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Naguru Teenage Information and

Health Centre
Report
July2008 – June 2009

“A place of their own”


Table of Contents
Table of Contents ................................................................................................i
List of Tables .....................................................................................................ii
List of Graphs ....................................................................................................ii
List of Figures ....................................................................................................ii
Acronyms......................................................................................................... iii
Executive Summary ............................................................................................ iv

CHAPTER 1 ........................................................................................................ 1
1.0 Background ............................................................................................. 1
1.1 Objectives: ............................................................................................. 2
1.2.0 General attendance ............................................................................... 2
1.2.1 New clients’ profile:............................................................................... 3

CHAPTER 2 ........................................................................................................ 4
2.0 Medical Services: ...................................................................................... 4
2.1 STI Diagnosis and Treatment: ....................................................................... 5
2.2 HIV Counseling and Testing (HCT) services: ...................................................... 6
2.3 Pregnancy Related Services: ........................................................................ 8
2.3.1 Pregnancy testing: ................................................................................. 8
2.3.2 Antenatal services: ................................................................................ 9
2.3.3 Postnatal Care: ................................................................................... 10
2.3.4 Post Abortion Care: .............................................................................. 10
2.3.5 Family planning services: ....................................................................... 11
2.4 Condom Distribution ................................................................................ 12
2.5 Challenges ............................................................................................ 12

CHAPTER 3 ...................................................................................................... 15
3.0 BCC/ADVOCACY...................................................................................... 15
3.1 IEC materials: ........................................................................................ 15
3.2 The Toll Free Help line (042-2222)............................................................... 15
3.3 Group Discussions (Health Talks): ................................................................ 17
3.4 Post Test Club:....................................................................................... 18
3.5 Radio Talk Shows .................................................................................... 20
3.6 Outreaches: .......................................................................................... 21
3.7 Advocacy activities.................................................................................. 22
3.7.1 The Parental Radio Program: .................................................................. 22
3.7.2 Dialogue Meetings................................................................................ 23
3.8 Publications .......................................................................................... 25

CHAPTER 4 ...................................................................................................... 27
4.0 Training and Research .............................................................................. 27
4.1 In House Staff Trainings ............................................................................ 27
4.2 External Professional Trainings attended by Staff: ........................................... 27
4.3 Training of Service Providers from KCC Health Units: ........................................ 30
4.4 Internship Placements: ............................................................................. 32
4.5 Training Policy Guidelines: ........................................................................ 33
4.6 Resource Centre: .................................................................................... 33
4.7 Research Activities: ................................................................................. 33
4.8 Challenges ............................................................................................ 34

CHAPTER 5 ...................................................................................................... 34
5.0 Monitoring and Evaluation (M&E) ................................................................. 34

i
CHAPTER 6 ...................................................................................................... 36
6.0 Finance and administration........................................................................ 36
6.1 Infrastructure ........................................................................................ 36
6.2 Resource mobilization and utilization ........................................................... 36
6.3 Partnerships and Public relation.................................................................. 37
6.4 Visitations and other Commemoration events ................................................. 39

Appendix: Activity Matrix 2008/09 ............................................................................i

List of Tables
Table 1: Contraceptive distribution........................................................................ 11
Table 2: Short trainings attended by staff ................................................................ 28
Table 3: Sources of non monetary support ............................................................... 37

List of Graphs
Graph 1: Over all attendance to all ASRH services – July 2008 – June 2009 .......................... 3
Graph 2: Summary of medical cases July '08 - June '09 .................................................. 4
Graph 3: Attendance to HCT services by gender .......................................................... 6
Graph 4: Toll Free Calls by Sex ............................................................................. 16

List of Figures
Figure 1: NTIHC New vision supplement on the Day of the African Child ........................... 26
Figure 2: Other sources of income ......................................................................... 37

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List of Acronyms
AHW Association of Hole in Wall Camps
AIC AIDS Information Centre
ANC Antenatal Care
ASRH Adolescent Sexual and Reproductive Health
BCC Behavioral Change Communication
FP Family Planning
HCT HIV Counseling and Testing
HIV Human Immunodeficiency Virus
IEC Information, Education and Communication
IPPF International Planned Parenthood Federation
KCC Kampala City Council
MoH Ministry of Health
MTAC Management Training and Advisory Centre
NTIHC Naguru Teenage Information and Health Centre
PAC Post abortion Care
PIDC Paediatric Infectious Diseases Clinic
PNC Post Natal Care
PTC Post Test Club
RATN Regional AIDS Training Network
STDs Sexually Transmitted Diseases

iii
Executive Summary
We have come to the end of the first year of the strategic plan (2008/09 – 2010/2011)
and we are delighted for the collaboration and support to the program activities. This
report covers the implemented activities for the period June 2008 – July 2009. During
this period, activities were implemented in accordance with the activity plan
extracted from the main Strategic plan. It’s in our honor therefore to share with you
the results of the implemented activities during the period.

We have continued to serve young people within the main catchment area (Kampala
District) and beyond (Wakiso, Mukono, Mpigi and other Districts of Uganda). During this
period, accessibility and utilization of ASRH services and information has been
promoted, yielding an overall attendance of 43,867 young people seeking the services
of the program. Highlights for the period are as listed below;

• 43,867 attendances were registered in general


• A total of 10,329 young people were counseled and tested for HIV
• 5,589 young people attended for STD’s and 43% of these were re-attendances.
• 1,098 young people reported with suspected pregnancy and were all tested for
pregnancy, counseled on Family planning and HCT.
• A total of 647 pregnant young adolescents made at least 4 ANC visits.
• A total of 163,825 print IEC materials were distributed and 88% of the IEC
materials distributed were produced by NTIHC.
• Parents who escorted their children to access services at the youth centre
increased by 9%.
• 72 outreaches were conducted both in schools and communities. There have
been efforts to strengthen partnerships and a number of such outreach
activities were implemented with partners.
• Efforts to advocate for community involvement were fruitful as the number of
referrals and outreaches organized by community leaders increased.
• A number of trainings have been conducted as part of strengthening the
program capacity to provide and promote quality ASRH services and
information.

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v
CHAPTER 1
1.0 Background
Naguru Teenage Information and Health Centre (NTIHC) is the pioneer program in
providing youth friendly Adolescent Sexual Reproductive Health (ASRH) services in
Uganda. This program was initiated in November 1994 by a Swedish Gynaecologist and
a number of volunteer counselors. It started as a voluntary activity but currently it’s a
community based organization located at Kiswa Health Centre. Its initial target was
young people in the age group of 10-24 years living in Nakawa division within Kampala
district.

The establishment of this program was purposed towards increasing awareness and
adoption of safe adolescent sexual and reproductive health behaviour and practices
and also to advocate for Adolescent Sexual and Reproductive Health Rights (ASRHR).
Being the first of its kind in the country, this program has been considered a model for
the country and among the best practices in the region.

The main activities are provision of ASRH services, Behaviour Change and
Communication (BCC) and Advocacy, Training, Research and Documentation. Although
the program provides a number of services, service delivery is its core. The core
package of service delivery consists of; STD management, general medical services,
counselling services, HIV Counselling and Testing, condom distribution, antenatal,
postnatal services, Family planning and Post abortion care. This package is
supplemented by BCC/Advocacy activities that comprise of; Group discussions, toll
free help line counselling, the speak out teen and parental radio programs,
distribution of IEC materials, educative films and outreaches. Training and research
are the other activities that support the provision of services.

In 2007, a five years strategic plan was developed to stream line the activities of the
program through the period 2007 – 2011. In the process, the program committed its
self to contributing to the reduction of the incidence of teenage pregnancy, HIV and
other STIs among young people as its goal. To achieve this goal, a number of
objectives were set as listed below;

1
1.1 Objectives:
2. To provide and promote access to quality services and information on
Sexual Reproductive health services and rights.
3. To strengthen partnerships, net working, technical, managerial and
institutional capacities to provide and promote services and information
for quality adolescent Sexual Reproductive health services and rights
4. To advocate for community involvement/participation in ASRH
programs.
5. To strengthen sustainability mechanisms and respond effectively to
environmental changes.

The period July 2008 – June 2009 marked the end of the first year of the strategic plan
(2008/09 – 2010/2011). During the period, activities were implemented in accordance
to the Strategic objectives.

1.2.0 General attendance


Naguru Teenage Information and Health Center (NTIHC) has continued to play a
leading role in the provision of a range of youth friendly ASRH services. This report
covers the activities implemented during the period July08 – June09 which is the first
year of the strategic plan period.

This was a challenging period in the history of the youth centre due to the decision by
Kampala City council together with Ministry of Health that required NTIHC to relocate
its premises to Kiswa Health Center where it is currently located. This affected the
general performance of the program activities. A cumulative total 43,867 young
people accessed ASRH services during the period, however this represents a 19%
reduction from the anticipate target of 54,090 young people.

2
Graph 1: Over all attendance to all ASRH services – July 2008 – June 2009

6,000
5,042
5,000 4,437
5,003 4,350
3,861
4,000 4,294
ATTENDANCE

3,549 3,537

3,000
3,141
2,658
2,000 2,171
1,824
1,000

0
JUL AUG SEP OCT NOV DEC JAN FEB MAR APR MAY JUN

1.2.1 New clients’ profile:


• 24,881 clients (46%) accessed ASRH services at NTIHC for the first time of which
66% were females and 61% were in-school.
• 47% of new clients were in the age bracket of 15-19 years whereas 37% and 16%
were in the age brackets of 20-24 and 10-14 years respectively.
• Although Kampala district is the target area for the youth program, some young
people come from other districts. This is partly due to the fact that there are
few or no youth friendly centers in the districts where they come from. In the
reporting period, 80% of the new clients came from Kampala district followed
by Wakiso district at 14% and Mukono district at 3%.
• In terms of marital status, 8% of the new attendances were young people co-
habiting, 3% in marriage while the rest were single.
• 87% of the new clients reported to be unemployed, while 11% and 2% had
temporary and permanent employment respectively.
• 10% of girls reported having ever had a child and 74% of them had their first
pregnancy in the 15 – 19 years age bracket. 81% of them reported having only
one child whereas 19% had two or more children.

3
CHAPTER 2
2.0 Medical Services:
• During this reporting period a total of 17,291 young people accessed medical
services.
• Young people who presented with Sexually Transmitted Infections (STIs) in the
treatment rooms accounted for 32% closely followed by malaria at 15% and skin
diseases at 14%.
• Kampala City Council through the main health centre supplied coertem drugs to
the youth clinic to be able to treat malaria cases.
• There are other medical concerns presented by young people when they visit
the Centre. These include concerns like breast changes, infertility and acne.
Graph 2: Summary of medical cases July '08 - June '09

PAC 23
ENT Cases 59
Dental Cases 202
Eye Cases 415
UTI 530
Menstrual Probs 1,069
Abdominal Pain 2,224
Headache 2,282
Skin Probs 2,376
Malaria 2,505
STIs 5,589

0 1,000 2,000 3,000 4,000 5,000 6,000

Number of Clients

4
2.1 STI Diagnosis and Treatment:
• Under this area, one of the key objectives of NTIHC during the reporting period
was to reduce the percentage of treated clients who were re-attending with
STI complications. Forty-three percent of the STI cases shown in the graph
above had previously received treatment at the youth clinic.
• 77% of clients who presented with STI cases were females. It has been observed
that in most cases they do not come for treatment with their sexual partners.
This therefore exposes them to re-infection. Each client who presented with an
STI was counseled about the need for partner notification and treatment. The
importance of male involvement, support and equal responsibility in SRH
matters has also been emphasized during the Radio Simba health talk shows, in
counseling sessions, community and school sensitization campaigns. In spite of
these efforts, the number of males who escort their partners for SRH services is
still low.
• The most common STIs presented at the clinic include herpes simplex, genital
warts and gonorrhea. On the other hand there were very few cases of syphilis
that were diagnosed. Out of 10,335 young people who tested for syphilis, 104
were positive giving a prevalence rate at 1%. This data is similar to the findings
of the Uganda HIV/AIDS Sero-Behavioural Survey (2004 – 2005) which show that
Herpes simplex type 2 is widespread, with 44% of Ugandans aged 15-49 infected
as compared to 3% of the population that have syphilis, with equal prevalence
among women and men.
• A sizeable number of clients also presented with candidiasis and most of them
thought that it was syphilis. Young people have so many misconceptions on
syphilis and take any discomfort either in their genitals or other body parts to
be syphilis.
• Focus was also put on availing family planning information and services to all
young people who came for STI diagnosis and other ASRH services.

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2.2 HIV Counseling and Testing (HCT)
services:
• During the reporting period the youth clinic introduced Routine Counseling and
Testing (RCT), a strategy that the Ministry of Health is currently promoting.
Every young person who came to the youth clinic was counseled about the
benefits of HIV testing and given an opportunity to test for HIV but each of
them reserved the right to opt out of the service.

• During the counseling sessions some of the major issues emphasized include the
ABC model for HIV prevention, the benefits of contraceptive use, couple
testing and disclosure of sero status.

• During the second half of this reporting period as the relocation exercise took
shape, a number of community based HCT services were provided through
outreaches. Community leaders that we partner with took on the role of
mobilizing young people to test for HIV.
Graph 3: Attendance to HCT services by gender

800
771 693 670 671
700 681

600 567 568 554 561


472
No. Tested

500 452
420
400 348 296
289 270 285
300 255 276 266 245
215 225
279
200

100

0
JUL AUG SEP OCT NOV DEC JAN FEB MAR APR MAY JUN

FEMALES MALES

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• A total of 10,329 young people were counseled and tested for HIV representing
a 17% short fall from the planned target. This short fall can be attributed to
the interruptions that were caused by the relocation of the youth clinic to
Kiswa Health Centre between March – May 2009.
• With an aim of addressing obstacles and challenges that come along with the
delivery of good quality counseling services, the counseling team held 107
departmental meetings during this period. These meetings provided service
providers with a forum for reviewing performance and sharing experiences on
counseling young people so as to have a common understanding on how to
package the information they give the young people.
• Of 10,329 clients who accessed HCT services, 311 tested HIV positive depicting
a prevalence rate of 3%. Females account for 93% of the clients who tested
positive. This figure confirms the notion that young girls continue to be more
vulnerable to HIV than the boys. This can be partly explained by the fact that
young girls face challenges in negotiating for condom use especially in cross
generational sex relationships whereas others engage in sex for money or other
material gains. To make matters worse, most of these men are not willing to go
for HCT with their partners.
• In terms of sero-status, young people aged 20-24 years accounted for 49% of
the positives followed by those aged 15-19 and 10-14 years accounting for 47%
and 2% of the positives respectively.
• Fifty-five percent (55%) of in school young people still accessed this service.
They accounted for 24% of the positive tests. The HIV prevalence is higher
amongst the out of school at 5%. Thus young people out of school are at higher
risk of contracting HIV.
• 67% of HCT clients were females partly because all new mothers attending the
antenatal clinic go through RCT for HIV.
• The age group 20-24 years accounted for 53% of attendance to this service
followed by 15-19 years at 43%, the 10-14 years at 3%. However it should be
noted that some clients come with their partners who are above 24 years of
age and special consideration is offered for them to test together. As a result
1% of the clients who tested were above 24 years.

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• Most of the young people who consented to have an HIV test were also tested
for syphilis. A total of 8,412 young people were tested which was 33% short of
the planned target of 12,541. This was due to the shortage of testing kits at the
beginning of the project period. A total of 104 were positive with syphilis while
17 turned positive with both syphilis and HIV.

Picture 1: A young person being bled for an HIV test to be carried out

2.3 Pregnancy Related Services:


NTIHC provides a core package of pregnancy related services that include pregnancy
testing, antenatal care, post natal care, post abortion care and family planning
services to young people.

2.3.1 Pregnancy testing:


• A number of young people came to the youth clinic requesting for a pregnancy
tests to be carried out. A total of 1,098 pregnancy tests were done and 49% of
the pregnancy tests turned out positive.

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• 52% of clients who turned out to be pregnant were in the 15-19 years age
bracket closely followed by those in the age bracket of 20 – 24 years and 10 -
14 years at 46% and 2% respectively.
• During the process of carrying out the pregnancy tests, service providers found
out that 36% of these pregnancies were unintended and therefore these young
girls were counseled on the dangers associated with unsafe abortions and the
support services available to them while pregnant. The high prevalence of
unwanted pregnancies among sexually active young girls points to the fact that
there is low use of family planning methods including condoms.
• All young people who tested for pregnancy were also counseled about the need
to test for HIV, the importance of consistent condom use and contraceptives to
prevent future unplanned pregnancies.

2.3.2 Antenatal services:


• Most of the young people who come to the youth friendly antenatal clinic are
often not psychologically and emotionally mature enough to cope with the
demands of pregnancy. Therefore, a lot of counseling and information giving is
done to prepare them to cope with some of the challenges of being pregnant.
Among the services provided as part of the antenatal care package are
preventive treatment for malaria, provision of iron supplements, abdominal
examinations, counseling on nutrition, hygiene, partner involvement, making
the birth plan, effects of alcohol and smoking among other issues. Needy young
mothers are also provided with insecticide treated nets and baby clothes.
• A total of 2,812 pregnant young adolescents attended the antenatal clinic with
62% of them in the age group of 15-19 years.
• A total of 647 pregnant young adolescents made at least 4 visits this reporting
period. This was a 79% increase from the planned target of 361 mothers. This
achievement could be attributed to youth friendliness of service providers and
the ability of youth center to provide some basic mother’s kits to the expectant
mothers who make it to the clinic on their fourth appointment visit.
• Routine syphilis and HIV testing was carried out to the 681 newly registered
antenatal mothers. Thirty-seven of the pregnant adolescents tested HIV
positive and were referred for PMTCT services at Kiswa Health Centre.

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• The importance of male involvement has been emphasized at the youth clinic
and as such a total of 144 males escorted their partners to the antenatal clinic.

2.3.3 Postnatal Care:


• During the first half of the reporting period a total of 289 mothers accessed
post natal care. However, this service was seriously affected in the second half
by the relocation of the youth clinic to Kiswa health centre whereby only 4
mothers were served.
• They received family planning and HIV test counseling as well as counseling on
condom use. They were also encouraged to bring their male partners to be
counseled about HIV/AIDS and family planning.
• Since uptake of post natal care is low NTIHC needs to devise strategies to
attract these mothers to come for the service.

2.3.4 Post Abortion Care:


NTIHC provides youth friendly post abortion care services which include post abortion
counseling, medical examination, provision of antibiotics and referral for further
management.
• In the reporting period 24 young people came to seek post abortion care
services. Of these clients, 10 were in school and 15 were in the 15- 19 year age
bracket. These clients presented with complications like reproductive tract
infections, bleeding and incomplete evacuation of the uterus. Some of these
cases were later referred to Mulago Hospital for further management since
Kiswa Health Centre does not have a theatre to handle such cases.
• Some of the main reasons for abortion presented by the clients were that their
partners were unwilling to accept responsibility; some were still in school,
feared negative reactions from parents/guardians whereas others were not
ready to raise a child.
• All these clients were counseled about post abortion contraception and the
need to test for HIV and use of condoms.

10
• Clearly the number of post abortion clients who turned up for medical care is
low compared to the high number of abortions carried out in Uganda. A 2006
study carried out by the Guttmacher Institute on unintended pregnancy and
induced abortions showed that an estimated 297,000 induced abortions are
performed each year in Uganda, which translates in to an annual abortion rate
of 54 per 1,000 women aged 15–49 years. However it is not known how many of
these young people are. Factors that explain why many Ugandan women with
serious complications do not seek or receive treatment include the fear of
revealing that they have had an abortion and concern that they will receive
hostile or judgmental treatment from health workers.

2.3.5 Family planning services:


• Deliberate efforts have been put in place to integrate family planning into
other ASRH services provided. A proactive approach was adopted to get more
males to support their partners to use family planning through counseling as
they came for HIV Testing, STD treatment and when they escorted their
partners for antenatal or postnatal services.
• Wherever family planning counseling was conducted, it included a display of
the available contraceptives and a discussion of the pros and cons of each.
• A total of 570 young people were registered for family planning services, this
was a 4% increase from the planned target of 550 clients. Eighty-two percent of
these were out of school and 58% were in the 20-24 years age group.
• Injectables at 47% seem to be the most preferred family planning method by
the young people.
Table 1: Contraceptive distribution
Method New users Revisits
Oral: Lo-femenal 45 37
Oral: Microgynon 13 12
Oral: Ovrette 11 9
Injectables 146 120
IUDs (Copper T) 0 0
Condoms 42 34
Norplant/Jadella 5 0
Other methods 101 0

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2.4 Condom Distribution
• There has been a steady supply of condoms from the Ministry of Health this
reporting period. Condoms are distributed at all service delivery points in the
clinic and also when community outreaches are conducted.
• Every health talk on condoms was followed by a demonstration of how they are
used. A total of 575,552 condoms were distributed. This represents an 8% short
fall in the planned target for distribution.
• During school outreaches students ask a lot of questions about condoms and
even ask for them. However, NTIHC doesn’t distribute condoms in schools
because this is against the policies of the Ministry of Education.

2.5 Challenges
• During community HIV counseling and testing outreaches, pre-test counseling is
done in groups. However post-test counseling sessions which require one to one
counseling, create challenges of handling big numbers, without breaching
individuals’ confidentiality.

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Testimony by one of the clients

enry Nkugwa, 17 yrs stays in Kireka 2km away from the drop in centre.
H ‘My parents died with my mother passing away in 1999 and father in January 2004.
Am now staying with my Uncle’s wife with 7 other people in the house. I was the only
child of my father although he had children from other wives. I dropped out of school in
primary six because I always had on and off fever, cough and a serious skin infection.

I have a friend called Semwanga who after seeing the pain I was going through advised me
to come for treatment at Naguru Teenage Centre. At first I was reluctant to visit the
centre because I knew my condition would not in improve for the better. Every time I met
my friend he would pester me about the need to go for medical check up. Tired of being
nagged by Semwanga I told him to escort me to the Naguru.

The day we went to the clinic I was registered and taken to the treatment room. While
there I was examined by a health worker who later gave me some medicine & encouraged
me to take an HIV test .It was scaring but I took the courage to test after being counseled
about positive living. The results showed that I was HIV positive. I was promptly referred
to a clinic for HIV positive young people in Mulago Hospital. To my surprise there were
many other HIV positive young people who looked happy whereas a few of them looked
weak. It is now 6 months since I tested for HIV and joined the HIV Clinic in Mulago Hospital
but I must say that my health condition has improved drastically. The skin rash is long
gone whereas the cough has subsided. Am also taking my drugs religiously although some
times I get nauseated.

Am no longer worried about my condition very much. In fact when I fully recover I plan to
enroll for vocational training to acquire skills in carpentry so as to get a job in future .If I
had not visited Naguru Teenage Centre for the initial treatment and HIV Testing probably
by now I would be dead. I now know my status and I always strive to adhere to the drugs
and counseling I get every time I visit Naguru and Mulago Hospital’.

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The Power of Peer Influence – Overcoming the Stumbling Blocks

idan 18 shared with one of the counselors the challenges he faced in changing his

D risky sexual behaviors and how he was able to start a new life after testing for
HIV and joining the post test club. Below is his story;

I had never imagined myself using condoms consistently with the many girl friends that I
was moving out with. I was a serial “player” and I enjoyed my game. I felt like I was on
top of the world and I would always boost about my escapades with my peers. One day I
visited Naguru Teenage Centre to watch video shows just because I was bored at home
since it was holiday time. I found quiet a number of adolescents in the video room waiting
to access services.
After watching two videos, one of the peer educators talked to us about the benefits of
HIV testing. She said that making the decision to test for HIV was not easy but it was
important to know one’s status. Later I also gathered the courage to test. I was counseled
about the expected HIV results, dangers of having many sexual partners and inconsistent
use of condoms. As I waited for my results I silently kept on counting the number of sexual
partners that I had slept with until I lost count. This made me very worried.
When my results were ready, the counselor invited me to receive them in his room. I did
not know what to expect but all the same I proceeded to receive my results. I was
overjoyed when the counselor told me that I had been found to be negative.

I went back home with a strong desire to change my risky sexual behaviors. Two weeks
down the road I ended up “backsliding”. I was back to my old game although this time I
was really puzzled about how to avoid risking with so many girls.

I felt helpless and did not think it was with in my power to abstain from sex or use
condoms consistently. My close friends back home did not make life easy for me. They
kept on telling me that sex with a condom was like eating a sweet with it’s cover, that I
was a coward and not man enough.
When I shared my predicament with a trusted friend who regularly visited Naguru Teenage
Centre, he advised me to join the post test club. At first I did not buy the idea because
attending the post test club on Saturdays was going to interfere with my weekend program
of watching movies at a nearby video hall. When he assured me that the club meets from
10am – 2 pm, I accepted to join it. That Saturday my friend introduced me to other young
people in the club and what particularly caught my attention was that members were very
friendly and shared with me their past sexual experiences and how they have been able to
reform. Hearing such testimonies from fellow teenagers made me stronger and the
recreational activities we engaged in were so exciting. Since then I have never looked
back, I have one girl friend and we have resolved to abstain from sex until marriage.

14
CHAPTER 3
3.0 BCC/ADVOCACY
The main objective of the BCC/Advocacy project is to provide accurate ASRH
information to young people and strengthen support for ASRH services. The following
activities are carried out to achieve this objective: Toll free counseling, “Speak Out”
Teens Radio Program, Parental Radio Program, IEC material development and
distribution, Group discussions, Outreaches, dialogue meetings with community
leaders and a Post test club.

3.1 IEC materials:


• During this reporting period, a total of 163,825 print IEC materials were
distributed compared 151,780 that had been planned making a 7.4% increase.
This increase is attributed to the school and community outreaches which were
conducted. 88% of the IEC materials distributed were produced the NTIHC

3.2 The Toll Free Help line (042-2222)


• During this reporting period, a total of 11,342 calls were received on the toll
free helpline compared to 17,922 calls that had been planned making a 36.7%
decrease. This shortfall is attributed to some technical problems that were
experienced by our service provider (Uganda Telecom) during the relocation
exercise.

15
Picture 2: A Counselor attending to a client on line

Graph 4: Toll Free Calls by Sex

GRAPH 3.2.0: TOLLFREE CALLS BY SEX, JULY 2008 TO JUNE 2009.

5,000 0
4,35
4,000 3
3,30
8
3,000 2,65
7 2,71
No. OF CALLS

6
2,05 5
2,000 1,693 1,69
1,247
1,023 971
1,000
596
361
0
1ST QRT 2ND QRT 3RD QRT 4TH QRT
TOTAL MALES
FEMALES

16
• The service was dominated by males who contributed 62% of the total calls.
This dominancy may be attributed to the assumption that males have more
access to telephones and also the fact that they always prefer to help
themselves other than visiting health centres.
• The 20 – 24 year old age group dominated the service by making 5,982 (53%)
calls, followed by the 15-19 years with 3,878 calls (34%), then the 10-14 years
age group with 143 calls (1%). And lastly, those who were above 24 contributed
to 1339 which represents (11%).Dominancy of the 20 -24 may be attributed to
better access to phones and have more counselling needs.
• The service was dominated by in-school young people who contributed a total
7,783(69%) calls compared to 3,559 (31%) calls made by out of school young
people.
• Young people mentioned different sources of information about the toll free
help line with peers ranking highest followed by Radio Simba, promotional
materials, Straight Talk publications, T- Shirts and stickers.
• A number of counselling issues were presented on the toll free help line which
are broken down to include, general problems (45%), sexual health (38%),
psychological concerns (9%), pregnancy related issues (4%) and body changes
(4%).

3.3 Group Discussions (Health Talks):


Group discussions are carried out everyday as clients wait to access services. The
purpose of these discussions is to provide accurate information on ASRH to clients who
come for services. The discussions are usually conducted by peer educators and
volunteers with assistance from service providers. They are meant to address general
ASRH concerns which are raised by young people. The group discussions are
supplemented by educative films shown and reading materials availed to the clients.
Some of the topics discussed include: body changes, HIV/AIDS, STDs, relationships, life
skills among others.
During this reporting period, a total of 305 discussions were carried out compared to
478 that had been planned making a 36% decrease. This reduction is attributed to the
relocation exercise which disrupted provision of services.

17
Picture 3: Counselors conducting a group discussion in the main waiting room

3.4 Post Test Club:


As the number of young people accessing HCT continued to increase, many clients
kept asking about what next in the area of prevention and positive prevention. In
order to address the many challenges and issues raised by those who test for HIV and
to provide on going counselling, a Post Test Club (HCT) was established. The objective
of the club is to increase awareness on HIV/AIDS prevention and positive living.
Membership remains voluntary to young people who have tested for HIV and know
their status regardless of the test results. Currently, the club has 191 members of
which 97 (51%) are males.
Post test club Members meet every Saturday and conduct group discussions on issues
related to ASRH and also engage in recreational activities which include indoor and
outdoor games in addition to watching educative films. Every month resource persons
from different organizations such as AIC, Straight Talk Foundation (STF), TASO,
Mildmay Centre among others are invited to facilitate a wide range of sessions.

18
20 post test club members were trained in peer education and are currently helping in
outreach activities. PTC members also participated in a quiz competition organized by
DSW for teenagers and won prizes.

Picture 4: PTC members in one of the meetings

19
Picture 5: PTC members in one of their performance rehearsals

3.5 Radio Talk Shows


As a strategy to reach more people with accurate ASRH information and promote
services, the program conducts two alternating radio talk shows every Sunday on Radio
Simba from 8.00pm – 9.00pm. The Teen radio program (Muvubuka weyogerere)
targets young people whereas parental program (Omuzadde no’mwana) targeting
parents. The talk shows are broadcasted live in the studio and in the community once
in a month to increase on people’s participation. A separate toll free hotline is
provided during the talk show to respond to listener’s concerns that are not related to
the topic being discussed.
During this reporting period, 39 teen radio talk shows were conducted of which 34
were in studio. A total of 691 calls were received of which 480 (70%) were by males.

20
Picture 6: A counselor & moderator during a talk show in Radio Simba studio

3.6 Outreaches:
In order to reach more young people with information and services, the program
continued to carry out outreaches in different communities. During this reporting
period, a total of 72 outreaches were conducted of which 17 were in schools. Some of
the schools visited include: Nabisunsa Girls School, Naguru Katali, St. Francis primary,
St. Jude, Kitante, Uganda Marty’s Lubaga among others. A total of 4,382 young people
were reached during these school outreaches.
Community leaders were also involved in organising outreaches in their communities
and as a result a total of 55 outreaches were organised in different communities which
include: St. Luke church, St. John’s church Kiwatule, Naguru remand home and Banda
community among others.
Through outreach activiesa, NTIHC continued to provide ASRH services to the hard to
reach young people such as the deaf and those in remand homes. In this regard, NTIHC
has been working closely with Deaf Link Uganda and Naguru Remand Home.

21
Picture 7: A peer educator talking to students of Nabisunsa Girls School

3.7 Advocacy activities

3.7.1 The Parental Radio Program:


• In an effort to strengthen parental support for ASRH services, a parental radio
talk show is broadcasted on Radio Simba once a month. Like the teen radio talk
shows, it is broadcasted on Radio Simba from 8.00pm – 9.00pm. This is an
advocacy program for parents and guardians of young people aimed at creating
awareness about ASRH issues and how parents can help young people overcome
the challenges they face.
• This program also focuses on how parents should understand their children as
regards their behaviours, roles & responsibilities in a family. Topics discussed
included: preparing children for school, having a productive holiday, parent
child communication sexual abuse among others.

22
• During this reporting period, a total of 12 Programs were conducted and 166
people participated by calling in during the talk show.

3.7.2 Dialogue Meetings


In order to strengthen community support for ASRH services, the program organised 13
dialogue meetings with different community leaders in Nakawa division. Participants
were selected from twenty four parishes of the division. The objectives of the
dialogues were to orient leaders on the ASRH issues in the community, identify
organisations which provide services to young people and how leaders can promote
services which are provided by NTIHC.
As a result of these meetings, community leaders became very active in referring
young people to the NTIHC for services, organising outreaches and radio programs in
their own communities.

Picture 8: Community Leaders attending one of the dialogue meetings

23
• During this reporting period, the program participated in three national events
which include World Population Day which was held in Mbarara, World AIDS Day
held in Kampala and Day of African Child held in Masindi. In all these occasions,
NTIHC was called upon to provide HIV Testing and Counselling (HCT) in addition
to conducting health talks and general counselling. The program also used
these opportunities to exhibit some of the materials produced and services
provided as a way of sharing with partners.

Picture 9: Young people picking IEC materials from NTIHC’s exhibition stall on the Day of
the African Child at Masindi Boma ground

24
Picture 10: NTIHC Participation in activities to commemorate the Day of the African Child
2009

3.8 Publications
A number of articles addressing different ASRH issues have been written by NTIHC staff
and published in different Newspapers and magazines. Some of the articles were
published in the Population and Development magazine of July 2008 and The New
Vision of 17th November 2008. In addition to the above a supplement was written in
The New vision news paper of 16th June 2009 commemorating the Day of African Child.

25
As we As
commemorate this stakeholders,
Day, we remember we need to be
the children who at the fore
have lost their front in the
lives through struggle to
HIV/AIDS, create a
malnutrition, healthy and
malaria, maternal safe
mortality, environment
abortion, ritual for our
child sacrifice/ children. We
murder, wars need to ensure
among others that there is
with out sufficient
forgetting those protection for
living in poor the children
conditions. and that child
protection
laws are
adequately
implemented.
NTIHC seeks to obtain and maintain a society of young people who are empowered
in Adolescent Sexual Reproductive Health and Rights (ASRHR) and part of the
target group are children aged 10 – 18 years. Some of NTIHC’s interventions are
geared towards contributing to child survival and development. The program
provides antenatal and postnatal services to young mothers and ensures that they
are availed with facilities, care and information on nutrition, hygiene and child
care.
Figure 1: NTIHC New vision supplement on the Day of the African Child

26
CHAPTER 4
4.0 Training and Research
Training and Research are key components of NTIHC program’s mandate in that they
support and inform provision of quality ASRH services to young people. In the July
2008-June 2009 reporting period, a number of training activities were executed as
explained below;

4.1 In House Staff Trainings :


These are 1 hour sessions which take place periodically at the facility premises
between 7.30-8.30 am or 4pm – 5pm according to the staff training needs identified.
Their main purpose is to support knowledge and skills enhancement in the ASRH field.
During the reporting period, 9 training sessions covering Kaposi sarcoma, drug and
substance abuse counseling, palliative care, couple HIV counseling, crisis counseling
among others were conducted.

4.2 External Professional Trainings attended by


Staff:
Several staff attended short training courses to improve on their skills and knowledge
in ASRH issues as shown in Table 1 below;
Name of Staff Designation Course Name & Host Duration Sponsor
Organization
Goreth Midwife/ International Training in 1 Month Sida
Nakiwala Counsellor Midwifery Competence-
Karolinska Institute Sweden
Management Of Post Partum 1 Week MoH
Haemorrhage - MoH
Martin Counsellor Palliative Care –AIC 1 Week RATN
Byamugisha
Bukenya Denis Counsellor Palliative Care – AIC 1 Week RATN
Therapeutic Recreation for
children affected by cancer- 1 Month AHW
AHW Camps Ireland
Nalubya Susan Administrative Monitoring and Evaluation of 2 Weeks IPPF
Manager HIV/AIDS Programs – CAFS
Costing of Health Services –
Uganda Ministry of Health 1 Week MoH
Egadu Robert Counselling Counsellor Supervision- AIC 1 Week AIC
Coordinator
Training of Trainers- MTAC 2 Weeks NTIHC

27
Namuwonge Midwife Palliative Care – AIC 1 Week RATN
Beatrice HIV Rapid Testing– AIC 1 Week AIC
Nabossa BCC/Advocacy Paediatric HIV/AIDS for Health 1 Week PIDC
Rebecca Assistant Professionals - PIDC

Kyamulabi Midwife Palliative Care – AIC 1 Week RATN


Christine
Mubuuke Felix In charge Data MCSE Windows Server 2003- 3 Months NTIHC
Makerere University
Nakasi Counsellor HIV Rapid Testing– AIC 1 Week AIC
Caroline
Ndizeye Training Assistant Training of Trainers- MTAC 2 Weeks NTIHC
Simon
Mirembe Midwife/ Training of Trainers- MTAC 2 Weeks NTIHC
Catherine Counsellor
Mpinga Peter Program Director Training of Trainers- MTAC 2 Weeks NTIHC

Table 2: Short trainings attended by staff

• Other trainings were also identified for staff as a way of ensuring that their
knowledge and skills on various ASRH issues remain relevant and responds to
emerging issues and needs of young people who come for services.
• NTIHC staff that include midwives, counsellors, peer educators and Managers of
different departments were trained in prevention and management of SGBV by
resource persons identified from the Ministry of Health. This training was in
response to increased cases of sexual abuse reported in the youth clinic.
Participants were therefore equipped with knowledge and skills in prevention
of SGBV and management of survivors.

28
• Two Counsellors namely Prossy Namuddu and Nakiwanuka Rebecca were also
trained by TASO under the TASO Experiential Attachment to Combat HIV/AIDS
(TEACH) initiative funded by Sida. The main goal of this one month training and
field attachment was to improve on service provider’s competence in provision
of HIV care and support services.

Picture 11: Staff attending one of the SGBV sessions

29
Picture 12: A Counselor engaging TASO HIV positive children in Play therapy

• 32 young people from the post test club were oriented on peer to peer drug
and substance abuse prevention by facilitators from Uganda Youth
Development Link (UYDEL).

4.3 Training of Service Providers from KCC


Health Units:
NTIHC continued to work closely with KCC Public Health Department in scaling up
provision of youth friendly services in seven of its health units namely Kiruddu, Kitebi,
Komamboga, Kawaala, Kawempe, Kiswa and Kisenyi. To this end, 17 young people
selected from the above health units were trained in peer education. The training
workshop lasted for five days in which different ASRH issues were addressed. The main
goal of the training was to equip participants with knowledge on ASRH issues and build
skills to transfer such knowledge to fellow young people.
Under the same arrangement, 25 KCC Health workers attended a 5 day training in
provision of youth friendly services. The main goal of the training was to equip

30
participants with knowledge and skills in order to promote and provide youth friendly
services at their respective health units. One of the participants shared this personal
testimony on communication with adolescents;

It had never occurred to me that the way I communicated with young people in the clinic was
inappropriate. I was always quick at blaming them for being reckless with their lives. There is
this 15 year old girl who visited our health centre and when I examined her she had severe
genital warts. My tone of voice and the fact that I did not seek consent to examine her must
have scared her very much to extent that she remained silent in the treatment room and
never came back for the next appointment. I always thought that warning young people about
their risky sexual behaviors and apportioning blame for those who “mess up” would make
them change for the better. This training has helped me realize that as health workers we
need to be empathetic, non judgmental and promote dialogue with young people in stead of
just warning and blaming them when they visit our clinics.

31
Picture 13: KCC Health workers engaged in a role play on Client –service provider
interaction.

4.4 Internship Placements:


NTIHC offers opportunities to students and other trained health professionals to put
into practice the knowledge acquired at school as well as learn from experienced staff
in various ASRH issues. They work along side NTIHC staff while providing services to
young people at the Centre or during outreaches. The duration of internship ranges
from 2 weeks to 6 months depending on their learning objectives. During the
reporting period we hosted a total of 26 interns from a number of Universities and
training institutions that we collaborate with. 15 of the interns were undergraduate
students pursuing degree courses in Social work and Counselling Psychology whereas 11
were pursuing post graduate studies at Makerere University Medical School Department
of Obstetrics and Gynaecology. At the end of their respective practicum periods, each

32
student was given an opportunity to provide feedback on the internship program. The
data from the evaluation shows that the students were quite satisfied with the
internship program. 95% of the students reported that they were able to apply the
theoretical knowledge they had acquired in class thereby getting hands on experience
in the ASRH field.

4.5 Training Policy Guidelines:


In an attempt to streamline training activities, NTIHC formulated policies that clearly
lay down the operational procedures in training department. A draft copy of proposed
training policies was presented to the entire NTIHC staff and Management who made
comments/suggestions that were discussed to reach consensus before including them
in the final policy document.

4.6 Resource Centre:


The resource centre was shifted to a more conducive environment in the training
department. It now boosts of over 300 local and international publications on
HIV/AIDS, young people’s sexuality and other reproductive health matters. The
publications are backed up by an electronic database of internet downloads which are
available free of charge to staff, our partners and the general public. NTIHC also
received a number of publications on gender mainstreaming in HIV/AIDS programs,
sexual and gender based violence and the revised Gender policy from Ministry of
Gender Labour and Social Development.

4.7 Research Activities:


NTIHC and UVRI signed a memorandum of understanding in which newly diagnosed HIV
positive young people from the youth clinic were to be recruited in a study on HIV
drug resistance. The study which is still on going is designed to find out how many
people are infected with drug resistant HIV and which antiretroviral drugs are
ineffective. 6 HIV Counsellors and 2 Laboratory Technicians were trained on the
criteria for recruiting clients, addressing ethical issues in HIV research and data
collection for the study.

33
4.8 Challenges
Conducting the YFS training workshop for KCC health workers was delayed for two
months because of the relocation of Naguru Health Centre to other KCC Health units.
The other reason for the delay is that in April and May 2009 most KCC health workers
were involved in the National Immunization Days spearheaded by the Ministry of
Health.
Two training activities scheduled for the July- December 2008 period were pushed
forward to the Jan- June 2009 period because of delay of disbursement of donor funds.
These activities include training of peer educators and staff training on sexual and
gender based violence.
There were more KCC health workers who expressed interest in being trained in
provision of youth friendly services but we did not have the capacity to conduct more
than one training workshop in the reporting period.

CHAPTER 5

5.0 Monitoring and Evaluation (M&E)


In 2007, a strategic plan was developed to streamline the activities of NTIHC, as part
of strengthening the effectiveness of the programs operations, it was found relevant
to promote monitoring and evaluation activities of NTIHC. In order to achieve this, it
was imperative to incorporate the M&E component into the program structure and
create the M&E department.
Although M&E as a stand alone department has not taken shape, the youth centre has
set targets and indicators that were developed during the development of the
strategic plan. These were linked to the program’s performances in the previous
years. An information management system is in place where various data bases exist.
These are used as monitoring tool to collect appropriate data as stipulated in the work
plans. A few staff have had short term trainings to enable them familiarize with the
element of M&E.

34
Unlike prior reports, the current reporting format has been revised to match with the
program work plans. There has also been an effort to try and synchronize the
monitoring tools to match with the existing HMIS as recommended by the MOH. It has
also been found relevant to equip more staff with knowledge in M&E and its relevance
to program activities to enable them appreciate the component. Efforts are underway
to link up with MOH to train staff in M&E. Although the process is still underway, some
work needs to be done for NTIHC to come up with a fully fledged M&E system.
The following activities have been found relevant in the process of strengthening the
M&E system.
• Review of indicators; although NTIHC has a three years strategic plan with a
work plan and log frame that stipulates the various activities and indicators, it
was found relevant to review the existing indicators in order to create a link
between program objectives, activities, out puts and outcomes. There is a
need to explore more on the outcome indicators and relate them to the HMIS of
MOH.
• Review of monitoring tools; it is imperative that the existing monitoring tools
be reviewed in order to link them to the reviewed indicators and also
synchronize them with the HMIS.
• Reviewing the reporting format; there is need to review the format in which
the 6 months, 12 months and end of project reports are presented so that they
are made in such a way that they inform management, stakeholders and
partners on the progress of activities in line with the intended objective.
• Developing the M&E Plan; there is need to come up with an M&E plan that will
guide the M&E activities of the program.
• Documentation; there is need to document the changes that are made in the
process of formulating an M&E plan which is in line with the HMIS.
For NTIHC to achieve a fully fledged M&E Department and a fully operational M&E
system there is need for concerted efforts. NTIHC therefore intends to embark on
implementing these activities during the next financial year in order to obtain the
desired results.

35
CHAPTER 6
6.0 Finance and administration
The Finance and Administration department is tasked with the recruitment, retention
and motivation of staff, provision of logistical support and general administration of
program activities and finances. During this financial year, there was increased need
for extension of infrastructure and provision of logistical support, strengthening and
implementation of policies and guidelines and ensuring projects are adequately
financed by mobilizing financial resources.

6.1 Infrastructure
During this period, changes in government plans constrained the program’s service
schedule and took it through remarkable changes especially during the second half of the
financial year. This was mainly as a result of the new developments at Naguru Health
Center that required the program to relocate its premises to Kiswa Health Center in
Bugolobi.

6.2 Resource mobilization and utilization


Swedish International Development Agency (Sida) has continued to be the main source
of funding for the program. During this period, a funding agreement was signed
between Kampala City Council and Sida on core support of NTIHC for the next three
years (2008 – 2011). Beside Sida funding, additional income has been raised from other
income generating activities such as outreaches, photocopying services, auction,
visitations, Training and Research.

36
Figure 2: Other sources of income

1% 12%
4%
9%

63% 11%

Auction Copier Services Outreaches

Practicum Research Visitation

Along side donor funding, the program also received non monetary support from KCC-
Public health department through Naguru Health Centre and Nakawa division Ministry
of Health, AIDS Information Center, Straight Talk Foundation and other partners.
Table 3: Sources of non monetary support
Source of support Form of support
Kampala City Council Premises, electricity & water
Ministry of Health Condoms
AIDS Information Center Laboratory supplies & Supervision
Straight Talk foundation Information, Education and Communication Materials

6.3 Partnerships and Public relation


As part of strengthening collaboration and partnership, the program participated in
the following conferences, meetings and workshops
• A consultative workshop for program officers of NGOs and CBOs to collect views
to be used in the production of a program officers’ manual on HIV/AIDS, human
rights and the law organized by Uganda Network on Law, Ethics and HIV/AIDS
(UGANET)

37
• A meeting at UAC to review an HIV/AIDS game organized by Uganda AIDS
Commission.
• A meeting for CBOs and NGOs operating in Nakawa Division organized by
Nakawa Divison , Gender and community development office.
• Debate on the new bill on HIV/AIDS organized by Uganda Health
Communication Alliance
• Dissemination workshop on child poverty findings in Kampala Area organized by
Kampala Area Federation in partnership with Christian Children’s Fund.
• Dissemination workshop on mainstreaming emergency contraception in the
public sector organized by Child Care and Rescue Programme (CC&RP). .
• East African Conference on alcohol organized by IOGT – NTO Movement
International Institute.
• Exploratory group workshop on HIV/AIDS prevention organized by UYDEL
• Gender mainstreaming orientation workshop for reproductive Health and
Adolescent Health services providers organized by ministry of Gender Labor and
Social Development.
• International Forum on ICDP from 24th – 25th November organized by Partners in
Population and Development (PPD).
• Launch of peer to peer drug abuse prevention program organized by Uganda
Youth Development Link (UYDEL)
• Launch of scaling up division HIV/AIDS prevention among young people and
other vulnerable group project organized by Nakawa Division in conjunction
with AMICAALL.
• Launch of the National Population Policy organized by population secretariat.
• Meeting for CBOs and NGOs operating in Nakawa Division organized by Nakawa
Division, Gender and community development office.
• National Symposium on high fertility organized by Population Secretariat.
• Opening ceremony for parliamentary Alliances for Health in Eastern and
Southern Africa organized by Partners in population and Development.
• Review of advocacy messages and fact sheets on reproductive health organized
by Population Secretariat.
• Systems building training for youth organizations working with young people in
Kampala district organized by The Kampala One Stop Youth Centre.

38
• The child helpline national consultation meeting
• The III UNGASS AIDS & SRHR FORUM organized by the Uganda Network on Law,
Ethics & HIV/AIDS (UGANET)
• Validation meeting for peer to peer services evaluation report organized by
UYDEL .
• Workshop on designing interventions to address SRHR among young people
organized by Novib.
• Workshop on finalizing the Adolescent Health Strategy and Guidelines for Youth
Friendly Services organized by Ministry of Health.
• Workshop on introduction of Misoprostol for management of postpartum
Hemorrhage(PPH) in Uganda organized by MOH
• Workshop on main streaming support to foster a joint accelerated response to
SRHR issues among young people within their education programme, organized
by NOVIB
• Workshop on reviewing the curriculum for integration of sexuality education
into the secondary school subjects that include Islamic Religious Education,
CRE, English, Biology and Geography organized by National Curriculum
Development Centre in partnership with UNFPA.
• Workshop on the orientation of Lukia’s story organized by JCRC
• Young people’s self coordinating entity familiarization workshop organized by
young People’s self Coordinating Entity (YP- SCE).

6.4 Visitations and other Commemoration


events
The program participated in several commemoration events, among them was
• Commemoration of Swedish National Day
• Commemoration of the World AIDS Day at Lugogo Indoor stadium
• Day of the African Child held in Masindi
• International Youth Day held in Mbarara district
• Launch of the state of Uganda’s and world population report at Hotel Africana
• Safe Mother hood Day held in Mpigi district, Buwama county
• World Contraception Day 2008, at Kiira road Play ground
• World Population Day held in Mbarara district, Kakyeka stadium

39
The program was privileged to host a number of guests among them were the
following;
• 2nd group of UPHOLD trainees in Adolescent Friendly Services provision
• Delegation of American friends for UNFPA
• Dr. Jotham Musinguzi, Regional Director, Partnership in Population and
Development
• Group from Columbia University
• Group from Lucia Youth Development Foundation
• Group from medical teams international
• Group from reach out, Mbuya
• Group from Swedish National Commission for UNESCO
• Group from the Swedish Association for Sexuality Education (RFSU)
• Team from Uganda Virus Research Institute
• Tutors from Health training Institutions
• UPHOLD trainees in Adolescent Friendly Services provision

40
41
Appendix: Activity Matrix 2008/09
SERVICE DELIVERY
Function Planned/Target Actual Variance Reason for variance Way forward
Intervention
Objective 1: To provide and promote access to quality services and information on SRH services and rights.
HIV Counseling • To increase the 10,329 young • Interruptions where • Increased
and Testing number of HCT clients people were 17% services had to be halted announcements about
served. tested Below so as the relocation our new location
target exercise of the youth • Increased outreaches
clinic to Kiswa Health in the community
Centre between March –
May 2009.
STD Management • To reduce the 2,740 young
percentage of STD people re-
clients who re-attend attended with
with STDs. an STD
• To increase the 5,589 young All clients • This is to be
proportion of STD people with an STD maintained whereby
clients who receive FP treated with were all STD clients are
counseling. an STD counseled counseled about
about FP Family planning
Pregnancy • To increase the 1,098 girls • Interruptions where • Increased
testing proportion of were tested 22% services had to be halted announcements about
pregnancy testing for pregnancy Below so as the relocation our new location
clients who receive & counseling target exercise of the youth • Increased outreaches
FP counseling by 25%. on FP clinic to Kiswa Health in the community
Centre between March –
May 2009.
• To increase the 1,098 girls
proportion of were tested All clients • This is to be
pregnancy testing for pregnancy who took maintained

i
clients who receive & counseled pregnancy
information (are on HCT tested were
counseled) on HCT counseled on
services by 25%. HCT
Antenatal care • To increase the 2,812 young • Interruptions where • These targets may
(ANC) attendance of young mothers 43% services had to be halted have to be revised due
people to ANC attended the Below so as the relocation to the new location
services. ANC clinic target exercise of the youth which is a health III
clinic to Kiswa Health and doesn’t have a
• To increase the 647 young Centre between March – maternity wing.
attendance of young mothers made 79% May 2009. Clients seem to prefer
people to four visits atleast ANC 4 Above a health centre that
per pregnancy. visits target has a maternity wing
Postnatal Care • Increase the 289 young 5% • Interruptions where
(PNC) attendance of young mothers Below services had to be halted
PNC mothers attended PNC target so as the relocation
services exercise of the youth
• To increase the 16 mothers clinic to Kiswa Health
proportion of ANC who had Centre between March –
clients who have ever attended ANC May 2009.
attended ANC at at NTIHC
NTIHC who turn up turned up for
for PNC by 10%. PNC
Post abortion • To increase the 24 young • Interruptions where • Increased
care (PAC) proportion of PAC people 41% services had to be halted announcements about
clients who receive attended PAC Below so as the relocation our new location
FP counseling by 10%. services & target exercise of the youth • Increased outreaches
were clinic to Kiswa Health in the community
counseled on Centre between March –
FP May 2009.
• To increase the 24 young
proportion of PAC people
clients who receive attended PAC

ii
HCT services. services &
were
counseled on
HCT
Family planning • To increase the 570 young • A proactive approach • This is to be
Counseling proportion of FP people who 3.6% was adopted to get more maintained
clients who receive received FP Above target males to support their
STD counseling. were partners to use family
counseled on planning through
STDs counseling

• To increase the 570 young


proportion of FP people
clients who receive received FP
HCT counseling. were
counseled on
HCT

• To increase the 570 young


proportion of PNC people
clients who receive received FP
FP counseling. services

Provision of • To be able to provide • All the 5 modern


contraceptives at least five modern 5 0 temporary
temporary contraceptive method
contraceptive are to be maintained.
methods by year two.
Distribution of • To increase condom 575,552 7.7% • Interruptions where • Increased distribution
condoms distribution pieces of male Below services had to be halted during outreaches in
condoms were target so as the relocation the community

iii
distributed exercise of the youth
clinic to Kiswa Health
Centre between March –
May 2009.
• To increase the 425 health • This is to be
proportion of clinic talks had maintained whereby
based IEC sessions condoms as every health talk on
where condoms are the topic for condoms was followed
discussed and discussion by a demonstration of
demonstrated by 3%. how they are used.
• Increased outreaches
in the community
Other ASRH • To increase the 671 young 75%
services proportion of young people Above
(growing up people seen for received target
issues) growing up issues information
who receive about puberty
information about
puberty.
• To increase the 7,978 young This was due to the
proportion of young people 5% increased outreaches This is to be
people seen for received Above carried out in the maintained
growing up issues information target primary schools
who receive about Sex,
information about rel’ships,
Sex, relationships, prevention of
prevention of STDs STDs and
and pregnancy. pregnancy

iv
BCC/ADVOCACY ACTIVITIES
Function Planned/Target Actual Variance Reason for Way forward
Intervention variance
Objective 1: To provide and promote access to quality services and information on SRH services and rights.
Toll Free Help • To increase the 11,342 calls 36.7% Below • Interruptions where • Production of
Line counseling number of calls on received target services had to be promotional materials
the Toll Free Help halted so as the • Conduct promotional
Line to 8 calls per relocation exercise drives
hour per day. of the youth clinic • Announcements on radio
to Kiswa Health program
• To increase the 4,021 calls 2% Centre between • Give prizes to 10 – 19
proportion of callers received callers Below target March – May 2009. year old callers
aged 10-19 years aged 10-19 years • Work with
utilizing the Toll Free organizations/communiti
Help Line es with young people in
this age group e.g.
schools to promote the
service.
Teen Radio • To have diversified 5 community radio 58% Below • Technical problems • Discussions are under
Program the listener ship of programs were target experienced by way with the service
the radio program by conducted service provider provider to rectify the
2011 during field problem.
broadcasting
IEC material • To increase the 144,166 IEC 10% • Young persons from • This is to be maintained
production capacity materials were Above the PTC were
of the current IEC produced target brought on board to
materials help in the
production of IEC
materials
• To have developed 2 IEC materials on . • To produce more
and produced new syphilis and relevant IEC materials
relevant & updated gonorrhea were • Review and update

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IEC materials. produced existing IEC materials
Outreaches • To increase the 72 outreaches 414% • During the • Work with other
number of conducted were conducted Above relocation exercise organizations working
out reaches per year target a number of with young people in the
(to schools and outreach activities community
communities) were organized
Group Discussion • To increase the 305 group 36% Below • Discussions were • Revise the target & focus
numbers of young discussions were target interrupted by the be put on number of
people attending carried out relocation exercise discussions conducted
group discussions. instead of young people
attending since they are
not registered.
HIV post test • To establish a post A Post Test Club • Functionalize the PTC
club test club with was established &
membership of members meet
increasing by 50% every Saturday
Objective 3: To advocate for community involvement/participation in ASRH program
Advocacy for • To conduct 13 dialogue • Involve community
community leadership forums meetings with leaders in promoting
involvement/ advocating to support community leaders services e.g. toll free,
Participation in ASRH activities in the were conducted. outreaches, community
ASRH programs. community radio programs etc
• Organize regular
meetings to get
feedbacks from
community leaders.
• To participate in at Participated in 4 25% Below Lack of Funds during • Participate in locally
least five ASRH ASRH events target one of the ASRH organized events
events each year events
• To have published at 3 articles were 25% Below • Write articles and submit
least four articles on published and target to different media
ASRH issues each year one supplement houses

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TRAINING ACTIVITIES
Function Planned/Target Actual Variance Reason for Variance Way Forward
Intervention
Objective 2: To strengthen partnerships, net working, technical, managerial and institutional capacities to provide and promote
services and information for quality adolescent Sexual Reproductive health services and rights
Training • Equip staff with • 9 In house training 0
relevant information sessions covering a
on current best wide range of issues
practices in different were carried out.
areas of management, • A 3 day staff
ASRH, HCT, SGBV, training on SGBV
Mainstreaming Gender was conducted
Issues into HIV/AIDS
Programming
• Conduct training for • 17 peer educators 0
Peer educators from were trained.
KCC Health Centres in
ASRH

• Provide support • This activity was not 100% The shifting of the • This activity will be
supervision to Youth carried out. Below youth clinic from implemented in the
Friendly Clinics with in target Naguru to Kiswa 2009/10 period.
KCC Health Centres interrupted the
plans.
• Training of new This activity was not 100% No volunteers were Will train volunteers
volunteers in ASRH carried out. Below recruited in that when they are recruited
target period

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• Conduct refresher This activity was not 100% There was delay in This activity will be
training for peer carried out. Below disbursement of implemented in the
educators in ASRH target donor funds. 2009/10 period.

• Conduct YFS refresher This activity was not 100% The training of KCC The refresher training
training for KCC Health carried out. Instead more Below health workers for will be conducted after
Workers 25 KCC health workers target the period 2009/10 support supervision has
were identified and was brought forward been carried out.
trained in YFS with the intention of
having YFS support
supervision
activities and
refresher trainings
pushed forward.
• Build capacity of staff 13 staff attended short 0
through professional courses conducted by
trainings different organizations
and training institutions.

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FINANCE AND ADMINISTRATION
Function Planned / Actual Variance Reason for Way forward
Intervention Target variance
Objective 4: To strengthen sustainability mechanisms respond effectively to environmental changes.
Resource • To have • Swedish International • The program gets • The one year • NTIHC is part of a
mobilizatio diversified Development Agency non monetary period was too coalition task force
n funding sources (Sida) has continued to contribution from short to have with other CBOs spear
to at least two be the main source of KCC, AIC, UNFPA secured funding headed by DSW in
donors by the funding for the and other partners. from other donors writing a joint
end of year three program. During this proposal to the EU.
period, a funding
agreement was signed
between Kampala City
Council and Sida on
core support of NTIHC
for the next three years
(2008 – 2011)
• To increase • Locally mobilized • There was a 65% • The biggest • Training and Research
local fundraising resources increased by over shot of the percentage (74%) proved to be the main
by 20% each 85% this year as intended target. of the realized sources of locally
year. compared to the income was raised mobilized resources.
previous financial from the on going Therefore an agent
year. training and need to boost up these
research activities within the
activities. program was realized.

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