The Health Systems Advocacy Partnership (HSAP) has been running for five years with an aim of contributing health systems so that people in sub-Saharan Africa gain better access to sexual and reproductive health services. The Partnership focuses on strengthening human resources for health and access to essential sexual and reproductive health commodities, while advocating for good governance and equitable health financing.
The project is being implemented by the African Center for Global Health and Social Transformation (ACHEST), AMREF and HEPS- Uganda as key partners in the Ugandan context.
Below, are some of experiences from the HSAP project.

Call her a woman on a mission. Jennifer Atim, a midwife frantically paces up and down the maternity ward at Amach HC IV in Lira District with a purpose: To make sure that every mother who reports for antenatal care or even childbirth is checked for preeclampsia and other pregnancy related complications.
Better known as a silent contributor to maternal deaths, Preeclampsia is a life-threatening condition among pregnant women.
Thanks to HSAP, Atim is one of the health workers Lira who is well equipped with information on detecting preeclampsia before it is too late to claim a life or lives.
“Before HSAP, we did not have a machine to detect the condition. It is because of the partnership that we now have one,” she says referring to the blood pressure testing machine.

“Every day, we receive about 10 new expectant mothers for antenatal care. The health workers know how test for preeclampsia and what next to do in case the mother presents the condition. We have also put up posters on management guidelines pinned up in the maternity wards. “
The most recent case the facility received was a young expectant mother – at 28 weeks – presenting severe headache. “We were able to detect it and referred her to Lira Hospital just in time for further management,” says Atim
She feels that there must be continuous sensitization among mothers to ensure that first-time mothers can benefit.

Dr. Isaac Orec, is the Incharge of Amach Health Center IV. However, as an bstetrician/gynecologist, he also doubles as the standby specialist for mothers who need emergency care for example C-section. However, his home is located several kilometers away from this health center, which means he has to spend a lot of time on the road to get here. The good news is that this will soon be a thing of the past. Under the HSAP project, partners engaged the health the District Health Office to rehabilitate the doctor’s house, on the premises of the Health Center.

Dr. Orec says this should inevitably ease his work. He is passionate about serving rural communities.
“When I was working at Lira Hospital, I kept on meeting mothers who should have benefited from health services at lower levels. I decided that I should locate myself at the strategic point which is a primary care site (Health Center). So, this makes me serve them without them having to spend a lot of resources coming to the regional hospital. I only refer the mothers who indeed need a referral,” says Orec.

Youth corner and Placenta pit and
built at Agatwa HC 2
On any given day, Dr. Loy Opio, the Assistant Medical Superintendent at Agwata HC II , receives 80-130 patients with different ailments including sexual and reproductive health. However, it was always difficult to have the youth among these patients.
The HSAP project, however, turned things round by building a youth corner, where young people can access health services without the fear of prying eyes from the elderly patients in the community. Dr. Opio says their complaints range from HIV and STDs, reproductive health and other psychosocial problems.
“We now have more adolescents coming forward. This facility is now known for the best suppression rate for HIV in the district,” boasts Dr. Opio.

The spacious center operates mainly in the evenings. “ We realized that that is the most convenient time for young people to come. They know that most outpatients have left the facility by that time,” says Dr. Opio. Inside the center are contraceptives on display. There is also a section for the TV screen where appropriate information on adolescent health are normally relayed.
According to Proscovia Agilo, a midwife and counselor at this facility, this has been lifechanging. “When a teen mom decides to go back to school after my counsel. Some young people even mention me at village meetings as the person who helped them. Some parents also send me their daughters to talk to them about sex education. This makes me so proud,” says Agilo
“I can feel it. These boys and girls are more empowered. They are going to make better and informed choices for their lives, compared to my generation,” says the 34-year-old.
She also praises HSAP for influencing the building of the placenta pit in the last financial year.
“F or a long time, we had to endure the awful smell from the old pit which was also putting our lives as health workers at risk,” says Agilo.

Compiled by Carol Natukunda, Communications Specialist, African Center for Global Health and Social Transformation