Uganda - Integrated reproductive and child health services improve reproductive health behaviors for adolescents and adults

BACKGROUND. In Uganda, maternal mortality ratio is 435 deaths per 100,000 live births and child mortality rate is 76 deaths per 1,000 live births. Contraceptive prevalence remains low at 24% and unmet need for family planning is high at 41%. THE PROGRAM. Plan Uganda, a child-centered international development organization, implemented a five-year (2005-2010) community-based health project in the rural districts of Luwero, Kamuli and Tororo and the urban district of Kampala, and with a total target population of 1 million. The project aimed to increase a) the number of children, adolescents, women, and men receiving information on child health, safe motherhood, and prevention of sexually transmitted infections including HIV/AIDS; (b) the uptake of modern contraception; (c) the number of adolescents receiving sexual and reproductive health services, and (d) access to Integrated Management of Childhood Illnesses services. Reproductive health services for adolescents and adults were provided within an integrated package. RESULTS. Major reproductive health-related outputs included the establishment of youth centers in each of the four Districts; training and facilitation of frontline government health workers and 298 community-based distributors of contraceptives and youth peer educators; and conduction of community, face-to-face and mass media education activities. As a result, the project experienced increased contraceptive prevalence of 62% (national is 24%); increased condom use during high-risk sex at 69% (national average of 56%); and decreased rates of multiple sexual partners at 13.8% (national average 27%). CONSEQUENCES. Local governments in these four districts are integrating adolescent health activities within their overall health programming.