2015 ccih fp preconference tonny tumwesigye

Uganda Protestant Medical Bureau

ENGAGING FAITH COMMUNITIES IN FAMILY PLANNING

Dr. Tonny Tumwesigye

Executive Director

CCIH Annual Conference 26th – 29th June 2015

www.upmb.co.ug Health in Totality

Background

• Founded in 1957 by government notice no. 672

• National umbrella organization for Protestant, Adventist and Pentecostal Founded member health facilities.

• Health technical arm of the CoU and the SDA Church

• 80% are in Rural & Hard to reach Areas

• It is one of the four religious medical bureau networks in Uganda (UCMB, UMMB, UOMB)


Coverage of UPMB

18 Hospitals

10 Health Centre IV

255 Lower Level Health Facilities

10 Health Training Institutions

Contributing about 40%

of the facility based

private not for profit

Health Care Facilities in

Uganda (Bureaus

contribute 80% & 45% of

Hospital Beds)


UPMB Vision & Mission

• Motto: – “Health in Totality”

• Vision: – “Transformed lives through Christian quality health care”

• Mission: – "Supporting members to witness for Christ through the

provision of quality health care“


UPMB Strategic Areas of focus (2014-2018) 1) Institutional Capacity Development

• Interventions like training and resource mobilization to improve – HRH for member health facilities and Governance structures

2) Support to Health Service Delivery

• Concentrates on logistical and technical facilitation for MHF – Infectious diseases e.g. HIV/AIDS and Reproductive health initiatives and

NCD – Health Systems Strengthening-CHI

3) Patient Safety and Quality Health Services

• Looks at setting standards and monitoring compliance to them for – Accreditation – Patient safety promotion, ICT improvement and Support supervision

4) Research Advocacy and Networking


WHY FOCUS ON FP/RH PROJECTS/PROGRAMS AT UPMB

Driven by;

National performance in Reproductive Health.

Ref; UDHS 2011. All indices are unacceptably Bad.

• Low uptake

• Low access

• Problems in commodity supply

• Very high fertility Rate


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)

• Until 2013, P/RH were being implemented as an Integral part of the health care at Facilities


Current FP/RH Programs

– Packard Foundation – A3-IRH Funded grant – E2A-Pathfinder International Funded Grant – Fp2020-Demand Creating Grant – CCIH/FHI360/JSI-Dialogue with Religious Leaders


FP ACTIVITIES CONT’D • Strengthen Capacity of Church run Health facilities to deveop &

Implement Quality FP services on a large scale yet attracting and unreachable clientele and improve Health services

• Started as Pilots-scattered across the Network • Engage and Strengthen capacity of Religious leaders • 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. • Ensure method Mix of FP services


Packard Grant

0

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

Year 1: Jan 2012 - May 2013 (Baseline) Year 2: Oct 2013 - Sept 2014 Year 3: Oct 2014 - Mar 2015 Progressive Acheivement todate

Chart Title

Male condoms Female condoms POP COC Moon beads Injectable Natural IUDs Implants BTLs Vasectomy Other methods


A3 Grant-FAM


E2A

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000

9,000

January - December 2014 (Baseline) October 2014 - May 2015

Chart Title

Male condoms Female condoms POP COC Moon beads Injectable Natural (LAM & TDM) IUDs Implants BTLs Vasectomy Other methods


FP2020

0

500

1,000

1,500

2,000

2,500

January - December 2014 (Baseline) February - March 2015

Chart Title

Male condoms Female condoms POP COC Moon beads Injectable Natural (LAM & TDM) IUDs Implants BTLs Vasectomy Other methods


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


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.


MALE ENGEMENT

Parent's get education in nutrition, family planning, and general care.


Lessons: Religious leaders • Using religious leaders as agents of change-The

Religious leaders have shown interest in knowing more about the Family planning and this has improved their confidence. Q

• 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“ PLAN A SMALL MANAGEABLE

FAMILY FOR A BETTER LIFE”

• Camps-whole package • All Member Health Facilities • Offer Youth Focused Family Planning Services


CHALLENGES

• Most of the projects are not able to offer permanent methods which is a challenge to the communities.

• High staff turnover especially the focal persons • Untimely monthly reporting which delays the entire reporting

chain • The providers both at facility and community level are not

willing to work as volunteers • Delay in transfer of funds which may delay implementation of

planned activities


BEST PRACTICES

• Working with different categories of providers including facility based health workers, community health workers and religious leaders has greatly improved quality of services offered.

• The involvement of religious leaders has enhanced the platform for RH/FP information to be delivered to congregations during their times of worship.

• Some community health workers especially under the Packard project have been trained on offering the injectable method of FP. This has increased the FP uptake in those particular communities.


CONCLUSSION

• Need is still enormous • Surgical camps should be included in the budgets in future • Train and mentor as many facility staff and CHWs as possible

to avoid setbacks during project implementation. • Emphasize timely accountability and reporting especially to

the community providers • During project design and budget development, facilitation

for the providers should be included to ensure that the providers are motivated.

• Availability of Commodities to ensure a method mix


THANK YOU

2015 ccih fp preconference tonny tumwesigye

Healthcare

health centre

quality health services

health training institutions

health technical arm

ncd health systems

profit health care facilities

lower level health facilities

totality fprh