A Spotlight on the Ministry of Health in Uganda

A CONVERSATION WITH DR. Olaro on World Contraception Day

Each month, the Self-Care Trailblazer Group places a spotlight on our members and their achievements. This month, we put the spotlight on the Director of Clinical Services and Senior Consultant for the Ministry of Health in Uganda. Dr. Olaro is also a Self-Injection Ambassador, an initiative led by the subcutaneous DMPA (DMPA-SC) Access Collaborative, implemented by PATH and JSI.  

TELL US A BIT ABOUT YOUR ORGANIZATION AND THE DEPARTMENT THAT YOU SIT IN! 

I am currently the Director Curative Services at the Ministry of Health. In my roll, I coordinate with UNFPA to provide family planning support to the health sector, serve as the FP2020 focal point chairlead the self-injection taskforce, and act as an ambassador for self-injection and self-care more broadly. I also currently head the Continuity of Essential Services Pillar in the context of COVID-19.  

My background is in the public sector, where I worked as a medical officer, senior surgery consultant and Hospital Director at Fort Portal Regional Referral Hospital. With 26 years of experience from working across all levels of the health systemI am able to bring knowledge from district and national level organizations to deliver health sector improvements in Uganda.  

HOW HAS COVID-19 MADE SELF-CARE EVEN MORE IMPORTANT IN OUR HEALTH CARE SYSTEMS?  

Self -care enables people to manage their own health and well-being. This is especially important during a pandemic when many people cannot reach a health facility. One great example of a self-care intervention that can help when individuals face obstacles in accessing health care facilities is the self-injection of DMPA-SC (Sayana Press). Self-injection was approved last year in Uganda and since then, women are beginning to self-inject across the country. Another example of an instrumental self-care intervention in Uganda is HIV self-testing. Self-care continues to be embedded in the continuity of health services throughout the country.  

TELL US ABOUT THE PROCESS OF ROLLING OUT DMPA-SC IN YOUR COUNTRY! 

The roll out of DMPA-SC in Uganda has been an interesting learning experience. Beginning in 2014, when DMPA-SC was registered in the country, the Ministry of Health has been an active leader in introducing this form of contraception throughout the country, alongside PATH and other partners.  

After piloting this intervention, we found that community health workers were able to administer sub-cutaneous (SC) injectables (in addition to IM), and with self-injection, we were able to reach new users with family planning. We also found that self-injection is highly acceptable, feasible and more cost effective when compared to women receiving DMPA-IM from service providers, making this an affordable alternative to traditional contraceptive options.  

AS A SELF-INJECTION AMBASSADOR, WHY DO YOU BELIEVE THAT OFFERING SELF-CARE CONTRACEPTIVE OPTIONS IS IMPORTANT AS AN ADDITIONAL OPTION FOR WOMEN SEEKING CONTRACEPTION?  

I am of the view that offering self-care contraceptive options in the context of a full family planning method mix is important because it empowers women to take charge of their sexual and reproductive health.  Self-care contraceptive options bring services closer to women.  

After the initial training from a community health worker or at a health facility, women can self-inject in the privacy of their own homes. This practice also allows women to save time and transport costs associated with travel and the wait at health facilities for service. Finally, the ability to store this product at home protects women from becoming vulnerable to stock-outs, which is especially valuable during a pandemic.  

Self-injection has been proven to improve injectable continuation by reducing clinic access challenges, making it an invaluable option for women seeking contraception.  

 

For more information on the Self-injection Ambassadors Initiative, please contact Katie Gray, kgray@path.org 

Banner image courtesy of Vennesa Vick.