Uganda

Over the past decade, Uganda has stood out in the public health community as an epicenter of the HIV epidemic while other reproductive health needs in the country have received comparatively little attention. For instance, contraceptive prevalence has quadrupled, yet still more men and women lack access to modern contraception despite a desire to use it, in part due to a shortage of trained providers. Insufficient reproductive and maternal health care is also a reason why young women in Uganda face an increased risk of obstetric fistula. It is within this context that EngenderHealth has activities throughout the country focus on:

• Expanding contraceptive choice
• Addressing HIV and AIDS through integrated care
• Treating and preventing fistula
• Involving men in reproductive health

 
Expanding Contraceptive Choice
Through the USAID-funded ACQUIRE Project, EngenderHealth works to advance the availability, quality, and use of reproductive health and family planning services in Uganda. Highlights include:

• Promoting the use of Norplant and the intrauterine device (IUD)—two low-cost, long-acting contraceptive methods—to help women space or limit their families
• Strengthening the capacity of the country’s Ministry of Health facilities to provide long-acting or permanent contraceptive methods
• Using the media to explore community attitudes toward long acting-contraceptives and to address myths about these methods
• Training staff in IUD and Norplant insertion and removal at hospitals and selected health centers in four districts of the country: Apac, Hoima, Mayuge, and Sembabule

 
Addressing the HIV Epidemic with Integrated Health Care
Through the ACQUIRE Project, EngenderHealth implemented a pilot project with The AIDS Support Organization (TASO) to integrate family planning with HIV and AIDS services. By integrating family planning with other sexual and reproductive health areas, programs can better respond to the needs of women living with HIV, increase efficiency, and accomplish multiple goals.

 
Treating and Preventing Fistula
In 2004, EngenderHealth began a project to increase community-level education and awareness about fistula prevention and treatment. Efforts are underway to:

• Improve health providers' fistula repair and care skills (including counseling);
• Link family planning and related reproductive health services for women as they embark on rehabilitation;
• Work at the community level to support prevention efforts;
• Use the print media to communicate key messages about safe motherhood.

 
Involving Men in Reproductive Health
Through the Men As Partners® (MAP) program, EngenderHealth engages men as active partners in reproductive health. In Uganda, EngenderHealth has held workshops with truck drivers at major transportation hubs to:

• Challenge their attitudes and behaviors that compromise their own health and safety, as well as the health and safety of their partners and children;
• Encourage them to become actively involved in fighting gender-based violence and the HIV epidemic.