Kawempe Division’s Medical Officer Reflects on Positive Changes Resulting from TCI Engagement
Contributors: Janet Adongo and Denis Sama
Dr. Isaiah Chebrot has been the Division Medical Officer (DMO) of the Kawempe division – one of the Kampala City Council Authority (KCCA) divisions in Uganda – for eight years. He oversees the implementation of health projects and partnerships with many non-governmental organizations (NGOs) and others who support Kawempe. Here, he describes his experience working with The Challenge Initiative (TCI), which has been engaged with Kawempe since 2018.
Out of many projects implemented by different partners in Kawempe, I see the light beyond the tunnel with TCI. When I reflect on the time with TCI, we have not remained as the same division. With the ‘Business Unusual’ approach, TCI first helped us look into ourselves in program design. We learned to identify our gaps and problems and had to think through how to work around them. We were then asked to identify our resources in terms of personnel, finance, materials and systems that would address the problems we outlined in order of their priorities.
One of our biggest challenges was how we would reach the community with family planning services. Only one public health facility provided free family planning in Kawempe division, while over 100 private facilities, mainly for profit, existed. So, we urgently called for a public health committee meeting and incorporated the private sector and other stakeholders. As a result, the private facilities were assessed for suitability, and we reached an agreement to enroll 19 of them to support the program scale up of FP to the community.
During the implementation of the program, the division achieved a lot by incorporating private health facilities. For example, we built the capacity of staff members from our government and private facilities and community health workers to provide services, advocate and mobilize communities through the integration of health services, outreaches, whole site orientation and onsite mentorship for facility staff. Simultaneously, local leaders and government staff members were continually coached on resource mobilization and family planning commodity security.”
Specifically, Dr. Chebrot observed the following achievements during three years of implementing various TCI approaches:
- The capacity to provide family planning services is paramount, and the staff, coaches and mentors among government and private health facilities have been trained.
- Integrating family planning with other health services continues to be provided in the communities through integrated outreaches.
- Resources for family planning are increasingly incorporated into the budgeting process.
- Data reporting systems have improved and are being monitored in government and private facilities.
- More private facilities are supported in addition to the public facility and providing alternative distribution channels to offer family planning commodities, counseling and referrals for commodities that they cannot dispense.
- Advocacy by different stakeholders for resource mobilization and utilization of family planning is discussed at almost all meetings, including on local radio stations.
- Community health workers have been incorporated into all public health programs to create demand, continued mobilization and refer clients for different health services, including family planning.
- Teenage pregnancies and abortions have been reduced because of increased sensitization and access to family planning services.
- Integrated outreaches and mentorships through in-reaches are now being implemented by facilities that TCI funds did not support.
Dr. Chebrot concluded:
All those gains mentioned – and we will ensure they continue – …is why I value TCI as a project with a difference and with brighter light to see beyond the tunnel.”