Motivation to Participate in Health Advocacy and Health Services: An evaluation of Advocacy for Better Health

Abstract

This study utilized the theory of planned behavior to investigate motivations for participating in health advocacy initiatives in Uganda. This study sought to uncover why participants choose to engage in health systems advocacy to evaluate the Advocacy for Better Health intervention. A household survey was administered to 946 respondents to capture norms, attitudes, and perceived behavioral control around health services and health advocacy. An exploratory factor analysis identified four latent factors: knowledge of health rights and responsibilities, perception of self-efficacy for health systems change, perception of quality of health facility services, and trust in medical system. In keeping with the Advocacy for Better Health theory of change, logistic regression showed increased odds of participation in advocacy associated with unit increases in knowledge of health rights and responsibilities and unit increases in perception of self-efficacy. Qualitative focus groups and key informant interviews validated these latent constructs. The implication is that efforts to engage citizens in health advocacy for health systems accountability should emphasize knowledge of rights and self-efficacy.