also shows general increases in preventive health indicators, depending on the number of active PDCs in the district. In addition, there is evidence of good collaboration between the Health Unit Management Committees and the PDCs, with the two groups usually attending each other's organizational meetings and sharing information about community health problems being seen at the health units. In some parishes, the PDCs are used to follow-up on individuals seen at the health units and assure that they are followed in the community outreach clinics.

It was found that all the PDC members interviewed understood their role as volunteers. Many commented on the importance of their work noting the elevated self-esteem they felt from being regarded as trained, knowledgeable leaders in their communities who could collect data about the condition of their communities and parish, and inform others about what they could do to improve their situations. Some of these volunteers commented that their payment for their work was seeing healthier communities with more latrines, cleaner houses and healthier children. They also noted that because they were volunteers, people were less suspicious of their motives for collecting data and trying to improve their communities.

Because of the status they’ve achieved from having the knowledge and skills to diagnose community problems and suggest solutions for resolving them, the PDCs are very interested in expanding their abilities, and many have received training in other development areas such as agriculture, planning, adult literacy, animal vaccination programs etc. PDCs are recognized as the entry points to the communities and many organizations contact them when they want to implement programs at the community level. PDCs are also having success in requesting tax revenues from the local governing councils for their prioritized development projects. To this end, several PDCs have convinced the sub-county and parish councils to allocate specific budgets for their development initiatives.

The documentation concludes that there are several potential resources for sustaining PDC activities. The key seems to be the foundation of a capable PDC that has internalized the ability to understand its needs and assert its rights. Once a PDC is aware of its needs and is able to document them, then they can develop a plan to address them. Many are also using their newly-acquired skills to create income-generating projects.

Lessons Learned:
One of the key lessons learned in the few years that the PDCs have been operating is that the community capacity building process is primarily a district-driven activity that depends largely on the commitment of each district. Their success really depends on the extent to which the district advocates for PDCs, allocates resources to them, provides them with supportive supervision, and generally provides political and administrative commitment to the process. The understanding and support of the CCB process by district and sub-county officials are keys to the success of these interventions. For example, in Iganga, Mukono and Kiboga (all very active PDC districts), the districts have purchased bicycles and other job-related materials for sub-county trainers. Therefore, it is important for there to be continuing efforts by the center and donor agencies to regularly orient and retrain district and sub-county officials.

At the beginning, there was some concern that the LCs might be threatened by the creation of PDCs. So, care was taken to assure that PDCs be created and desired by LCs, and that LCs maintain involvement in the PDC process. It was stressed that they should form the PDCs only when they clearly understand and agree with the roles and responsibilities stipulated as well as the anticipated requirements and limitations of their functions. This has been a very successful approach and is probably responsible for the close working relationships observed between successful PDCs and LCs.

Some observers have seen the issue of volunteerism as an obstacle to the successful functioning of PDCs. As stated above, the consultants did not find this to be the case with the PDCs that were interviewed. When asked, many of them responded that their payment was to see the village standard of living improved. Others mentioned that the recognition they received from the villagers as community workers with important knowledge and skills to share was reward enough for them. The effective PDCs really have a good understanding of their roles and this is largely due to the work performed by the sub-county trainers in preparing them to carry out their responsibilities as well as the supportive supervision the trainers have provided.

One of the obvious lessons is that even though this is a capacity building process that is supposed to shift responsibility for development to the community level and create a bottom-up approach, in actuality it is a long-involved process and requires a lot of top-down support. This means that once the PDCs have been trained and have internalized their roles, they still need on-going support from higher levels in order to learn how to manage the political system and apply their skills. Even though the governing structure is decentralized, there is still a lot of learning and positioning that needs to take place if PDCs are to be effective. For this reason, the PDCs really need to be able to work in partnership with the higher levels in order to become established and fulfill their community development roles.


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