Iganga health centres open less hours as housing deficit bites

By Chris Kiwawulo

Whenever Anthony Musiire fell sick and needed to consult a health worker, he would find Nakalama health centre III near his home in Kakongoka ‘A’ village closed.

And he would not wait for its opening because he had to go as early as 6:00 am to school in Iganga town about 14km away from home.

Musiire said the centre would open at around 10:00 am when most youths were at school and close at around 4:00 pm when they had not yet returned home.

On the weekends, the health centre would hardly open.

Since the health centre was the only nearby facility offering free services, Musiire would be forced to go in for herbal medicine whenever he fell sick.

But one day, Musiire narrated, he developed a Sexually Transmitted Infection (STI), and he spent almost a week without treatment.

“It became too bad, and I was getting a smelly discharge (Urethral discharge). But I had heard on the radio that Reproductive Health Uganda (RHU) treats STIs, and I decided to go there for help on my way from school,” a rather shy Musiire revealed.

Musiire has never turned back, and when he became an RHU peer educator in 2011, he decided to rally fellow youth in Nakalama who shared the same fate like him to seek treatment from RHU.

The story about delayed opening and lack of access to health services was echoed by Vicent Muwonge, 24, from Bugumba village in Iganga municipality and Janat Namborio, 21, from Bulamagi sub-county.

It is little wonder that when an alliance of 12 health service providing organisations set foot in Iganga district in 2011, many youths have thronged their centres for health services and information on sexuality.

The alliance has also helped to equip some health workers in public health centres with skills regarding how to administer youth friendly services and ensuring privacy while offering services to them, stated Susan Akello, the Iganga RHU in-charge.

“The problem with youth is that they do not want to be seen accessing health services like family planning and STI treatment at the same centres where their parents seek health care,” she said.

Akello, however, said outreaches need to be scaled up in all parts of the district to benefit more youth as well as the introduction of outdoor games like football that attract young people.

Currently, the Alliance has been working in Bulamagi, Nakalama and Iganga municipality and youth have been treated to mainly indoor games like a pool table and Ludo.

Akello revealed that out of every 10 youth who go STI testing, six test positive. She also noted that through disseminating information on radio and through peer educators, they have registered an increment in the number of youth who seek health services through the alliance.

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Youth from Iganga: Vicent Muwonge and Janat Namborio

“At the RHU clinic, we used to get about three youth a day but over 30 youth come nowadays. For outreaches, we used to get about 30 youth but we get over 120 young people coming for round table talks and health services,” she observed.

But the issue of stock-outs of especially STI drugs and testing kits is still a challenge now that the number of youth accessing services has increased, according to Akello.

Sr. Ruth Namusaabi, the Iganga Assistant District Health Officer in charge of maternal health explained that facilities open late and close early because health workers do not have accommodation near the facilities as it should have been.

“You find a health worker travels about 40km every day to and from her workstation. If a health worker has to travel 20km to his/her workstation, the chances are high that they will reach late given that the roads are bad, and they use Boda-bodas most of the time. They also have to close early so as to avoid reaching home late,” Namusaabi explained.

But she said they were liaising with the government to address the issue.

Namusaabi, however, hailed the alliance of Sexual and Reproductive Health and Rights (SRHR) service providing organisations for filling in the missing gap where public health centres have failed.

“The alliance members have helped us to test youth for STIs including HIV/AIDS, cancer screening and treatment. They have also disseminated information about sexuality through radios and youth talks during outreaches, and this has reduced teenage pregnancies in the district from 43% around the year 2000 to around 30% today,” Namusaabi said.

The alliance of 12 service providers helps Iganga youth access sexual and reproductive health services and knowledge.

The alliance, operating in nine Eastern and Northern Uganda districts comprises; Amref Health Africa, Restless Development, UNESCO, RHU, Uganda Young Positives, Uganda Net for Young People living with HIV/AIDS, Straight Talk Foundation, School Net Uganda, Reach a Hand Uganda, Clinton Health AIDS Initiative, Family Life Education Program, and Mamas Club.

Susan Ajok, the Straight Talk Foundation executive director noted that the milestones the alliance has achieved were a result of each of them bringing in the different expertise, citing message packaging for adolescents where Straight Talk Foundation was key.

“Going forward, we expect to do better, and if we get resources, we can cover the entire country. The only challenge is that sometimes the resource envelope is small to allow us effectively sustain implementation of this project,” Ajok pointed out.

Jackson Chekweko, the RHU executive director noted that much as the alliance’s focus is on nine districts, organisations like his were using the alliance model on how to ensure access to youth friendly services to scale up service provision amongst youth countrywide.

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UNESCO national professional officer for HIV/AIDS, Charles Draecabo

However, Chekweko noted that coordination of alliance partners was a bit weak and needed strengthening going forward. “This project needs to continue because issues of sex and sexuality among youth are overwhelming wherever you go,” he said.

The UNESCO national professional officer for HIV/AIDS, Charles Draecabo, said one of the ingredients of youth friendly services was ensuring that they are easily accessible from a reasonable distance at no cost and under private conditions.

Draecabo urged public health centre IIs and IIIs to consider youth while delivering services and designate special corners for them for privacy.

“We also need to engage other private service providers and support them to provide youth-friendly services,” he added.

Draecabo revealed that the health alliance was pushing for the approval of the national school policy that would necessitate the training of health professionals in youth-friendly ways of administering services to ensure easy access and privacy for young people.

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