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UHMG Reaches Most at Risk Population in Kabale through the RHITES- SW Project

The Kigongi is a ward in central division in Kabale municipality. In this ward, there are numerous settlements but one thing in common is the semi-permanent homesteads & sedentary lifestyle of the residents. Majority of the visible residents are women; a few of them involved in the tiniest petty businesses of kiosks with bottom of the pyramid quantities of fast moving goods, sachets of alcohol & calabashes of local brew. For almost every woman in this community, there is at least one child under 5 years – it’s not surprising for a woman in this community to have up to 3 children under 5!

Although some women affirm that they are housewives, it’s hard to see their husbands. Most of them are “neighbours”, a term used to mean female sex workers, in Kabale. Some women remodel every evening and become ladies of the night on the dusty and congested streets of Kabale town, a few meters away from their settlement. Many also practice transactional sex within their homesteads. Up to 83.1% of female sex workers targeted for 2016 have been reached with HIV Testing and Counselling services (Kamukira HCIV Data). The HIV prevalence among the portion of them living in Kigongi community is 6.6 %, higher than the national prevalence rate of 6.4% (Kigongi community July HCT data at Kamukira HCIV). Positive living is emphasized during counselling sessions and in a bid to contribute to the achievement of the 90% 90% 90% cascade, UHMG through the USAID Regional Health Integration to Enhance Services South West (USAID RHITES-SW) project continues to reach this high risk group with comprehensive HIV services.

UHMG works with Kamukira HCIV staff and Katuna MARPs Project, a community based organisation in Katuna, to ensure that this groups receives comprehensive health education, counselling, HIV testing, STI screening and treatment, family planning services including condoms as a dual protection and referral to health services for ART treatment and adherence services through bi-weekly targeted integrated outreaches. The project identified and oriented Social Behaviour Change Communication champions to conduct one to one sessions, group dialogue discussions on health topics including gender based violence, distribute condoms and disseminate IEC materials complemented with weekly radio talk shows. “Many women in our community know about condoms but many times fail to negotiate condom use with their clients because it involves a money factor. It’s a long time dilemma we live with; sex without a condom earns women more compared to protected safer sex. So it is hard to leave money on the table in favour of a condom use” said one participant during the dialogue meeting.

Joan Nabasiige, a freelance kitchenware hawker from Najjanankumbi, Kampala, is a frequent visitor to this community. She comes to sell but also check on her elder sister who stays in this place. Joan asserted that women in this community are highly compromised because of alcohol, hard-hitting poverty, and lost hope.

“Many of them can be transformed through income generating activities. I have observed many consider sex work as a source of income. Therefore skills in income generating activities would go a long way in improving their lifestyle and livelihood” Joan

Kingogi ward is dotted with similar communities. There are more than 100 laid-back women of reproductive age in this particular settlement with some of them visibly drunk during day. The few men found here are either drunk or running petty makeshift trades.

Despite the available family planning services during outreaches, most women have not taken up this service. There is urgent need to fully integrate family planning (FP) services given the high fertility rate in this area. Many women would most likely not prefer to have so many children but their lifestyle and the lack of capacity to negotiate for protected safer sex results into unplanned pregnancies.

Reminders in form of Information Education and Communication (IEC) materials are also left in their vicinity to constantly aid their memories on the basic steps individuals can adopt to live better lives.

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