Young women in Uganda are faced with multiple challenges which prevent them from achieving their sexual and reproductive health rights: uptake of modern family planning contraceptives is generally very low at 30%1 for all methods. Among sexually active young people 15-24 years, only 11% are currently using a method. Unmet needs for family planning is at 38%, yet over 292,000 abortions are carried out each year, most of which are unsafe. NTIHC integrated FP services in all components of ASRH, with the aim to increase uptake of modern FP contraceptives among young people. Studies indicate that women’s ability to exercise reproductive autonomy including access to effective contraceptives and safe abortion services leads to better health for women.
The aim of this study was to assess the importance of integrating FP services with other SRH and HIV services, in increasing uptake of modern contraceptives; and to assess the quality of FP services provided to young people through the integration model.
Data from a cross section of 840 women who access FP contraceptives at HTIHC clinic in 2012/2013 was extracted from service records and analyzed. A descriptive analysis was applied as the main analytical tool and some correlation was done to assess relationships between service utilization and initial point of contact/ service sought. Provider performance of FP tasks was assessed in four services (STD care, HCT, PNC and pregnancy testing, through observation of service delivery sessions and using standard performance checklist/ tool for clinical service providers. Data was compared with 2010 survey which was conducted using the same tool. And finally client exit interviews were conducted to assess client satisfaction with FP services provided.
Contraceptive uptake increased from 18 to 65 clients on average per month, with over 65% new acceptors. Over 48% of all users stayed on a method for at least 12 months in 2013. The providers gave information about all the available FP service and contraceptive methods (25.2%) in 2010 and (37.5%) in 2013. The provider discussed benefits and side effects of each FP methods (21.8% – 42.1%). Client satisfied with the discussion of ways to prevent unwanted pregnancy increased from 89% to 98%, (p=0.05), provider discussed how to choose FP method increased from 64% to 82%, (p=0.04).
Integration of ASRH services appeared to be important for increasing uptake of modern FP methods for young women, potentially reducing unplanned pregnancies and increasing chances for realizing reproductive health rights of women . However quality of service is significant for acceptability. The challenge though is increased waiting time for clients.