Reproductive Health Training manual - HEPS UGANDA

HEPS-Uganda: “Making Health Rights and Health Responsibilities a Reality”
CONTENTS
List of acronyms .........................................................................................................................................................................................................................................................................................ii
Overview.......................................................................................................................................................................................................................................................................................................iii
Acknowledgment ......................................................................................................................................................................................................................................................................................iv
Module I: Definition of key terms........................................................................................................................................................................................................................... 1
Introduction:................................................................................................................................................................................................................................................................................................5
Definitions of terms ..................................................................................................................................................................................................................................................................................2
Module II: Health Rights ............................................................................................................................................................................................................................................ 4
Health rights.................................................................................................................................................................................................................................................................................................4
Module III: Family planning full, free and informed choice.......................................................................................................................................................................... 9
Family planning Rights ........................................................................................................................................................................................................................................................................... 10
Family planning choice......................................................................................................................................................................................................................................................................... 11
Right to full choice:................................................................................................................................................................................................................................................................................. 11
Right to free choice: ............................................................................................................................................................................................................................................................................... 15
Right to informed choice: .................................................................................................................................................................................................................................................................... 17
Module IV:Family planning responsibilities ....................................................................................................................................................................................................19
Clients’ responsibilities as a consumer of health services: ................................................................................................................................................................................................... 20
Module V:Myths and misconceptions..................................................................................................................................................................................................................22
Dispelling myths and misconceptions…………………………………………………………………………………………………………………………………………………………………………….31
References: ................................................................................................................................................................................................................................................................................................ 29
iiiii

OVERVIEW
Health is very important; it is the essence of our everyday existence. For us to be healthy and realize our social, economic and development goals,
we must know our health rights and practice our health responsibilities, including the right to voluntary contraception. HEPS-Uganda realizes this
need and undertakes this challenge in partnership with different stakeholders, to make health rights and health responsibilities, a reality in
Uganda.
The community outreach training aims at empowering health consumers to demand their health rights and take their own health responsibilities
when it comes to voluntary family planning. Health care providers do not own health. Health is an everyday experience influenced by the choices
that we make and the choices made available to us.
Nevertheless, many people do not see it this way. They don’t know their health rights and are unaware about their health responsibilities. Most
health consumers don’t know these rights and responsibilities when making decisions about their health. The goal of the outreach training is to
empower community members on health rights and health responsibilities particularly when it comes to choosing the right contraceptive based on
the personal health decision being made, including birth spacing and timing.
To empower community members to demand their health rights and exercise their health responsibilities, HEPS-Uganda is very pleased that you
have agreed to be one of our community trainers.
The objectives for this training manual are to provide information on the HEPS/ Reproductive Health Supplies Coalition (RHSC) project and its
focus on stockouts at public health facilities and as well as to increase knowledge amongst the attendees of free, full and informed choice as well as
the central role that stock availability plays.
About this Project: This project is aimed at empowering communities to combat contraceptive stockouts and expand contraceptive choice at local
health facilities. The project focuses on mobilizing communities to take action at the facility level to address stockouts and then packages evidence
gathered at the local level to be shared at the national level for higher level action. The project objectives are:
 To increase awareness within communities on the importance of contraceptive choice and availability.
 To reduce stock-outs at health facilities in two districts through engagement of civil society, health facility staff, HUMCs and other key
stakeholders at the District level to ensure contraceptive availability and choice.
 To increase engagement of national stakeholders (MoH, NMS, and advocacy groups, Parliamentarians) to champion the issue of availability of a
broad range of contraceptives as a fundamental right.
LIST OF ACRONYMS
DHO District Health Officer
EMHSLU Essential Medicines and Health Supplies List for Uganda
FAQ Frequently Asked Questions
FP Family Planning
HCII Health Centre II
HC III Health Centre III
HC IV Health Centre IV
HEPS Coalition for Health Promotion and Social Development
HUMC Health Unit Management Committee
MOH Ministry of Health
NMS National Medical Stores
RH Reproductive Health
RHSC Reproductive Health Supplies Coalition
IUDs Intrauterine Devices
IUS Intrauterine Systems
VHTs Village Health Teams’
STIs Sexually Transmitted Infections
viv

INTRODUCTION
Uganda is experiencing poor performance in maternal health with 438 deaths per 100,000 live births due to pregnancy related complications which is
equivalent to 16 mothers dying every day. The Ugandan Ministry of Health acknowledges that family planning (FP) is a cost effective means to lower
maternal mortality rates given that it reduces the risk of exposure to pregnancy as well as reduces the incidence of unsafe abortions. Yet, there remains a
high unmet need for FP at 35% and 77% of women report never having discussed FP with a health worker (UHDS 2011). Nearly a quarter of women of
reproductive age would like to delay, space or stop having children and are not given the choice to do so. One of the best ways to support clients in this
regard is to empower them through human rights based approach to FP health service delivery that ensures full, free and informed choice.
The National Health System in Uganda is made up of the public and private sector (private for-profit and private not-for-profit). The health services are
structured into National Referral Hospitals (NRHs) and Regional Referral Hospitals (RRHs), General Hospitals, Health Centre (HC) IVs, HCIIIs, HCIIs and
Village Health Teams (VHTs) at community level providing supportive services such as disease surveillance, referral of patients, drug distribution among
other activities (HSSIP 2010/11, 2014/15, NDP 2010/11-2014/15). The range of health services delivered varies with the level of care in public health
facilities. However, public health facilities up to Health Centre I (VHTs) provide family planning services; HCIIIs in particular provide a comprehensive
family planning package at sub county level, at HCIIIs there are provisions for laboratory services for diagnosis, it’s a first referral cover for the sub county.
The project is targeting lower health facilities to contribute to increased uptake and reduce stockouts to ensure that the right to full, free and informed
choice is respected.
OBJECTIVES OF MANUAL
1. Explain key concepts, meaning and importance of access to family planning as well as full, free, and informed choice.
2. Define and list health rights and responsibilities.
3. Dispel common myths and misperceptions about family planning methods.
ACKNOWLEDGMENT
After a few years of going out to the rural communities to conduct outreach training, there was a need for standard education materials to guide all the
Trainers of the HEPS Outreach Programme. To develop this manual, HEPS reviewed the previous edition of the Community Empowerment Manual on
Health Rights and Responsibilities to incorporate family planning rights and responsibilities.
HEPS-Uganda acknowledges with thanks the input of Dr. Tony Mugasa and Licoln Byaruhanga, the consultants who both helped with the technical parts of
these education materials, Ellen T. Tompsett from the Reproductive Health Supplies Coalition (RHSC), and the rest of HEPS staff specifically Ms. Rosette
C.K. Mutambi the Executive Director, Mrs. Prima Kazoora the Head of Training and Capacity Building, Mr. Denis Kibira the Deputy Executive Director, Ms.
Kilande Esther Joan the Program Officer, the Communication Officer Mr. Eric Wakabi and Ms. Caroline Aruho the Program Assistant for participating in the
review process of the manual.
Special thanks to the Reproductive Health Supplies Coalition (RHSC) team for the institutional support rendered to HEPS-Uganda directly through the
community outreach programmes focusing on addressing contraceptive stockouts and choice. These projects will build on HEPS-Uganda’s current
community empowerment and policy advocacy efforts to increase access to family planning and other reproductive health commodities.
We also acknowledge the contributions of other partners not specifically mentioned here in the report for their commendable support that HEPS benefited
from to make the document comprehensive.
Ms. Rosette C.K. Mutambi,
_______________________
Executive Director
HEPS-Uganda
viivi

MODULE I:
DEFINITION OF TERMS
OBJECTIVE:
The objective for this module is to provide a brief introduction of the training guide and definitions for different terms used in this manual.
1viii

DEFINITIONS OF TERMS
HEALTH
Is a state of complete physical, mental and social well-being and not merely absence of disease or infirmity (definition from WHO).
REPRODUCTIVE HEALTH (RH) is a state of complete physical, mental, emotional and social well-being in all matters related to the
reproductive system, its functions and processes. Reproductive health, therefore, implies that people are able to have a satisfying and safe sex
life, the capability to reproduce and the freedom to decide if, when, and how often to do so.
RIGHT TO HEALTH
Can be understood as the right for a human being to enjoy the variety of facilities, goods, services and conditions necessary for the realization
of the highest standard of health. Universal Declaration of Human Rights affirms that, “Everyone has the right to a standard of living adequate
for the health and wellbeing of himself and of his family, including food, clothing, housing, and medical care” (United Nations 1948).
ESSENTIAL MEDICINES
Essential medicines are those medicines that satisfy the priority health care needs of the population (WHO). In Uganda a government
approved list of essential medicines is called the Essential Medicines and Health Supplies List for Uganda (EMHSLU). The medicines on
Uganda’s essential drug list are based on needs at all levels of care. The EMHSLU is the basis for rational selection, forecasting, quantification,
procurement, prescribing and dispensing of medicines in the health care system. It is important to note that RH commodities are part and
parcel of Essential Medicines.
PATIENT RIGHTS
Encompass the legal and ethical issues in the provider-patient relationship, including a person's right to privacy, the right to quality medical
care without prejudice, the right to make informed decisions about care and treatment options, and the right to refuse treatment.
MISCONCEPTION
A belief or an idea that is not based on correct/ accurate information or an explanation that is not clearly understood by people.
MYTH
An idea or story that many people believe but that does not exist and is false.
RUMOR
A piece of information or a story that people talk about but that may not be true.
HORMONE
Hormones are chemical messengers secreted by cells or glands in our bodies. They travel in the bloodstream to tissues or organs. They work
slowly, over time and influence many different processes including our reproductive processes.
CONTRACEPTIVE
Contraceptive method choice refers to the range of contraceptive methods with different attributes that are available and accessible to clients
on a reliable basis for people to choose from.
PERMANENT METHOD AND LONG-TERM METHOD
Long-term and permanent contraceptive methods are clinical methods that include hormonal implants, intrauterine devices, no-scalpel (NSV),
and tubal ligation. They are critical to meeting Reproductive Health (RH) and Family Planning needs over a long period of time. These FP
methods offer important additional choices for individuals, including: spacing or limiting pregnancies, and responding to changing
reproductive lifecycle circumstances.
SHORT-TERM METHOD
Short term methods are those used temporally to prevent pregnancy and Sexually Transmitted Infections (STIs), these methods include
condoms, pills, injectables and withdrawal methods.
2 3

1. RIGHT TO HEALTH CARE:
This means that every person has the right to affordable (within your means) and accessible (within your reach) health care, including
functioning public health and health care facilities, goods and services. Care should be given, without discrimination, regardless of whether
you are a man, woman, young person / disabled/ Muslim, Catholic/ tribe etc.
One example of the right to health care is the walking
distance to the nearest health center.
Right to health care
Your right to access to health care is violated:
if you don’t live in a 1hour/5KM walking
distance of the nearest health center.
As a health consumer you have the right to access the best quality and appropriate health care irrespective of your sex
(male/female), disability, age religion, ethnicity, political belief and economic or social status.
MODULE II:
HEALTH RIGHTS
OBJECTIVE:
1. By the end of the session the participants will be able to understand the fundamental health rights.
As part of the health care system, health service providers must ensure that they uphold the rights of all clients regardless of age,
disability, sex, religion, race, culture or HIV status. All clients have the following rights that apply to all health services
4 5

2. RIGHT TO ACCESS ESSENTIAL MEDICINES: You have a right to access essential medicines in right quantities as prescribed by a
trained health care provider. It is important to note that every medicine carries with it some degree of benefits on one hand
and risks on the other. To reduce the degree of risks you need to use the medicines correctly; the medicines should be
prescribed by the right person, for the right illness, at the right time, in the right quantity/dose, for the right length of time and
at the right price
3. RIGHT TO PRIVACY AND CONFIDENTIALITY: You have the right to privacy and confidentiality while accessing health care
centers. This includes audio privacy and physical. This right enables the client to discuss his or her health freely with the provider.
The health provider may not discuss the client with other people without permission.
This means that a health provider shall respect the confidentiality of information relating to you and your family; such
information shall not be told to anyone without the client’s permission. And this means that you are able to freely discuss your
method with the health provider in
private.
One example of the right to privacy
and confidentiality is that you can
speak in private with the health
provider.
Right to privacy and confidentiality
Your right to privacy and confidentiality is
respected: if you can speak in private
with the doctor, so nobody can hear what
you are consulting about.
4. RIGHT TO COMFORT: Health providers should ensure that the surroundings where you discuss are comfortable; not crowded
with proper shelter and hygiene.
5. RIGHT TO DIGNITY: The health providers should make you the client feel welcome and accepted whether well-dressed or not,
educated or not, rich or poor.
6. RIGHT TO SAFETY: The health provider should make the surroundings safe from infections and physical harm. A dirty, squalid
environment could lead to the client acquiring infections from the health centre. This is a clear violation of rights and breech of
professionalism.
7. RIGHT OF OPINION: Health provider should allow clients to make suggestions about their choices, feelings and the health
provider shall honor them.
8. RIGHT TO CONTINUITY OF SERVICES: Health provider should have a friendly attitude. Services should always be available and the
clients should feel encouraged to come back for services. The health provider shall know where to refer him or her for services
that cannot be provided and the referral should be made.
6 7

MODULE III:
FAMILY PLANNING RIGHTS
OBJECTIVES
1) Understand and be empowered to uphold the family planning rights of access to full, free, and informed choice.
2) Identify and discuss factors that hinder access to full, free, and informed choice, as well as respect for, protection of and fulfillment
of rights in family planning provision.
RIGHT TO COMPLAINT AND REDRESS
One example of the right to complaint and redress is having
structures such as the Health Unit Management Committee in
existence in the health care centers where you are able to make
a complaint.
Right to complain and get redress
When your right is denied seek redress from: a)
Health facility in charge, b) Health Unit Management
Committee (HUMC committee) members and c)
(DHO).
If you are not satisfied with the manner in which you have been served, you have the right to make a complaint and get redress
according to prescribed procedures.
This means that if you feel that one of your health rights, explained in these education materials, have been violated in any way,
you have the right to make a complaint and get redress according to prescribed procedure.
TAKE HOME MESSAGE: Know your health rights and demand that they are respected.
8 9

FAMILY PLANNING CHOICE
RIGHT TO FULL CHOICE:
Questions to the group: What do you see in this picture? Is
the right to full choice respected?
Right to full choice
Question to the group:
Do you have a similar situation in your community?
Your right to full choice is respected: if you go to the government
health centre service provider or dispensary you can receive get the
necessary products.
A client has the right to access the widest range of methods possible from which to choose. This means that service providers
should ensure that a wide range of methods are always available at the health center. While not every method is available at
every type of health centre listed in the table, at a minimum, the methods available at each public health facility should be in
accordance with the standards.
.
FAMILY PLANNING ACCESS
While the rights listed above apply to all health services, including FP, there are some rights that apply particularly to FP services.
Client-centered FP means that the client is entitled to access FP services and to make a full, free, and informed FP choice in a way
that respects their basic health rights.
RIGHT TO ACCESS FAMILY PLANNING: Clients have the right to access FP products. This means services and products have to be
affordable (reasonably priced) and available for everybody. In Uganda, these services are provided free at government health
centres. The following table denotes the Uganda Ministry of Health Service Standards at each administrative level for particular
types of FP services provided.
Administrative Level Facility Level Uganda National Minimum Health Care Package Service Standards
National/RRH
Referral Hospital
National Referral
Hospital
 Permanent FP Methods
 Long term FP Methods
 Short term FP Methods
District Hospital District Hospital  Permanent FP Methods
Health Centre IV (Sub district) Health Centre IV (HCIV)  Permanent FP Methods
Health Centre III (Sub county) Health Centre III (HCIII)  Long term FP Methods
Health Centre II (Parish) Health Centre II (HCII)  Long term FP Methods
Health entre I (Village) – Trained
VHTs
Village Health Team
(VHT)(equivalent to
HCI)
VHT provides:
 Short Term FP Methods. See page 20
10 11

Questions to the group: What do you see in this picture?
Questions to group: Is the right to full choice respected?
Your right to free choice is respected: if the health
care provides a wide range of methods to
determine which method is best for you with your
proper consultation.
Is the right to full choice respected?
Right to full choice denied
Your right to full choice is violated: if you go to the
healthy facility with a prescription and they are not
able to give you the products you need.
Is the right to full choice respected?
Right to full choice denied
Your right to full choice is violated: if you go to the
healthy facility with a prescription and they are not
able to give you the products you need.
12 13

RIGHT TO FREE CHOICE:
Is the right to free choice being respected?
Your right to free choice is violated: if the health care provider
determines which method is best for you without your proper
consultation.
Question to the Group: Why do these attributes matter and how do
they support free choice?
Right to free choice
You must use
this method
I would like to
choose a method
A client is free to decide whether to use FP and which method she/he likes voluntarily without pressure from anyone. This
means that neither government policies nor health providers shall promote one method over another, leaving the client free
to choose whichever method he/she prefers.
Variety of methods
TYPES OF METHODS
1. SHORT TERM METHODS
i. Condom
ii. Pills
iii. Injection
iv. Breast feeding &moon beads
2. LONG TERM METHODS > 3YEARS
I. Implants
II. IUD
3. PERMANENT METHODS
i. Tuboligation
ii. Vasectomy
TYPES OF METHODS
1. SHORT TERM METHODS
i. Condom
ii. Pills
iii. Injection
iv. Breast feeding & moon beads
2. LONG TERM METHODS > # YEARS
i. Implants
ii. IUD
3. PERMANENT METHODS
i. Tuboligation
ii. Vesectomy
14 15

RIGHT TO INFORMED CHOICE:
Questions to group: What do you see in this picture?
Is the right to informed choice
respected?
Right to informed choice
Your right to informed choice is respected if you have
been sensitized by a health care provider on the
different types of FP methods, benefits and side effects.
Clients should be given correct, easy to understand, unbiased, and complete information about all FP options, including benefits, side
effects, risks, and information about the correct use of the method chosen, as well as the risks of non-use. For example, the client
should be informed of what the method is, how it works to prevent pregnancy, advantages, disadvantages, who should use the
method, who should not etc.
Questions to the group:
What do you see in this picture?
Is this the right or wrong reaction by the client?
HEPS-Uganda: “Making Health Rights and Health R esponsibilities a Reality”
Some Attributes that Matter to Clients
• Non surgical
• Does/ does not require a pelvic
exam
• Does/ does not require
touching one’s genitals
• Has/has no impact
on pleasure
• Frequency of use
/of clinic visits
• Side effects
• Risks
• Discreetness
• Hormonal
• Nonhormonal
• Barrier
• Client
• Partner
• Provider
• Short acting
• Long-acting reversible
• Permanent
Mode of
Action
Control
of Method
Duration
of
Effectiveness
Ease and
comfort
of use
Right to free choice
16 17

MODULE IV:
CLIENT RESPONSIBILITIES
Buying of FP methods in a market is illegal and not safe
Selling of FP methods in a market is illegal and not safe
Objectives: By the end of this section, the health consumer will be able to fully understand his or her responsibilities as a
family planning client.
MODULE IV:
CLIENT RESPONSIBILITIES
Buying of FP methods in a market is illegal and not safe
Selling of FP methods in a market is illegal and not safe
Objectives: By the end of this section, the health consumer will be able to fully understand his or her responsibilities as a
family planning client.
Questions to the group: Can you name the different types of
FP methods?
Your right to make an informed choice is violated if you
don’t participate in choosing the right method for you.
TAKE HOME MESSAGE: It is your right to have access to family planning services and make a full, free and informed choice.
Stockouts violate this right, you play a role in safeguarding and monitoring to ensure this right is respected at all times.
Right to informed choice
Buying FP methods in a mar-
ket is illegal and not safe.
Selling of FP methods in a
market is illegal and not safe.
18 19

THE HEALTH CONSUMER HAS THE FOLLOWING RESPONSIBILITIES TO UPHOLD:
 Provide accurate information to the health service providers.
 Comply with instructions given by the health worker.
 Keep appointments.
 Practice healthy behaviors.
 Help to dispel rumours instead of promoting them.
 Refer friends to where they can obtain FP services.
 Report side effects of contraceptive use to the service provider.
 Respect and work with service providers.
TAKE HOME MESSAGE: Always be a responsible family planning service consumer.
CLIENTS’ RESPONSIBILITIES AS A CONSUMER OF HEALTH SERVICES
Clients’ Responsibilities
Health consumers’ have the responsibility to get FP products and services from a qualified health provider or registered drug outlet. This
means the health consumer needs to see a trained, qualified health provider (in a health centre, hospital, clinic in the community) to get a
prescription for FP options. Avoid accessing FP methods from hawkers, market vendors or ordinary shops.
20 21

Question to the Group: What are some of the common FP myths and misconceptions heard in your community?
There are a number of myths and rumours circulating amongst women that prevent them from making a fully informed choice. Here we dispel
some of the most common myths and rumours.
MODULE V:
DISPELLING MYTHS AND MISCONCEPTIONS
Objectives: By the end of the section, the participant should be able to understand and dispel common myths and misconceptions
about family planning methods.
22 23

What other types of contraception are there?
Intrauterine methods of contraception are small devices which are inserted into the womb by a gynecologist. Also known as the “coil,” an IUD
is a small t-shaped plastic device that is armed with a copper wire. A IUS is similar to an IUD, but releases small doses of a progestogen instead
of copper. Once in place most intrauterine methods will provide contraceptive protection for up to five years (IUS) or even up to ten years
(copper IUD). Intrauterine methods do not provide protection from STIs.
What is the emergency pill?
The emergency pill, often known as ”the morning after pill”, can be used to prevent an unplanned pregnancy when unprotected sex has taken
place or another method of contraception has failed. The emergency pill should be taken as soon as possible, ideally within 12 hours after sex.
You should speak to your healthcare professional as soon as possible if you think that you or your partner might need the emergency pill. It
should not be used regularly because of its high hormone dose. It should only be a back-up method.
Is the withdrawal method efficient at preventing an unplanned pregnancy?
No, it is not. The withdrawal method (when a man removes his penis from the vagina before ejaculating) is highly unefficient. As commonly
used, about 27 pregnancies occur per 100 women whose partner uses withdrawal over the first year.
How can I protect myself from STIs?
The condom is the only form of contraception that offers protection against most STIs if used properly. To protect yourself from STIs you must
use a condom properly every single time you have sex.
Can hormonal contraception protect me from STIs?
No, it cannot. The condom is the only form of contraception that offers protection against most STIs if used properly. The condom and
hormonal contraception can be used together to provide highly efficient contraception plus protection from STIs.
Who can I talk to about which type of contraception will be best for me?
You can discuss contraception with your gynecologist or a member of staff at a public health facility/ family planning clinic.
What should I do if my partner won’t use contraception?
FREQUENTLY ASKED QUESTIONS (FAQS) ABOUT CONTRACEPTION
This page is a summary of the most frequently asked questions about contraceptives
Who is responsible for contraception in a relationship?
You are and so is your partner! Both partners in a sexual relationship are responsible for contraception.
What is the most efficient way of preventing an unplanned pregnancy?
Contraception is the only way to prevent an unplanned pregnancy if you are planning on having sex. Different types of contraceptive suit
different people at different times in their lives. Talk to your healthcare professional to find out which type of contraception will be best for
you and your partner.
What is a condom and how does it prevent an unplanned pregnancy and protect men and women from STIs?
A condom is a latex or polyurethane sheath that fits over the penis when it is erect. The condom is rolled down over the erect penis before
sexual intercourse takes place to prevent sperm from entering the vagina. The condom should be held in place on the penis as soon as
ejaculation has occurred, to ensure that it does not slip off and to prevent any sperm from escaping when the penis is withdrawn. The female
condom is a polyurethane sheath which fits inside the woman’s vagina. It works in the same way as the male condom: by preventing sperm
from entering the vagina.
What is hormonal contraception and how does it prevent an unplanned pregnancy?
The pill, vaginal rings, patches, some intrauterine systems, and implants are all different types of hormonal contraception. They all contain
hormones which, when taken as directed, are highly effective in preventing pregnancy. Some types of hormonal contraception contain the
hormones estrogen and progestogen. These inhibit ovulation (stopping the release of eggs from the ovaries) and thickening the mucus at the
entrance to the womb. Some types contain only progestogen and work either by thickening the mucus at the entry to the womb and changing
the womb lining or by thickening the mucus at the entry to the womb and inhibiting ovulation.
The pill which contains both estrogen and progestogen (so-called combination pill) is commonly taken for 21 days, followed by a 7-day break
(or 7 days of “dummy” pills that contain no active ingredient). The pill which only contains progestogen, is taken without a pill-free interval.
Rings and patches are changed weekly to monthly; implants are changed after a certain number of months or years. It is important to
remember that hormonal contraception does not offer protection from Sexually Transmitted Infections (STIs).
24 25

Activity: What is my responsibility for ensuring full, free and informed choice?
Facilitated Round Table Discussion (30-45 min)
FACILITATOR NOTES
Instructions:
 Break into small groups (8 people max).
 Each table identifies a timekeeper and a rapporteur
Read out loud/write on flipchart/or put on a slide the following text for everyone to see:
“Accountability for ensuring full, free and informed choice is not just for service providers and counselors. All actors play a role in safeguarding and
monitoring full, free and informed choice. In your role within your community what action(s) can you take to ensure full, free and informed choice?”
For example, if you are a health provider you might identify the following action items: 1. I will always follow national FP counseling guidelines and the
GATHER methodology to ensure that FP clients have free and informed choice; 2. I will speak with the health clinic manager/committee to ensure that my
health facility has appropriate client feedback mechanisms in place, including organize monthly meeting with clinic to review client feedback.; 3. Place
orders for a range of contraceptive methods to ensure that NMS knows what women want. If you are a religious leader you might identify the following
action items: 1. I will organize and dedicate three sermons that incorporate messages on the importance of full, free and informed choice. If you are a local
government leader you might identify the following action: 1. I will meet monthly with health providers and district level officials to identify and address
any arising issues with stockouts.
Every participant writes three examples of two or three actions that s/he can take on a piece of paper. (10 min) and read and discuss these with others at
the table (20 min).
Report to plenary.
PARTICIPANT HANDOUT
Activity: What is my responsibility for ensuring full, free and informed choice?
In your role within your community what action(s) can you take to ensure full, free and informed choice? List three
1.
2.
3.
First and foremost don’t have sex with him or her! If your partner won’t use contraception, you might want to reconsider whether you want to
have a sexual relationship with this person. If this is the case, you could tell your partner that you will not have sex with someone who does
not respect you or himself/herself enough to use protection.
Questions to group: What do you see in this picture?
Is this perception correct or wrong?
Will using contraception now prevent me from being able to have a
baby when the time is right?
No, it will not. Condoms are removed after sex and hormonal
contraception effect stops as soon as a woman stops taking the
pill or has a ring, patch, or implant removed.
TAKE HOME MESSAGE: Family Planning methods/commodities are safe and are scientifically proven.
Incase of doubt, see a trained service provider for more information
26 27

REFERENCES:
1) Global Handbook for family planning providers 2011 (WHO Department of Reproductive Health)
2) National Policy guidelines for Sexual and Reproductive Health – 3rd Edition, 2011
3) Rerence Handbook on Family Planning For Community Based Family Planning Service Providers and supervisors by the Regional
4) Centre of Quality of Health Care(RCQHC)
5) Health Sector Strategic Investment Plan 2010/11, 2014/15
6) National Development Plan 2010/11-2014/15
7) HEPS – Uganda Community Training Guide on Access to Essential Medicines 2013
8) World Health Organisation (WHO)
COM MITMENT FORM
Activity Timeline
1.
2.
3.
4.
5.
Name: ……………………………………………………………………………………………… Sub county: ………………………………………………………………………
Your role: ………………………………………………………………………………………... Contact: ……………………………………………………………………………
Signature :………………………………………………………………………
28 29

Reproductive Health Training manual - HEPS UGANDA

Recommended

Recommended

More Related Content

What's hot

What's hot (20)

Viewers also liked

Viewers also liked (18)

Similar to Reproductive Health Training manual - HEPS UGANDA

Similar to Reproductive Health Training manual - HEPS UGANDA (20)

Reproductive Health Training manual - HEPS UGANDA