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'sgeteducationinnutrition,familyplanning,andgeneralcare.

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

2015 CCIH FP Preconference Tonny Tumwesigye

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2015 CCIH FP Preconference Tonny Tumwesigye