Contributors: Allan Katamba and Njeri Mbugua
Contraceptive use is low in Uganda with just about 35% of all women using a modern method. The unmet need for these women stands at 28%. Uganda also has one of the fastest rates of population growth at 3.2% per year and a high fertility rate of 5.4 children per woman (PMA2020 2016; UDHS 2016).
Among the reasons for low use of contraception are barriers to access and a shortage of trained health staff. With a sizable adolescent population and high adolescent fertility rates, the unmet need for reproductive health services is expected to increase. However, as The Challenge Initiative moves into its second year of implementation, the Ugandan government is stepping up its response to reduce this unmet need for contraception.
The Initiative – locally implemented by Jhpiego as Tupange for Better Cities – began activities last year in Busia, Buikwe, Iganga and Mukono. All four reflected on their first year of implementation at a recent meeting to prepare for Year 2. The cities trained health care workers on providing long-acting reversible methods and implemented integrated community outreaches in poor urban settlements, which involves bringing family planning and other health services to a venue within the community. In addition, Busia trained village health teams and family planning champions that helped create awareness as well as demand for services through referrals to health facilities.
Buikwe saw an approximate 26.5% increase – from 6,535 to 8,266 – in the number of new acceptors within the period of implementation of March to June 2018 when compared with the same period in 2017.
“The integrated outreaches created an opportunity for women and men to access family planning services that are otherwise unreachable to most of them. With Tupange for Better Cities, the health teams were able to mobilize communities, as family planning services were not very popular at community level,” said Dr. Richard Bbosa, Buikwe’s District Health Office.
In Mukono, the city identified other partners who could support their implementation activities and conducted advocacy efforts with other community stakeholders.
“The Initiative has given us an opportunity to create an awareness through collective efforts with the Municipal leadership. A multi-sectoral approach will improve service delivery leading to affordable services,” said Dr. Anthony Kkonde, Mukono’s Principle Medical Officer.