Research shows that for a relatively modest investment, family planning saves lives and improves maternal and child health outcomes and lifts families out of poverty by helping women have fewer children and freeing them to participate in the labor-force market. Worldwide, 222million people have an unmet need for contraception and in Africa, it is 53%. Uganda’s fertility rate is still ranked among the highest globally; the national family planning prevalence rate remains at 39% among women of reproductive age between 15-49 years and unmet need for family planning at 34.3%.

Uganda’s Maternal Mortality Rate, though reducing, is still very high at 336/100,000 live births, driven by low modern contraceptive use. It is estimated that one-third of maternal deaths and 20% of child deaths can be averted by use of modern contraception, and that women who wait at least two years before becoming pregnant again are more likely to avoid anemia and survive childbirth.

In Uganda, only 26% of married women in their reproductive age are using a modern family planning contraceptive method. Major barriers exist in accessibility, affordability and availability of modern contraception and these include limited awareness on the long-term benefits of FP, myths and misconceptions, limited health care workers to serve overwhelming number of women in need of FP services.

For Uganda to attain its vision of a middle-income economy, it must pursue investment in family planning to support households to have fewer children and subsequently reduce child dependency ratio and increase the number of working- age adults. Family planning is therefore the starting point to support women attend school, participate in the labor-force, pursue their career aspirations and live their dreams.

In 2020 December, we received D-prize award to pilot “Sayana Press contraceptive intervention” among women in Mukono district to contribute to Uganda’s vision of attaining middle income status. In the pilot phase, we trained 50 licensed private practitioners in the distribution of Sayana Press contraceptive interventions and reach over 600 women in 3 months. Private practitioners are considered critical in Uganda’s health system as they reach a wider clientele base in urban settings.

Because of the strong and supportive partnership of the Private health care providers, the program interventions have scaled to include 20 additional facilities in Mukono Districts and 40 private health care facilities Kampala City that have continued to increase access, and utilization of sexual and reproductive health services.

Below are the details

In April 2022, a joint team of consultants from Briaze Health Initiative responded to a call for proposals by Global Health Corps, Uganda to review the Ugandan health system set up with an aim of recommending a feasible HSS project to be implemented by the GHC alumni.

The review was implemented in phases, the activities included; inception meeting with the GHC team, internal meetings were held to agreed on the different departments at MoH to be engaged during the review and among these where; Department of Reproductive and Child Health, Department of Community Health, Department of Environmental Health and Department of NCDs. To narrow down the divisions further. Review documents were developed which included a key informative interview guide for the MoH officials and other stakeholders, a policy document review checklist and a stakeholder analysis spreadsheet. All MoH and National level stakeholder engagement meetings were successful completed. We completed the process with an ideation session with the GHC alumni community.

Both the document review and respondents’ discussions highlighted that although there has been an improvement in some of the health indicators, most of the implementation has been affected by the inadequate funds mainly resulting from the government’s failure to allocate the 15% health sector budget in accordance with the Abuja declaration. Other inherences include, lack of research, poor prioritization and most of the implementation relying on external donors.

Several opportunities for partnership with Global Health Corps were identified guided by the current disease burden and health system building blocks. These included; mental health awareness campaigns using media and community platforms, increasing access to FP information services, focus on adolescents sexual and reproductive health services and information, demand creation for COVID vaccination, for have been identified as well as support an extended GHC fellowship period at the MoH to 2 years so as to reduce on the gap of understaffing. After an intensive one day ideation session with twenty one members of the alumni community, Mental health prevention and promotion for adolescents in Kampala slums was selected with focus on substance and drug abuse as the alumni project. Lastly, the alumni community recommended for a robust needs assessment in selected communities at the start of project implementation