TABLE 1.

Comparison of General FP Program Interventions and Additional AYSRH Interventions in Three Ugandan Local Governments

General FP Program OnlyGeneral FP+AYSRH Program
AdvocacyIncreased government allocations to FPIncreased government financial allocations for FP and AYSRH
FP champions

Youth engagement:

• Governance level: monthly program implementation team meetings through youth champions

• Community level: intergenerational dialogues with parents, community leaders, and key elder influencers

With interfaith religious leaders discussing AYSRH

Service deliveryWhole-site orientations related to FP, including commodity and data management• Additional whole-site orientations for reducing bias toward youth who access contraceptives and dispelling myths about the appropriateness of all methods
Health facility strengthening through 72-hour makeoversQuality improvement through application of national standards for adolescent- and youth-friendly health services and supervisory checklists, with specific attention to reducing health provider biases
Integrated FP outreachesa and in-reachesbIntegrated youth-focused outreachesa and in-reachesb
Fixed-day services at facilitiesAdditional fixed-day services for youth in the same facilities as fixed-day services for general FP program
Supportive supervision on providing FP methodsSupportive supervision by district quality assessment teams emphasized the provision of all contraceptive methods including long-acting reversible contraceptive methods; assessment and implementation of the quality checklist
Postpartum FP for all women

• Postpartum FP for young mothers (particularly unmarried teenagers)

Pharmacy engagement and training on reducing bias and eliminating myths and misconceptions about AYSRH and ensuring referrals for long-acting reversible contraceptive methods

Demand generationCounseling and referrals through trained community health volunteers• Counseling and referrals through trained community health volunteers, who include youth recruits and youth champions
Male engagement initiatives

• WhatsApp groups for youth

• Social mobilization through community events

• Radio segments on AYSRH

  • Abbreviations: AYSRH, adolescent and youth sexual and reproductive health; FP, family planning.

  • a An integrated FP outreach is a health service delivery activity done in the community away from the facility to bring contraceptive services closer to the community. The services are provided at the community level within locally available venues—such as schools, social halls, workplaces, community grounds, markets, and religious facilities—focusing on both men and women of reproductive age.27

  • b In-reaches describe the provision of FP services to clients mobilized from the community to a particular facility, usually a primary health center, on designated days of the week. The facility providers where in-reaches occur work closely with the community social mobilizers to synchronize mobilization days to clinic days for seamless service provision.28