Submission ID 118599
| Issue/Objective | Uganda's Ministry of Health (MoH) is developing a five-year adolescent health strategy, yet the absence of an interim operational framework impedes coordinated action, particularly for marginalized youth's access to sexual and reproductive health and rights (SRHR) services. With 24% of teenagers experiencing pregnancy (UDHS 2022) and limited adolescent-friendly health services (RMNCAH Sharpened Plan II, 2022/23-2026/27), systemic gaps in financing, monitoring, and civil society engagement exacerbate challenges. Communicable diseases like HIV further strain under-resourced systems (BMJ 2015;351:h4148). This context demands urgent civil society-led advocacy to establish a cohesive, time-bound implementation plan, ensuring equitable service delivery and policy alignment with youth needs (FP 2030). |
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| Methodology/Approach | PSIU engaged national and sub-national stakeholders via three pathways: Leveraging MoH partnerships to join technical groups - consultative technical working group meetings, weekly Teenage Pregnancy Surveillance and Response meetings - and regional forums, including Mubende regional stakeholders' orientation - a hotspot for teenage pregnancies (The Independent, 2024) - to strengthen and integrate ADH and school health linkages; Co-designing interventions using key DHIS2 adolescent health performance indicators' data (2022-2024), including Out-Patient Department attendance, number of Post Abortion FP, and new users of family planning methods, etc. and youth feedback; Internal alignment meetings to harmonize advocacy and programming. This multi-stakeholder, evidence-driven approach ensured policy relevance and inclusivity. |
| Results | The advocacy initiative achieved several key outcomes by December 2024. Advocacy secured civil society representation in all ADH CIP consultative technical working groups, fostering inclusive priority-setting. Additionally, Mubende regional stakeholders collectively advocated for the institutionalization of the District Committees on Adolescent Health (DiCAH), contributing to the official launch of DiCAH guidelines by the Ministry of Health in October 2024. Two PSIU recommendations were adopted: strengthening M&E systems at national and subnational levels, for example ADH dashboards integrated in DHIS2, to track and improve data analysis of adolescent-specific outcomes like contraceptive access; and, enhancing the capacity of health service providers to deliver equitable, integrated, and youth-friendly health services. Insights from the 2022-2024 ADH performance indicators identified nineteen high burden districts including Amuru, Budaka, Namayingo, Mayuge, Namisindwa, Manafwa, Kole, Oyam, Dokolo, Amolatar, Otuke, Kwania, Lamwo, Kiryandongo, Soroti, Kapelebyong, Ntoroko, Bundibugyo and Obongi for prioritization. Lastly, feedback mechanisms, including the submission of quarterly partner reports to the MoH, were established to share project learnings and progress in reaching youth with sexual and reproductive health services, including contraception. A 75% reporting compliance was achieved, highlighting progress and fostering accountability. The results demonstrate the importance of collaboration, local advocacy and evidence-based integration, and accountability mechanisms in driving policy formulation and improving adolescent health programming. |
| Discussion/Conclusion | The successful development of Uganda's ADH CIP 2023/24 - 2025/26 through civil society advocacy demonstrates several key learnings for policy advancement. The process shows how civil society organizations can effectively influence implementation planning despite resource constraints, providing a replicable model for other civil societies in resource-limited settings. Of the three pathways, leveraging MoH partnerships to secure representation in technical working groups and regional forums was most effective. It rippled into tangible outcomes and addressed the gap in civil society exclusion and operational framework deficits. thereby Underscoring civil society's role in bridging policy-action gaps. Priority objectives include: Operationalizing DiCAH guidelines nationally Creating civil society coordination platforms for aligned advocacy, and Standardizing youth-friendly service reporting. Results highlighted local capacity gaps, necessitating structured support for DiCAH and health workers. Sustained advocacy must institutionalize civil society engagement and strengthen subnational structures to ensure impactful implementation. This model offers a replicable framework for youth-inclusive health planning in resource-limited settings. |
| Presenters and affiliations | Bashir Kabuye Population Services International Uganda Bashir Kabuye Population Services International Uganda |
