On 11th and 12th, August Naguru Youth Health Network in partnership with Uganda Youth and Adolescents Health Forum organized two days meeting to validate the rapid assessment report and develop a youth advocacy plan. The two days meeting was held at the Uganda Youth and Adolescent Health Forum offices and was attended by 29 participants (F=13, M=16). The rapid assessment was conducted by Senfuka Samuel and Patrick Ojilong and followed-up action points from a meeting held in January 2019 by UYAHF, the Ministry of Health Reproductive and Infant Health Division, and the Uganda RMNCAH+N CSO platform. This meeting was for 14 youth-led and youth-serving organizations to learn about and orient them on GFF processes in Uganda and the implementation of the Uganda Reproductive Maternal and Child Health Improvement Project so that they effectively and meaningfully engage with MoH, Districts, communities, World Bank, and other relevant stakeholders. As a key outcome of the meeting, young people called for support to develop a joint youth advocacy action and coordination plan for GFF and the URMCHIP that would be informed by their challenges, needs, and opportunities.
The joint advocacy action plan is anticipated to improve the coordination of youth-led and youth-serving organizations in influencing GFF processes in-country through enhancing participation, transparency, accountability, and making it easier to keep track of Uganda’s GFF commitments and implementation of the URMCHIP project. The rapid assessment was around young people’s experiences, challenges, and best practices on demand, access, and utilization of youth-friendly services. The rapid assessment was carried out in Busia and Pallisa districts in eastern Uganda, both districts were categorized by the Investment Case for RMNCAH sharpened plan as among the highest-burden districts with the unmet need for family planning and high teenage pregnancies. It should be noted that the originally targeted districts were Tororo and Busia but Tororo was replaced by Pallisa in consultation after finding out that Tororo was in its initial stages of implementing RBF.
Several tools were used during the research to collect data such as; questioners for health unit in-charge, adolescent health care providers, peer educators among others, FGD guide for young people/ adolescents, health facility RBF revenue sheet, key Interview Guide for youth-led organizations, and key information Interview Guide for Ministry of Health official. Patrick Ojilong took the participants through the review of the rapid assessment report and the key findings.
Some of the challenges highlighted within the RMNCAH and URMCHIP are; although the RMNCAH sharpened plan investment case articulates the key strategies for improving adolescent health, the URMCHIP that operationalizes the RMNCAH sharpened plan conspicuously omits a component of adolescent health in its title and largely prioritizes maternal, new-born, and child health-related services, cross the districts reached for this assessment, there is an evident lack of deliberate planning targets for adolescent health specifically compared to other RMNCAH related issues, adolescent health is still considered multi-sectoral issues and as such, there is an evident lack of well distinct roles of different stakeholders neither are RMNCAAH assemblies as a means to achieve mutual accountability by all stakeholders but also improve coordinated response as envisaged in the Investment Care for RMNCAH sharpened plan 2016-2020 happening in districts, the lack of adolescent health-related platforms at local government levels compared to the national level makes adolescent health least considered a priority in most local government among others.
Participants categorized the issues they identified after reviewing the report into service, coordination, and accountability. Under service delivery, there is the lack of specific service packages e.g. post-abortion care (PAC) it wasn’t incentivized, specifically incentivized indicators for adolescent health in RBF/ URMCHIP, stock out of short term family planning commodities, lack of youth-friendly corners among others. Under coordination, participants identified the lack of single voice accountability capacity at lower levels of CBOS, unclear leadership structures, weak and structured network on youth/adolescent health issues among others. Accountability issues identified included the limited demand for accountability for RBF money, poor community monitoring, planning, and designing of URMCHIP implementation by young people, lack of a specific budget line for the adolescents at the district level among others. At the end of the two days meeting the participants had identified three advocacy issues to carry forward which included; having specific ADH indicators in the RMNCAH, having sufficient youth-friendly corners, and an increase in the number of trained ADH care providers