Train 150 AGYW (10-24 Years) on Menstrual Hygiene

Background and introduction:

African Child and Youth Development Initiative (ACYDI) has partnered with Orphans and Vulnerable Children Empowerment Group (OVCEG) and Buvuma District that comprises scattered island settlements with limited infrastructure, making access to quality health, education, and water services extremely challenging. The population is predominantly fishing communities, where HIV prevalence is alarmingly high at 11.5% (UBOS 2014), more than double the national average of 5.5% (UPHIA 2020). Nationally, women bear a higher burden (7.1%) compared to men (3.8%).

To address these disparities, ACYDI, in partnership with OVCEG and other stakeholders, implemented a Community Led Monitoring (CLM) and Menstrual Hygiene Management (MHM) project. The initiative aims to improve health service delivery and strengthen HIV prevention efforts across the islands. While Uganda has made progress in reducing HIV, TB, and malaria-related mortality, current interventions remain insufficient to achieve epidemic control by the 2030 SDG-3 target. Multisectoral engagement is essential, and CLM empowers communities to actively monitor services and hold stakeholders accountable.

 Key Achievements:

• Enrolled 43 AGYW (10–24 years) into the programme.
• Health facilities pledged to continuously monitor service delivery and follow up on identified challenges.
• Presented CLM data collected through the DHIS system to facility teams, fostering data-driven dialogue.
• Provided psychosocial support and counselling to HIV-affected persons in fishing communities.
• Reached 8 health facilities (Lwajje H/C III, Bugaya H/C III, Namatale H/C III, Nkata, Lubya, Buwooya, Busamuzi, and Lukale Health Centre IIIs) and engaged 50 health workers/stakeholders.
• Secured stakeholder commitments to improve HIV prevention services, including expanding access, reducing stigma, and enhancing health education.
• Sensitized 6 Village Savings and Loan Association (VSLA) groups on Menstrual Hygiene Management.

Challenges Encountered:

• Accessibility Issues, scattered islands make it difficult for Persons with Disabilities (PWDs) and AGYW to reach health centres.
• Awareness Gaps, inadequate health education on HIV prevention methods, including PrEP and PEP.
• Confidentiality Concerns, compromised privacy and fear of status disclosure discourage community engagement with CLM monitors.
• Service Delivery Gaps, frequent stockouts of condoms, lubricants, and other HIV commodities; long waiting times at facilities.
• Transport & Safety, lack of life jackets for boat travel between islands; high transport costs deter community members from seeking care.
• Youth Friendly Services, existing services are often not tailored to young people's needs, creating additional barriers.

Key Recommendations:

• Commodity Security, Work with the District Health Office and National Medical Stores to strengthen forecasting, distribution, and buffer stock systems to prevent stockouts of HIV prevention supplies.
• Confidential Feedback, introduce anonymous reporting channels suggestion boxes, toll-free lines, or encrypted platforms to enable community members to share concerns without fear of identification.
• Disability-Inclusive Access, conduct accessibility assessments and provide assistive devices, transport options, and support staff to ensure PWDs are fully included in CLM processes.
• Satellite & Mobile Clinics, establish temporary outreach posts and regular mobile clinic visits on remote islands to reduce travel distances and improve data collection.
• Stigma Reduction, that is, the District Health Office and CLM partners should mandate continuous training for health workers on stigma-free, respectful communication and patient centered care.