Sexual and reproductive health program: 2014 annual report
The report presents major achievements of the SRH Program in summaries that are useful to policymakers, program managers, health service providers and other stakeholders. The level of analysis in the report is primarily descriptive and is particularly useful for assessing progress of the program activities, against national targets as set out in National Health Sector Strategic Plan (NHSSP), Millennium Development Goals (MDGs), and Sexual Reproductive Health (SRH) strategy. The program is one of the key players in MDG 4 which is to reduce infant mortality from 79 to 24. MDG 5 speaks to maternal health issues, which amongst other things is to reduce maternal mortality.
Coordination of the program is supported by an Inter-agency Technical Coordinating Committee (IATCC) which meets quarterly. A number of technical working groups have been commissioned to harmonize technical assistance and foster collaboration in the development of interventions of different thematic areas of SRH. These include: PMTCT TWG, ASRH TWG, Condom TWG, Gender and family issues TWG and the Reproductive Health Cancers Task Team.
The Programme Manager provides both management and technical oversight for the programme and is assisted by six technical leads. There have been challenges of human resources in regards to the number of approved and established posts in the organogram. There are only two established posts in the program and both are filled. Presented below are findings from the 2014 report;
• A slight increase of pregnant women coming in at <16 weeks of gestation, from 20% in 2012 to 28% in 2014 and 91percent facility deliveries were reported. Lubombo has a relatively low population however it accounts for 33 percent of the home deliveries.
• In 2014 35 maternal deaths were reported; in 2012, the percentage of deaths as compared to live deliveries was 0.106percent, in 2013 it was 0.140percent, and has decreased in 2014 to 0.131percent.
• A total of 75131 female condoms and 2107379 male condoms were distributed at health facilities. The number of oral contraceptives distributed was 202571 and Injectables were 301400 in 2014. Uptake for implants has remained the same as the previous year where about 3677 women were inserted implants, there has been an increase in the uptake of IUCD’s over the years; 1261 in 2013 and 1961 in 2014
• There is a significant increase in the number of prostate cancers reported at inpatient (65 in 2012- 112 in 2014).
The following are some of the recommendations of this report;
• There is need to strengthen the notification of maternal death at community level by engaging and involving the community through continued sensitizations and trainings.
• Strengthen messages on the dangers of delivering at home
• Revive type B clinics to provide delivery services by ensuring they are well equipped with human resource, supplies, equipment.
• With the evidence of drug interaction between jadelle and EFV Art regimen, there is need to increase counselling and aggressive history taking to rule out potential drug to drug interaction among people on ART. Moreover there is need to increase demand for dual protection by offering condoms with every method.