Tuhimbise Ndibalema is an Assistant Nursing Officer at the Mpumudde Health Centre (HC) IV in Jinja.

Mpumudde Health Centre (HC) IV in Jinja, Uganda, recently expanded to accommodate different departments. Before The Challenge Initiative (TCI) began supporting Jinja in February 2022, each department decided what services to provide without consulting other departments. Specifically, the maternity unit offered only maternal and child health (MCH) services with limited staffing levels constraining service provision. As a result, those who came for antenatal care (ANC) received only delivery and postnatal services. A mother could not receive other services at that specific department because services were not integrated.

Tuhimbise Ndibalema, an Assistant Nursing Officer at the facility, said she was one of only two providers able to provide family planning services. Since both of them are midwives, they would prioritize pregnant women on busy ANC days, while those seeking family planning services may have to wait a long time. If neither of them were there, a family planning client would miss out completely on receiving family method counseling and services.

TCI provided coaching support on several interventions, including family planning integration and whole site orientation (WSO).

Mpummude HC IV had several departments with potential for integration. When TCI came, we learned about improving our indicators and considering family planning as key to reducing maternal and infant mortality. Integrating family planning is one of the interventions we chose to institutionalize at our facility to improve family planning utilization. We are empowering the facility staff to initiate family planning, reduce missed opportunities and client time, and improve service delivery. For the integration to happen, we chose to build the capacity and address myths and misconceptions among the facility staff.”

As a result, the facility conducted a WSO for 10 days, with 29 staff from various departments completing the training. Ndibalema said:

We used to miss many clients from the outpatient department [OPD], laboratory and inpatient departments, for example, because they came for other services, not family planning. But when a health worker introduces a family planning topic, they end up taking one of the methods. As a result, we are currently receiving referrals from different departments to the family planning clinic and we are providing methods in selected departments, which are captured in the family planning registers in the OPD department.

We work hand-in-hand with service providers in the different departments to provide quality services and refer clients. Our system has changed, reducing the number of facility attendance through integrating service. Clients now get a complete package during one visit, and we ensure our clients are more satisfied. Institutionalizing facility integrations into service delivery is very doable by strengthening the health system and increasing linkages at the facility level. It is cost-effective and gives clients satisfaction.”

In just two months of offering integrated services, the facility reached 125 clients in May and 98 clients in June with an additional 74 clients referred. She concluded by saying:

Thanks to TCI for opening our eyes.”