Dr. Tonny Tumwesigye, Executive Director of the Uganda Protestant Medical Bureau describes the organizations composition and mission and explores how faith communities can be engaged in family planning education and promotion.

1. ENGAGING FAITH COMMUNITIES IN
FAMILY PLANNING
DR.TONNY TUMWESIGYE
Executive Director UPMB
CCIH Annual Conference June 22nd 2014

2. UPMB BACKGROUND
• Founded 1957 to manage mission hospital
grants and serve as liaison between the
facilities and government
• Protestant Churches-COU, SDA, and
Pentecostal Churches like Elim, Deliverance,
Full Gospel, Pentecostal Assemblies of God
and Church of God.
• 80% are in Rural & Hard to reach Areas

3. • Network of 278 health facilities (18 Hospitals
Including 10 Training Institutions, 7 HCIVs, 54
HCIIIs, 199 HCIIs)
• Part of three Medical Bureaus-Catholic, Moslem
and Orthodox
• 45% of the Hospital Beds in Uganda
• 65% of the Nursing and Midwives Training
• 25% 0f the Lower level facilities
• 40% of this is by UPMB
• UPMB & UCMB formed JMS to supply Medicine

4. UPMB- KEY STRATEGIC AREAS
4 Strategic Areas of Focus (2014-2018)
• Institution Capacity Development
• Support to Health Service Delivery
• Patient Safety and Quality Health
Services
• Research, Advocacy and Networking

5. 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)

6. FOCUS ON FP/RH
PROJECTS/PROGRAMS AT UPMB
Driven by;
National performance in Reproductive Health.
Ref; UDHS 2006, 2011. All indices are
unacceptably Bad.
• Low uptake
• Low access
• Problems in commodity supply

7. PAST PERFORMANCE (2002 -2004)
• Strengthening the Capacity of Ugandan Health
Networks in Integrated Maternal Health and Sexual
Reproductive Health Services (SRH) in Rural
Communities
– 10 Health facilities in 10 Districts
– Funded by Family health International (FHI360)
– Focused on SRH IEC & service provision, post-
abortion care with treatment of STIs, Counselling
and Provision of Commodities

8. PAST PERFORMANCE 2006 – 2009
• Reaching Women and Girls with Quality SRH
Services and Information
– 10 Health facilities in 10 Districts
– Funded by Big Lottery Fund/Interact World Wide-
UK
– Focused on SRH IEC & service provision, post-
abortion care with treatment of STIs, Counselling
and Provision of Commodities

9. PAST PERFORMANCE-2009 – 2013
• Strategic Project on Maternal and Neonatal
Health
– Funded by Big Lottery Fund-UK
– 31 Health Facilities, 20 Districts
– To support facility and community based Maternal
and Neonatal Health services.
– Focused on SRH IEC & service provision, post-
abortion care with treatment of STIs, Counselling
and Provision of Commodities
– Built Maternal waiting Huts
– Provided Ambulances for referral

10. Current Performance
• National Expansion and Strengthening of
Sustainable TBHIV Services in Uganda (NESH)
– 2012 - 2017
– Funded by Centres for Disease Control and
Prevention (CDC)
– 15 Hospitals in 10 Districts (scaling up Annually-2
in 2012)
– Family integrated in on going Activities like
EMTCT

11. Current Performance
• Africa Christian Health Associations (ACHA)
Family Planning Project
– 2013 – 2015
–Funded by PACKARD FOUNDATION USA
–Pilot in 2 Districts, 2 Health facilities
• To strengthen capacity of church run health
facilities to develop and implement quality
FP programs on a larger scale ,yet
attracting an unreachable clientele and
improving rural health services.

12. UPMB- FP ACTIVITIES
• FP integrated in nation wide EMTCT
implementation in 60 UPMB supported
Health facilities-the VHTs/ CBVs are still
active.
• FP commodity distribution through in-kind
support from USAID project in collaboration
with Uganda Health Marketing Group
(UHMG).

13. FP ACTIVITIES CONT’D
• 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.

14. FP COMMODITY DISTRIBUTION BY UPMB IN FY
2012-2013
No ProductDescription Unitofmeasure QuantityDistributed
1 CombinedOralcontraceptives(Microgynon) cycle 10,883
2 Progesteroneonlycontraceptives(Microlut) Cycle 2,830
3 Malecondoms Piece 164,416
4 Femalecondoms Piece 500
5 Jadelle(5-year,2-rodlevonorgestrel)Implants Piece 6,160
6 Implanon(3-year,1-rodetonogestrel)Implants Piece 652
7 Depo-proveraInjection vial 2,000
8 MisoprostolTablets tablet 300
9 Copper-TIUDs Piece 264
10 Emergencycontraceptivepill 2’s 43

15. UPMB MHFs Family Planning service utilization statistics by method – FY 2012-2013
and FY 2011-2012
• DataforFY2012-2013 representsdatacollectedfrom85.2%of allUPMB MHFs (100% hospitals,
100% HCIVs,90.6% HCIII and82% HCII)
• DataforFY2011-2012 representsdatacollectedfrom75.1%of allUPMB MHFs (76.5% hospitals,
157.1% HC IVs,83% HCIII and73.5% HC II)

16. FP INTEGRATION-CASE OF BWINDI
Parent'sgeteducationinnutrition,familyplanning,andgeneralcare.

17. FP INTEGRATION
• A total 60 VHTs/CBVs trained to give
contraceptives .
• Through this network, more than 500 clients
access FP services a month.
• Integrates FP into HIV and postnatal clinics,
and runs Family Planning Camps (All Methods
including BTL, Vasectomy).

18. 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
“ PLAN A SMALL MANAGEABLE FAMILY FOR A
BETTER LIFE”

19. 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.

20. Lessons: Religious leaders
• Using religious leaders as agents of change Good uptake of
natural methods by Religious leaders-The Religious leaders
have shown interest in knowing more about the Family
planning and this has improved their confidence.
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

21. Success story – Peer education for
religious leaders

22. 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
• Camps-whole package
• All Member Health Facilities
• Offer Youth Focused Family Planning Services