In 2012, Ministry of Health reports showed that approximately 52.7% of Uganda’s population is under 15 years of age, one in every four Ugandans (23.3%) is an adolescent and one in every three (37.4%) is a young person.
Without a doubt, these huge numbers, scattered across all regions of the country with various social and economic settings, face various challenges; especially with in the sexual and reproductive health line.
It should be noted that there are very many young girls aged below 15 years of age who are already having children due to the lack of reproductive health information and guidance.
In 2015, 51.7% of Ugandan women were found to be having their first child before the age of 20 according to a survey by Reproductive Health Uganda.
Closing these Gap
Situated near Mengo, and close to St Balikkuddembe Market, Kisenyi Health Centre IV serves people around Kisenyi, Mengo and Kampala town.
Being in the Central Business District, people from different corners come to access the services from as far as Wakiso, Makyindye, Kitebi, Kyengera among other areas.
People of different groups and nationalities access the services, including refugees; majorly Somalis, Congolese, Sudanese, and even some sex workers.
Muvubuka Agunjuse Reproductive Health Information and Service Provision Centre
This youth friendly service centre is gazetted with a focus of providing health services to the young people, adolescents at Kisenyi HC IV.
The bold printed poster of the centre has attracted adolescents, youths and young adults to access the various reproductive services from this unit, which are provided from Monday-Friday.
Inside the centre, many youths can be seen sitting eagerly, waiting to be served as they engage in conversations.
We interacted with Lillian Nalukenge, a psychiatric at this ‘Muvubuka Agunjuse’ center to get more information about its operation.
Her major role at the youth centre is to clerk patients.
Order of admission
This reproductive health information and service provision centre handles people of a specific age.
“When patients come in, we screen them at the triage. Our preferred age group lies between 10-24 years. However, if they are not within our age group, we direct them where they should go,” Nalukenge explained.
Nalukenge said that their triage, as per any medical facility, has a book where all the bio data of every patient or inquirer is registered.
This information also captures the temperature figures for whoever comes in, considering the current Covid-19 situation.
Before meeting the clinicians, the young people are engaged in health talks and discussions on sexual reproductive health.
“As they wait to see the clinicians, we use that time to do health talks. However, we first have a prayer because we believe in God. The health talks depend on the topic we have to discuss that day; whether STIs, HIV and life skills among others. At times, topics are chosen from among the patients’ suggestions and debates are held,” she explained.
Adherence to SOPs
While serving the young people, the Standard Operating Measures are prioritised in order to prevent the spread of COVID-19.
Upon observing the group, each one of them wore their face mask and maintained a social distance.
“We sanitize, measure the body temperatures of the young people with a temperature gun in order to prevent the spread of COVID-19,” Nalukenge said.
Services provided at the unit
Because it is a government funded project, all services are provided free of charge.
“We provide sexual and reproductive health services; offering family planning, treatment of infections, HIV testing and counselling among others to the youth. We also have departments for those who want to see gynaecologists and clinicians. All this is at no cost,” Nalukenge said.
Although patients come with various issues including pyschosocial issues, illness and consultations, the sub divisions within the facility setting make it possible for each case to be handled.
Timothy Sserubiri, an advocacy and research staff at the centre, said that adolescents who are interested in learning are skilled in making art and crafts.
He noted that during the lockdown, up to now, the unit is receiving many patients.
This is attributed to the fact that many young people have got STIs from engaging in sexual acts, some are mentally ill while others are stressed out as they had been used to being at school, and now, they are exposed to all kinds of new environments and experiences which, unfortunately, are not the best.
A Friendly Approach
At the unit, equality between patients and caretakers is emphasized.
“We put ourselves in their shoes. We don’t behave like bosses. We first create friendships and we do not judge them,” Nalukenge stated.
The youth are involved in discussions and decision making strategies about their reproductive health.
“When you start judging them, they will feel uncomfortable to disclose their problems,” she added.
Because they are young, most adolescents find it difficult to express themselves and disclose their issues which makes finding solutions a bit hard sometimes as disclosed by Nalukenge.
“Young people below 15 years of age may not be able to express themselves. Here, we take them as youth, but at home, their parents see them as children. We are challenged here as we want to help them, especially in unfortunate scenarios like rape but they are afraid of opening up,” Nalukenge said.
However, through friendly counselors, they are able to progress with time.
Services are at times limited due to less funding.
“We need to procure raw materials for our skilling guides; at times contraceptives get finished yet they are always urgently needed,” said Sserubiri.
He also confirmed that the most challenges that are faced with the young people are centred around reproductive health.
Nalukenge attributed the increased stress and mental health issues among children to parents’ toughness and negligence.
“I encourage parents to be friendly with their children and create time to get involved in the youth heath services. Some parents become over ruling and rude to the extent that children find it hard to disclose any reproductive problems to them,” she noted.
Interventions during the pandemic
Media reports have shown rising cases of teenage pregnancies and Gender Based Violence since the lockdown was effected in March this year. However, interventions have been made to address these issues.
“We came up with a radio program; Muvubuka Agunjuse on Simba Fm to address issues related to Gender Based Violence which rose during the pandemic. This program runs from 2 pm to 3 pm every Sunday and we would refer the youth to counselors while public transport was prohibited,” Nalukenge said.
She also said that there is a consortium of ‘Right Here Right Now’ with over 14 institutions that have got offices around the country to avail reproductive health information and offer the services to those who need them.