Promoting Menstrual Health & Hygiene

Savings Groups Promote Menstrual Health

Adolescent girls and young people have come together to promote their menstrual health and hygiene, which is one of the leading sexual and reproductive health care challenges faced by women of reproductive age in the refugee and host communities in Nakivale and Oruchinga refugee settlements. It is for this reason that Shared Action Africa supported 30 adolescent girls and young women to form a savings and lending group that they named “Oruchinga Youth Protection Group”, with a membership of 25 girls and 7 boys.

The group was initially formed as a savings and lending group to help members pool their meagre savings on a weekly basis, but also as forum through which members would be provided sexual and reproductive health counselling and services. It is through subsequent meetings, where members noticed consistent absenteeism by female members around the same period every month, that the leadership decided to find out from their members why they were not attending group meetings on a regular basis.

It was then revealed by members that lack of access to sanitary pads during menstruation hindered them from joining group activities, and it is for this reason that they jointly decided to seek training on how to produce handmade sanitary pads.

To support their efforts, Shared Action Africa provided them UGX 150,000 which they used to buy some materials that they are using both during training, as well as in the production of reusable sanitary pads for their own personal use and for close family members.

“The sanitary making group activity has not only strengthened the social connectedness of members, but it has improved the menstrual hygiene and health of members. This is because we not only meet to save and lend out to each other, we also meet to receive education on how to promote personal hygiene during menstruation. We are working hard to improve our skills in the making of sanitary pads so that we can grow beyond making sanitary pads for our own use into turning it into an income generating activity for both individual members as we as for the groups.

We are grateful for the support provided to by Shared Action Africa and African Women’s Development Fund. We plan to share this knowledge with other youth led groups so that they can also have a group activity that does not help them bond, but also addresses their menstrual health because we also believe young people are the best agents and drivers of change amongst their peers, and the community they live in.”

Surviving and Healing from Sexual Assault and Trauma

Krematic’s Story

KREMATIC’S STORY | Surviving and Healing from Sexual Assault & Trauma

Krematic a 23-year-old survivor of rape is rebuilding her life through the psychosocial that she is receiving through the Youth SRHR Friendly space created at the Rubondo HCIII facility in Nakivale Refugee Settlement in southwestern Uganda. At the age of 18, Kremestic, a Congolese refugee was sexually assaulted at age of 18 as she returned from school. At the time, she did not know how to access information and support to take the steps taken to immediately following a sexual assault. For instance, to get the care she needed to prevent unwanted pregnancy, and never found justice for the crime committed against her. Consequently, at the age of 23 she is still picking up the pieces after this traumatic experience that happened 5 years ago. She was banished from her home by her parents due to the stigma associated with raising a single mother coupled with the burden of caring for an additional person in an already resource constrained environment.

The sexual assault impacted my lives in so many ways that I struggling to recover from. I was chased from my home, and I had to find shelter for myself and my child. I was not ready to become a mother and had no support. I was interested in pursuing an education with the hope of improving our lives as family, because it is very hard to survive as refugees in another country. I struggled to find employment and take care of my child at the same time. It is not until I heard about the Shared Action Africa and the programs, they were implementing in my village that I got interested on how I participate to help with my personal healing, and also help others that might be going through the same struggles recover and start a support group that will help us bond around specific activities that we could do together like starting joint income generating activities or forming a savings and lending groups from which we would access small loans to meet our financial needs.

After receiving training from Shared Action Africa on various topics related to adolescent sexual and reproductive care, and learned about how to prevent unwanted pregnancies through emergency contraception, prevention of STIs, particularly HIV through Prep, menstrual hygiene among other topics, I was motivated to serve in the capacity of Peer Educator and Advocacy Champion. Serving in the capacity of advocacy Champion, I am part of Youth SRHR Collective, that brings together 170 other adolescent girls to advocate for spaces to be created at some health facilities so that the young people like myself can access sexual and reproductive health care in a safe environment. Also, through the knowledge acquired through attending group meetings where we are sensitized by our rights to sexual and reproductive health and rights, and the services available at the health facilities, I not only counsel my peers on the same subjects, but I more empowered to make informed decisions, in case I encounter the same situation as I did five years.

In addition to being part of team of committed young people making a difference in our community, I am also earning a monthly stipend from providing SRHR related services to my peers. Similarly, through training provided by Shared Action Africa, I joined a savings and lending group through which I can access some small loans, whenever I have a financial need.

I am particularly happy with the reflective community dialogues conducted for adolescents together with their parents to discuss subjects related to sexuality, a subject that is culturally never discussed by parents with their children. I am very supportive of this activity because if my parents had an opportunity to participate in the same, I would probably be living with my parents now. Such programs are important to change the mindsets of our communities about allowing adolescents and young people to access sexual and reproductive health care to improve our lives.
I would like to urge Shared Action Africa to bring us vocational training programs for single mothers like me so that we can get a second chance in life.

Thank you, SAA, for changing our lives and my community.

Amplifying Young Women’s Voices

Amplifying Young Women’s Voices | Reproductive Justice

On International Women’s Day, March 8th, 2022, Shared Action Africa, celebrates the young women and men at the forefront of advocating for increased access SRHR services that are tailored to the unique needs of adolescents and young women. The ongoing campaign is supported under our advocacy initiative known as Arise for Reproductive Justice for Refugee Girls in Nakivale and Oruchinga refugee settlements and host communities in southwestern Uganda.  The advocacy efforts are aimed at influencing the creation of youth-friendly corners at the health facilities where adolescents and young people can access SRHR services without fear of reprisal by their communities. Access to youth-friendly SRHR services among others is aimed at preventing the occurrences of early and teenage pregnancies among young people like 17-year-old Berita Byukusenge.

Beritah a refugee from Rwanda with her 9-month-year-old baby in Kiretwa village

Beritah, like many young girls, became pregnant during the prolonged school lockdown of over 14 months to curb the spread of the COVID-19 disease. Due to lack of access to information about reproductive health, peer pressure, and the need to access basic needs such as food, clothes that could not be provided by her immigrant parents from Rwanda, she fell under the influence of a married man. She got pregnant and her relationship with the married man deteriorated and was characterized by emotional and physical abuse, Simultaneously, Benita was expelled from her home by her parents and sought refuge with an older woman in another village. In exchange for a roof over her head, Benita is working in the old woman’s banana plantation. Benita’s experience could have been different if she had had access to a safe place or environment where the youth can access information on sexual and reproductive health.

“I became pregnant because I lacked knowledge on sexual and reproductive health care. If only I had access to someone I trusted to talk to as well as a safe place where I could access information without shame and fear of ostracization from my community. My situation would have been different because as a teenage mother, I not only have to take care of myself, I also have to provide a home to my nine-month-old baby. To earn a living, I work in the banana plantation of an elderly woman in our village. If only I had information on contraceptive use, I would not be a statistic of early and unwanted pregnancy. One uninformed decision has forever changed my life.”

Beritah with her baby in the banana plantation where she works to earn a living.

To reduce, the high incidences of teenage/adolescent pregnancies among refugee adolescents, which is at 8.7% according to Makerere College of Health Sciences, Kampala, Shared Action Africa is working towards a shift in practice, behavior change, and policy implementation towards increasing access and utilization of SRH services for girls like Beritah.  To this end, a Youth Collective for SRHR was created to partner with others and advocate with others for youth-friendly spaces for SRHR to be established at all health facilities in Nakivale Refugee Settlements. Similarly, the project identified and trained Peer Educators whose role is to mobilize and educate their peers to foster positive behavior change geared towards increased utilization of sexual and reproductive health services that are tailored for adolescents and young people. Young people such as Benita and others like her, are not only willing to share their stories but also serve as change agents within their communities to influence behavior among their peers to utilized youth-specialized SRHR services. And it is for this reason that we celebrate them this International Women’s Day.

Empowering Women through Family Planning

Empowering Women through Family Planning | SRHR Services

28-year old Fezascola Kabana from DRC has 4 children while 2 passed on. Due to limited access to information and family planning services, she was not able to properly space her children in the way she wanted to.

“Through the community family planning health education and service camps organized by Shared Action Africa, I got information on the different family planning methods and I was able to start using an Implanon for 9 months now. The camp increased access the family planning services to my fellow women and I because before it was expensive to go the health facility. Moreover, I regularly get information from a village health team member in my village hence I feel very comfortable with my method of choice. Being able to plan my births has only helped improve my health but has also improved my income as I can now spend enough time in my business. I am able to take care of my children and I am not worried about an unplanned pregnancy,” said Feza

Harriet’s Story

As a frontline health worker, she was expected to continue providing health care to the patients in the refugee settlement that visited the poorly equipped health facility to handle covid-19 patients. The health facilities in the refugee settlement lacked adequate information on the disease as well as supplies such as PPE and hygiene supplies to protect the health workers and patients from the disease. Therefore, having to work under these highly challenging conditions has increased the increased risk health workers in the refugee settlement experiencing mental health problems.

I remember the fear and panic among our health team on the first day we got a patient of COVID-19. Though we had to carry out business as usual, we could not shake off the feeling of contracting the novel virus. With time, we have seen more patients of COVID-19 at our health facility but this does not make it easier on us. In addition, the quarantine centre is near our health centre so we are afraid of getting in contact with people who would potentially be infected. Moreover, ours is a service of proximity hence we can’t afford to social distance. Not so long ago, we had a mother who tested positive for COVID-19 and was referred to Mbarara hospital. This puts us in a position of being scared of the people we are serving. In a day, our facility serves approximately sixty to seventy people in day and these people come from around ten villages. But then, some of the people who come in to use the services are not protected! They don’t have protective gear because they can’t afford it or don’t know the importance. This is made worse due to their refugee status that makes them more vulnerable. Most are still not aware of the protective and safety measures against COVID-19.

Having such an unsettled mind affects the entire person and having peer to peer support, continuous updated information on COVID-19 and supportive supervision will go a long way to help us cope with the virus. Getting enough protective gear such as masks, specs, gloves, aprons is very paramount for us to serve the community with reduced fear of acquiring the novel virus. Due to lack, we are at times we are forced to reuse items like disposable masks which is very unhealthy. Our health centre has put in place the protective gear such as hand washing facilities, temperature guns and alcohol sanitizer.

More than having the protective gear is our need for counselling and other psycho-socio therapies to protect our mental and emotional health. At the bare minimum, we need psycho-socio support on a bi-weekly basis so that we serve our communities better while taking care of our emotional needs.

Hedwig’s Story

Hedwig’s Story | Make PPE Available for Everyone

Due to the uncontrolled movements of people across the Uganda and Tanzania boarder, Rubondo Health Centre II in Nakivale Refugee Settlement is now located in an area that is threatened by a potential outbreak of covid-19. The situation has worsened due to the unavailable access to PPE and other hygiene supplies to protect vulnerable populations such as refugees from COVID-19.

Hedwig works as a midwife with Rubondo Health Centre II situated at the Uganda Tanzania Border and serves Nakivale Refugee Settlement. Given that the health centre is close to the border of Tanzania and Uganda, it gets patients from both countries including the refugee’s settlements. With limited COVID-19 testing available for everyone, there is an increasing risk of spreading the virus.

“As a health worker, we are in constant fear of contracting disease as we are expected to continue providing our services amidst this pandemic. By the nature of our job, we are in constant proximity with our patients, and protecting ourselves is becoming increasingly harder due to limited access to PPE.”

Consequently, the health workers such as Hedwig have become increasingly vulnerable to COVID-19, and the situation is worsened because they cannot access COVID-19 testing when they need. This is true because COVID-19 tests are unavailable in remote areas of the country such as Nakivale Refugee settlement which is located more than 380 kilometers away from the capital. Therefore health workers in these remote are constantly worried that they will not only catch the disease, but are mentally by the mere thought of infecting their family members weighs a lot of our mental health.

The health workers mental state is further affected by the limited knowledge in diagnosing COVID-19, particularly in the absence of proper testing as well as other respiratory diseases having similar symptoms. Therefore, receiving updated information on COVI9-19 and regular training on how to handle patients that might display symptoms attributed to COVID-19 would go a long way in addressing their fears and mental health amidst the pandemic,

We are therefore grateful for our collaboration with Shared Action Africa that helps us access PPE and other hygiene supplies that have enabled us to continue providing the essential health services to the refugee and host communities in Nakivale Refugee Settlement. We are also hopeful that through this partnership, health workers will receive the psychosocial support we need to remain mentally stable and continue to provide quality health care services to our patients.


Health Worker Story

Health Worker Story | Skilling Health Workers

Jessica , an enrolled midwife at Nakivale health centre iii is one of the participants in the training Shared Action Africa conducted among the 20 frontline health workers (midwives) from 7 health centers to provide family planning services and cervical cancer screening to or refugee women in Nakivale Refugee Settlement. The theory and practical training equipped the health workers with knowledge and skills to provide quality integrated family planning and long acting family planning services to maximize availability and accessibility of FP services at all levels of family planning service Nakivale Health Centre III, working in the maternity ward. She is one of the frontline line workers trained in the provision of family planning methods and cervical cancer training.

“I can now administer cervical cancer screening and can properly diagnose it and support women who have it. I also gained skills in the administration of both short-term and long-term family planning methods, but I am particularly for the new knowledge on the insertion and removal of IUDs, use of female condoms and cervical cancer screening. I had never seen a female condom before the training but now I know how to use it. I can offer a wide range of family planning services. Since the trainings, the family planning users have increased from 50 to 70 per week. Much as we still have to deal with a lot of misconceptions, cultural beliefs and wrong information in the community concerning the use of family planning, we the health workers are more empowered to support the women and girls that come to health centre to receive health

The training also improved my customer care skills as I serve the women and girls who come to the facility. Some of them can’t properly express themselves in the common language but I can understand what they are saying. This training enabled me to understand the human rights-based approaches of providing quality care.

Nevertheless, the demand exceeds the supply; due to the large number of refugees in the settlement, we have limited resources in terms of manpower and supplies. This causes unwanted pregnancies leaving many women and girls in vulnerable situations. Passing on this knowledge and skills to Village health teams will go a long way to increase the number of FP users and cervical cancer screening since people will be more aware and services will be brought nearer to them.”