Train 100 men & 40 boys in Uganda on menstruation

Summary:

The African Child and Youth Development Initiative (ACYDI) in partnership with OVCEG-CSO, Buvuma District local government and other stakeholders in the HIV affected communities have implemented the Community Led Monitoring (CLM) aimed to enhance health service delivery and HIV prevention efforts in 52 isolated islands of Buvuma district. The CLM has brought together multi-stakeholders through a participatory approach such as community members e.g. men, boys, and AGYW contributed to strengthening quality, access, and accountability in health service delivery especially on this key performance indicator of Menstrual Hygiene Management (MHM).

Key Achievements:

• The feedback meeting with stakeholders and duty bearers increased and empowered community engagement in monitoring health interventions as well as provided recommendations for MHM and health improvement.
• The district feedback meeting provided solutions to the problems identified during the data collection by the CLM Monitors.
• The duty bearers appreciated the steering committee members efforts that was made in mobilisation of communities for CLM.
• The stakeholders and duty bearers pledged support in improving HIV prevention services in Buvuma district, including increasing access, reducing stigma, and enhancing health education.
• The feedback district meeting engaged the duty bearers and stakeholders in evidence-based monitoring, advocacy and long-term impact.
• The feedback meeting addressed challenges identified during data collection and contributed to the better healthcare outcomes.
• The feedback meeting enhanced the capacity of health workers and engaged them in evidence-based monitoring, advocacy and long-term impact.
• The duty bearers pledged to continue monitoring the health service deliveries and follow up the progress and provide feedback to ensure that challenges are addressed, and services are improved.
• The duty bearers pledged support in improving HIV prevention services, including increasing access, reducing stigma, and enhancing health education.

Challenges encountered:

• Cultural and linguistic barriers where health facilities noted that health education materials may not be culturally or linguistically appropriate for all community members, which can create barriers to understanding and accessing HIV prevention services and health interventions such as MHM.
• Duty bearers noted that some health services such as Menstrual hygiene and HIV prevention services, such as PrEP (Pre-Exposure Prophylaxis), may not be consistently available or accessible to all community members.
• Lack of CLM IEC materials e.g. brochures, banners etc. for project visibility
• Lack of computer/laptop for report writing.
• Lack of life jackets for the ACYDI staff while travelling using boat water transport to conduct activities in the island facilities like Nkata Centre and Lubya Health centre III.
• Lack of Youth-Friendly Services and inadequate services for young people where community members expressed concerns.
• Stigma and Discrimination and fear of judgment where duty bearers shared concerns about being judged or stigmatized by healthcare providers, which can prevent them from seeking HIV prevention services.

Lessons Learnt:

• The project used a multi stakeholder approach where several CSOs, CBOs and community participated such as health facilities, boys, men, women, AGYW, CSOs networks, people living with disabilities, female sex workers, women, boys, CLM Monitors at the community, and steering communities from the affected communities.

Recommendations:

• Develop targeted MHM health education programs for specific populations, including young people, AGYW, Boys, men and key populations.
• Establish a monitoring and evaluation framework to track progress and assess the effectiveness of the recommendations.
• Establish community feedback mechanisms to ensure that community concerns and suggestions are heard and addressed.
• Implement and enforce strict confidentiality protocols to protect client information.
• Increase community outreaches and engagement to promote MHM and HIV prevention services and encourage uptake.
• Provide life jackets to the CLMs to ensure safety during the water/island visits.
• Provide training for healthcare providers on stigma reduction, confidentiality, and non-judgmental service delivery.
• Provision of CLM IEC materials e.g. brochures, banners etc. for project visibility.

Summary:

The African Child and Youth Development Initiative (ACYDI) in partnership with OVCEG-CSO, have co-implemented the Community Led Monitoring (CLM) aimed to implement a Community-Led Monitoring (CLM) approach to enhance HIV prevention efforts in Buvuma district with support from TASO Uganda and Global Fund TB/Malaria project. The CLM brought together different stakeholders to introduce the project, discussed its objectives, and outlined implementation plans. The project formally introduced the CLM project, shared the implementation roadmap, and discussed the roles of stakeholders in ensuring its success. Through this participatory approach, community members e.g. men, women, AGYW contributed to strengthening quality, access, and accountability in health service delivery such as Menstrual Hygiene Management (MHM), supporting the realization of national health priorities.

Key Achievements:

• The project identified the non-performance key indicators of the CLM project (Nkata health centre III and Lubya Health Center III) which are based in the scattered islands of Buvuma district.
•  It highlighted the roles of the key stakeholders of the CLM project.
• The duty bearers of Buvuma district local government participated in the dialogue.
• Approximately 110 Men, 43 boys, and 85 AGYW participated in the project
• The participants learned about the MHM, other diseases and non-disease health intervention areas.
• The participants learned about human rights and how to handle GBV cases.

Challenges encountered:

• Lack of life jackets while crossing Lake Victoria to the mainland in Buvuma district.
• Insufficient training materials.
• Early pregnancies for the adolescent girls and young women (AGYW) who are below 18 years of age.
• High rate of AGYW who are engaged in sexual work (Female Sex Workers) due to high rate of school dropout and early marriages at the age of 13 years.
• Lack of digital cameras to capture photos for documentation.
• Insufficient tablets and laptops 
• Insufficient transport refund given to the participants who were coming from far places in the island communities.

Lessons Learnt:

• The secretary for health welcomed the CLM project in all 52 isolated islands of Buvuma district and the stakeholders shall support the project.
• The project used a multi stakeholder approach of involving all the stakeholders at the different levels like districts, affected communities, health facilities, men, women, boys, AGYW, CSOs networks, people living with disabilities, community monitors at the community level, and steering communities from the affected communities.
• The project identified health facilities with poor performing indicators where the CLM project is now implemented.
• The project uses qualitative and quantitative data collected by the CLM Monitors at different health facilities and community levels.
• The stakeholders and duty bearers welcomed the CLM project and promised to support the project during the implementation.

Recommendations:

• Procurement of life jackets while crossing Lake Victoria to the mainland in Buvuma district.
• Provision of sufficient training materials and resources e,g MHM Manuals, DILDOs, SRHR manuals etc.
• Provision of counselling services to avoid early pregnancies for the adolescent girls and young women (AGYW) who are below 18 years of age.
• Creation of income generating activities to reduce the high rate of AGYW who are engaged in sexual work (Female Sex Workers) due to high rate of school dropout and early marriages at the age of 13 years.
• Procurement of digital cameras to capture photos for documentation.
• Procurement of sufficient tablets and laptops.
• Provision of sufficient transport to the participants who are coming from far places in the scattered island communities.