EVERY WOMEN EVERY CHILD UN COMMISSION ON LIFE-âSAVING
EVERY WOMEN EVERY CHILD UN COMMISSION ON LIFE-âSAVING
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.