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AYSRH na Uganda N'oge ọrịa COVID-19

Ensuring provision and access to information, ọrụ, and commodities

Ọrịa COVID-19 emebiela ndụ ndị nọ n'afọ iri na ụma na ndị na-eto eto n'ogbe ndị Uganda n'ọtụtụ ụzọ.. Site na COVID-19 izizi mbụ na Machị 2020 wee na nkuchi nke containment jikoro, such as the closure of schools, movement restrictions, and self-isolation. N'ihi ya, the health and well-being of young people, especially adolescent and youth sexual and reproductive health (AYSRH) in Uganda, 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, like:

  • 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 (SRH).
  • 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.
Onye ọrụ ahụike obodo n'oge nleta ụlọ, providing family planning services and options to women in the community. Ebe E Si Nweta: Jonathan Torgovnik/Getty Images/Onyonyo nke Ike.

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%).

N'ihi ihe ndị a, the already alarming rate of teenage pregnancies (25%) drastically increased. Other catalytic factors (adolescents and young women engaging in transactional sex for basic needs, mwakpo mmekọahụ, 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. Na mgbakwunye, 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.”

Nke Cross-Sectional Study on the Sexual and Reproductive Health Challenges Among Young People During the COVID-19 Lockdown found that 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, mgbe 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, Ministry of Health (MOH) 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. Ndị a, 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 (pịa ịgbasa)

  • 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 (pịa ịgbasa)

  • *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.
  • Nlekọta onwe onye: 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 (pịa ịgbasa)

  • HIV self-testing.
  • Self-injectable contraceptives.
  • Utilization of enabling tools and platforms, such as online pharmacies.
  • Encouragement of multi-month supply of some nlekọta onwe commodities.
  • 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 (pịa ịgbasa)

  • Condom.
  • 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. Ebe E Si Nweta: Jonathan Torgovnik/Getty Images/Onyonyo nke Ike.

Looking Forward in the New Normal

The MOH, development and implementing partners, cultural and religious leaders, nne na nna, 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, ndị na-eto eto, women and girls, 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.

AYSRH na Uganda N'oge ọrịa COVID-19
Mutoru dị oké ọnụ ahịa, MPH

Advocacy & Partnerships Coordinator, Ndị Ọrụ Ndị Mmadụ Mba Nile

Precious bụ ọkachamara ahụike ọha na onye echiche siri ike na-akwado ahụike na ọdịmma nke obodo gburugburu ụwa., nwere mmasị siri ike na ahụike mmekọahụ na ịmụ nwa na nha anya nwoke na nwanyị. N'ihe fọrọ nke nta ka ọ bụrụ afọ ise nwere ahụmahụ na ịmụ nwa, ahụike nne na nke ndị nọ n'afọ iri na ụma, Precious na-anụ ọkụ n'obi maka iwepụta ihe ngwọta ga-ekwe omume na nke ga-adigide maka ahụike ọmụmụ na mmekọrịta ọha na eze dị iche iche na-emetụta obodo ndị dị na Uganda., site na usoro mmemme, nkwukọrịta strategic na nkwado amụma. Ugbu a, ọ na-eje ozi dị ka onye na-ahụ maka nkwado na onye nhazi mmekọ ọnụ na Services International - Uganda, ebe ya na ndị mmekọ n'ofe ụlọ ọrụ na-arụkọ ọrụ iji gbasoo ebumnobi ga-akwalite atụmatụ maka atụmatụ ezinụlọ na ahụike ịmụ nwa na Uganda.. Precious debanyere aha na ụlọ akwụkwọ echiche nke na-ekwusi ike na ịkwalite ahụike na ọdịmma nke ndị mmadụ na Uganda na n'ofe ụwa.. Na mgbakwunye, ọ bụ Global Health Corps alum, onye mmeri maka nlekọta onwe onye maka ahụike mmekọahụ na ịmụ nwa na njikwa ihe ọmụma na Uganda. Ọ nwere MSc. na Ahụike Ọha sitere na Mahadum Newcastle – United Kingdom.

Dr. Ben Kibirige

Advocacy Manager, Foundation For Male Engagement Uganda

Dr. Kibirige is a medical doctor by profession, women’s rights activist, sexual reproductive health rights (SRHR) 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.

Tonny Snowman

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 (SRHR) 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, SRHR, and Climate change. Tonny is a former country coordinator for the International Youth Alliance for Family Planning (IYAFP) in Uganda.

Norah Nakyegera

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 (AYSRH) mmemme mmemme, nyocha, 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, ime amụma, and lasting change.

Alex Omari

Onye isi ala East Africa KM, Ọmụma ihe ịga nke ọma, Amref Health Africa

Alex bụ onye na-ahụ maka atụmatụ ezinaụlọ na nka na ahụike Amref Health nke Africa Institute of Capacity Development.. Ọ na-arụ ọrụ dị ka onye isi nchịkwa ihe ọmụma mpaghara (East Africa) maka oru ngo ihe omuma. Alex agafeela 8 ahụmahụ afọ na-eto eto na ndị ntorobịa mmekọahụ na ike ịmụ nwa (AYSRH) imewe mmemme, mmejuputa iwu, nyocha, na nkwado. Ugbu a ọ bụ onye otu ndị ọrụ nka nka maka mmemme AYSRH na Ministry of Health na Kenya. Alex bụ onye a họpụtara ahọpụta nke Royal Society for Public Health (FRSPH) na onye bụbu onye nhazi obodo Kenya maka International Youth Alliance for Family Planning (IYAFP). Ọ nwere nzere bachelọ sayensị (Ahụ Ike Ndị Mmadụ) na Master of Public Health (Ahụike ọmụmụ) sitere na Mahadum Kenyatta, Kenya. Ugbu a, ọ na-agbaso nzere nke abụọ Master's na Public Policy na School of Government and Public Policy (SGPP) na Indonesia ebe ọ bụkwa onye ọkachamara ahụike ọha na ahụike na-ede akwụkwọ na onye na-enye aka na webụsaịtị maka Strategic Review Journal.

Sarah Kosgei

Onye njikwa netwọkụ na mmekọrịta, Amref Health Africa

Sarah bụ onye njikwa netwọkụ na mmekọrịta mmekọrịta na Institute of Capacity Development. O nwechaala 10 Ahụmahụ afọ nke na-enye nduzi na mmemme mba dị iche iche na-akwalite ike nke usoro ahụike maka ahụike na-adịgide adịgide na Eastern., Central, na South Africa. Ọ bụkwa akụkụ nke Women in Global Health – Africa Hub Secretary nke bi na Amref Health Africa, Isi mpaghara nke na-enye ikpo okwu maka mkparịta ụka na ohere imekọ ihe ọnụ maka iduzi mgbanwe nwoke na nwanyị n'ime Africa. Sarah bụkwa onye otu mkpuchi ahụike Universal (UHC) Ọrụ ndị mmadụ maka ahụike (HRH) sub-kọmitii na Kenya. O nwere akara ugo mmụta na Ahụike Ọha na Masters Executive na nchịkwa azụmahịa (Ahụike zuru ụwa ọnụ, Nduzi na njikwa). Sarah bụ onye na-anụ ọkụ n'obi na-akwado maka nlekọta ahụike nke mbụ na nha anya nwoke na nwanyị na Sub-Saharan Africa.

Irene Alenga

Ijikwa ihe ọmụma na ntinye aka obodo, Onye na-akwado ngwa ngwa

Irene bụ ọkachamara n'ihe gbasara akụ na ụba na-elekọta mmadụ nwere ihe karịrị ya 13 ahụmịhe afọ na nyocha, nyocha amụma, njikwa ihe ọmụma, na njikọ aka. Dị ka onye nyocha, o tinyela aka na nhazi na mmejuputa ya 20 Ọrụ nyocha gbasara akụ na ụba mmadụ na ngalaba dị iche iche n'ime mpaghara Eastern Africa. N'ọrụ ya dị ka onye ndụmọdụ njikwa ihe ọmụma, Irene etinyela aka na ọmụmụ gbasara ahụike site n'ịrụ ọrụ ahụike ọha na ụlọ ọrụ lekwasịrị anya teknụzụ na Tanzania, Kenya, Uganda na Malawi ebe o nweworo nke ọma njakịrị akụkọ mmetụta yana mmụba nhụta nke ntinye aka. Ọkachamara ya n'ịzụlite na ịkwado usoro nchịkwa, nkuzi mụtara, a na-egosipụtakwa omume kachasị mma na nhazi mgbanwe nhazi afọ atọ na usoro mmechi nke USAID| Sistemụ njikwa ihe nnyefe na ntinye (SCMS) 10-afọ oru ngo na Tanzania. Na omume na-apụta nke Human Centered Design, Irene emeela nke ọma na njedebe dị mma iji kwụsị ahụmịhe ngwaahịa site na-eduzi ọmụmụ ahụmịhe onye ọrụ mgbe ọ na-emejuputa USAID| DREAMS Project n'etiti ụmụ agbọghọ na ụmụ agbọghọ na-eto eto (Ndị AGYW) na Kenya, Uganda, na Tanzania. Irene maara nke ọma n'ịchịkọta akụrụngwa na njikwa ndị na-enye onyinye, karịsịa na USAID, DFID, na EU.

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