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ENGAGING FAITH COMMUNITIES IN FAMILY PLANNING
DR.TONNY TUMWESIGYE Executive Director UPMB
CCIH Annual Conference June 22nd 2014
UPMB BACKGROUND
• Founded 1957 to manage mission hospital grants and serve as liaison between the facilities and government
• Protestant Churches-COU, SDA, and Pentecostal Churches like Elim, Deliverance, Full Gospel, Pentecostal Assemblies of God and Church of God.
• 80% are in Rural & Hard to reach Areas
• Network of 278 health facilities (18 Hospitals
Including 10 Training Institutions, 7 HCIVs, 54 HCIIIs, 199 HCIIs)
• Part of three Medical Bureaus-Catholic, Moslem and Orthodox
• 45% of the Hospital Beds in Uganda • 65% of the Nursing and Midwives Training • 25% 0f the Lower level facilities • 40% of this is by UPMB • UPMB & UCMB formed JMS to supply Medicine
UPMB- KEY STRATEGIC AREAS
4 Strategic Areas of Focus (2014-2018) • Institution Capacity Development • Support to Health Service Delivery • Patient Safety and Quality Health
Services • Research, Advocacy and Networking
FP/RH IN AT UPMB
• FP implemented within the National Health Framework
• Services are offered by level • Commodities supplied within the National
Framework (NMS (all)
FOCUS ON FP/RH PROJECTS/PROGRAMS AT UPMB
Driven by; National performance in Reproductive Health. Ref; UDHS 2006, 2011. All indices are unacceptably Bad. • Low uptake • Low access • Problems in commodity supply
PAST PERFORMANCE (2002 -2004)
• Strengthening the Capacity of Ugandan Health Networks in Integrated Maternal Health and Sexual Reproductive Health Services (SRH) in Rural Communities – 10 Health facilities in 10 Districts – Funded by Family health International (FHI360) – Focused on SRH IEC & service provision, post-
abortion care with treatment of STIs, Counselling and Provision of Commodities
PAST PERFORMANCE 2006 – 2009
• Reaching Women and Girls with Quality SRH Services and Information – 10 Health facilities in 10 Districts – Funded by Big Lottery Fund/Interact World Wide-
UK – Focused on SRH IEC & service provision, post-
abortion care with treatment of STIs, Counselling and Provision of Commodities
PAST PERFORMANCE-2009 – 2013
• Strategic Project on Maternal and Neonatal Health – Funded by Big Lottery Fund-UK – 31 Health Facilities, 20 Districts – To support facility and community based Maternal
and Neonatal Health services. – Focused on SRH IEC & service provision, post-
abortion care with treatment of STIs, Counselling and Provision of Commodities
– Built Maternal waiting Huts – Provided Ambulances for referral
Current Performance
• National Expansion and Strengthening of Sustainable TBHIV Services in Uganda (NESH) – 2012 - 2017 – Funded by Centres for Disease Control and
Prevention (CDC) – 15 Hospitals in 10 Districts (scaling up Annually-2
in 2012) – Family integrated in on going Activities like
EMTCT
Current Performance • Africa Christian Health Associations (ACHA)
Family Planning Project – 2013 – 2015 – Funded by PACKARD FOUNDATION USA – Pilot in 2 Districts, 2 Health facilities • To strengthen capacity of church run health
facilities to develop and implement quality FP programs on a larger scale ,yet attracting an unreachable clientele and improving rural health services.
UPMB- FP ACTIVITIES
• FP integrated in nation wide EMTCT implementation in 60 UPMB supported Health facilities-the VHTs/ CBVs are still active.
• FP commodity distribution through in-kind support from USAID project in collaboration with Uganda Health Marketing Group (UHMG).
FP ACTIVITIES CONT’D
• Capacity building of health workers and CBVs • Strengthening community referrals for FP
services. • Community mobilization and sensitization. • Conduct integrated FP outreaches • Development and printing of IEC materials.
FP COMMODITY DISTRIBUTION BY UPMB IN FY 2012-2013
No Product Description Unit of measure Quantity Distributed 1 Combined Oral contraceptives (Microgynon) cycle 10,883 2 Progesterone only contraceptives (Microlut) Cycle 2,830 3 Male condoms Piece 164,416 4 Female condoms Piece 500 5 Jadelle(5-year,2-rod levonorgestrel) Implants Piece 6,160 6 Implanon (3-year, 1-rod etonogestrel) Implants Piece 652 7 Depo-provera Injection vial 2,000 8 Misoprostol Tablets tablet 300 9 Copper-T IUDs Piece 264 10 Emergency contraceptive pill 2’s 43
UPMB MHFs Family Planning service utilization statistics by method – FY 2012-2013 and FY 2011-2012
• Data for FY 2012-2013 represents data collected from 85.2% of all UPMB MHFs (100% hospitals,
100% HC IVs, 90.6% HC III and 82% HC II)
• Data for FY 2011-2012 represents data collected from 75.1% of all UPMB MHFs (76.5% hospitals,
157.1% HC IVs, 83% HC III and 73.5% HC II)
FP INTEGRATION-CASE OF BWINDI
Parent's get education in nutrition, family planning, and general care.
FP INTEGRATION
• A total 60 VHTs/CBVs trained to give contraceptives .
• Through this network, more than 500 clients access FP services a month.
• Integrates FP into HIV and postnatal clinics, and runs Family Planning Camps (All Methods including BTL, Vasectomy).
Lessons : Messaging
• FP Messages Be simple, clear and easy to understand –HTSP (Healthy Timing And Spacing)
• Local language most preferred for packaging information/messages (Bicycle Photo-CCIH).
• Consistence in Branding (consistent messages being sent out) makes people appreciate messages e.g
“ PLAN A SMALL MANAGEABLE FAMILY FOR A BETTER LIFE”
Lessons: Working with men
• Husbands/men play a dominant role in decision making regarding Reproductive Health services.
• Most available RH services are not male/men friendly (men are never part of the FP process as women are introduced to FP without their husbands considering that they don’t come with their wives).
• Addressing the RH care of couples would increase male engagement in FP.
Lessons: Religious leaders
• Using religious leaders as agents of change Good uptake of natural methods by Religious leaders-The Religious leaders have shown interest in knowing more about the Family planning and this has improved their confidence.
Quote from a Rev “Initially, I preached messages against use of modern family planning methods, But this has changed with the Training I received. Some of my followers at church ask: How come the message is now different? This issue needs action and not mere prayers, I keep explaining.”
• Peer education is a powerful tool for training e.g use of
religious Champion Religious leaders to Train others
Success story – Peer education for religious leaders
Scale up strategies • FP integration into existing RH services like EMTCT and Cancer
screening • Increased use of CHWs to increase access and utilization for FP
services at community level. • Use of Religious leaders to promote and create demand for
services related to child spacing. • Male involvement • Messaging-Local, simple and consistent • Camps-whole package • All Member Health Facilities • Offer Youth Focused Family Planning Services