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