GOVERNMENT OF UGANDA THE UNITED NATIONS POPULATION FUND (UNFPA) pot

List of Abbreviations AGOA African Growth and Opportunities Act ANC Antenatal Care AWP Annual Work Plan CCA Common Country Assessment CEDAW Convention on Elimination of all forms of Disc

COUNTRY PROGRAMME ACTION PLAN

2006 – 2010

GOVERNMENT OF UGANDA THE UNITED NATIONS POPULATION FUND

(UNFPA)

List of Abbreviations

AGOA African Growth and Opportunities Act

ANC Antenatal Care

AWP Annual Work Plan

CCA Common Country Assessment

CEDAW Convention on Elimination of all forms of Discrimination Against Women

CP5 5th Country Programme

CP6 6th Country Programme

CPAP Country Programme Action Plan

CSO Civil Society Organisations

EAC East African Community

EBA Everything But Arms

EmOC Emergency Obstetric Care

FGC/M Female Genital Cutting/Mutilation

FGM Female Genital Mutilation

GoU Government of Uganda

HMIS Health Management Information System

ICPD International Conference on Population and Development

IDP Internally Displaced Person

MDG Millennium Development Goals

MFPED Ministry of Finance, Planning and Economic Development

MGLSD Ministry of Gender, Labour and Social Development

MOH Ministry of Health

MOLG Ministry of Local Government

MYFF Multi-Year Funding Framework

NEPAD New Partnership for African Development

PD Population and Development

POA Programme of Action

POPSEC Population Secretariat

RH Reproductive Health

RHCS Reproductive Health Commodity Security

SGBV Sexual and Gender-Based Violence

SRH Sexual and Reproductive Health

SWAp Sector-Wide Approach

TCI Traditional and Cultural Institutions

UBOS Uganda Bureau of Statistics

UNAIDS United Nations Joint Action on AIDS

UNDAF United Nations Development Assistance Framework

UNDP United Nations Development Programme

UNFPA United Nations Population Fund

UNICEF United Nations Children‟s Fund

UNS United Nations System

WHO World Health Organisation

Table of Contents

List of Abbreviations i

Table of Contents Iii The Framework 1

Part I Basis of Relationship 1

Part II Situation Analysis 1

Part III Past Cooperation and Lessons Learned 3

Part IV Proposed Programme 5

Reproductive Health Component 6

Population and Development Component 10

Gender Component 12

Part V Partnership Strategy 14

Part VI Programme Management 16

Part VII Monitoring, Assurance and Evaluation 18

Part VIII Commitments of UNFPA 19

Part IX Commitments of the Government 20

Part X Other Provisions 22

Annex I: The CPAP Results and Resources Framework .23

Annex II: The CPAP Planning and Tracking Tool 26

Annex III: The CPAP Monitoring and Evaluation Calendar 30

THE FRAMEWORK

The Government of Uganda, hereinafter referred to as “the Government” and the United Nations Population Fund, herein referred to as “UNFPA” being in mutual agreement to the content of the Country Programme Action Plan (CPAP) and to the outlined responsibilities in the implementation

of the Country Programme; and

Furthering their mutual agreement and Cooperation for the fulfilment of the Programme of Action

of the 1994 International Conference on Population and Development (ICPD), ICPD + 5, other

related conferences, and the Millennium Development Goals (MDG);

Building upon the experience gained and progress made during the implementation of the of the

GoU – UNFPA Fifth Country Programme (CP5),

Entering into a new period of cooperation, which is based on the recently approved Country

Programme Document, the United Nations Development Assistance Framework, the Common Country Assessment and Uganda‟s Poverty Eradication Action Plan:

Declaring that these responsibilities will be fulfilled in a spirit of friendly cooperation;

Resolutions 2211 (XXI) of 17 December 1966, 34/104 of 14 December 1979, and 50/438 of 20 December 1995 of the General Assembly of the United Nations and the standard letter of agreement

between Government of Uganda and UNDP of 29 April 1977 provide the basis of the relationship between the Government and UNFPA This Country Programme Action covering the period from 1

January 2006 to 31 December 2010 is to be interpreted and implemented in conformity with these resolutions The Country Programme Action Plan consists of 10 parts wherein the general policies, priorities, objectives, strategies, management, responsibilities and commitments of the government

and UNFPA are described, and two annexes

Uganda participates and is signatory to both the International Conference on Population and Development Programme of Action (ICPD PoA) and the Millennium Development Goals (MDGs) The country has developed the Poverty Eradication Action Plan (PEAP) as the medium term development framework with a goal of reducing the population below poverty line from present 38%

to 28% by 2014 The country is member of the East African Community (EAC) and the African Union (AU) and participates in initiatives such as New Partnership for African Development (NEPAD), African Growth and Opportunities Act (AGOA) and Everything But Arms (EBA) Uganda‟s population grew from 6.5 million in 1959 to 24.4 million in 2002, and is currently projected

at 26.7 million At the current growth rate of 3.3% per annum, which is among the highest in the world, the population is projected to reach 54.8 million by 2025 and 103 million by 2050 (UN 2002) The rapid population growth is attributed to the high total fertility rate at 6.9, high unmet need for family planning at 35% and the resultant population momentum The population is mainly rural (88%) and youthful, with 52% below 15 years and 20% aged 15 – 24 years

Uganda remains one of the poorest countries of the world ranking 144th out of 177 least developed countries according to the 2005 Human Development Report As measured by income poverty, the proportion of the population living in poverty is not only high but also increasing Poverty declined from 56% in 1992 to 44% in 1997/8 and to 34% in 2000 but rose to 38% between 2000-2003 Inequality as measured by Gini-coefficient also rose markedly from 0.39 to 0.43 between 1999/2000 and 2002/3 Poverty rose in almost all regions of the Country with a particularly sharp rise in the East The North remains the poorest region in the country (MFPED, 2004) Findings from the Participatory Poverty Assessment (PPA) II, show that women and child headed households are poorer than male-headed households and poverty is concentrated among disadvantaged groups including orphans and vulnerable children, the elderly, the disabled, the chronically ill and the displaced (MFPED 2003)

Northern Uganda has since the mid -1990s experienced violent conflicts and insurgency due to rebel activity particularly in the sub-regions of Acholi, Madi, West Nile as well as Teso and Lira This has adversely affected economic productivity and general livelihood in the affected regions

Although considerable progress has been registered in women emancipation including participation

in leadership where women account for 40% of elected positions in local government and 28% of Parliament, gender disparities still persist This in part is due to lack of capacity to mainstream gender in programming, inadequacy of gender desegregation, gaps in legal framework for addressing gender based violence and inadequate participation of girls in education and SRH services

Sexual and gender-based violence (SGBV) is common and highest in conflict-affected areas where rape, abductions and the exchange of sexual favours for basic necessities are prevalent For instance, girls who live in IDP camps are highly vulnerable to rape as they move around in search of food, water and firewood Moreover, sexual slavery and transactional sex among adolescent girls and women at home and in schools have increased the risk to physical trauma, STIs including HIV infection and early pregnancy Community and social support systems for IDPs are over-stretched or have collapsed, making the poor, women and children more vulnerable to socio-economic difficulties Relevant institutions have limited capacity to provide the necessary psychosocial support for victims of SGBV

The health sector continues to be characterised by inadequate and low-skilled human resources, poor infrastructure, inadequate equipment and supplies, and a poor referral system As a result, sector indicators remain undesirable with maternal mortality ratio at 505 deaths per 100,000 live births, the infant mortality is 83 per 1000 live births and 38% of all infant deaths are neonatal deaths Life expectancy at birth is only 45.4 years for males and 46.9 years for females Access to and utilization

of health services, notably for reproductive health is low as reflected in the low skilled attendance at childbirth (38%) and high unmet need for Emergency Obstetric Care (EmOC) at 95% among others Despite knowledge on contraception being very high at 96%, the contraceptive prevalence rate only increased from 5% in 1989 to 23 % in 2001, with only 48% of the married women having spousal approval of the use of family planning Knowledge on contraception among adolescents aged 15 – 19 years is 92% for girls and 96% for boys Despite this, the contraceptive prevalence among girls in this age group is only 9%

Uganda has had several initiatives focusing on young people However, there is still limited access to adolescent sexual and reproductive health information and services Social, economic and cultural factors still play a significant role in influencing the behaviour and practices of young people Teenage pregnancy rate of 31% remains one of the highest in sub-Saharan Africa, contributing to

maternal mortality and morbidity, including obstetric fistula Female genital mutilation/cutting is still existent among the Sabiny and other communities

Uganda has registered considerable progress in the fight against HIV/ AIDS as evidenced by reduction in prevalence rate from 18% in 1992 to 7% in 2005 About 1.1 million Ugandans are estimated to be currently living with HIV The predominant mode of infection remains unprotected heterosexual transmission followed by mother to child transmission (MTCT) Women and young people, especially girls, are most vulnerable with 55% of those infected being women and a prevalence rate of 4.9% among young people Awareness of HIV/AIDS is universal but knowledge

on prevention of HIV infection is not as high (86.6%) Condom use is a well-known method of preventing HIV infection, but only 7% of women and 12% men use condoms Socio-cultural practices and tradition contribute to the high incidence The epidemic has contributed significantly to

an increase in orphan-hood currently standing at 1.8 million

The decentralized system of governance and sectoral development frameworks provide opportunities

to integrate population issues in development taking advantage of a wealth of data collected in the recent past However, most of the existing surveys provide only national and regional level information and may not be adequate for programming at district and lower levels Data management systems such as the Health Management Information System (HMIS), Logistics Management Information System (LMIS); Education Management Information System (EMIS); Local Government Information Communication System (LOGICS) are often not very comprehensive and standardised Civil registration is generally poor with only 4.2% of the children registered and only 20% of them having a birth certificate

The United Nations Population Fund support to Uganda started as far back as 1975 through the project approach The cooperation between Government of Uganda and UNFPA based on programme approach began in 1985, and since then five Country Programmes have been implemented The most recent covering the period 2001 to 2005 was intended to support Uganda towards achieving targets set in the ICPD POA, Convention on Elimination of all forms of Discrimination Against Women (CEDAW) and the Millennium Declaration Its goal was to

contribute to a better quality of life for Ugandans through improved reproductive health, sustainable

population growth and development, enhanced gender equity and equality, and the empowerment of women The Programme focused on three thematic areas, Reproductive Health (RH) including Family Planning and Sexual Health; Population and Development Strategies (PDS); and Advocacy The RH Sub-programme covered 24 out of the then 56 districts in the country It expanded the emergency obstetric referral system from 8 to the current 16 districts In collaboration with other partners, particularly DELIVER, the programme improved mechanisms for forecasting, procurement and distribution of contraceptive commodities The Programmeexpanded reproductive health services and information for young people from 12 to 24 districts through two programmes, African Youth Alliance (AYA) and Programme for Enhancing Adolescent Reproductive Life (PEARL) Efforts to eliminate Female Genital Mutilation/Cutting (FGM/FGC) in the then Kapchorwa district (REACH) resulted in the formulation of community bylaws to end FGM/FGC

in 9 out of 16 sub-counties Based on a needs assessment on obstetric fistula, UNFPA procured specialised equipment for 6 regional hospitalsand initiated training of doctors and nurses to support fistula patients The programme also built skills for different categories of health service providers through pre-service and in-service training Despite these efforts, there are still gaps in RH service

delivery, particularly EmOC and Reproductive Health Commodity Security (RHCS)

The PDS Sub-Programme covered all the districts and led to successful completion of the

2002 national population and housing census; strengthening of district planning units to integrate population factors into development plans; revision of the national population policy; the finalization of the adolescent health policy and; establishment of a monitoring and evaluation system

The Advocacy Sub-Programme had a national coverage and resulted in improved partnerships with legislators, NGOs, media houses, cultural and faith-based institutions; establishment of Good-will Ambassadors and the population and media network; and development of the national media advocacy strategy The Programme increased support for population issues in the media and among political, district, religious and cultural leaders

Under the Programme, a number of lessons were learnt Partnerships with political institutions, Goodwill Ambassadors, the media, civil society and cultural and faith-based institutions ensure credibility and greater acceptance of sexual and reproductive health information and services, particularly for young people The innovative EmOC referral system (RESCUER) greatly contributed

to reduction of maternal deaths However, the capacity of districts to sustain such a system remains inadequate The pilot Fistula project has provided hope for women who have been repaired and received treatment Nurses and Doctors have been trained on Fistula repair and counselling while 6 hospitals have been equipped with Fistula repair equipment Maternal death audit, particularly the community verbal autopsies resulted in increased male involvement in early referral of obstetric emergencies and opens up a dialogue between health workers and communities on reproductive health issues Community based distribution of contraceptives significantly contributes to acceptance

of family planning It also requires incentives for its sustainability A wide range of FP methods including long-term and permanent methods attract more clients as compared to fewer methods Political support is critical for success of FP and therefore advocacy and policy dialogue is an essential ingredient for a successful FP programme Uncoordinated and overlapping programmes takes time away from service provision and therefore a national training plan would be essential in coordinating and harmonising training programmes Regular and routine technical support supervision especially after training is critical for improved performance of the trained health providers Empowerment of young people to participate in the design, implementation and evaluation of their sexual and reproductive health programmes tremendously contributes to raising their voices, addressing their real needs and achieving greater results A fair mix of information and services enhances young people‟s utilisation of health services FGC/M “surgeons” who have denounced the practice are an effective medium for de-campaigning against FGC/M

For effective implementation of the population programme, it is critical to develop systems and tools such as the M&E system, training manuals, standards and protocols at the beginning of the programme Building institutional and technical capacity of implementing partners is essential for effective programme implementation and management

Focus on advocacy as a strategy in support of RH and PDS promotes creation of a supportive environment critical for achievement of desired outcomes

Closer linkage of Reproductive Health and HIV/AIDS programmes creates synergy and also ensures increased funding for underserved RH programmes

Inclusion of a specific Gender component, which includes SGBV and gender mainstreaming, is essential for ensuring a gender focus of all programmes at the design, implementation, monitoring and evaluation Documentation of lessons learned and best practices facilitates sharing of experiences and replication of programmes

Understaffing at the UNFPA Country Office is a constraint to programme implementation and management and participation in policy dialogue Regular orientation of implementers in UNFPA‟s programme and financial policies and procedures ensures adherence to UNFPA‟s programme management

All these lessons will be utilized in the design and implementation of the 6th Country Programme

The Country Programme Action Plan (CPAP) builds on the Country Programme Document for Uganda (DP/FPA/DCP/UGA/6) approved by the Executive Board of the United Nations Development Programme and the United Nations Population Fund The CPAP also builds on the concepts and commitments outlined in the United Nations Development Assistance Framework (UNDAF) jointly determined by the resident UN partners in Uganda in close partnership and with the support of the Government of Uganda

The Programme responds to national priorities, which have been articulated in the PEAP under five pillars namely, 1) Economic Management; 2) Enhancing Production, Competitiveness, and Incomes; 3) Security, Conflict Resolution, and Disaster Management; 4) Good Governance; and 5) Human Development The United Nations System (UNS) through the CCA identified four areas of cooperation on the national medium-term development priorities contained in the PEAP The UNDAF further articulated these areas of cooperation under five outcomes namely: (1) increased opportunities for people, especially the most vulnerable, to access and utilize quality basic services and realize sustainable employment, income generation and food security; (2) Good Governance, accountability, and transparency of Government and partner institutions improved at all levels (3) The promotion and protection of human rights, especially of the most vulnerable is strengthened; (4) individuals, civil society, national and local institutions are empowered and effectively address HIV and AIDS, with special emphasis on populations at higher risk; and (5) people affected by conflict and disaster, especially women, children and other vulnerable groups, effectively participate in and

benefit from the planning, timely implementation, monitoring and evaluation of programmes

The GoU/UNFPA 6th Country Programme is designed to contribute to four UNDAF outcomes, while ensuring linkages with the Multi Year Funding Framework (MYFF) The MYFF is UNFPA‟s medium term plan for the period 2004-2007 that specifies the organizational results with the aim of strengthening the Fund‟s contribution to the implementation of the PoA of the ICPD in the context

of poverty reduction and in line with UNFPA‟s New Strategic Direction The MYFF outcomes are: 1) A policy environment that promotes reproductive health and rights; 2) Access to comprehensive reproductive health services is increased through improved systems and services; 3) Demand for reproductive health is strengthened; 4) Utilization of age and sex disaggregated population-related data is improved; 5) National, sub-national and sectoral policies, plans and strategies take into account population and development linkages; and 6) Institutional mechanisms and socio-cultural practices promote and protect the rights of women and girls and advance gender equity

The CPAP takes into consideration the experiences of the Fifth Country Programme (2001-2005) It takes note of the national reform processes, following particularly the decentralization, emphasising a district specific approach The partnership evolved under the 5th Country Programme will continue

to be strengthened and intensified especially in 33 districts, twelve of which are in the conflict affected Northern Region and have the poorest RH indicators

The goal of the 6th Country Programme is to contribute to poverty eradication and a better quality of life for the people of Uganda by improving sexual and reproductive health and rights; ensuring sustainable population growth and development; and enhancing gender equity and equality Areas for joint programming with partner agencies include interventions in: HIV/AIDS, emergency obstetric care, sexual and gender-based violence, adolescent reproductive health programmes, and data collection, dissemination and analysis

The country programme has three outcomes under three components: Reproductive Health; Population and Development; and Gender

Reproductive Health component

The outcome of this component is: men, women, young people and other vulnerable groups have access to and utilize comprehensive sexual and reproductive health information and services, including HIV/AIDS prevention This outcome contributes to UNFPA‟s MYFF outcomes 1, 2 and 3; UNDAF outcomes 1, 3, 4 and 5 The programme component is designed to respond to the health sector priorities of the Government of Uganda as articulated in the second Health Sector Strategic Plan (HSSP II) outcomes, through core interventions outlined in Clusters 1 and 2 It is in line with the Strategy to Improve Reproductive Health in Uganda and the HIV/AIDS National Strategic Framework, among other national frameworks

Under this component, UNFPA will continue to strengthen the MOH, other relevant sectoral ministries, NGOs and CBOs in the provision of integrated RH services including safe motherhood, HIV/AIDS prevention, ARH services and family planning in selected project sites The programme will endeavour to ensure integration of RH programmes with the multi-sectoral HIV/AIDS programmes Integrated RH services will be availed to men, women and young people, particularly the vulnerable groups including those affected by conflict and other emergencies as well as those at high risk of HIV/AIDS This will be achieved through three deliverable outputs, which have been discussed in the proceeding section

Output 1: Increased availability of comprehensive sexual and reproductive health

services, particularly family planning, emergency obstetric care, antenatal care, STI/HIV/AIDS prevention and adolescent-friendly health services, emphasizing reproductive health commodity security and the needs of people affected by conflict

Key strategies to be employed to achieve this output are: Developing systems for improving performance and quality of service with a major focus on institutional capacity building, particularly

at District and Sub-District levels; and Promoting, strengthening and coordinating partnerships with the Ministry of Health, selected NGOs and CSOs The output will be achieved through joint programming with UNICEF, WFP and WHO

Major Activities:

1 Provide Emergency Obstetric Care (EmOC) The programme will support the rolling out of EmOC Services at HC III, HC IV and hospital level including the establishment of maternal death reviews in selected districts as specified in HSSP II It will put in place obstetric emergency referral system in line with the National Road Map for Maternal and Newborn Health, equip health facilities, provide support for on job performance improvement/enhancement and strengthen partnerships between EmOC stakeholders including the private sector On the basis

of lessons learnt from the RESCUER Programme implemented during the 5th Country

Programme and in collaboration with partners, UNFPA will support the design of more cost effective ways of revitalizing, maintaining and scaling up of the RESCUER Programme while ensuring its sustainability It would also upscale Fistula activities in 6 public and Private Not For Profit referral hospitals as well as set up one Fistula repair centre to train doctors and nurses The programme will focus on prevention and develop curriculum for training in obstetric fistulae

2 Provide antenatal care and post-natal care: The programme will work with partners to scale

up antenatal care by ensuring that pregnant women receive Goal-oriented Antenatal Care and after delivery, women receive quality postnatal care Under the goal oriented ANC, focus will be

on increasing access to services and ensuring availability of essential equipment and supplies

3 Support Reproductive Health Commodity Security and Provide Family Planning Services: The programme will support improved Reproductive Health Commodity Security through a functional RHCS coordination mechanism with an agreed national strategy and operational plan as well as ensure a functional Logistics Management Information System The programme will support the work of the Reproductive Health Division to plan, manage and coordinate the forecasting (through Country Commodity Manager), procurement and distribution of contraceptive commodities including the procurement of contraceptive commodities and RH supplies The programme will work with partners to revitalize Family Planning through various interventions to ensure that women, men and young people receive the relevant and appropriate information on family planning as well as contraceptives of their choice, including permanent methods to enable them postpone, space and limit pregnancies as desired The programme will ensure provision of quality FP services in selected districts UNFPA will work with other partners to ensure contraceptive commodity security at all levels

4 Provide post abortion care: The programme will work towards reducing unwanted pregnancy and unsafe abortion through revitalization of family planning and post abortion care in particular It will further ensure that those women who suffer complications of unsafe abortion receive prompt treatment through post-abortion care as well as strengthen post abortion family planning counselling

5 Provide STI/HIV/AIDS and other reproductive tract infections services: The programme will support IEC and community mobilization with emphasis on the Abstinence, Be faithful, and Condom use (ABC) principle PMTCT services will be made accessible for pregnant women who will be supported through antenatal and family planning clinics with special focus on conflict areas STI prevention will be integrated into family FP through counselling and discussion on sexuality and partner relationships

6 Provide Sexual and Gender Based violence (SGBV) services: The programme will support partners to initiate SGBV treatment, counselling and referral services for survivors The services will be linked to activities implemented under the gender component and will among others include provision of emergency contraception, post abortion care, treatment of STIs, and post-exposure prophylaxis for HIV infection after rape, screening and treatment of cervical cancer, prevention of primary and secondary infertility, and treatment of gynaecological conditions The services will involve community participation, and will contribute to improved user provider

relations, men‟s participation, and women‟s empowerment to make reproductive health choices

7 Provide Adolescent Sexual and Reproductive Health (ASRH) services: The programme

will support interventions aimed at reducing teenage pregnancy rates and provision of integrated ASRH services based on good practices and lessons learned from AYA and PEARL projects of

the 5th CP The programme will scale up friendly health services and information for adolescents and young people, and institutionalise ASRH information and health service provision

Output 2: Increased availability of culturally and gender-sensitive behaviour change

communication (BCC) for sexual and reproductive health including HIV prevention

Two major strategies will be employed namely: a) Advocacy and policy dialogue to support and promote culturally and gender sensitive behavior change for sexual and reproductive health, including HIV prevention (b) Promoting, strengthening and coordinating partnerships with high level policy and decision makers, Parliamentarians, Goodwill Ambassadors, cultural leaders, faith based leaders and the media as well as CSOs Partnership will also be established with UNICEF through joint programming to the extent possible

Major Activities

1 Revitalization of Family Planning Services: The programme will address the inadequate access to client friendly family planning information and SRH services through advocacy to secure commitment to: - increase funding for family planning; IEC; provide adequate variety of

FP services at delivery sites; integrate Youth Friendly Services at health delivery sites; and integrate life-planning skills for young people at school, community and household levels

2 Lobby for support of Reproductive Health Programmes: The programme will lobby for increased resource allocation and prioritisation of RH Programmes; a supportive policy environment to encourage the private sector to participate in the funding and implementation of

RH programmes; improved access to friendly ASRH information and services; promotion of responsible reproductive and sexual behaviour including voluntary abstinence and dual protection among the young people; and the review of existing laws and policies that negatively impact on adolescent RH The programme will advocate for EmOC at all levels so that there is adequate allocation of resources both human and financial to increase access and utilization of the services

3 Conduct BCC and advocacy campaigns: Advocacy and policy dialogue will be conducted targeting high-level policy and decision-makers on issues related to Family Planning and reproductive rights These campaigns will target leaders at all levels to leverage increased resources for RH services especially for emergency obstetric care; support programmes addressing culturalissues that promote early marriage, early sexual debut and sexual exploitation The programme will support MOES to institutionalise ASRH, counselling in schools and communication skills and fistula prevention and repair into pre-service and in-service training of health workers; Policy dialogue will be held with the Ministry of Finance and Planning on operationalization of the hardship policy aimed to encourage service providers to work in hardship areas Other agencies will be will be supported to upscale interventions on livelihood skills for young people. The support will include operationalisation of the Uganda Media Advocacy Strategy

4 Undertake a Multi Media Campaign on SRH: The programme will support a multi media campaign using print, electronic and folk media on SRH services and specifically on family planning methods, skilled attendance at birth, STI treatment, PMTCT and SGBV among other sexual and reproductive health issues The media campaigns will address existing misinformation, rumours and myths about family planning and motivate men, women and young people to use

FP contraception correctly and consistently It will ensure availability of IEC materials in ANC, PNC outpatient, and at PAC and adolescent clinics in selected districts Increase awareness

amongst the community, especially adolescents on the benefits of delaying/spacing births Advocacy amongst community and religious leaders on the need for Family Planning will also be carried out

5 Educate adolescents and young people on life planning skills: The programme will support initiatives that have proved successful to educate adolescents and young people in and out of schools on life planning skills and SRH Such initiatives include youth to youth enter-educate activities using youth networks and clubs and parent-child communication A National Curriculum for ASRH and Life Planning Skills for young people in schools has been developed and needs to be institutionalised

Output 3: Strengthened institutional capacity to design, implement, monitor and

evaluate the effectiveness of sexual and reproductive health and HIV/AIDS policies, guidelines and programmes

The key strategies to be applied in achieving this output will include: i) building a strong evidence base on which programmes will be monitored and evaluated to ensure that they are achieving results and reaching the poor; ii) developing systems for improving performance by providing support for human resources planning, training and performance assessment systems that are crucial to enhancing efficiency and accountability

Major Activities

1 Train service providers and programme managers The programme will support skill development for health workers in: Emergency Obstetric Care, Post Abortion Care, adolescent sexual and reproductive health, Family Planning, Logistics Management, fistula prevention and repair, provision of sexual and gender-based violence medical care, counselling, communication and RH commodity security It will support skill building for media personnel to address reproductive health/ gender issues; train implementing partners in Behaviour Change Communication as well as advocacy; train youth friendly trainers at national, district, school and community level on life planning skills; and provide skills to young people to leverage resources for their livelihood skills development

2 Develop Tools to support SRH information and services The programme will support development of HIV communication strategy, finalize and operationalize an RH communication strategy and develop a national reproductive health training and follow-up plan It will support the review of selected RH training materials and harmonisation of all ASRH and Life Planning Skills for Primary and Secondary Curricula ensuring integration of human rights and gender It will support development of a strategy for accessing resources to support livelihood skills among young people The programme will further support reprinting and distribution of RH policies, strategies, guidelines, protocols and procedures manuals and support training of service providers in their use

3 Procure essential RH equipment, commodities supplies and contraceptives The programme will ensure that facilities in selected districts are equipped with Basic and Comprehensive EmOC equipment and supplies and fistula repair equipment The Programme will support Reproductive Health Commodity Security through strengthening a functional system of forecasting, procurement and distribution of commodities and supplies The

programme will also support procurement of recreational equipment for young people

4 Participate in health sectoral reforms UNFPA will participate in health and other related

sectoral reform processes in order to influence greater resource allocation for sexual and

reproductive health especially family planning, EmOC, PMTCT and adolescents‟ SRH services

In this regard, staffing at the country office will be increased with more time and resources being spent on policy dialogue UNFPA will endeavour to make a financial contribution to the Health and HIV/AIDS Partnership Funds It will enhance participation in SWAP funding through contribution to the budget for contribution of contraceptives, training of midwives

5 Strengthen health data management The programme will support development of capacities for collection, analysis dissemination and utilisation of health-related data including HIV/AIDS that is desegregated by sex, age and other socio-demographic variables The programme will strengthen the existing databases and information management systems such as the HMIS, LMIS, and Country Response Information Systems for improved SRH programming Capacity

of selected health facilities will be strengthened to accelerate provision of quality HMIS data

6 Undertake Formative and Operational Research The programme will support behavioural monitoring studies for young people, operational and socio-cultural research on issues related to improving access and quality of services, facilitating collection, analysis and use of routine reproductive health data generated by the national health management information system by ensuring computerized system and internet facilities at health facilities

7 Document Lessons learned and Best Practices The programme will document lessons learnt

and good practices and disseminate them widely, particularly through existing Knowledge Assets and in-country networks, and use health data/information and other documented experiences on SRH and SGBV for advocacy and policy dialogue with national and district leadership for provision of support in reducing the practice

8 Provide Support Supervision The Programme will provide inputs for support supervision by Regional Teams 1(nationwide) It will have on board a minimum of 5 Regional Reproductive Health Coordinators who will work closely with a UNFPA Technical Advisor based at the Ministry of Health

Population and Development Component

The outcome of this component is: poverty eradication policies, frameworks and programmes at national and sub-national levels take into account population, reproductive health and gender issues This outcome contributes to four UNDAF outcomes 1, 3, 4 and 5 as well as PEAP Pillars 2, 3 and 5 The component also contributes to the UNFPA MYFF outcome 4 and 5 Under this component, three outputs will be delivered as discussed in the proceeding section

Output 1: Increased availability of disaggregated population data at all levels

The main strategies will include building and using a knowledge base; and promoting, strengthening coordinating partnerships Partners that will be involved in delivery of this output will include government institutions at central and district levels Joint programming will be done with UNDP, WFP and UNICEF among others

Major Activities:

1 Regional Teams plan, supervise and provide technical assistance to Districts reproductive health

interventions

1 Collection, analysis and dissemination of data that is disaggregated by age and sex. This broad activity will involve: conducting further analysis, packaging and dissemination of 2002 Census; undertaking preparatory activities for the 2012 Census; undertaking the 2006 Demographic and Health Survey; collecting and disaggregating by gender, data on HIV and AIDS prevalence among pregnant women and young people in conflict affected areas; conducting baseline and end line surveys, and follow-up studies; and establishing and regularly updating a population, gender and reproductive health database Support will also be extended

to the Uganda Participatory Poverty Assessment Project (UPPAP) to ensure that RH and Gender issues are fully incorporated in the assessments A National Integrated Management and Information System (IMIS) will be set up to improve availability of data up to the district level

2 Revitalise Birth and Death Registration. This activity will ensure that in target areas, all births and deaths are registered and certificates issued This will involve: providing registration materials including registers and computers; equipping personnel with the necessary skills; mobilizing and sensitising households and communities on Birth and Death Registration; and conducting advocacy campaigns among leaders on Birth and Death Registration

Output 2: Strengthened institutional and technical capacity of national and

sub-national planning units to integrate population dimensions into development frameworks

The major strategy for achieving this output will be developing systems of implementing and coordinating institutions for improved performance Major partners will include Government institutions as well as UN agencies including UNDP, UNAIDS, and UNICEF

Major Activities:

1 Training and equipping coordinating and implementing institutions This will include: training in data management to promote utilization of existing data; conducting short courses on programme management, gender analysis and mainstreaming; training District Planning Units on mainstreaming of HIV and AIDS at local government level; procuring transport and data processing equipment for key institutions; and training implementers at national and district level

in advocacy and behaviour change communication

2 Integrate population issues into sectoral policies and programmes. This will involve: conducting training/orientation workshops among policy makers and planners both at national and lower levels and CSOs to promote greater understanding of the critical linkages between population, poverty and the environment; conducting sensitisation workshops for key players in strategic sectors to ensure appropriate budgetary allocations and integration of population, RH and gender issues; undertaking training in integration of Population, RH and Gender, in development planning; and establishing a functional documentation centre for knowledge sharing

3 Support Coordination Mechanism: The Programme will support holding of regular coordination meetings for implementing agencies, donors and sectors to monitor programme performance These meetings will be at national, district and project levels

4 Establish and strengthen M&E systems: A functional M&E system for the Programme will

be established linked to the National Integrated Monitoring and Evaluation System (NIMES), IMIS and other systems In this regard, the programme will support the establishment and regular updating of a population, gender and reproductive health database

Output 3: Increased commitment to and support for the implementation of population,

reproductive health and gender policies and programmes

The major strategy for achieving this output will be advocacy for gender issues, reproductive and sexual rights, legislation, policies and programmes Government institutions, and UN agencies particularly UNICEF will be a major partner in delivery of this output

Major Activities:

1 Conduct advocacy campaigns The programme will support evidence based advocacy and IEC interventions on population, RH and gender and socio-cultural issues The campaigns will target donors and policy makers at national and district levels

2 Review, update and disseminate the existing population and RH policies and laws The programme will support analysis of the existing policies and laws and identify existing gaps The programme will advocate for enactment and enforcement of gender-sensitive laws and bylaws relating to population and development; formulating the National Population Action Plan; and popularising the National Population Policy among decision makers at all levels

3 Organize and participate in national and international events These events will include World Population Days, Women‟s Day Youth Day and AIDS Day The programme will support the development the State of Uganda Population Report and its launch together with the State of the World Population Report Public debates on topical issues and participation in national and international conferences and meetings related to population and development will be supported

Gender Component

The outcome of this component is: institutional mechanisms and sociocultural practices promote the rights of boys, girls and women, protect them against sexual and gender-based violence and other harmful practices, and advance gender equity and equality This outcome contributes to UNFPA‟s MYFF outcomes 2 and 3 The component directly contributes to 3 UNDAF outcomes (1, 3 & 5) and all the PEAP pillars The component has two outputs, which are discussed in the proceeding section

Output 1: Strengthened capacity of the Government and other relevant

institutions to formulate, review and implement pro-poor, sensitive legal frameworks, policies and laws

gender-The key strategies that will be applied to achieve this output include: (i) Developing a system for improving performance by creating national capacity for undertaking interactive planning, monitoring and evaluation systems that are results oriented; (ii) Advocacy and policy dialogue for implementation of gender and women‟s empowerment policies and strategies; (iii) Promoting, strengthening and coordinating partnerships with CSOs including Cultural Institutions and Faith Based Organizations This will be achieved through the successful implementation of the following lead activities:

Major Activities

1 Conduct Gender Analysis of RH and PD policies, plans and legislation The programme

will support gender analysis of RH and PD policies, plans and legislation to help identify, interpret and measure the extent and nature of gender-based differences and inequalities The

gender analysis will be disseminated to relevant stakeholders and an action plan developed and implemented

2 Review and design Gender and Women’s Empowerment Policies and Strategies The

programme will support repackaging the Revised National Gender Policy and Action Plan, and the Community Mobilization and Empowerment Strategy into user-friendly formats for dissemination among partners at national and district level; and Revising the National Action

Plan on Women

3 Develop Gender Sensitive Programme Indicators

The programme will support analysis of the Census, UNHS, and UDHS data and repackage and disseminate it for evidence based policy dialogue on gender issues

4 Conduct Research and Disseminate Findings

Relevant studies and reports on gender in RH and PD (including the baseline study on Gender Violence in Apac and Mbale districts) conducted during the 5th Country Programme will be widely disseminated among stakeholders A compendium of Gender will also be developed and a gender, population and pro-poor bulletin will be prepared and disseminated Support will also be provided for community dialogue on gender, population, RH and family life issues with TCIs, FBOs, and women groups and training women leaders, CSOs and other key actors in advocacy, lobbying and management skills in gender, RH and PD issues will be also be a priority

5 Develop the capacity of stakeholders in Gender and Development Programming

The programme will support the development of a Gender and Population Manual and subsequently support a national training programme on the same The national training programme will focus on Country Programme Managers, implementers and other partners at central and local government levels on gender advocacy, policy dialogue, gender mainstreaming, budgeting and resource mobilization; training Local Government Technical Staff in integration

of gender issues in development plans

Output 2: Increased access by stakeholders to information, counselling, social

support and treatment of and protection against sexual and based violence and other harmful practices

gender-To achieve this output, the key strategies will include: (i) Promoting and strengthening partnerships with stakeholders handling SGBV including CSOs; (ii) Advocacy and Policy Dialogue for strengthening the legal frameworks on SGBV issues; and (iii) Building and using a knowledge base to address specific challenges in Sexual and Gender Based Violence in selected districts

Major activities

1 Establish a database for male and female victims on SGBV: A database for male and female victims on SGBV will be established This will be critical in ensuring that they receive the support they need in coping and recovering from the effects of SGBV Information in the database will be analysed on a regular basis to inform interventions on SGBV

2 Train in GBV prevention and management: The programme will develop the capacity of stakeholders, especially in conflict areas to identify violations, seek protection and redress, and empower the public to respect human rights CSOs will be strengthened to support male action groups and other partners in advocating against (as well as handling) SGBV in their interventions TCIs, FBOs, and CBOs will be trained in gender sensitive marriage counselling among other key issues on SGBV

3 Establish networks and coalitions for Advocacy The programme will also strengthen coordination and partnerships in line with the SGBV National Strategy, to disseminate information, provide counselling, psychosocial support, and enhance the capacity to document experiences and lessons learned in implementing gender interventions This will be achieved through partnership and establishment of networks and coalitions with medical, legal, media and

law enforcement professionals

4 Establish a model SGBV recovery centre A model concept for the SGBV recovery centre will be developed and a model functional SGBV recovery centre established in two of the already existing health facilities Consultative forums on SGBV will be held with stakeholders including clan councils, traditional healers, health workers, TBAs, CSOs, local leaders, FBOs, and TCIs

5 Develop manuals and materials A Sexual and Gender Based Violence training manual for

health and social workers will be developed The programme will also support the development

of service guidelines for health and social workers for handling SGBV The guidelines will be disseminated to various target groups and their utilization monitored IEC and BCC materials will be developed on SGBV which will be disseminated and utilized to conduct community based media campaigns for men, women, girls and boys on SGBV Materials on gender sensitive quality marriage counselling for religious, cultural and community based organizations will also

be developed National essay and poster contests on SGBV for youth and children will also be organized Develop and operationalize an SGBV Monitoring system in programme districts

6 Develop and disseminate SGBV materials Simplified versions of SGBV draft laws and Bills

will be developed and disseminated widely Advocacy workshops for draft SGBV law and Bills will be conducted with key stakeholders, while gender analytical studies on relevant proposed legislations will also be conducted Legislators, Judicial and Law Enforcement Officials (including Parliament, LCs and LC Courts, Police, Magistrates Courts) will be trained on gender sensitive laws and human rights approaches

7 Female Genital Cutting A baseline survey on Female Genital Cutting will be conducted in Kapchorwa and Bukwa districts and pockets with communities still practicing FGC, which among others may include pockets in Bugiri, Busia, Tororo, Soroti, and Nakapiripirit, districts The experiences and lessons learnt from the REACH approach implemented during the 5th CP will be documented and disseminated to inform on the intervention under the CP 6 Consultative forums/meetings will be held with concerned communities and Local Councils working on enactment of bye- laws, ordinances and laws to prohibit FGC Based on the findings from the baseline survey the communities will be sensitised in identified districts Support will be granted to provide alternative sources of income to reformed traditional practitioners of FGC („surgeons‟) while psychosocio support and legal aid will be provided to women, girls, and families affected by FGC

Successful program implementation will depend on the coordinated action of the Ministries of Finance, Planning and Economic Development (MFPED), Ministry of Health (MOH), and the Ministry of Gender, Labour and Social Development (MGLSD) Other important national partners include the Ministry of Local government (MOLG), Ministry of Eduction, Uganda Bureau of Statistics, National Curriculum Development Centre, Uganda AIDS Commission, the Uganda Human Rights Commission, and the Offices of the First Lady of Uganda and of the Nabagereka of