SURVEY REPORT
2018
WAY SURVEY REPORT 2018 02
program background
03
Survey rationale
04
Survey Objectives & Questions
05
Methodology
06
Survey implementation
07 - 015
Survey findings
016
Recommendations
017
Appendices
01 | WAY SURVEY REPORT REPORT | WAY SURVEY REPORT
Program background Reach A Hand Uganda (RAHU) is implementing the Women, Adolescents, Youth (WAY) and Rights Empowerment Program under the Government of Uganda and United Nations Population Fund (UNFPA) 8th Country Programme and is supported by the Danish Embassy. The programme that rolled out in January 2018 aims to enhance women and young people’s access and utilization of quality Sexual Reproductive Health and Rights (SRHR) and Gender Based Violence (GBV) services in refugee settlements and host communities in the West Nile and Acholi sub-regions in the districts of; Adjumani, Agago, Amuru, Arua, Kitgum, Lamwo, Moyo and Yumbe. To achieve this, the programme seeks to stimulate demand, improve access, and strengthen the supply of SRHR and GBV services. During the year, RAHU partnered with Outbox, Care International, Ministry of Health and the District Local Governments.
02 | WAY SURVEY REPORT
Survey rationale Access to Sexual reproductive Health and Right of young people especially the adolescents and women Gender-based violence remains a big challenge in Uganda. The limited to SRHR information and services has led to increased cases of teenage pregnancies, early marriages and GBV. According to the Director of Public Prosecution (ODPP), out of 1,594 new rape and 7,618 defilement cases reported in 2015 and 2016, only 57% brought punishment to the perpetrator. The Child and Family Protection Unit of the Uganda Police Force has only 645 police officers to cover 112 districts. This makes it hard for the police to respond to the numerous reported cases, in addition to lacking the requisite skills and financial capacity to tackle issues related to GBV. The police and Ministry of Health—the two leading public institutions in GBV response—spend an estimated UGX 37.7 billion (about $10.4 million) annually dealing with GBV. The survey sought to establish the extent to which Young people are accessing these services within their communities. Surveys were conducted in 2018 with a goal of assessing the quality of care young people’s SRHR services in the intervention districts.
03 | WAY SURVEY REPORT
Survey objectives To identify the quality of Sexual Reproductive Health and Rights (SRHR) and Gender-based Violence (GBV) services offered to the young people. To identify SRHR and GBV issues affecting young people in the intervention communities. To establish the roles of community leaders (duty bearers) in addressing young people’s SRHR and GBV issues.
Survey questions The surveys were guided by the following questions 1. What is the quality of SRHR and GBV services to young people? 2. What are the SRHR issues affecting young people in the intervention communities? 3. What is the role of community leaders in addressing SRH and GBV issues of young people?
04 | WAY SURVEY REPORT
Methodology Design The survey employed a cross-sectional design. A purely quantitative approach was used to collect survey data. Survey employed close-ended questionnaires that were used to collect data from young people, health workers, district officials, and the family protection unit under the police department. Sampling The survey used simple random sampling technique to select young people accessing SRH and GBV services at the health facilities and in the catchment areas. Purposive sampling technique was used to select health workers/facilities, district officials, and family protection unit under the police department into the study. These were selected based on their role in enabling and facilitating young people to access SRH and GBV services in the respective communities. The survey was conducted in the 8 WAY intervention districts of; Adjumani, Agago, Amuru, Arua, Kitgum, Lamwo, Moyo and Yumbe. It was conducted between June to December 2018. A total of 353 respondents took part in the survey broken down; young people[male-76/female-102]; Health Workers[male-32/Female-32]; district officials[male-28/female-27]; & the Family Protection Unit[male-28/female-28]. The complete breakdown of participants in district is appended to this report.
05 | WAY SURVEY REPORT
Survey implementation 80 youth champions(10 selected from each of the 8 districts) underwent a 1-week training that focused on the WAY program, survey methodology, community mobilisation, field data collection and submitting completed surveys through the SautiPlus online platform developed by RAHU. They were oriented about the core research ethics including, informed consent, confidentiality, protection of beneficiaries etc. Youth champions were supported by the district mentors who routinely met with them to discuss progress and the quality controls. District mentors are individuals who are based at the district local government that took on the responsibility to mentor and support youth champions to enable them to effectively implement the program activities in the respective communities.
06 | WAY SURVEY REPORT
Survey findings 1. SRHR Services Offered to Young People Healthcare workers(n=64) Health workers with training on youth-friendly service provison (n=64)
31% No The pi-chart below indicates that
31%
69% yes
of the interviewed health workers reported that they did not receive any form of training in the provision of youthfriendly services in previous 6 monthly prior to the interview.
51%
of the Health workers provided modern FP services to less than 10 young people
17% 4%
5%
while, , and reported providing modern FP services to between 11-30, 30-50 and more than 50 young people respectively.
23%
reported not providing any modern FP service at all.
44% 31%, 8%
of the health workers provided HIV counselling to less than 10 young people. Respectively
13%
and reported providing HIV counselling to 11-30, 30-50 and more than 50 young people.
4%
reported not providing at all.
07 | WAY SURVEY REPORT
30% 11% 7% 2%
30% 16% 5% 2%
of the health workers reported not testing any young person.
reported testing between 11-30, 30-50 and above 50 young people only due to the services not being available reported not being able to provide any counselling services
47%
provided to less than 10,
reported providing counselling to 11-30, 30-50 and above 50.
Treatment on the other hand, while
50%
of the health workers reported not testing any young person.
40% did not provide any treatment
36% provided treatment to less than 10 people.
13%, 8% 3%
of the health workers reported providing services to between 11-30, 30-50 and above 50 young people respectively.
34% 56%
of the health workers reported never using police form 3 to report GBV while reported requiring to use the form for less than 10 times.
5%, 3% and 2% reported using the form between 11-20, 21-30 and more than 30 times respectively.
47% 44%
of the health workers did not refer any young person to a CDO/NGO while referred less than 10 young people.
5%, 1%, 2% and 2% reported
referring between 11-20, 21-30, 31-40 and more than 50 young people to CDOs/ NGOs
08 | WAY SURVEY REPORT
Quality of healthcare for young people(178) young people by age (n=178)
Number of young people (96)
45%
34%
45% 45%
15 - 9
14 - 20
45% 34% 16% 16%
24+
10 - 14
of the respondents were aged between 15-19, between 20-24, between 10-14 were above 24 years
young receiving SRH & GBV services (178)
Number of young people (96)
84%
69%
31% 16%
Male
Female Gender
59%
of the respondents were female and 41% were male participants
09 | WAY SURVEY REPORT
17% 29%
of the respondents spent more than 2 hours to reach a health facility.
25% 26% 3%
Took between 10-30 minutes and
29% spent between 1-2 hours,
took 30 minutes to an hour, took only 10 minutes.
Of the services provided by the various health facilities,
21% 16% 14% 5% 20% 16% 9%
reported being aware of malaria, services, reported condom demonstration and distribution, reported family planning,
reported alcohol counselling. Antenatal services, mental health, reported gender-based violence, and
Before receiving a service,
37% 11% 11% 21% reported waiting more than 2 hours,
reported waiting between 1 to 1 & ½
reported between 1 & ½ hours - 2 hours,
reported waiting between 30 mins-1 hour &
21%
reported waiting between 30 mins-1 hour
010 | WAY SURVEY REPORT
45% 23% 16% 16% 15% and
of the respondents reported spending 1-5 minutes with a health worker at a health centre;
reported spending more than 20 minutes
reported between 11-20 minutes;
reported spending between
1%
6-10 minutes. Only reported not spending any time with a health worker.
84% sought and received SRH and GBV services from health centres compared 69% of males. More females,
90.5% of the respondents felt that health workers had treated them well when they sought services while 9.5% felt that health workers did not treat them well.
79% of the respondents said they’d recommend a friend to a health facility while 4% said they would not. 2. SRHR Issues affecting young people Child and family protection department (police officers) (n=56) Reported GBV cases involving young people 35%
Physical Abuse
34%
Sexual Abuse Economic Abuse
11%
None of the above
10%
Emotional Abuse
10%
011 | WAY SURVEY REPORT
94%
of the respondents had recorded young people as victims of crime as indicated in the graph below.
Young people victim of crimes (n=56)
Number of young people (%)
60%
62%
yes
38%
No 40%
Male (26)
Female(30) Gender
92% of the respondents had recorded crimes by young people. 17% of the respondents had never been referred GBV cases against young people from a health facility. However, 54% and 13% reported receiving between 1-5 and 6-10 young victims of GBV from health facilities. The remaining 15% reported receiving 11 and above referral cases from health facilities. According to the respondents, the commonest GBV associated with young people includes; physical abuse (34%), sexual abuse (34%), emotional abuse (10%), economic abuse
(11%) and others (10%). At least 56% of the respondents had referred 1-5 cases of GBV to the criminal department while 19 had referred at least 6-10 cases. 11%, 1% and 13% had referred 11-20, more than 30 and 0 cases respectively to the criminal department.
58% of respondents reported attending between 1-5 events with a focus on young people with the community liaison officer. 6% reported between 6-10 events, 3% reported attending more than 15 events respectively while 33% reported not attending youthfocused events conducted with the community liaison officer as indicated in the graph below. At the youth focused events, physical abuse was discussed 25% of the time while, sexual abuse and alcohol and drug abuse were discussed 22% and 20% f the time. Other topics included; crime (11%), economic abuse (10%), and emotional abuse (9%). It should be noted that only 3% reported that none of the above topics were discussed.
012 | WAY SURVEY REPORT
The respondents noted that the commonest challenges experienced when working with young people include; poor communication (27%), poor facilitation (26%), lack of training on YFS (24%), poor mobilization (21%) and others (2%). Challenges faced working with young people (n=56) 28% 26% 24%
Frequency (96)
22%
Communication
Facilitation
lack of training with YP
Mobilisation of YP
Changes
3. The role of community leaders in addressing young people’s SRH issues District officials (n=55) Actions taken to address YP’s SRH & GBV issues (n=55) 40% 33% 29%
27%
23% 22%
20%
20%
Worked with schools to implement and/or monitor exercising GBV policies and guidelines National
23%
22%
21%
Community campaigns and dialogues
Strengthen cooperation between police, healthcare, schools & CSO’s
20%
Training of health professionals District
Sub-county level
013 | WAY SURVEY REPORT
57% 11% 11% 10% 12% 55% of the respondents were community development officers,
were Chief Administrative Officers
29% 14% noted between 4-6
noted 6 and above youth focused activities
were town clerks
were district health officers and
were district health officers and
noted that 1-3 youth focused activities had been organised,
At the various youth focused events, different topics were discussed. According to the respondents, at the sub-county level, 14% of the time GBV was discussed, HIV/AIDS Discussed 11% of the time and family planning, 8% of the time. At district level, 7% of the time, GBV was discussed, 8% discussed HIV/ AIDS and 10% of the time discussed family planning.
When relaying information to young people, at the sub-county level, community dialogues were used 29% of the time, workshops, 14% of the time, sports activities, 17% presentations 12% and national events and field trips 8% and 7% of the time respectively. The youth focused activities targeted out of school children 12% of the time, 5% in schoolschool children and 82% of the activities targeted both. 43% of youth focused activities used more than UGX 500,000, 32% used between UGX 100,000 and 500,000 and 25% used UGX 0-100,000.
014 | WAY SURVEY REPORT
Youth focused activities were funded by the district local government,
23% 31% 6% by the national government,
by NGO/ stakeholders and
by external funders.
Respondents took action to address GBV and SRH at sub-county by monitoring GBV policies and guidelines,
23% of the time, training in GBV response 22% of the time, community activities, campaigns and dialogues 33% of the time and cooperation with stakeholders 23% of the time. At district level, monitoring GBV policies and guidelines, 27% of the time, training in GBV response 29% of the time, community activities, campaigns and dialogues 22% of the time and cooperation with stakeholders 21% of the time. District officials reported that between 1-25 young people attended 69% of the time, 22% of the time between 26-75% of the time, 2% of the time more than 75 attended. 6% of the time no young people attended the local council meetings. District officials reported that few young people 1-25 young people attended 51% of the WAY programme meetings, 26-25 attended 35% of the meetings, only 9% of the meetings were attended by more than 75 young people. At 4% of the meetings, no young people attended.
015 | WAY SURVEY REPORT
Recommendations There is need to train health workers, and police in providing and addressing young people’s SRHR and GBV needs. Incentivize young people to seek SRHR and GBV related health through YFS provision and YF corners in health centers. There is need to establish youth-friendly spaces at health facilities where young people can freely interact and access information. There is a need to encourage young people to shun criminal activities through engaging them in productive (potentially income generating or talent development) activities. There is a need to establish more health facilities in the mainly remote communities so that it can reduce the time it takes young people to travel to access services to the health facilities. There is a need for health centres to have specific days when they attend to young people’s SRH needs. There is need to equip all health services with the required health services and commodities so that young people can access them services.
016 | WAY SURVEY REPORT
Appendices Table 1.1 The table below indicates the survey sample size, and the participants that took part in the surveys across the 8 intervention districts. A total of 353 participants took part in the surveys as indicated and broken down below; District
Young People
Health care workers
District Officials
Family PU
Total
M
F
M
F
M
F
M
F
Adjumani
13
14
4
4
4
4
3
3
49
Agago
8
15
4
4
3
3
4
4
45
Amuru
12
14
4
4
3
4
4
3
48
Kitgum
8
16
4
4
4
3
3
4
46
Lamwo
12
14
5
4
4
3
4
4
49
Moyo
10
14
5
4
3
4
4
3
47
Yumbe
5
10
4
4
4
3
3
4
37
Arua
8
5
4
4
3
3
3
3
32
Total
76
102
32
32
28
27
28
28
353
017 | WAY SURVEY REPORT
get in touch Reach A Hand Uganda
Plot 7502, Block 244, Heritage Village (Kitaranga) - Kansanga, on Kansanga - Ggaba Road P.O. Box 21288 Kampala,Uganda T. +256 414 697 037, E. info@reachahand.org W. www.reachahand.org
