SEXUAL REPRODUCTIVE HEALTH RIGHTS UMBRELLA PROGRAM AND DISTRICTS

QUARTERLY NARRATIVE PROGRESS REPORT January-March, 2019

KISEMBO MONICA APEER EDUCATOR CONDUCTS CONDOM EDUCATION AND DISTRIBUTION TO SEX WORKERS AT FOFO LANDING SITE ON 18TH FEBRUARY 2019

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NAME OF CEDO- (CHILD RIGHTS EMPOWERMENT AND ORGANIZATION DEVELOPMENT ORGANIZATION)

REPORTING PERIOD January-March 2019

EXECUTIVE SUMMARY

CEDO-Uganda with funding from the International HIV/AIDS Alliance through Community Health Alliance Uganda (CHAU), is implementing a Five (5) years Sexual Reproductive Health Rights Umbrella Program (SRHRU2016-2021) in seven (7) sub counties of and five (5) sub counties of Kikuube district. The project is currently implemented in the nineteen (19) health facilities of which eight (8) are in Hoima and eleven (11) health facilities are in Kikube district. The project targets priority populations; 10-14, 15-19, and 20-24, vulnerable children that include; street children, slum dwellers, orphans, disabled children, Young People Living with HIV/AIDS (YPLHIV). It also targets young key populations including; Sex Workers, MSM, truckers, and Fisher folks.

The overall goal of the 2016-2021 Programme is to contribute to improved health of Ugandans and the HIV/AIDS and SRHR response under the four (4) outcomes indicated below; i. Expanded access and increased use of quality, inclusive and integrated HIV and SRHR services among the vulnerable and key populations. ii. Increased adoption of safer sexual practices among vulnerable and key populations. iii. An enabling HIV and SRHR environment for vulnerable and key populations. iv. Strengthened institutional capacity of implementing organization (s) to deliver quality and inclusive HIV and SRHR program.

During the reporting period (January-March 2019), CEDO-Uganda Trained 40 peer educators, Mentored health workers, Conducted thirty (30) integrated SRHR and HIV outreaches and 15 Moon light activities, Conducted radio promotion activities including radio talk show, Conducted a stakeholders review meeting, conducted a quarterly review meeting with peer educators, Conduced condom education and distribution in partnership with health facilities and peer educators, and conducted dialogues with gatekeepers to discuss the socio-cultural/gender based/structural drivers of HIV epidemic that may hinder access to SRH services as a result of the above interventions, CEDO was in position to achieve the following per each indicator;

With number of people reached with SRHR/HIV services, 7143 young people (4,072males 3071females) were reached with SRHR/HIV information, HCT, FP, PAC, Post SGBV counselling, SMC, condom education and distribution.

During the quarter, 2983 young people (1637males 1346females) number of people were reached with HCT & received their test results. This was done through partnership with government health facilities during outreaches and moonlight activities for KPs

With Number of WRA reached with modern FP method, 253 females were served with FP services. This was done during the integrated outreaches and moon light activities throughout the quarter in the districts of Hoima and Kikuube district.

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During the quarter, only 33 young women received PAC services. This was done through direct and indirect referrals to Marie stopes blue clinics by peers.

Throughout the quarter, 251 number of males were reached with SMC services in both districts of Kikuube and Hoima. 118 males reached in Hoima and 133 reached in Kikuube. All these were mobilized by peer educators and referred to IDI for Circumcision and were treated as complete referrals under the umbrella program

With STI screening services, 2372 young people (1292males and 1080females) were reached with STI services. This was done through outreaches and moonlight activities throughout the quarter. For beneficiaries who tested positive for STIs, they were given treatment and referrals were documented for follow up and management of the infection

Throughout the quarter, 16 clients were reaches with post SGBV services especially counselling by health workers from the supported facilities.

During the quarter, 26 Health Workers were mentored in provision of adolescent friendly SRH and HIV services. This covered issues like; Privacy being maintained at the facility, Confidentiality is honoured, Youth are welcome regardless of marital status, Boys and young men are welcome, Service providers are attentive to youth needs. Convenient hours, Convenient location, Adequate space, Sufficient privacy and Comfortable surroundings.

For number of completed referrals, 298 referrals were complete out of the 305 referrals made during the quarter. These 251 referrals for SMC, 33referrals for PAC and 14 referred for ART initiation.

With number of condoms distributed to end users/young people, 37,874 condom pieces were distributed to fisher folks, sex workers YPLHIV and other adolescents and young people. This was affected by condom stock outs at the facilities especially from January to February 2019

For number of copies of IEC materials distributed, 379 (299 T-shirts and 80 Caps) IEC materials were distributed 80 T-shirts and 40 Caps to peer educators, 259 T-shirts and 40 Caps to health workers district officials and project staff. This increased feasibility of the project in both Hoima and Kikuube

1. Performance progress on outcome 1: expanded access and increased use of quality, inclusive and integrated SRHR and HIV services among vulnerable and key populations

1.1 What were the main outcome 1 planned activities implemented and key achievements obtained during the quarter?

1.1 Support provision of integrated SRHR and HIV services through health outreach delivery points:

During the reporting period, 30 outreaches and 15 moon light activities were conducted, reaching 2983 young people (1637males 1346females) with HCT, 2372 young people (1292males and 1080females) with STI screening, 253 females were served with FP services, and through

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referrals 251 number of males were reached with SMC services and 33 young women received PAC. 12 people tested positive and were referred and linked to other service providers for care and support.

Nabutundu Racheal a worker from Kyehoro HC III screening a client during an integrated

targeted outreach at Panyamuru landing site on 21st January 2019

A health worker from to Kigorobya HC IV conducting HIV and STI screening exercise at Hanga th Hotspot on 16 February 2019 during an integrated targeted outreahe

1.2 Mentorship of health workers During the quarter, 26 Health Workers were mentored in provision of adolescent friendly SRH and HIV services. This covered issues like; Privacy being maintained at the facility, Confidentiality is honoured, Youth are welcome regardless of marital status, Boys and young men are welcome, Service providers are attentive to youth needs. Convenient hours, Convenient location, Adequate space, Sufficient privacy and Comfortable surroundings, Youth are involved

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in program design, Both boys and girls are welcomed and served, Unmarried clients are welcomed and served, Group discussions are available, Parental involvement is encouraged but not required, Affordable fees are available, A wide range of services is offered or necessary referrals are available, An adequate supply of commodities is available, Drop-in clients are welcome, and appointments are arranged rapidly, Waiting times are short, Educational material is available on-site, Services are well promoted in areas where youth gather, Linkages are made with schools, youth clubs, and other youth-friendly institutions as well as Alternative ways to access information, counseling, and services are provided

Sunday Kenneth CEDO Staff (standing) during mentorship of health workers on 06th March 2019 at Kyehoro Health centre III

1.3 Trained 40 peer educators on sexual reproductive health

During the quarter, 40 (21male 19female) peer educators selected and identified from 19 mapped health facilities in Hoima and Kikuube district were trained on Training Methods of Interactive Approaches with Young People, Peer Education, Group Dynamics, Key Growth and Development Changes During Adolescence, Child Marriages and Having Sex with Older People, Teenage Pregnancy and Abortion, Pregnancy Prevention, Sex and Sexuality, Gender and Gender Stereotypes, Gender Based Violence, Life Skills, Sexual & Reproductive Health Services & Rights, Drug & Substance Use, Healthy Relationships and Safer Sex. The peer educators included all risk categories such as; Slum dwellers, orphans, disabled children, Young People Living with HIV/AIDS (YPLHIV), Sex Workers, MSM, truckers, and Fisher folks. The training was aimed at enhancing capacities of 40 Peer Educators (PEs) on Sexual Reproductive Health

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and wanda tool used in data collection under the SRHR Program

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Dr Kwikiriza Nicolus DHO Kikuube district giving opening remarks before the training kicked off on day one 16th January 2019 at Kijungu Hill hotel Hoima district

Nakazzi Grace CHAU staff taking peer educators through a session on day one during peer educators training at Kijungu Hill Hotel 17th January 2019

1.2 What are the main implementation challenges met during the quarter and how were they addressed? • Un able to record all project beneficiaries during outreaches remains a challenge Peer Educators, Drama group, and CEDO staffs offered generic SRHR information to the attendees but only those that received the one on one services were actually tracked and recorded in the daily record books. Those who just received SRHR information without moving to the tent to receive other services where not tracked/recorded. However, going forward, CEDO is to have more peer educators at an outreach to easily record all participants

2. Performance progress on outcome 2: increased adoption of safer sexual practices among vulnerable and key populations

2.1 What were the main outcome 2 planned activities implemented and key achievements obtained during the quarter? 2.1 Distributed Commodities (condoms) to adolescents/young people and key populations During the quarter, 37,874 condom pieces were distributed to fisher folks, sex workers YPLHIV and other adolescents and young people. This was affected by condom stock outs

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at the facilities especially from January to February 2019. This was aimed at increasing safer sexual behaviour amongst the risky population. These were given out during integrated outreaches, and dialogue meeting by peers in the safe spaces. This contributes to increased adoption to safer sex practices by adolescents / young people and key population within the project scope of operation (Hoima and Kikuube district).

Kisembo Monica a peer educator distributing condom to sex workers after a condom education session at FOFO landing site on 18th February 2019 Hoima district

2.2 Conducted peer led dialogues in the safe spaces During the reporting period, peer educators conducted 36 dialogues in the safe spaces reaching 543 fellow peers discussing issues on Key Growth and Development Changes during adolescence, Teenage Pregnancy and Abortion, Pregnancy prevention, aa well as Sex and Sexuality. During this peer also able to air out bottle necks to access SRHR services including un friendly environment at health facilities as well as poor attitudes of service providers who tend to judge them for the actions they have taken. This deters them from accessing SRHR services thus affecting their sexual health and well being

2.2 Conducted a quarterly review meeting with peer educators During the reporting period, a quarterly review meeting with peer educators was conducted to review performance, successes and challenges faced by peer educators under the SRHR Umbrella program. During the review meeting, it was found that some peer educators (20%) still need more mentorship on the Wanda data collection tools. It was still under the same meeting that they were further mentored on how to use the tools. According to the allocated targets, peer educators had achieved at least 60% of the set and agreed targets during their training in January 2019. Resulting from the meeting, mentorship schedules were drafted by peer educators and field officers for Kikuube and Hoima district

2.3 Conducted peer led radio talk show During the reporting period, a peer led radio aimed at give project briefs on the Sexual Reproductive Health Rights umbrella program (SRHRU 2016-2021) to beneficiaries, so as

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to build more ownership, solicit for their continued involvement in implementation to enhance sustainability as well as Increased peer educator’s engagement in project implementation activities. During the talk show, peer educators reached out fellow peers with SRHR information on teenage/unwanted pregnancies, safer sex practices, STI/HIV prevention and why the need to access SRHR services

Kisembo Monica a peer educator discussing teenage/unwanted pregnancies prevention during a radio talk show on 22nd March at Spice FM radio

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Peer educators (Ajuna Cleophas left of photo and Busobozi Ibrahim right of photo) during a radio talk show discussing SRHR Issues on STI management and prevention and Adolescent Growth and development respectively 22nd March 2019 at Spice FM radio

2.4 Conducted 30 community theatres/drama shows to sensitize adolescents and young people on SRH issues. During the reporting period, in collaboration with Drama Actors and, Hoima United Drama Actors, CEDO conducted a total of 30 community theatres on integrated SRHR and HIV in districts of Hoima and Kikuube. These reached 7143 young people (4,072males 3071females). The drama groups are made up of 30 adolescents and young people to attract more youth to turn up for project activities. This helped in informing the adolescents and young people on the life styles they need to live to have healthy living. The skit carries massages on STIs, family planning, teenage pregnancies, safe male circumcision, HIV/AIDS and effects of peer influence in decision making. Besides that, CEDO uses the community theatres/drama shows to disseminate the integrated SRHR and HIV information/messages to the young people. The skit is paused to allow the young people (listeners) to participate by asking questions and obtaining answers from the peer educators. Drama is supplemented with soft music suitable for young people and this helps in retaining the young people to attend the Integrated SRHR and HIV outreaches, and to retain them at the outreach as they wait to receive the integrated SRHR services by the health workers.

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Hoima united drama group performing a traditional dance as fisher folks look on during an integrated targeted outreach at Nkondo II landing site on 20th March 2019

Sunday Kenneth CEDO staff registering a KP during an integrated targeted outreach at th Nkondo II landing site on 20 March 2019

2.2 What are the main implementation challenges met during the quarter and how were

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they addressed?

What are the main implementation challenges met during the quarter and how were they addressed?

3. Performance progress on outcome 3: an enabling SRHR and HIV environment for vulnerable and key populations 3.1 What were the main outcome 3 planned activities implemented and key achievements obtained during the quarter? 3.1 Conducted community dialogues with gatekeepers During the quarter, 29 dialogues with gatekeepers were conducted aimed at discussing the socio-cultural/gender based/structural drivers of HIV epidemic, that hinders free access to SRH services like basic counselling, HTS, Family planning, STI screening, Safe Male Circumcision, and condoms. During the dialogue, gatekeepers noted that cultural and religious beliefs have retarded SRH services in the area in a sense that parents do not know the appropriate age of their children to access sex and sexuality education leading to un informed decisions taken by adolescents and young people. However, resulting from the dialogue, beliefs and perceptions on SRHR services hindered access to the services. It was agreed to always engage office of the Community Development Office to always engage parent on hindrances of SRHR access.

Wandera Herbert CEDO staff conducting a dialogue meeting with gatekeepers at Nyabuhere village Kikuube district on 10/02/2019

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Asobora Joel CEDO staff conducting a dialogue meeting at FOFO landing site Hoima district on 18th February 2019

3.2 What are the main implementation challenges met during the quarter and how were they addressed? • Due to limited knowledge on advocacy related issues, advocacy engagement was not done at district level affecting outcome 3. However CHAU organized a 3days advocacy training at Rider Hotel Mukono which built CEDO staff capacities in advocacy sub sequent a joint advocacy plan was drafted to achieve on outcome 3

4. Performance progress on outcome 4: strengthened institutional capacity of implementing organisations (NGOs and CBOs) to deliver quality and inclusive SRHR and HIV services 4.1 What were the main outcome 4 planned activities implemented and key achievements obtained during the quarter? 4.1 Conducted a quarterly review meeting with stakeholders During the reporting period, a quarterly review meeting with stakeholders was conducted to review performance, successes and challenges of the SRHR Umbrella program. The stakeholders included both Political and Technical teams from the District Local Government, Religious Leaders and CSO representatives. In total, 56 (26males 30 females) stakeholders from Hoima and Kikuube district attended the meeting which focused on sharing the progress, successes and challenges of the SRHR Umbrella program so as to solicit for technical support from district local government Resulting from the review meeting, it was agreed; • Next review meeting CEDO should involve more stakeholders like police especially CFPU (child and family protection unite), probation office and all sub county development officers to guide on procedures on handling SGBV cases both at community and district level • CEDO, Reproductive Health Uganda and other players in sexual reproductive health issues to organise and conduct a 2-3 days’ review meeting to have all issues affecting sexual reproductive health of adolescents and young people fully discussed at length with stakeholders. • DHOs office, CEDO and its allies to further strengthen or build capacities of health workers especially on long term methods of family planning

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Dr Kwikiriza Nicolas DHO Kikuube district giving welcoming remarks during the stakeholders meeting on 29th March 2019 at Kijungu Hill Hotel Hoima

Asobora Joel CEDO staff presenting project achievements to stakeholders during a th stakeholders meeting held on 29 March 2019 at Kijungu Hill Hotel Hoima

4.2 Routine Data Quality Assessment by CHAU Staff

During the quarter, CHAU team in the data management section together with CEDO staff conducted a RDQA exercise. During the exercise, Wanda tool (Beneficiary and service trucker) filled in by both peers and health workers were reviewed to assess the accuracy of data collection completion on all parameters. During the process, it was found that some peer educators were not filling in all the parameters especially on the date of birth of the beneficiary on the beneficiary form. Resulting from the RDQA,

• It was recommended that peer educators must fill all parameters including date of birth of the beneficiary on the beneficiary form. Additionally, CEDO should provide project enough data collection forms to all PEs. • Work plans must be aliened to accommodate meaningful activities to achieve some

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outcomes especially outcome 3 of the program (creating an enabling environment for Key population and vulnerable young people)

DR Bitira David interacting with Dr. Byenume Fredrick Hoima District Health Inspector during RDQA exercise on 19th March 2019 at Mparo Guest Apartments Hoima district

Dr. David Bitira reacting to project briefs presented by Wandera Herbert Team leader during RDQA visit to CEDO at Hoima field office on 19th March 2019

4.2 What are the main implementation challenges met during the quarter and how were they addressed? • Most of the stakeholders from Kikuube district requested for per diem during the quarterly review meeting since they travelled from Kikuube to Hoima. Negotiations were next quarter to hold different quarterly review meetings in each district.

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5. Other activities implemented during the reporting period and their outputs

6. Concise description of good practices identified and lessons learned during the quarter

During the reporting period, good practices include; • Involvement of all health workers at the affiliated facilities simplifies the work of the focal persons at the health facilities and increases team worker during the integrated SRHR and HIV outreaches. • Mobilization of the targeted young people through use of drama and music. This approached helps to ensure that young people get retained at the outreach site from start to the end of the outreach

7. Outputs: attach any key project outputs achieved during the reporting period (summary table of outputs, success stories, case studies, activity reports)

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I AM A CHAMPION, I HAVE CHANGED MY COMMUNITY. (Kisembo Monica a Peer Educator narrates her story)

reach out to a number of key populations around my community. Most adolescent especially girls are now informed where, when and why they need to access SRHR services like modern family planning methods. This has helped Kisembo Monica a Peer Educator affiliated to Toonya HC III in the reduction of an intended narrates her story to a CEDO staff. Photo credit: Sunday pregnancies and early marriages in Kenneth my community.

“I am extremely proud that I have been The first time I got to know about CEDO able to change mind sets of some of my was through the in-charge of Toonya health pillow peers in my community. I know centre III who introduced me to the there might be still a lot desired for all SRHRU umbrella program that CEDO was young people and the community members conducting in Hoima district where by his to change their mind set but a least facility was among the beneficiary facilities. there are those that have changed. I When CEDO was conducting identification attribute this achievement to CEDO and selection of peer educators, I was lucky Uganda because of their continuous to be among those that were selected and engagements with Toonya Health centre trained as a peer educator. I used the III. The health workers of the facility opportunity of being a peer educator to help have been empowered and through the improve my fellow peers around the lake integrated outreaches and moonlight shores on their SRHR and HIV knowledge activities that they conduct in my hence make informed choices especially on community the young people have been the improvement on the uptake of modern empowered and given information about family planning methods. their SRHR and can now make their own informed choices about the family Before the SRHRU program was introduced planning methods they want. If it was not to our community, the youth around the for CEDO may be my community would landing site were quite ignorant and had a have remained ignorant and carry on with lot of misconceptions about modern family the misconceptions, they had about planning methods. Being a landing site the modern family planning. I want to take youth (fisher folks, sex workers and this opportunity to thank CEDO Uganda YPLHIV) and other youth adolescents did and its allies for selecting me as their not know much about their SRHR, including peer and also for choosing my community information and where to access SRHR as a beneficiary community. Long live services. CEDO.” Following a three-days training by CEDO Compiled by Joel Asobora under the SRHRU program I was equipped with information, communication and Project Field Officer, Hoima. mobilization skills which has enabled me to CEDO Uganda

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one week thinking about the opportunity. I wanted it but was scared of being MY LIFE WILL NEVER BE THE SAME stigmatized. After talking to myself and my family, we agreed to take up the AGAIN- Aharikundira Justine Narrates opportunity. I decided to disclose my status

such that a lot of young people can get lessons to learn from my experience. I was later trained by CEDO with other peer educators on the provision of SRH and HIV information to our fellow peers. This has eased my work as a peer educator and as a peer mother at the facility. When am having engagements with my fellow peers in community I always let them know of my status openly and it has helped them change their sexual behaviors. I also use the opportunity to pass on information about HIV/AIDS prevention and other SRH information such that the youth can make informed choices. Aharikundira Justine 22 a peer “My life will never remain the same because educator affiliated to Nsozi Health I was empowered to disclose my status by Centre III Jesca a midwife of Nsozi HC III and this has helped me to live freely and appreciated in community. Disclosure has helped the I have been positive living for some time youth in my community to learn from my but it is something that I did not feel experience and hence improve on their everyone should know because there is a lot sexual life. With much appreciation i want of stigmatization in my community. However, to thank CEDO-Uganda for selecting me as with a number of engagements with CEDO I a peer educator because I have been realized it is good for me to open up about exposed to different opportunities and my status (positive living) such that other recognized in my village as a contact person youth and community members can learn not only for CEDO but also for the facility from me. in making referrals. My family is living a Before the CEDO intervention, I was faced healthy and happy life since am always the with the scare of stigma in community. I first to be consulted on health related was afraid that I will be looked at as issues.” immoral, reckless and irresponsible. I did Complied by Sunday Kenneth not see any sense in opening up about my project field officer Kikuube status to community. I felt it should remain CEDO-UGANDA between my family and the health workers from whom I used to get medication. During the time CEDO was identifying and selecting peer educators, the midwife (Namatovu Jesca) told me about opportunity of becoming a peer educator for CEDO in the SRHR project. She however told me that I would have to feel free to open up about my status because they wanted a positive living youth to provide SRH and HIV information to fellow peers. It took me

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Summary table of program outputs

-

hat provide provide hat

uted

k outs of any of the of of any outs k the

ed to HIV/AIDS ed

service explicitly that

/

dvocates trained/ mentored to trained/ dvocates

dvocacy strategy on SRHR and on SRHR and dvocacystrategy

results

les reached with with reached SMC les

services

resources

populations

HIVservices

of women and girls affected HIV affected by girls ofwomen and

r of r condoms distributed

meetings CSOs/CBLNs held with district CSOs/CBLNs with meetings held

six tracer medicines tracer six

unity gatekeepers who champion adoption adoption who champion gatekeepers unity

level intervention level

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Numbe

Proportion of completed referrals of Proportion completed

adolescent/youth friendly friendly services adolescent/youth

health facilities with health workers trained in trained with in workers facilities health health

SRHR/HIV prevention interventions SRHR/HIVprevention

Number of IEC materials distrib of IEC Number materials

Number of ma Number

Number of people reached with reached of services people STI Number

Number of people reached with reached of people services PAC Number

HIV for young, vulnerable and key populations vulnerable HIVfor young,

commodity forecasting & supply supply & management commodityforecasting

Number of people reached with reached individual/small of people Number

addresses GBV and coercion relat GBV and addresses

Number of community SRHR ambassadors trained/ of SRHR community ambassadors Number

leaders on HIV/SRHR on funding policies and of use on HIV/SRHR policies leaders on funding

Number of people reached with reached services of SGBV people post Number

community

Number of people reached with reached method FP of people modern Number

Number of people reached with reached integrated SRHR/HIVof people Number

of safer sex practices among young, vulnerable and key and young, among vulnerable practices ofsex safer on socio held sessions of dialogue community Number

Number of people reached with individual /small group with /small reached group individual of people Number

group/community level intervention/services addressing intervention/services level group/community

cultural/gender based/ structural drivers of HIV based/ structuralepidemic drivers cultural/gender

Number of Number

Number of people reached group/ reached an small by of individual/ people Number

Number of people reached with reached test their of people HCTNumber received &

legal rights/protection legal

Number of HWs trained/mentored in provision of SRH in and of HWs trained/mentored Number

mentored to develop and implement an advocacy strategy to advocacy and develop implement an strategy mentored

develop and implement an a and implement an develop

Number of health facilities without facilities stoc of health Number

on SRHR and HIV for young, vulnerable and key and key populations vulnerable HIV SRHR on and for young,

Number of comm Number

Number of dialogue of dialogue Number

Number of health facilities (HC III facilities t of health &IV, Number hospitals)

Number of SRHR community a Number

During the

0 0 0 0 0 0 0 0

33 16 05 26 29

253 251 298 2,372

quarter 2,983

7,143 37,874 379

0

0 0 0 0 0 0 0 0

59 05 26 00 53

Cumulative total 34

586 378 322

8,983 7,191

13,379 123,048 379

3 3 2 3 3 7 3

Project target 65

779 216 104 104 260

60%

9,521

77,899 11,252 17,311 12,118 12,983

519,328 129,832

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% achievement to

0% 0% 0% 0% 0% 0% 0% 0% 0%

40% 25%

6.1% 4.3%

date 100%

17.1% 79.8% 2.15% 59.3% 27.3% 23.6% 0.29% 50.9%

8. Report reviewed by (name, designation) MAALE JULIUS KAYONGO, HEAD OF PROGRAMS

9. Report submitted by (name, designation) ABDALLAH BYABASAIJA, EXECUTIVE DIRECTOR

10. Signature

11. Date of submission

12. Organization’s official stamp

13. List activities per outcome planned for implementation during the next quarter that differ from your approved annual work plan

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