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युगांडा में AYSRH COVID-19 महामारी के दौरान

Ensuring provision and access to information, सेवाएं, and commodities

COVID-19 महामारी ने युगांडा के समुदायों में किशोरों और युवाओं की आजीविका को कई तरह से अस्त-व्यस्त कर दिया है. मार्च में पहली COVID-19 लहर के साथ 2020 रोकथाम के उपायों को अपनाया गया, such as the closure of schools, movement restrictions, and self-isolation. नतीजतन, the health and well-being of young people, especially adolescent and youth sexual and reproductive health (आयुषः) युगांडा में, took a hit.

Impact of COVID-19 on AYSRH

Research suggests that the efforts aimed at managing the COVID-19 pandemic de-emphasized the provision of other essential services, such as those relating to an individual’s SRH. The selective prioritization of some of these services left individuals, particularly adolescents and young people, with no means of making informed decisions and maintaining their health.

Adolescents and young people often access health-related information in discreet ways, पसंद करना:

  • From schools.
  • Youth-friendly corners in health facilities.
  • Through peer educators.

The closure of some of these avenues and restrictions in movement meant that adolescents and young people could not utilize these services—in addition to an already restrictive and unresponsive policy and operational environment that includes:

  • Negative perceptions about access to contraceptives for adolescents and young people.
  • Poor provider attitude.
  • The moralization of sexual and reproductive health (एसआरएच).
  • Unfriendly and high costs of services.

These greatly hinder the improvement of AYSRH in Uganda.

Community health worker during a home visit, providing family planning services and options to women in the community. Credit: Jonathan Torgovnik/Getty Images/Images of Empowerment.
गृह भ्रमण के दौरान सामुदायिक स्वास्थ्य कार्यकर्ता, समुदाय में महिलाओं को परिवार नियोजन सेवाएं और विकल्प प्रदान करना. श्रेय: जोनाथन तोर्गोवनिक/गेटी इमेजेज/इमेजेज ऑफ एम्पावरमेंट.

The Makerere School of Public Health surveyed the impact of COVID-19 on access to family planning services and unintended pregnancies. It indicated that individuals failed to obtain and utilize family planning and other SRH health services due to:

  • Movement restrictions (9%).
  • Closure of health facilities (17%).
  • Fear of contracting the virus (49%).
  • Family would not allow due to COVID-19 (13%).

इन कारणों से, the already alarming rate of teenage pregnancies (25%) drastically increased. Other catalytic factors (adolescents and young women engaging in transactional sex for basic needs, यौन हमला, forced marriage for economic benefits to avert COVID-19-related poverty) aided the increase. Some regions, like the Acholi sub-region, which reported over 17,000 pregnancies, recorded more adolescents and young women procuring abortions. These procedures were predominantly unsafe. इसके साथ ही, a significant portion of adolescent girls and boys re-evaluated their continuation of school.

The confirmation of the second wave of the COVID-19 pandemic brought a series of containment measures like those implemented during the first wave. These spell doom for already vulnerable adolescents and young people and could deter Uganda’s progress toward achieving its demographic dividend phase.

“The confirmation of the second wave of the COVID-19 pandemic brought a series of containment measuresThese spell doom for already vulnerable adolescents and young people.”

The Cross-Sectional Study on the Sexual and Reproductive Health Challenges Among Young People During the COVID-19 Lockdown पाया गया कि 28% of young people reported that they did not have access to information and/or education concerning SRH. More than a quarter of participants (26.9%) reported that testing and treatment services of sexually transmitted infections were not available during the lockdown, जबकि 27.2% of the respondents could not obtain contraceptive supplies.

Improving AYSRH in Uganda in the Context of COVID-19

Even as the government refines the measures for plateauing the COVID-19 pandemic curve, स्वास्थ्य मंत्रालय (मोह) has teamed up with implementing partners in the reproductive health realm in Uganda. They have adopted various innovative strategies for continued provision and access to SRH services and information. इन, if scaled up across Uganda and other countries, could potentially contend with the effects of COVID-19 on AYSRH and salvage the gains registered over the years.

  • Adoption of guidelines and frameworks to guide service delivery in the context of COVID-19: The Adolescent Health Division at the MOH collaborated with key stakeholders and implementing partners. They developed and adopted guidelines for the continuity of SRH service provision for adolescents and young people in the context of COVID-19.

Guideline Proposals (विस्तार करने के लिए क्लिक करें)

  • The use of technology to share information on available SRHR services and access points.
  • Guidance on task sharing/shifting at health facilities.
  • Directives on health service delivery interventions.
  • Leadership interventions.
  • Strategies for sustainable financing interventions.
  • Infrastructure and commodity security interventions.
  • Utilization of digital tools: With school closures and movement restrictions, most adolescents and young people utilized digital tools/online platforms more than usual for school learning, social activities, and general information. Partners in Uganda leveraged this opportunity to share information on SRH, provide counseling, and link users to online pharmacies.

Examples of Tools and Platforms (विस्तार करने के लिए क्लिक करें)

  • *284*15#—USSD code that facilitates access to SRHR information through text.
  • Toll-free line Salt Helpline.
  • Phone apps like Sauti Plus.
  • Dedicated TV channels like Sauti TV as well as social media platforms.
  • खुद की देखभाल: Maintaining health and preventing illness during the lockdown required individuals to rely on their abilities. They utilized information and health commodities available to them, with limited interaction with the health system.

Self-Care Interventions for SRHR Popularized by the MOH and Partners (विस्तार करने के लिए क्लिक करें)

  • HIV self-testing.
  • Self-injectable contraceptives.
  • Utilization of enabling tools and platforms, such as online pharmacies.
  • Encouragement of multi-month supply of some खुद की देखभाल माल.
  • Leveraging the private sector’s reach and platforms: The MOH, in collaboration with development and implementing partners, identified opportunities within the private sector to continue providing SRH services. One of the private companies identified was Safe Boda, a motorbike transport company with a massive reach in the Kampala metropolitan area and neighboring towns. The transport company uses a digital application to coordinate client pickups and drop-offs. It was updated to include an e-shop to facilitate online purchase and delivery of reproductive health products.

E-shop’s Reproductive Health Products (विस्तार करने के लिए क्लिक करें)

  • कंडोम.
  • Contraceptive pills.
  • HIV test kits.
  • Pregnancy test kits.
  • Mama Kits (clean delivery kits).

This innovation enabled individuals, including adolescents and young people, to access products in the comfort of their homes. Similar interventions included the use of regular commercial Boda Bodas (motorcyclists) to distribute reproductive health products from pharmacies and drug shops (chemists) to clients.

  • Social-behavioral change—integrating COVID-19 and SRHR messaging: The MOH and district health teams collaborated with partners to design and integrate targeted messages on SRH. These stakeholders utilized the same communication channels to share information on COVID-19 and SRH. Some partners worked with the district-level COVID-19 task forces and supported the team with hiring megaphones for sharing COVID-19 information across communities—encouraging individuals to seek SRH services and information. The Kampala metropolitan area saw collaboration among the Capital City Authority to design and share messages through mobile media vans, especially in the urban poor communities. Partners also ensured the inclusion of peers and youth leaders within these tasks teams to support responses to adolescents’ and young people’s needs.
  • Layering service provision and leveraging existing structures: The MOH and its partners utilized already existing health service provision structures. They used community service points for HIV/AIDS care and immunization to layer SRH services for individuals, including adolescents and young people.
Phoebe Awuco (orange & white top), a community mobilizer and head of the Self Help Women Group Alita Kole, at her home with her orphan grandchildren. Credit: Jonathan Torgovnik/Getty Images/Images of Empowerment.
Phoebe Awuco (orange & white top), a community mobilizer and head of the Self Help Women Group Alita Kole, at her home with her orphan grandchildren. श्रेय: जोनाथन तोर्गोवनिक/गेटी इमेजेज/इमेजेज ऑफ एम्पावरमेंट.

Looking Forward in the New Normal

The MOH, development and implementing partners, cultural and religious leaders, अभिभावक, and community individuals recommended:

  • Fast-tracking the finalization and dissemination of a continuity strategy for SRHR information and service provision for adolescents and young people, thus encouraging prioritization of the needs of this unique population.
  • Partners ensure continuity in the provision of SRH information and services for adolescents and young people as a complementary effort to the MOH programs.
  • CSOs/Taskforces provide PPE items to peers in the community to protect them from contracting COVID-19 as they do the door-to-door visits to identify and support responses to SRH needs.
  • Including young people in the COVID-19 task force and on the team of village health team workers, to facilitate targeted focus on adolescents and young people.
  • Consultation with organizations and movements of adolescents, युवा लोग, महिलाएं और लड़कियां, and young people living in vulnerable situations on a regular and inclusive basis to guarantee considerations throughout the creation of tailored COVID-19 responses.
  • Invest funding to facilitate scale-up of innovations that yielded most results in reaching the adolescents and young people and supporting them during the lockdowns, while being mindful of innovations such as the digital and tech platforms that are likely to cause inequities.

The government should integrate SRH within COVID-19 and emergency response. To mitigate poor SRH outcomes because of the pandemic lockdown, it should be recognized as an essential service. This is critical for adolescents and young people (especially low-income young women and girls) who are mainly disadvantaged.

युगांडा में AYSRH COVID-19 महामारी के दौरान
कीमती Mutoru, मील प्रति घंटे

Advocacy & Partnerships Coordinator, जनसंख्या सेवा अंतर्राष्ट्रीय

प्रीशियस एक सार्वजनिक स्वास्थ्य पेशेवर है और दुनिया भर में समुदायों के स्वास्थ्य और भलाई के लिए एक विचार-मजबूत वकील है, यौन और प्रजनन स्वास्थ्य और लैंगिक समानता में गहरी रुचि के साथ. प्रजनन में लगभग पांच वर्षों के अनुभव के साथ, मातृ और किशोर स्वास्थ्य, प्रीशियस युगांडा में समुदायों को प्रभावित करने वाले विभिन्न प्रजनन स्वास्थ्य और सामाजिक मुद्दों के लिए व्यवहार्य और टिकाऊ समाधान खोजने के बारे में उत्साहित है, कार्यक्रम डिजाइन के माध्यम से, सामरिक संचार और नीति वकालत. वर्तमान में, वह जनसंख्या सेवा इंटरनेशनल - युगांडा में एक वकालत और भागीदारी समन्वयक के रूप में सेवा कर रही है, जहां वह युगांडा में व्यापक रूप से परिवार नियोजन और प्रजनन स्वास्थ्य के एजेंडे को बढ़ावा देने वाले उद्देश्यों को आगे बढ़ाने के लिए बोर्ड भर के भागीदारों के साथ सहयोग कर रही है।. कीमती उस विचारधारा के सदस्य हैं जो युगांडा और दुनिया भर में आबादी के स्वास्थ्य और भलाई में सुधार पर जोर देता है।. इसके साथ ही, वह एक ग्लोबल हेल्थ कॉर्प्स फिटकिरी है, युगांडा में यौन और प्रजनन स्वास्थ्य और ज्ञान प्रबंधन के लिए स्व-देखभाल के लिए एक चैंपियन. वह एक एमएससी रखती है. न्यूकैसल विश्वविद्यालय - यूनाइटेड किंगडम से सार्वजनिक स्वास्थ्य में.

डॉ. बेन किबिरिगे

Advocacy Manager, Foundation For Male Engagement Uganda

डॉ. Kibirige is a medical doctor by profession, women’s rights activist, sexual reproductive health rights (एसआरएचआर) consultant, and master trainer accredited by Makerere School of Public Health. He has over four years of experience advocating for family planning-related programs and inclusive SRHR service provision to all young people. He also advocates for gender equality, women's rights, and quality and affordable health care for young girls and women through meaningful youth participation in national development processes.​ Dr. Kibirige is currently the general secretary for the SHE DECIDES Uganda local movement and the alternate steering committee representative for Men Engage Network in Uganda. He is a co-founder of Centre for Young Mothers’ Voices, a local NGO advocating for the rehabilitation and reintegration of teenage mothers back into mainstream social life.

टोनी स्नोमैन

Advocacy and Partnerships Officer, Foundation For Male Engagement Uganda

Tonny is the advocacy and partnerships officer at Foundation for Male Engagement Uganda. He is a public health practitioner and sexual reproductive health and rights (एसआरएचआर) specialist with seven years of experience in the design and implementation of SRHR among young people in Uganda. He is the current chairperson of the Youth4UHC movement in Africa as well as a member of the UNFPA Youth technical working group on Population, एसआरएचआर, and Climate change. Tonny is a former country coordinator for the International Youth Alliance for Family Planning (IYAFP) युगांडा में.

नोरा नाकेगेरा

Advocacy and Campaign Officer, Uganda Youth and Adolescent Health Forum (UYAHF)

Norah Nakyegera is a women's rights activist who is committed to advocating for and promoting the sexual reproductive health rights of adolescents and young people. Norah has over two years of experience in adolescent and youth sexual and reproductive health (आयुषः) कार्यक्रम कार्यान्वयन, अनुसंधान, and advocacy.​ She strongly advocates for gender equality, women's rights, quality and affordable health care for young girls and women, and the meaningful participation of young people in the national development processes.​ Currently, she is the advocacy and campaigns officer at the Uganda Youth and Adolescent Health Forum. Her ultimate goal is to create a grassroots movement that understands and values human rights and takes responsibility for respecting, defending, and promoting human rights.​ She is also a member of the Global Shapers Community (an initiative by the World Economic Forum), where young people are central to solution building, नीति निर्माण, and lasting change.

एलेक्स ओमारी

पूर्वी अफ्रीका केएम अधिकारी, ज्ञान सफलता, Amref स्वास्थ्य अफ्रीका

एलेक्स एमरेफ हेल्थ अफ्रीका के क्षमता विकास संस्थान में तकनीकी परिवार नियोजन/प्रजनन स्वास्थ्य अधिकारी हैं. वह क्षेत्रीय ज्ञान प्रबंधन अधिकारी के रूप में काम करता है (पूर्वी अफ़्रीका) ज्ञान सफलता परियोजना के लिए. एलेक्स खत्म हो गया है 8 किशोर और युवा यौन और प्रजनन स्वास्थ्य में वर्षों का अनुभव (आयुषः) कार्यक्रम डिजाइन, कार्यान्वयन, अनुसंधान, और वकालत. वह वर्तमान में केन्या में स्वास्थ्य मंत्रालय में AYSRH कार्यक्रम के लिए एक तकनीकी कार्य समूह के सदस्य हैं. एलेक्स रॉयल सोसाइटी फॉर पब्लिक हेल्थ के निर्वाचित फेलो हैं (एफआरएसपीएच) और परिवार नियोजन के लिए अंतर्राष्ट्रीय युवा गठबंधन के लिए केन्या के पूर्व देश समन्वयक (IYAFP). उनके पास विज्ञान स्नातक है (जनसंख्या स्वास्थ्य) और सार्वजनिक स्वास्थ्य के मास्टर (प्रजनन स्वास्थ्य) केन्याटा विश्वविद्यालय से, केन्या. वह वर्तमान में स्कूल ऑफ गवर्नमेंट एंड पब्लिक पॉलिसी में पब्लिक पॉलिसी में अपनी दूसरी मास्टर डिग्री कर रहा है (एसजीपीपी) इंडोनेशिया में जहां वह एक सार्वजनिक स्वास्थ्य और स्वास्थ्य नीति लेखन विद्वान और सामरिक समीक्षा जर्नल के लिए वेबसाइट योगदानकर्ता भी हैं.

सारा कोसगीक

नेटवर्क और साझेदारी प्रबंधक, Amref स्वास्थ्य अफ्रीका

सारा क्षमता विकास संस्थान में नेटवर्क और भागीदारी प्रबंधक हैं. उसके पास ओवर . है 10 पूर्वी में स्थायी स्वास्थ्य के लिए स्वास्थ्य प्रणाली की क्षमता को मजबूत करने की दिशा में तैयार बहु-देशीय कार्यक्रमों को नेतृत्व प्रदान करने का वर्षों का अनुभव, केंद्रीय, और दक्षिणी अफ्रीका. वह ग्लोबल हेल्थ में महिलाओं का भी हिस्सा हैं - अफ्रीका हब सचिवालय Amref Health Africa में अधिवासित है, एक क्षेत्रीय अध्याय जो चर्चा के लिए एक मंच प्रदान करता है और अफ्रीका के भीतर लिंग-परिवर्तनकारी नेतृत्व के लिए एक सहयोगी स्थान प्रदान करता है. सारा यूनिवर्सल हेल्थ कवरेज की भी सदस्य हैं (यूएचसी) स्वास्थ्य के लिए मानव संसाधन (एचआरएच) केन्या में उप-समिति. उसके पास पब्लिक हेल्थ में डिग्री है और बिजनेस एडमिनिस्ट्रेशन में एक्जीक्यूटिव मास्टर्स है (वैश्विक स्वास्थ्य, नेतृत्व और प्रबंधन). सारा उप-सहारा अफ्रीका में प्राथमिक स्वास्थ्य देखभाल और लैंगिक समानता के लिए एक उत्साही वकील हैं.

आइरीन अलेंगा

ज्ञान प्रबंधन और सामुदायिक जुड़ाव लीड, वकालत त्वरक

आइरीन एक स्थापित सामाजिक अर्थशास्त्री हैं जिनके पास 13 अनुसंधान में वर्षों का अनुभव, पालिसी विश्लेषण, ज्ञान प्रबंधन, और साझेदारी सगाई. एक शोधकर्ता के रूप में, वह over . के समन्वय और कार्यान्वयन में शामिल रही है 20 पूर्वी अफ्रीकी क्षेत्र के भीतर विभिन्न विषयों में सामाजिक आर्थिक अनुसंधान परियोजनाएं. ज्ञान प्रबंधन सलाहकार के रूप में अपने काम में, Irene तंजानिया में सार्वजनिक स्वास्थ्य और प्रौद्योगिकी-केंद्रित संस्थानों के साथ काम करके स्वास्थ्य संबंधी अध्ययनों में शामिल रही है, केन्या, युगांडा और मलावी जहां उसने प्रभाव कहानियों को सफलतापूर्वक छेड़ा है और परियोजना हस्तक्षेपों की दृश्यता में वृद्धि की है. प्रबंधन प्रक्रियाओं के विकास और समर्थन में उनकी विशेषज्ञता, सीख सीखी, और यूएसएआईडी की तीन वर्षीय संगठनात्मक परिवर्तन प्रबंधन और परियोजना बंद करने की प्रक्रिया में सर्वोत्तम प्रथाओं का उदाहरण दिया गया है| वितरण और आपूर्ति श्रृंखला प्रबंधन प्रणाली (एस सी एम एस) 10-तंजानिया में वर्ष परियोजना. मानव केंद्रित डिजाइन के उभरते अभ्यास में, Irene ने USAID को लागू करते हुए उपयोगकर्ता अनुभव अध्ययन आयोजित करके एक सकारात्मक एंड टू एंड उत्पाद अनुभव की सुविधा प्रदान की है| किशोरियों और युवतियों के बीच ड्रीम्स परियोजना (AGYWs) केन्या में, युगांडा, और तंजानिया. Irene संसाधन जुटाने और दाता प्रबंधन में अच्छी तरह से वाकिफ है, विशेष रूप से यूएसएआईडी . के साथ, डीएफआईडी, और यूरोपीय संघ.

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