Uganda Reach hosts HelpAge Uganda

My 21, a team of  HelpAge in Uganda visited Uganda reach offices to try to understand how the URAA offices work. On this day, the visitors went through our programme of work and shared key information.

Mr Fred Ouma, the CEO, URAA said the orgnaisation now has two active projects in northern Africa and some in Eastern Uganda.

The HelpAge team was impressed and urged URAA to continue doing what it committed itself to do.

Roles played by THPs in supporting social development activities.

Post by Ivan

 

THPs play a significant role in social development activities that range from providing counselling services to clients to providing education awareness to the community on appropriate herbs to be used for different ailments. Some noted that their services to those living positively with HIV and AIDS is limited to only those that would have come out in the open and disclosed their status to the public. THPs also value their participation in community activities where they share their experiences  such as during the District AIDS Action Committee meetings.

THPs were found to be contributors to community development because they are the entry point by the biomedical health practitioners in programmes such as HIV/AIDS campaigns, hygiene, sanitation, immunization campaigns, and malaria control (mosquito net distribution). THPs are considered as advisors to community development work such as construction of community schools and roads. 

THPs share a  cell phone message at a THP conference

 

They provide services to their clients within the community at reasonable costs, refer clients presenting with signs and symptoms of HIV for VCT to health facilities, are used by development partners for community mobilization in other community development programmes such as child immunization, malaria prevention and control programmes. To those that disclose their status and are on conventional medical treatment the THPs noted that their major roles involve encouraging their clients to adhere to prescribed medicines and providing other traditional medicinal options to manage and treat opportunistic infections such as diarrhoea. The THPs explained that they do not interrupt the treatment cycles that would have been prescribed by conventional doctors but they complement them.

However, most THPs said they do not keep well organised clients data. They simply invite the patient to come back; if they don’t the THPs would not make a follow up. Only one percent acknowledges that they do keep a register of their patients and information such as names, Date of birth, diagnosed ailments and the medications provided. There was agreement among the THPs that the most common ailments presented by older persons range from Back aches, urinary blocking, diarrhoea whilst the younger demography presents HIV related illness and other common STIs. They noted that older people prefer THPs because they began utilising traditional medicine well before the advent of modern medicine to their communities.

The community has a lot of faith, trust and respect for THPs. The services provided by THPs is seen as life saver by the older persons and the community appreciates that working with older persons needs patience as they need a lot of care and support.

Strengthening collaboration between traditional health practitioners and bio-medical health practitioners

Post by Ivan Kintu

A recent study by URAA found that THPs are first point of contact for treatment (most trusted by their clients) in most rural communities and this provide an opportunity for THPs to provide services such as HTC/HCT if their capacity is developed and provided with testing supplies.

The study also found that there are still lots of mistrust by BHPs on roles of THPs which result in lack of reciprocal referrals between THPs and BHPs. However, there can be opportunities to promote collaboration if the referral is not centered on bio-medicalization: i.e. focusing on non scientific issues like counseling, and adherence support.

 The nurses share  a moment of learning with THPs & TBAs at Iganga

Need for exploring how THPs can effectively collaborate with BHPs in key HIV prevention strategies such as Male Circumcision and PMTCT.

Capacity of TBAs should be built to provide services beyond delivery to include comprehensive reproductive service provision which can be effective in preventing maternal deaths in rural areas.

In order to improve the relationship between THPs and BHPs it is critical to identify where exactly do THPs fit in the wider heath management model for the particular country. For example, community health workers are clearly part of specific level in the health management model and therefore 

1.8 million children are currently living with older persons.

Living a long life is a great achievement and the older persons of Uganda have made immense contributions to building and developing the country. This includes caring for their grandchildren, especially orphans, many of whom have been affected by HIV and AIDS.

 In fact, 1.8 million children are currently living with older persons. Grandmothers, in particular, play an important role in caring for their grandchildren which enables working age parents to produce food for their families or enter the labour market.

Older persons continue to guide and inculcate Ugandan cultural values in their children and grandchildren, as well as preserving Uganda’s rich and diverse cultures. A case in point is this grandmother in Nalutuntu sub-county she is 76 years and she takes care of seven (7) grand children many of them have lost parents to HIV/AIDS. “They are my grand children and i love them I will continue to take care of them as long as am still alive. I have lost three sons and two daughters to HIV/AIDS. ‘Mukeneya ya tujira’ AIDS is terrible!  Maria Teresa laments.”

IDOP Message to LCV Kasese

The Constitution of the Republic of Uganda (As at 15^th February 2006) Article 32 Clause (1) states that “Notwithstanding anything in this Constitution, the State shall take affirmative action in favour of groups marginalised on the basis of gender, age, disability or any other reason created by history, tradition of custom, from the purpose of redressing imbalances which exist against them”[1].

The Local Government Act which provides for representation of older women and men at all levels of local councils [Cap 243, Section 23 (6)] which states that “There shall be two elderly persons a male and a female above the age of 60 years on every lower local government council who shall be elected by the respective executive committees of the associations of the elderly”[2].

Despite the presence of the above provisions in the laws of Uganda, older persons have continued to be neglected with no programme specifically designed to meet their needs and we as older persons therefore request your excellence to urgently attend to our requests/issues as expressed.

SOCIAL PROTECTION:

Key note: 37% of older persons are among the poorest of the poor in Uganda. Poverty eradication policies, frame works and programs to not target older persons.

Therefore as older persons:

·        We urge the government to expedite the approval of the Program Plan of Action for the Older Persons’ Policy and its implementation.

·        We urge the government to formulate social protection interventions that will adequately meet the needs of vulnerable older persons.

·        We urge the government to establish a universal non-contributory pension for older persons.

·        We urge the government to absorb local government pensioners to get their pensions from the Ministry of Public Service, unlike to day when local government pensioners are confined to district revenues.

·        We urge the government to expedite the approval of the Bill for the National Council of Older Persons.

·        We urge the government to permit the representation of older persons from local council 1 to parliament.

 

FOR GOD AND MY COUNTRY

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[1] 1997 Constitution of the Republic of Uganda as amended

[2] 1997 Local Government Act CAP 243

IDOP Message Kasese

While there is considerable effort by Government and other non-state development actors to prevent the spread of HIV and AIDS, there are no explicit attempts made to target Older Persons. It is for example falsely assumed that Older Persons are sexually inactive and yet available studies by Uganda Reach the Aged Association (URAA) indicate the contrary. To demonstrate this, one of the studies revealed that 64% of the Older Persons are sexually active, of which 91% never used condoms during sexual intercourse.

Besides, research evidence also suggests that many of the Older Persons are not aware of preventive strategies, which ultimately leaves them exposed to contracting HIV and AIDS. For example: many Older Persons take care of People living with HIV and AIDS such as own children and grandchildren and can contract the disease from direct contact with their blood. Furthermore, Older Persons being in menopause are liable to experience thinning of the virginal wall which potentially causes injury during sexual intercourse and thus increasing risks of contracting HIV and AIDS.

Key Note: Older Persons are not specifically targeted in the Uganda AIDS Indicator Survey, UNGASS Report, Uganda Demographic Health Survey, National HIV and AIDS Policy, and the National Prevention Strategy. It is worth noting that older persons are not recognized as a group at risk of HIV infection in the Uganda AIDS Indicator Survey. Long queues coupled with the Young counselors placed at the HCT Centres are a demotivating factor for Older Persons to access HIV related services.

Therefore as Older Persons:

·        We urge Ministry of Health to provide age appropriate, quality and comprehensive information and education on HIV&AIDS transmission, prevention, testing, care and treatment services;

·        We urge Ministry of Health to include older persons on the peer education, Home Based Care and Counseling Training programmes at community level;

·        We urge Ministry of Health to introduce special clinic days for Older Persons to interact with counselors for testing;

·        We urge Ministry of Health to introduce community based HIV&AIDS outreach services to engage Older Persons;

·        We urge Ministry of Health to introduce a special desk and consideration for Older Persons at HIV Counseling and Testing Centers;

·        We urge MOH to introduce age related specific ARVs as is the case for children;

·        We urge Ministry of Health to extend the age bracket from 49 – 60+ in the UAIS, UDHS and other related HIV and AIDS strategic documents during reviews;

FOR GOD AND MY COUNTRY