The first day-clinic at Kasangali primary school in Kasese in 2019 before COVID19
One of the outreach day-clinics in Rubirizi district at Katerera Town Primary School in 2021
One of the outreach day-clinics in Rubirizi district at Kyabakara Primary School in 2021
Outreach clinic at Kyanya Kasese during COVID19 lock down
Community Health Worker directs a woman interested in Family Planning method at an outreach day Clinic in Kasese
Outreach day clinic offering family planning and primary health care services
Back Park nurse outreaches to homes for information and family planning services
Training of community health workers on COVID19 and community sensitization on COVID19
RCRA Pack Park Nurses going through poor terrains to reach girls and women in great need for contraceptives
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About the Community we serve

The Teenage Pregnancy rate in Kasese District stands at 48% per district health information system June 2021. According to the Kasese district population data 2021, adolescents and youth ( young people) ( 10-24 years) accounts for 34.80% of the population. According to UBOS 2014, a high percentage (14.4%) of the females aged 10-19 had ever been married and 17.9% females aged 12-19 years had ever given birth and yet only 18.8% households are 5km or less to the nearest health facility, whether public or private. Teenage pregnancy in Kasese district has remained high at 23% (DHIS2, 2020) of the 93% total attendance during ANC first visit by the pregnant women being women aged 10-19 years. This is mainly attributed to cultural beliefs, corporal punishment by the parents and schools, limited access to sexual reproductive health education, sexual violence such as rape and defilement, child neglect and abandonment.

The closure of learning institutions for the whole year of 2020 and additional lockdown in June 2021 due to COVID 19 prevention measures has increased the risk of girls' exposure to sexual abuse, defilement and early marriages. The lack of space at some health facilities to innovatively creat youth friendly services for adolescent sexual reproductive health (ASRH) service utilization. The effects of COVID 19 on the health service continuity has affected ASRH. ASRH services were neither considered as routine nor provided on demand, focus at health facilities was more on provision of curative services.

RCRA with funding from Community Health and Sustainable Environment (CHASE Africa) is implementing a program to accelerate uptake of numerous family planning methods in hard to reach rural communities in Rubirizi, Kasese and Bunyangabu district of Western Uganda. The program creates awareness on the benefits of being able to choose the timing and spacing of children and the family planning methods available thereby accelerating access to contraceptives and other primary health care services, through integrated outreach day-clinics, door-to-door distribution of short-term methods and health education by Community Health Workers, service provision and referrals to health facilities for women interested in long-term methods. This program is only funded by CHASE Africa, which since inception in 2019 has delivered over 17,600 family planning services to girls and women.

Group photo of peer educators in Kasese district for Busongora County after a long week refresher training on reaching adolescents 10-19 years with information and appropriate reproductive health services, the adolescent and youth SRHR project is made possible with support from Community Health and Sustainable Environment ( CHASE Africa) and additional assistance for Bukonzo County from Preston-Werner Initiatives.

The project will utilize these structures to strengthen ASRH service provision at facility level through training, infrastructure support, mentorship and improved health information reporting and utilization. Equipping adolescents with information through sexuality education peer-led sessions as well as in youth friendly spaces by the trained health workers.

The project will also engage district technical team and political leadership to enforce government laws and policies on defilement, sexual exploitation and abuse.

Actions:

Conduct weekly outreaches in primary Schools to provide health education and information; Reproduce and locally printing ASRH IEC materials, and training manuals and job guides for peer educators. This is aimed at strengthening information provision to adolescents through peer to peer sessions conducted by peer educators; Delivery of information packages for adolescents graduating from group sessions at Village level; Awareness raising dialogue meetings at sub-county level with community leaders to raise awareness on adolescent sexual reproductive health issues and role of all leaders and parents; monthly outreach clinics to primary schools adolescents and youth for health education; weekly intergenerational learning between grandmothers and school children on keeping girls in school end teenage pregnancies; Support Schools establish nutrition kitchen garden; Conduct study to understand the effect of COVID-19 on girls retention in primary schools.

women at Family planning services point during RCRA’s signature integrated outreach day clinic at Kasangali Primary School, others services offered during outreach day clinics includes, cervical cancer screening, immunization, antenatal care, HIV Testing services, child deworming, Malaria testing and treatment, Hep B testing, pregnancy screening, counseling services and doctor consultations, Eye clinics, condoms distribution, health education,   tree planting education and distribution of trees, attended by all people regardless of age and gender, we work directly with the district ministry of health office for additional staff and medical supplies, Sub-district Public Health Centre IIIs  and RCRA Community Health Centre III.

The project started in 2019 with 2 sub-counties and today has expanded to 13 sub-counties in Kasese district, held targeted outreaches in Rubirizi and Bunyangabu district in 2021 and currently operating the the whole Busongola and Bukonzo Counties in Kasese district with support from CHASE Africa and additional ASRH support from Preston Werner Initiatives for capacity strengthen of peer educations in 2 new sub-counties participating on the 1,000 women’s gardens for Health and Nutrition flagship programme.

Children receiving immunization and deworming services during outreach day clinic

Women during outreach day clinic lining up for different family planning services both long and short-term methods, counseling and information sessions.

RCRA Backpack Nurse going through terrains to reach women and children with health services in the mountainous communities in Kasese district, on 4WD vehicle can maneuver through.

RCRA staff attending adolescent health club session at Hima Public Primary School, adolescent health clubs in primary schools are serving a information vehicles for adolescents’ health and rights and access to SRHR services.

Doctor prescribing medicines for one of the clinic attendants during outreach clinic at Katerera Primary School in Rubirizi district.

Nurses dispensing medicines to the clinic attendants during outreach clinic at Katerera Primary School in Rubirizi district.

Midwife offering FP information session during outreach clinics for women to know and decide on the method of interest at Katerera Primary School. Traditionally, all our outreach clinics starts with health educations on benefits and effects of each FP methods so that they are empowered with all information about all available modern contraceptives.

Construction of energy saving stoves as part of the integrated health and environment programme in Kasese district, women are support to plant trees but also to have energy efficient stoves and reduce on tree cutting for wood needs.

Women and Men lining up for family planning services at Mohokya PS in Kasese district

RCRA BPN offering health and climate awareness education during door-to-door outreaches, offering short and long-term FP services and referrals to public free health centres.

RCRA BPN with beneficiary of FP method during follow-up on clients who used a method during outreach clinics.

Outreach clinic at Kitswamba facility in Rubirizi district, during COVID19 gathering restrictions.

CHASE Africa Partner visit from CHV in Kenya for information sharing and learning on each other for delivery of SRHR programs and outreach day-clinics

RCRA CHW during door-to-door outreach offering integrated health and climate education and distribution of short-term methods and initiating referrals

RCRA CHW making home visit following up on the user of FP and collecting feedback on the service benefits in Kasese district.

Grandmothers after access seeds for re-planting in Kitswamba sub-county, each grandmother received 10kg of gnuts.