Uganda

Over the past decade, Uganda has stood out in the public health community for its successful efforts to reverse the trajectory of HIV by changing behaviors and making treatment accessible. But other reproductive health needs have lagged behind. Scarce and poor quality maternal health care place Ugandan women at increased risk of death or injuries like obstetric fistula. It is within this context that EngenderHealth’s activities in Uganda focus on improving the quality of essential and emergency obstetric care and treating and preventing fistula.

Through the Fistula Care Project, EngenderHealth is strengthening the capacity of two hospitals to prevent and treat fistula: Kitovu Mission Hospital in Masaka District and Kagando Mission Hospital in Kasese District.

Our activities include:

• Improving health providers' fistula repair and counseling skills, including training surgical teams
• Training midwives and medical officers to monitor women in labor and recognize warning signs to prevent fistula and maternal mortality
• Enhancing family planning and related reproductive health services for women after they have been repaired
• Using the media—radio broadcasts, videos, and posters—to communicate messages about preventing fistula and to promote maternal health across the country
• Supporting partnerships between public and private hospitals to increase nationwide access to fistula prevention and care, making services more accessible at all levels of the healthcare system
• Advocating with governmental officials and others to raise awareness of fistula and to call for more attention and resources

 
Recent Activities
Through 2008, the EngenderHealth-led ACQUIRE Project worked to advance the availability, quality, and use of reproductive health and family planning services in Uganda. Highlights included:

• Strengthening the capacity of the country’s Ministry of Health facilities to provide long-acting and permanent contraceptive methods
• 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
• 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
• Orienting 122 community reproductive health workers and village health teams on family planning
• Using the media to explore community attitudes toward long-acting contraceptives and to address myths about these methods

Through ACQUIRE, EngenderHealth also implemented a pilot project with the AIDS Support Organization (TASO) to integrate family planning with HIV and AIDS services. And through a project called Positive Prevention, EngenderHealth and a local partner developed a curriculum—which is now used nationally—to train health providers to protect the health of people living with HIV and their partners.