Introduction
The Maternal and Child Health and Nutrition (MCHN) Activity is a five-year, USAID-funded program to improve the quality of maternal and child health (MCH) and nutrition through support to the Government of Uganda. As USAID/Uganda’s flagship initiative in the MCH and nutrition arena, the activity supports the Mission in maximizing the quality and effectiveness of its combined efforts for improved MCH and nutrition outcomes. EnCompass is proud to lead the activity’s gender, youth, and social inclusion (GYSI) work, under which gender-based violence (GBV) has been a priority area.
GBV in Kampala
GBV is pervasive in Uganda, with 22 percent of women between the ages of 15 and 49 having experienced sexual violence. Such violence is believed to be rooted in unequal power relations, control of resources, and harmful social norms. GBV exacerbates pre-existing health issues for women and girls.
In 2020, the activity conducted an in-depth GYSI analysis to identify gaps, opportunities, and practices in access to and use of MCH and nutrition services by marginalized and underserved populations: women and girls, youth, individuals with disabilities, low-income groups, certain ethnic and religious groups, and orphans and vulnerable children. Key findings at the Kampala level indicated that GBV hinders women’s and girls’ access to MCH and nutrition services and further community mobilization and coordination is needed to strengthen GBV prevention and response.
GBV as a MCHN Activity Priority
The MCHN Activity advanced several initiatives to improve GBV prevention and response in Kampala during its second year of implementation. It provided a package of services to health facilities, including guidance on screening for GBV, first-line support, post-GBV counselling and clinical care, and HIV testing and counseling to treat a total of 3,429 survivors. Further, the GYSI team delivered several trainings across health facilities in Kampala to train 138 youth peers in adolescent/youth-responsive services and leadership skills, 113 peer mothers/leaders in improving access to and utilization of services for adolescent girls and young women, and 310 health service providers in GYSI integration at the facility level. Sessions and discussions on GBV were integrated into each of these trainings, and trainers across deliveries observed that participants highlighted existing challenges regarding GBV and recommendations to improve service delivery for GBV survivors. Challenges include the prevalence of GBV in communities which often leads to adolescent pregnancies, lack of GBV screening and reporting, and weak referral processes and networks, among others. Some key recommendations from training participants included improving documentation and processes for GBV screening, increasing police support at health facilities, continuing training and mentorship to ensure peer leaders and health service providers are well equipped to offer comprehensive treatment and support to survivors, conducting awareness-raising to ensure GBV cases are reported, and creating linkages for economic livelihoods.
The GYSI team continues these training efforts and also provides ongoing mentorship at each of the facilities where health service providers and peer leaders were trained through routine facility visits.
Health worker conducting a health education session on GBV at Kawala Health Center IV
16 Days
To commemorate the 16 Days of Activism against GBV, the MCHN Activity integrated GBV and gender into trainings for Village Health Teams and local community leaders. The team also conducted a GBV focused health education session for patients and disseminated materials and talking points for health workers to use when leading other health education sessions at different service delivery points, such as teenage centers and maternal, neonatal, and child health departments. Further, the GYSI team is also supporting the dissemination of messaging to raise community awareness about GBV and available post-violence services. See example in the card below.
The MCHN Activity is eager to build upon these existing efforts and continue applying holistic approaches to improve GBV prevention and response efforts in Kampala.
To learn about our work on the USAID MCHN Activity during COVID-19 visit our website.
Photos by: Joy Angulo and USAID