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Resilience for Health Service Continuity During the COVID-19 Pandemic

The declaration of Covid 19 as a global pandemic and contingent measures taken by the Ugandan government including subsequent nationwide lock downs affected plans and strategies for programmes and service delivery at all levels. With the extended lockdowns and reduction of numbers of people that can congregate, strategies including community dialogues, intergenerational meetings and service outreaches could not be conducted. On the other hand, reports of sky rocketing adolescent and teenage pregnancies, increased bride kidnaps, and pleas from women with no access to contraceptives of their choice were increasing by the day. It looked like we were destined to fail on our mission, the distance between UFPA/InPACT team and the communities we serve seemed to be becoming longer every day that passed.

It was clear that we needed to re-think and re-energize the community-based family planning approaches we had initially designed. Participatory discussions between InPACT and select Village Health Team (VHT) members were held and it was resolved to adopt a door-to-door approach, because of the following benefits it would bring to the program.

  1. We would remain compliant to the national measures of avoiding group meetings

  2. Social distancing could well be ensured

  3. Women who were shy to bring their concerns during dialogues would ably express themselves during door- to door meetings

  4. It was easy to have couples discuss and agree on their FP method of choice

  5. VHTs could pick methods for refills and deliver them and/ or work with health workers to provide services to continuing clients at home

  6. The approach empowers and equips VHTs to handle and respond to FP questions

The door-to-door (D2D) approach was adopted in the districts of Kibaale & Kyankwanzi during the months of June through to July 2021 when stringent lock down measures were directed.

The approach has proven to be an effective strategy. Since its adoption, InPACT has registered the greatest yield in numbers reached and referred for family planning services. We have also noted that more in-depth discussions happen when we use this approach. Men and women who participate in the door-to-door sessions tend to acquire and retain the FP information passed on to them. Others – especially low parity women seem to understand better the importance of healthy timing and spacing of pregnancies based on the questions they ask. Other benefits also accrued to the family, including receiving referrals for other health conditions.

Samuel Kwesiga – InPACT Kibaale district coordinator, admits, that the door-to-door approach may not enable us reach many women in a short period, but is quick to add that the approach empowers women to make their reproductive choices better and that such women are more likely to continue using contraceptives for a longer period than those who attend in large groups and made rushed choices. InPACT will continue using blended community mobilization approaches including the door-to-door for broader and more sustainable impact within communities.

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