EVERY WOMEN EVERY CHILD UN COMMISSION ON LIFE-âSAVING

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Product development/ market shaping: Limited varieties accepted in Uganda (implanon & jadelle) and market is mainly through public procurement. Less incentive for the private sector investment. Though the market price at global has been halved, at country level, implants prices are still a barrier to access. High cost, related to “front-‐loading” of one-‐time costs for long-‐term use. Awareness/ demand The rate of implant insertion is high but it is matched with an equally high rate of implant removal. There is a gap in maintaining clients on the implant probably because of inadequate management of common side effects like bleeding. Also, there are social-‐cultural & religious barriers leading to low acceptability by the rural communities insufficient male involvement and adverse reactions to implants including bleeding. Implants are not widely known. -‐ HCII&III have capacity to insert but do not have supplies -‐ HCIV and above have limited capacity but do not have supplies -‐ Stock outs and supply chain which include over stocks and under stocks -‐ Provider bias and knowledge on how to manage side effects, poor counselling skills -‐ Continuous bleeding leading to discontinuation of use -‐ Insertion and removal needs training of health workers -‐ Fear of side effects (severe haemorrhage) -‐ Restrictive distribution channel/Medicalisation of contraceptives -‐ Social-‐Cultural & religious barriers leading to low acceptability by the rural communities insufficient male involvement Implementation plan a) Immediate plan • Build capacity of the National Drug Authority to test quality of implants and register additional suppliers for Uganda to increase the number of options (brands) of implants available on the Uganda market • Develop and print information package / IEC materials for the final consumer, conduct community sensitization to create awareness on contraceptive implants and expel rumors and misconceptions, support the on-‐going Healthy choices radio programs on RH/FP • Support scale up of ICT and communication solutions for improved distribution and consumption data including the incorporation of data on implants in the m-‐Trac mechanism b) Intermediate plan Train more health workers on insertion and removal of implants. Training should provide for use of instructional videos and online certification. Training will also focus on improving provider counseling aimed at supporting client choice and eliminating biases and dissemination of the national adverse reaction management guidelines by public and private sector providers.
3.1.3 Emergency Contraceptive Pill Problem statement Uganda introduced the Emergency contraception in the public sector in 2008 and guidelines were developed and distributed to the health facilities by the national Medical Stores warehouses. However, emergency contraception is not well integrated into family planning programs leading to inadequate use and provision as part of contraceptive method mix. Specific issues identified Provider issues: Low provider and user awareness including use post rape and also there is sufficient information and skills to provide the product; Pharmacists and drug-‐sellers are not trained in advocacy and provision; Not widely available particularly in rural health facilities units. Emergency contraception is not well integrated into family planning programs. Adolescents and youth in schools & rural areas have limited access & knowledge on where to find them and how to use them. Pharmacists and drug-‐sellers are not trained in advocacy and provision. Poor availability and access issues at public health facilities while they are expensive in the private sector. Awareness/ demand Consumers including youth and adolescents are not knowledgeable about emergency contraception as an effective method of pregnancy prevention. Service providers are also not adequately knowledgeable of ECPs as a Family Planning method. Implementation plan a) Immediate plan • Review of the family planning strategy and guidelines to provide for the use of ECPs and develop job aids and train health workers on counseling and dispensing of ECPs • Through social marketing develop media messages, IEC materials, community programs, train youth to be part of the VHT program. b) Intermediate plan Continue provision of ECPs through the public pull & push logistics system including continued inclusion in the basic kits for HCII & HC III 3.2 Maternal Health Commodities
Page 2 and 3: 1. BACKGROUND ...................
Page 4 and 5: 1. BACKGROUND 1.1 Introduction The
Page 6 and 7: RMNCH services and commodities
Page 8 and 9: 1.3 Process of development of
Page 10 and 11: integrated. There will be an i
Page 15: community level. However the po
Page 20 and 21: Specific issues identified Provid
Page 22 and 23: A parallel step will be to im
Page 24 and 25: inefficiencies and sustainability
Page 26 and 27: 3.4.2 Amoxicillin tablets for tr
Page 28 and 29: progressively achieve national c
Page 30: REFERENCES 1. Annual Health Secto

EVERY WOMEN EVERY CHILD UN COMMISSION ON LIFE-âSAVING

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EVERY WOMEN EVERY CHILD UN COMMISSION ON LIFE-âSAVING