The Joyce Fertility Support Centre

Congratulations! This Entry has been selected as a finalist.

The Joyce Fertility Support Centre

Uganda
Project Summary
Elevator Pitch

Concise Summary: Help us pitch this solution! Provide an explanation within 3-4 short sentences.

The Joyce Fertility Support Centre initiative offers health education, referrals, counselling and parenting choices to couples, individuals with fertility disabilities and give the plight of the condition to insert it in the health priority programs on reproductive health delivery. The initiative includes any woman/man who faces reproductive ill health catastrophes as a result of failure to receive appropriate reproductive health services. Primary beneficiaries are community people, couples with fertility problems, low income and rural communities who require education/awareness on health. Main service involves; organising communities into a structural support groups to give the plight of specific conditions of ill health with in reproductive health. High lighting catastrophes that affect mostly low income and marginalised communities; the initiative brings attention of medical partners to identifying health problems in the communities. We work on referrals of the communities to hospitals and clinics for treatment and organise the communities to utilise medical services. At the end of the health education programs, communities choose to spend finances to achieving a health life. This is making health a priority program in their expenditures. The Joyce Fertility Support Centre program is pioneering a pilot program for using communities to pool resources to meet their health demands. This is a five year development. After five years, initial development is to be turned into a National Health Insurance Program for low income and marginalised and rural setting communities. This is to be achievable by 2015

About You
Location
Project Street Address
Project City
Project Province/State
Project Postal/Zip Code
Project Country
Your idea
Focus of activity

Disease Prevention and Health Promotion

Start Year

2001 Joyce Fertility Support Centre was incorporated as a Non Governmental Organisation Registration no. S914-3444

Positioning in the mosaic of solutions
Main barrier addressed

Cultural taboos and health illiteracy

Main principle addressed

Leverage abundant resources at the community level

Innovation
Description of health product/service offering:

The Joyce Fertility Support Centre initiative offers health education, referrals, counselling and parenting choices to couples, individuals with fertility disabilities and give the plight of the condition to insert it in the health priority programs on reproductive health delivery. The initiative includes any woman/man who faces reproductive ill health catastrophes as a result of failure to receive appropriate reproductive health services. Primary beneficiaries are community people, couples with fertility problems, low income and rural communities who require education/awareness on health. Main service involves; organising communities into a structural support groups to give the plight of specific conditions of ill health with in reproductive health. High lighting catastrophes that affect mostly low income and marginalised communities; the initiative brings attention of medical partners to identifying health problems in the communities. We work on referrals of the communities to hospitals and clinics for treatment and organise the communities to utilise medical services. At the end of the health education programs, communities choose to spend finances to achieving a health life. This is making health a priority program in their expenditures. The Joyce Fertility Support Centre program is pioneering a pilot program for using communities to pool resources to meet their health demands. This is a five year development. After five years, initial development is to be turned into a National Health Insurance Program for low income and marginalised and rural setting communities. This is to be achievable by 2015

Description of innovation:

The innovation targets the community itself to turn it into a productive force to manage health service. It starts with identifying the cause of reproductive disabilities and incorporates the community into accessing health education, learning where to access treatment, bring on board such communities to discuss with providers. The innovation creates behavioural change for the communities to prioritise on health to desist from cultural myth and believes that put reproductive failure to curses and taboos. Communities take informed decisions after intensive education/awareness programs. Communities in Uganda believed that infertility, the inability to conceive and give birth is a cultural taboo. Anybody who has not produced is cursed. They believed that infertility affected only the female gender and also believed that infertility is not treatable. All such myth has been disproved by the proofs that scientific interventions have revealed. The Joyce Fertility initiative differs from the existing programs in the field. Originally people have not been involved in participation, they are treated as passive recipients, are not encouraged to create a position for health among their basic needs. They have no link with providers of health services and they look at the providers from the giving end. They are made to believe that the government will provide every service to cover their health problems. The Joyce initiative brings communities on board to be partners and direct participants. Realising the need to participate in resource mobilisation, the services provided in the initiative include; health education, referrals, getting communities closer to doctors, health practice to the community, reaching out through media channels and making health problems a common factor in the community-not a taboo or curse. In a nutshell, medical services are brought to the door steps of the community for them to take up informed decisions.

Operational model:

A recruitment drive calling upon everybody with a health problem relating to reproductive health to join a separate support group, initially started as a support for couples faced with infertility. It has extended to all conditions of reproductive ill health. Initiative offer support groups which intensively look at information on specific problems, emotional support, counselling, referrals to health providers, statistical data collection; resource mobilisations for treatments, Basic Research. Findings from support group activities do stimulate national exhibitions of the problems addressed, conferences that target wider communities. Groups found under the Joyce initiatives are; Endometriosis support group, fibroids/Polycystic Ovary Syndrome group, miscarriage group, still birth group, adoptive parents group, tubal damage & pelvic adhesion group, early menopause group, cancer cervix group, male factors- fertility disability groups All above conditions are prevalent among the undeserved and low-income communities. They are called marginalised simply because they lack structures that mobilise and cause representation for their causes. The Joyce initiative covers three districts and the structure moves from a unity family to village, parish, sub-county, county up to the district levels. In order to work effectively, we engage partnership like minded organisations that support reproductive health.

Human resources:

Coordination team, implementers of the aims and goals; - The members department headed by administrative personnel - The media awareness headed by a media manager - International relations headed by an international relations officer - Outreach program headed by an outreach officer who connects to communities, makes awareness of the community programs developed by the initiatives and programs for the community participations. - Research and Statistics; Basic Research and clinical findings taken on specific problems in health interventions. - Background; Founding member who is also the coordinating team is an environmental scientist. Social scientists, Economists, Office Administration, Social worker/Social Administration, Counsellors, Gender analyst, Doctors, Nurses, Voluntary workers Levels of education; Diploma, Degree, Masters Degree

Key operational partnerships:

Key operational partnership The medical providers; Doctors, Nurses, Midwives in private and public services The department of Reproductive Health Uganda The World Health Organisation-Department of Reproductive Health and Research (Geneva) The Global Network of Patient Leader Community- International Consumer Support for Infertility (iCSi) The Uganda Reproductive Health Advocacy Network (URHAN) The Youth Initiative Groups-Uganda Pioneers Association The European Society for Human Reproduction and Embryology (ESHRE) Membership The Media; Television, Radio, Newspapers of Uganda. Main partners Government; Ministry of Health, Reproductive Program, Ministry of Gender, Department of Medicine, Department of Public Health, Department of Social Research, Department of Food Science-Makerere University Uganda Media; Uganda Broadcasting Services (UBC), National Radio and Television, New vision-National Newspaper NGOs; Uganda Reproductive Advocacy Network, Uganda Medical Association, Uganda Private Medical Practitioners Roles of partners In the Joyce initiatives, the Ministry of Health oversees our work, acknowledges our recommendations and approves our work. World Health Organisations (WHO) offers the global views on Health and offers text that enriches us on reproductive health. Gender Ministry links us to the social gender mainstream interventions with communities, acts as a useful resource for data on gender issues. University and the listed departments; Basic research, clinical findings are guided by the University committees such as scientific committees who guide and endorse research by the health program. WHO offers support guidance to reproductive problems forwarded by the initiative at Joyce and comes up with global views. European Society for Human Reproduction and Embryology (ESHRE) scientific findings on studies undertaken in Human Reproduction where the Joyce team sends representatives to participate each year. International Consumer Support for Infertility (iCSi) a coalition of 40 like minded organisations that support country initiatives on reproductive health. URHAN a coalition of organisations that undertakes reproductive initiatives in Uganda How central All the above partnerships have contributed to the delivering of ideas and strategic plans undertaken by the Joyce initiative on health education, partnership with providers, referrals, resource mobilisation for low income groups, informing the government, compiling data to develop specific interventions with communities.

Impact
Financial Sustainability:

<ul><li class="entry-label">Fees charged to clients?: <span class="entry-text">Yes</span></li><li class="entry-label">How do you assure affordability?: <span class="entry-text">We allow subscription from the beneficiaries although we offer services to those who do not subscribe, it becomes rather voluntary to subscribe. Subscribers feel an obligation to contribute to the group activities and such funds are extended to the service of those who may not afford. When it comes to the pooling of resource to achieve medical services as a group, priority is given to the subscribers first. The non subscribing members are utilised in other fundraising programs. Their presence is valued as a human resource. The entire initiative to date has 1000 subscribing members while the recorded target group is thirty thousand persons in three districts. </span></li><li class="entry-label">Earned incomes as a percentage of operating costs: <span class="entry-text">30%</span></li><li class="entry-label">Other funding sources: <span class="entry-text">It is not financially self sustainable, no profits are accumulated at the end of the financial year. There is always a deficit that is transferred to another accounting year. What is achievable is to progress with implementation of the annual priority programs. Other sources of funding; Founders contribute fundraising initiatives like sales, corporate sponsorship of programs and international friends? donations. </span></li><li class="entry-label">Strategy for long-term sustainability: <span class="entry-text">-The annual subscription fee from voluntary membership -Founders contribute annually -Conference fees for continuing medical education provided by the initiative -Lobby for corporate funding from pharmaceutical companies to support the unrestricted grant for continuing medical education. -Grants from international friends that support the cause -A charitable entity such as a charitable shop to generate funds for supporting the activities. -Use celebrity and influential persons for the plight of the cause. -Lobby the Department of Health to support the initiative -A formalised pool of funds from communities for supporting health initiatives </span></li></ul>

Current and Future Impact:

<ul><li class="entry-label">Total number of clients: <span class="entry-text">1000</span></li><li class="entry-label">Clients in the past year: <span class="entry-text">30,000</span></li><li class="entry-label">Percentage of low-income clients: <span class="entry-text">90%</span></li><li class="entry-label">Impact: <span class="entry-text"> Impact: The development of support groups to manage health problems among the target group has created a structure that brings them on board to be direct participants, learn the causes direction to access treatment and understand and partner with providers. Communities have the choice to choose where and how they should be treated. A centre for learning, communities participation in the continuing education on health have impacted the community. The impact has gone a long way to erase what is referred to as marginalized society. More skilled health services have been introduced as the communities demand for quality. More health services are introduced in the community, the initiative is becoming a self rolling model and communities choose to mobilise resources to meet treatment costs other than waiting for the government to fund the sectors providing health. </span></li><li class="entry-label">Overall "market": <span class="entry-text">(d) Demand: - Educative information on reproductive health; all reproductive diseases, causes and treatment options and where to access treatment. - Communities are tied in un experimented herbal drugs, myths - Demand for interpretation of scientific proven information, statistical data to prove numbers of prevalence. All kept at a citizen registry in order to tarry with government records. - Pre-treatment; psychological treatment for stress and depression, emotional support for isolation, referral to supportive doctors who are informative, skilful and involve participation of patients in the treatments. - Demand for clinical intervention at the Parish and County levels, mobile visits by doctors so that citizens do not move very long distances to regional referrals. - Mobilization of citizen centres for treating patients - Demand for representation on medical boards to determine the distribution of services. Other clients; Originally Joyce has been holding services for infertility investigation treatment on education, preventions & counselling support. Target group; pregnant women with high risk factors, post natal care that results in miscarriage, still birth, ectopic pregnancies etc. Babies recruited into the foster & adoptive homes. Reproductive target group; Young adolescent girls recruited in endometriosis support and education. This is to involve a national program of young girls and young women who may be suffering from endometriosis a hormonal disorder that affects women of a reproductive age. Maternal mortality; the initiative is concerned about the highest mortality rates. In Uganda every 100,000 birth, 505 women die in delivery all of them are rural based, urban poor & marginalised groups. The high occurrence of labour obstructions that cause ruptured bladders to women delivering from homes & Traditional Birth Attendants. Apart from death, a big number suffers fistulas and there is no Obstetric intervention carried out on them. This leads to isolation, suicide attempts by those women. The initiative is working with experts to have trained doctors work with Traditional Birth Attendants. Already Joyce Fertility Support Centre is working with Sheba Hospital in Israel to involve young doctors is working with Traditional Birth Attendants in Uganda (program already in preparation). This is followed by a safe motherhood delivery package to prepare mothers in rural areas and underserved communities to access Obstetric care and safe delivery. Countries; the initiative is being replicated in Kenya-Hope Fertility Support Centre, Zimbabwe-Chipo Chedu Trust is adopting it. We are looking at all countries of Sub-Saharan Africa; Nigeria, Ghana, Rwanda, Burundi, Uganda, Kenya and Tanzania to start with. </span></li></ul>

Scaling up strategy:
Stage of the initiative:

<i>Scaling Up</i> stage.

Expansion plan:

The program is in Kampala, Mpigi and Wakiso Districts. Some feasibility has been carried out in Mukono District and Mbarara and Iganga. In 3 years, the initiative will be complete in 3 districts and incorporating the 1st phase of 3 more Districts. Existing collaboration with other Ashoka Fellows in East Africa; Christine Jordan-Life in Africa, Sebina Salongo- East & Central Uganda Integrated Farmers Association, Irene Mutumba- Enterprise Development Limited to give another life to the marginalised groups of people from Northern Uganda who have been displaced by the war. An integrated initiative including a health education and treatment interventions is in June this year. Working with Ashoka Fellow Betty Chishava Zimbabwe, to integrate treatment, counselling, education on health to the childless and people faced with reproductive problems in Zimbabwe. Joining the coalition for social security advocacy with Ashoka Fellow Lillian Keene Mugerwa-Platform for Labour Action, 90% of the marginalised underserved childless couples but in particular women, can not meet costs for medical treatment. Social security in Uganda targets employed groups and Joyce would like to insert a component of health for all in the social security sector. African families put all investment in children and later expect the children to cater for their social security. This leaves a gap for people who have no children. Fellow Stella Amojong- Advocacy for Teenager Mothers Kenya, reproductive interventions for the youth adolescents and prevention of teenage pregnancy. This program is under feasibility to be effected in 2007. It targets youth in urban poor and rural communities in Uganda/Kenya. Working with other countries e.g. Chen Patients Association Israel, to study interventions in service delivery from a developed country to lobby Israel to extend technological transfer in the treatment of reproductive problems. Working in Kenya to advance reproductive health for youth, adolescents with Hope Fertility Support Centre Kenya, a network developed from the Joyce Fertility Support Centre Idea. We have carried out feasibility in the 1st East African Scientific Conference on Endometriosis that took place in Uganda on 14th March 2006 and called on scientists from Uganda, Kenya, Tanzania, Belgium and Israel.

Origin of the initiative:

The Joyce Idea was born in 1998 through a real life experience of a patient my self (Rita Sembuya). I struggled for 17 years between 1986-2003. During that period, I had seen over ten doctors, had five surgical operations for tubal repair and myomectomies for fibroids, I went through a lot of physical pain, emotional and had a psychological burden. In the end, doctors referred me to try advanced countries in Europe. After putting down all challenges of my situation, I started writing down a program that would wholesomely work to the rescue of the community for all patients with infertility and all reproductive conditions. The initiative Joyce Fertility Support Centre Uganda addresses the gaps for information for understanding reaching out to fellow patients and doctors. 17 years of my treatment have worked as feasibility for identifying the problems that the initiative is addressing. 1000 members have registered to utilise the service of the initiative. They are direct participants in their health care. I personally have a feeling that if the Joyce organisation was there at the beginning of my own infertility struggle, it would have helped me to become a biological mother.

Sustainability
Policy change:

Joyce initiative is working out a structure to put on board communities to be direct participants in health care delivery. Through the health education support group mobilisation, sharing challenges with providers & sharing findings, we would like to erase the situation of marginalised groups. The communities are a great human resource to cause a holistic approach to health care for all starting from the unit family. It is not about supplying medicine, it?s about understanding how the bodies should be treated and taking an informed priority for all people. All representatives to go on administrative & legislative positions are represented & elected by the communities from family unit to national levels. Once the country?s health system is built on a strong structure demonstrated above Joyce activities, foreign policy becomes clear and transparent. The World Health Organisation (WHO), United National Funds for Population Activities (UNFPA), Population Secretariat, Centre for Disease Control (CDC) and World Bank Projects are managed by the beneficiaries, there is no need for experts to be called from other countries. In conclusion a down top system of policy for health.

randomness