Browsing by Author "Tumuhairwe, Juliet"

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Boosting Contraceptive Uptake in Urban Uganda: Older Women Benefit When Layering Adolescent and Youth Interventions Onto Existing Family Planning Programming
    (Global Health: Science and Practice, 2024-05) Bwire, Albert; Sama, Denis Joel; Mirano, Jessica; Nyachae, Paul; Owino, Kenneth; Nabukeera, Josephine; Tumuhairwe, Juliet; Malik, Maheen; Salas, Ian; Mitchell, Vanessa; Bose, Krishna
    Introduction: Uganda has a large young population with a high unmet need for family planning (FP). Although there have been many efforts to improve access to and uptake of contraception, improvements have been slow. The Ministry of Health Uganda partnered with The Challenge Initiative (TCI) to implement a novel multipronged approach layering adolescent and youth sexual reproductive health (AYSRH) onto a functioning general FP program for women of reproductive age in 3 local governments of Buikwe, Mukono, and Iganga. We describe the approach and aim to determine whether layering AYSRH interventions onto an existing program resulted in increased contraceptive uptake among adolescents and youth aged 10–24 years and among women aged 25–49 years. Methods: We analyzed service statistics from the Uganda Health Management Information System to assess contraceptive uptake for adolescents and youth (aged 10–24 years) and older women (aged 25–49 years) before and after the implementation of the AYSRH approach in 3 areas (Buikwe, Iganga, and Mukono) compared to 11 areas where only the general FP program was implemented and the Uganda country total. Results: This analysis showed that before the start of TCI’s support, levels of contraceptive uptake were similar in all local governments. However, after implementation, there was an increase in uptake for general FP program only areas (1.7-point advantage over country total) and an even greater increase in general FPþAYSRH areas (2.4-point advantage over FP only programming). This was observed in both adolescents and youth aged 10–24 years and among women aged 25–49 years. Conclusion: The layering of TCI’s AYSRH interventions onto a wellfunctioning FP platform not only increased contraceptive uptake among adolescents and youth aged 10–24 years but also boosted uptake among women older than age 25 years.
  • Thumbnail Image
    Item
    ‘Nurture the sprouting bud; do not uproot it’. Using saving groups to save for maternal and newborn health: lessons from rural Eastern Uganda
    (Global Health Action, 2017) Ekirapa-Kiracho, Elizabeth; Paina, Ligia; Muhumuza Kananura, Rornald; Mutebi, Aloysius; Jane, Pacuto; Tumuhairwe, Juliet; Tetui, Moses; Kiwanuka, Suzanne N.
    Saving groups are increasingly being used to save in many developing countries. However, there is limited literature about how they can be exploited to improve maternal and newborn health. Objectives: This paper describes saving practices, factors that encourage and constrain saving with saving groups, and lessons learnt while supporting communities to save through saving groups. Methods: This qualitative study was done in three districts in Eastern Uganda. Saving groups were identified and provided with support to enhance members’ access to maternal and newborn health. Fifteen focus group discussions (FGDs) and 18 key informant interviews (KIIs) were conducted to elicit members’ views about saving practices. Document review was undertaken to identify key lessons for supporting saving groups. Qualitative data are presented thematically. Results: Awareness of the importance of saving, safe custody of money saved, flexible saving arrangements and easy access to loans for personal needs including transport during obstetric emergencies increased willingness to save with saving groups. Saving groups therefore provided a safety net for the poor during emergencies. Poor management of saving groups and detrimental economic practices like gambling constrained saving. Efficient running of saving groups requires that they have a clear management structure, which is legally registered with relevant authorities and that it is governed by a constitution. Conclusions: Saving groups were considered a useful form of saving that enabled easy acess to cash for birth preparedness and transportation during emergencies. They are like ‘a sprouting bud that needs to be nurtured rather than uprooted’, as they appear to have the potential to act as a safety net for poor communities that have no health insurance. Local governments should therefore strengthen the management capacity of saving groups so as to ensure their efficient running through partnerships with non-governmental organizations that can provide support to such groups.