FAMILY PLANNING PROJECT REPORT (Jan-March 2017)

FAMILY PLANNING PROJECT REPORT (Jan-March 2017) Strengthening the integration of family planning services to increase access to family planning services for vulnerable girls and women 1

TABLE OF CONTENTS 1.0 Introduction... 3 1.1 Project progress... 3 2.0 The training... 4 2.1 Health workers training... 4 2.2 Community Volunteers Training... 4 3.0 Family planning Services... 6 3.1 Community Education... 6 3.2 Community based family planning... 7 3.3 Facility based family planning... 9 4.4 Strategies used for penetrating the community... 10 4.0 Challenges... 10 5.0 Conclusion... 10 2

1.0 INTRODUCTION Provision of family planning in Uganda has been a challenge due to lack of knowledge and misconceptions about family planning and this has been an obstacle affecting the service delivery leading to low uptake of the service and unwanted pregnancies. The Kawempe Home Care Family Planning project started in January 2017 to increase access to family planning services for vulnerable girls and women in the community. This project sought to reduce on high levels of unplanned pregnancies, unsafe abortion and mortality rates in our community. It covers 3 months (January-March 2017) of the work that has been done. 1.1 PROJECT PROGRESS Targets Achievements Objective 1: To increase family planning knowledge of 10 health worker and 10 community health worker 100% of health worker dispose increased knowledge and skills in family planning counseling, methods and referral 100% of community health worker have increased knowledge and skills in family planning counseling, methods and community mobilization -From the pre-test, post test and practicum, 10 (100%) of the health workers demonstrated increased knowledge and skills in family planning -10 (100%) of community health workers had increased knowledge in family planning counseling, methods and community mobilization Objective 2: To provide family planning services to 500 vulnerable girls and women in Kawempe division 95 % of clients access good quality family planning services in Kawempe Home Care clinic 95 % of clients receive appropriate referrals, if requires 95 % of vulnerable girls and women receive family planning education and contacts 50 % of clients access good quality basic family planning services or referral in community outreaches -275 (55%) of clients have received quality family planning services -45 (100%) clients that required referral were referred to appropriate centres -1221 people received family planning education -105 (21%) of clients received quality family planning from the community 3

2.0 THE TRAINING The family planning training for health care providers and the community volunteers took place for ten days, with each group taking 5 days respectively. A total of 10 community volunteers and 10 health care providers were trained with the aim of acquiring knowledge and skills so as to sensitize, educate and provide the clients and the community with family planning service. 2.1 HEALTH WORKERS TRAINING The health care providers were trained by an external facilitator, who is an expert trainer from Reproductive Health Uganda. There were lots of exciting activities involved during the training; one of them was use of models for demonstration were everybody tried out to allay anxiety, a participant s manual was provided for reference and members shared their experiences and challenges incurred while in the field. Picture 1: A participant demonstrates on a model Picture 2: The facilitator demonstrates implant insertion In addition a field placement was organized at Kiswa Health Centre IV which is a government facility to enable the participants have hands on and provide evidence of learning. This was also another way for the facilitator to evaluate the training. The medical team was extremely thrilled about this training which exposed them to different types of family planning available in Uganda and enhanced their family planning skills. The team believes that the work is made easy and is looking forward to increasing on the family planning up take. 2.2 COMMUNITY VOLUNTEERS TRAINING The community volunteers were excited about the opportunity offered to them in training for family planning; it was the first of its kind. This training took five days and was facilitated by an internal facilitator from Kawempe Home Care (KHC). They learnt how to effectively sensitize people about family planning and also provide short-term methods. The family planning training was successfully completed and the participants acquired knowledge and skills that they will integrate in the client care package. The community will be penetrated for 4

free services and this will help in reducing on unwanted pregnancies and acquiring children that are planned for. ABOVE: A facilitator training community volunteers, LEFT: A participant practicing how to properly communicate to clients, RIGHT: A participant demonstrating how to use a condom 5

3.0 FAMILY PLANNING SERVICES KHC offers both short term (pills, condoms, moon beads and injectables) and long term methods (IUD and implants). Family planning services were provided to clients both at the facility by health workers and in the community by the community volunteers. The community volunteers sensitized clients in the community, provided methods and referred clients to appropriate health facilities. 3.1 COMMUNITY EDUCATION Picture 3: A community volunteer (in red) educating women during SACCO group meeting Community family planning education was done by a team of 10 community volunteers who took family planning information and methods to women and men in the community. The education targeted both men and women. Men were targeted because when they are aware of benefits of family planning, uptake of services by women is made easier. Family planning education took place for small groups of people in places like markets, saloons, local cinemas and on individual basis including the door to door approach. The community education kicked off in February because January was filled with project initiation and trainings. A total of 1221 people were educated in the community on family planning during the reporting period. Chart 1: Shows the number of clients educated during the quarter 0 515 January February 706 March 6

3.2 COMMUNITY BASED FAMILY PLANNING The community volunteers provided short term family planning methods which included; pills, injectables and moon beads. They also provided male and female condoms, although they were not counted as family planning methods because consistent use wouldn t be ascertained. Women who needed long term methods and those with complicated cases were referred to Kawempe Home Care and other health centres of their convenience. A total of 107 women received methods from the community; 71 received pills, 23 received injectables, 8 received emergence pills and 3 received moon beads. Fifty three women received female condoms and 512 men received male condoms. Forty five women were referred to KHC clinic by the community volunteers for methods and management of complicated cases. Graph 1: Shows the number of clients that received different family planning methods 80 70 71 60 50 45 40 30 20 23 Clients that received methods 10 0 8 3 7

I am able to educate the community on various family planning topics and also give methods Providing family planning In the community My name is Maria Assumpta. I have been a community volunteer at Kawempe Home care for 9 years. The family planning training helped me gain a lot of knowledge in family planning which was previously a gap. I am able to educate the community on various family planning topics and also give methods. After the training I was giving methods under supervision but I passed the interview and can now administer methods on my own including injectables. I usually target places were ladies sit for long hours like the saloons, women SACCO groups and church groups. I also target men at boda-boda (motocycle) stages and garages. Also I talk about family planning everywhere I go. Maria in a saloon educating women on moon beads When I educate people on family planning, they get so interested because some of them know nothing about family planning and some have myths but I counsel them and they get to know the truth. Some people get methods right away and some think about it and get back to me for methods. I thank Kawempe Home Care for giving me knowledge that has added value to my work. I am able to answer all people s questions and am very confident when educating people. 8

3.3 FACILITY BASED FAMILY PLANNING Clients were educated on family planning at the facility on daily basis. They were provided with long term and short term methods. For permanent methods (vasectomy and tubal ligation), clients were referred to other health centres. A total of 168 clients received family planning methods at facility; 25 received pills, 28 received implants, 3 received IUD and112 received injectables. Eight women had their implants removed. Number of women that received FP 3 28 112 25 Pills Injection IUD Implant Picture 4: Shows a clinician inserting an implant 9

4.4 STRATEGIES USED FOR PENETRATING THE COMMUNITY Informing the local village leaders (LC1) about the activities especially when approaching men in groups. This is for security reasons. Sensitizing men about family planning so that they can be in sync with their partners. The outspoken men in the community are mainly targeted because they can easily disseminate the family planning information. When not sensitized, these men can potentially spread misconceptions in the community. The men targeted included boda-boda men (motorcycle taxi), men in local cinemas among others. Women groups where women converge to carry out certain activities. These included saloons, Savings and Credit Co-operative (SACCOs), women church groups Door to door family planning where community volunteers move in homesteads to counsel and give family planning methods. Word of mouth where the clients that receive quality services become the credible influential sources spreading the family planning messages in the community and referring people for the service. 4.0 CHALLENGES -There is lack of pregnancy testing kits in the community to confirm clients pregnancy status before administering family planning methods. -Many women like moon beads which we don t have at free of charge. 5.0 CONCLUSION The Family planning project has helped to equip health workers and community volunteers with knowledge and skills in Family planning. The clients can readily access most methods that they require from KHC. The family planning uptake has greatly increased and we are positive that soon we shall comprehend reduction in unwanted pregnancies in our community. We appreciate Sustain Health Partnerships for the financial support and look forward to more collaboration. 10

APPENDIX 1: DATA COLLECTION TOOL FOR COMMUNITY VOLUNTEERS 11