Inclusive Sexual and Reproductive Health

A number of fundamental health challenges threaten the well-being of Ugandans, including under-5 mortality, malnutrition, HIV/AIDS and reproductive health. Access and coverage is still lower than the global averages and targets despite several interventions that exist to improve maternal, newborn and child health. The weak health systems in Uganda to implement and support these interventions and the poor quality of services along a continuum of care-from pregnancy to childbirth and post childbirth means that pregnant women and children unnecessarily face the burden of illness, mal-nutrition and mortality

The Uganda’s persistently high maternal mortality rate of 438 per 100,000 live births is attributed to a weak health system, characterized by inadequate capacity to recruit, train and motivate health personnel at Health Facility levels and inadequate medicines and medical supplies that affect delivery of quality health services, especially for rural populations. Although Maternal and Child Survival is a high strategic priority as indicated in the National Development Plan and the National Health Policy, Uganda is far from achieving the SDG targets of reducing maternal mortality ratio to less than 70 per 100,000 live births, neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births

Uganda has the second youngest populations in the World, with children under 18 years accounting for 56.7% and young people (10-24 years) accounting for 31.4% of her population. The demand for Sexual and Reproductive Health and Rights (SRHR) and HIV services is growing since many are becoming sexually active and of reproductive age, coupled with the current unmet need for SRHR and services across all age groups.

With a generalized HIV prevalence estimated at 6% nationally with pockets of higher HIV prevalence especially among key and priority populations (KPs and PPs), implies that Uganda is still far from the SDG targets of ensuring universal access to sexual and reproductive health-care services, including family planning, information and education and universal health coverage. Targeting key and priority populations (KPs and PPs), people in reproductive age, adolescent and young people with information, services and support to Sexual and Reproductive Health and Rights (SRHR) will be a critical game changer in improving the health status of the Ugandan population.

ICD focus on inclusive sexual and reproductive health of people by: Improving both the ’supply‘ of health services (the availability and quality of services) and the ’demand for‘ services (uptake), Taking an  integrated approach which strengthens the health systems and addresses the greatest health needs among the most affected, focusing on improvements in the health of women of child-bearing age, children under five and adolescents, engaging families and communities in promoting positive health-related behaviour (both preventative and health-seeking), tackling social barriers, engaging a range of health service providers including government, private sector as well as empowering health rights holders to hold service providers to account while recognizing that government is the duty-bearer in the provision of health care and articulation of health policy.

In 2011, ICD received grants from Management Sciences for Health under the Strides for Family Health programme (USAID funded) to improve the delivery of quality Family Planning, Reproductive Health and Child Survival interventions in Bugiri and Namayingo districts.

Currently, the Heroes 4 Gender Transformative Action Programme (Heroes 4 GTA is a four-year integrated sexual reproductive Health and Rights Programme (ISPHD) implemented in partnership with Amref Health Africa, Cordaid, MIFUMI and International Center for Research on Women (ICRW) with Amref Health Africa in the lead. Heroes 4 GTA aims at improving the wellbeing of young people (10-24 years) and women (15-49 years) by empowering them with SRHR/SGBV information in 9 districts of high burden in Uganda to fully enjoy their sexual reproductive health and rights. In Bugiri, the Heroes programme is working with Inclusive Community Development (ICD) in the Sub Counties of: Kapyanga, Budhaya and Buluguyi to deliver on objective one of the programme. Heroes through objective one seeks to provide better information to young people in a bid to promote greater freedom of choice about their sexuality and this is done through curriculum-based approaches.

Heroes 4 GTA in response to the need expressed by different local governments to create awareness in their communities on laws and policies that protect adolescents, youth and women from SRHR violations and SGBV sensitized 10 communities around the 10-targeted schools in Bugiri District. The sensitization sessions were on prevention and response to SGBV using the Domestic Violence Act 2010 and management of teenage pregnancy in school settings using the revised guidelines for the prevention and management of teenage pregnancy in school settings in Uganda among others.

Hesitancy in embracing the return to school of teenage mothers remains a big challenge in most communities in Uganda. The guideline that was developed with reference to Draft National School Health Policy and Sexuality Education Framework emphasizes the importance of Adolescents enjoying their rights to SRHR/SGBV services.