By Anzoo Evaline

Over 5,200 farmers in the West Nile Region are still awaiting inputs following the exit of the Agriculture Cluster Development Program (ACDP) a year ago.

The program was launched in 2017 as a transformative initiative to boost Uganda’s agricultural productivity, with an expected end date of March 2022. However, it was later extended to September 2023 to recover the time lost during the COVID-19 lockdown. The program was worth USD 150 million and targeted 57 districts nationwide. Its objectives included increasing production, improving productivity, and enhancing market linkages through value chain interventions clustered into 12 major sectors. About 55% of the funds approximately USD 82million was allocated for agro-inputs, while the remaining amount supported matching grants for farmer associations to upgrade storage facilities, machinery, and operations. 

Despite ambitious expectations to transform the livelihoods of 450,000 farmers including 180,000 maize producers, 110,000 coffee growers, 95,000 bean farmers, 40,000 rice farmers, and 25,000 cassava farmers these goals remain largely unmet. The project also aimed to facilitate the formation of 300 Area-Based Community Cooperative Enterprises and support 3,000 rural producers.

An electronic voucher system (E-Voucher) was awarded to United Bank for Africa (UBA) to facilitate the cashless distribution of vouchers to smallholders and subsistence farmers to assist them in accessing high quality agricultural input. The e-voucher is electronically delivered typically via SMS or e-mail containing unique code sometimes a PIN for verification and the farmers can deliver the e-voucher online at the retailer’s website during checkout and he or she provides the e-voucher code to detect the value from their purchase total, which is automatically applied to the balance or deducted from the purchase.  The inputs farmers are supposed to receive include inputs such as fertilizers, pesticides, agrochemicals, tractor hire services, and seeds according to their requests. Under the program’s priority sectors, West Nile was grouped into Cluster 12, focusing on cassava and coffee enterprises.

Despite these arrangements, farmers enrolled through UBA, each paying 148,000 shillings for inputs, failed to access their supplies by the end of the project. This situation affected approximately 2,614,000 farmers across the 76 districts, according to project records.

In 2018, the Minister for Agriculture, Animal Industry, and Fisheries, Vincent Ssempijja, commissioned the E-Voucher Management System during the launch of the ACDP in Lukaya, Kalungu District. This system was intended to promote commercial production of maize, beans, cassava, rice, and coffee across 42 districts. The government contracted UBA to supply, install, and manage the E-Voucher platform, with the National Information Technology Authority (NITA-U) responsible for registering participating farmers, while a few agro-input dealers were engaged to supply inputs.

However, farmer frustrations grew as access to inputs remained elusive even after payments were made, extending beyond the project period. Many farmer groups disintegrated, and some began threatening legal action against local governments especially those who paid for inputs that were never delivered.

In districts from Nebbi to Maracha, a total of 5,276 farmers are distressed after being duped in the cost-sharing deal. Farmers were expected to pay 148,000 shillings for inputs, with the government covering the remainder. For example, at Aryek Cooperative Union in Nebbi, farmers are demanding 165 million shillings for undelivered inputs. Its chairman, Powell Ongey, lamented, “We have been following up on these funds, but the service provider (UBA) has remained silent despite several follow-ups. We’ve handed the matter to the district authorities. This situation has caused mistrust among members and leaders, and we hope the government will help us recover these losses.”

Joyce Piwa, Nebbi District Agricultural Officer, added that UBA had pledged to refund the farmers’ contributions through the E-Voucher system. “I believed all 3,783 farmers had been cleared. I will follow up,” she said.

Efforts have been made to reach out to the Uganda Bank of Africa (UBA) through phone calls and emails by the agriculture officer of Nebbi district but no feedback was given.

Farmers speak up:

Aryek Cooperative Union is among five local cooperative societies in Nebbi that received Shs 3 billion for cassava factory construction, part of the Shs 34 billion in funds the government received from the World Bank (WB). This funding aimed to support 118 farmer organizations across 24 pilot districts, focusing on value addition to produce before market.

The situation in Nebbi mirrors that of Arua district, where only 200 out of 2,040 farmers have received inputs two years after the program’s conclusion. Stephen Candia, a farmer in Awika Village, Arivu Sub-county, expressed his frustration: “It’s hard to trace the contractors since they were introduced to us by the district. I wish the district would intervene and help recover our money because, since I paid 148,000 shillings, I haven’t seen any return. I ordered fertilizers, gumboots, and tractor services to open up my land, but none of these have materialized.”

Based on the 2023 Engineering audit conducted by the Office of the Auditor General, several issues were identified concerning the rehabilitation of community access roads, E-voucher program faced challenge of beneficiary identification, benefiting districts lacked fund for maintaining the constructed roads, delay in procurement. Specifically, projects worth Shs 63 billion remain incomplete, with works only at 20% completion by the end of the project period in each local government. Additionally, 14 projects valued at Shs 73 billion had not yet commenced. These projects focused on restoring community access roads to improve market linkages and were managed through high-breed procurement mechanisms.

Arua District Chairman Alfred Okuonzi criticized the Ministry of Agriculture, Animal Industries, and Fisheries (MAAIF) for a lack of transparency in managing projects aimed at transforming farmers and, ultimately, the country’s economy. He stated that “corruption within MAAIF has reached unprecedented levels, with staff acting with impunity and without accountability.” Out of frustration, Okuonzi emphasized the need for a thorough audit of these projects to ensure value for money.

He further condemned the contractor, United Bank for Africa, noting that costs incurred amount to billions of shillings, yet farmers remain impoverished. “MAAIF should stop implementing projects like witchdoctors working from Kampala offices without proper monitoring or engagement with local governments,” he added.

There is also evident frustration within local governments. In Maracha District, at least 1,208 farmers have yet to receive their funds or inputs, raising concerns about project execution by contractors, ministry officials, and district authorities. Stephen Obitre, the district chairman, explained that he brought this issue to the attention of the Minister of State for Agriculture, Bwino Fred Kyakulaga, during his visit earlier this year. The Minister directed that the contractor should refund all farmers whose funds were misappropriated through the Electronic Voucher system, as the contractor failed to supply inputs. Obitre lamented that most components of the Agriculture Cluster Development Program (ACDP) had collapsed before implementation.

He expressed disappointment, stating, “We expected farmers to access inputs at reduced costs, markets through rehabilitated roads, and add value to their products. However, nothing tangible has materialized, value-addition facilities are non-functional, road works are only 20% complete, and inputs have not been supplied. This is a disaster, and the officers involved in implementing the ACDP should be held accountable.”

In response, Dr. Henry Nakelet Opolot, the Commissioner of Agricultural Extension and Skills Management and Project Coordinator for ACDP, reported in 2021 that the project had achieved a 74% disbursement rate as of May 2021. He declined further comment when contacted but referred to the project implementation report, which indicated that both government and farmers contributed a total of UGX 84 billion, UGX 54 billion by the government and UGX 27 billion by farmers across 57 districts.

The report also stated that out of an estimated 450,000 targeted farmers, 416,518 enrolled in the e-voucher subsidy program, with 277,990 ordering inputs and 200,984 receiving them; the reasons for the remaining farmers not receiving inputs remain unspecified.

Efforts to obtain comments from United Bank of Africa proved unsuccessful, as their known phone lines were unavailable.

Key Facts:

During the 2015/16 financial year, MAAIF borrowed US$ 150 million from the World Bank to fund the Agriculture Cluster Development Project (ACDP). The main objectives were to increase productivity, production, and commercialization of selected agricultural commodities across 57 districts in Uganda. The project officially ended in 2023 after several extensions. It comprised four components: Agricultural Inputs (seeds, planting materials, fertilizers, pesticides) – US$ 65 million, Agricultural Water Management – US$ 36 million, Post-harvest Handling, Storage, Value Addition, and Market Linkages – US$ 34 million, Project Management and Regulations  US$ 15 million.

Regrettably, most of the project components were effectively halted before full implementation in many beneficiary districts.

With a recognition of the widespread failures and continued frustrations surrounding the management and implementation of Uganda’s agricultural development projects amid significant funds borrowed from the World Bank and substantial investments, critical components such as road rehabilitations, input provision, and market linkages remain incomplete or ineffective. The ongoing issues, including the theft of farmer funds, delayed project activities, and collapsed infrastructure, underscore a pattern of mismanagement that has undermined the initial ambitions to transform farmers’ livelihoods. Moving forward, there is a clarion call for comprehensive audits, stringent oversight, and accountability measures to ensure that the scarce resources are utilized effectively to realize the intended economic and social benefits for Ugandan farmers.

By Bazio Doreen.

Adjumani has been nominated as a model district for teenage pregnancy surveillance and response in the financial year 2024/2025 in a zoom meeting convened by the Ministry of Health.

The early morning zoom meeting was held on Friday 19^th September 2025 in collaboration with the Ministry of Education and Sports under the theme: “Strengthening multi sectoral approaches towards reducing teenage pregnancy.”

Previously, Adjumani was also recognized as the best district in Adolescent programing during the 2024 Safe Motherhood conference. 

As of June 2025, the teenage pregnancy rate in Adjumani stood at 15.7% against a national target of 24%. This means that in Uganda, one out of four girls aged 15 – 19 years is already pregnant or has a child.

However, in Adjumani, the coverage of adolescents and young people in Sexual and Reproductive Health related care is quite commendable. In the financial year (FY) 2024/2025, among expectant mothers who attended their 1^st antennal visit, 2,351 out of 14,984 were adolescents; out of 13,572 deliveries conducted, 1,852 were adolescents; and among 49,146 family planning users, 2,255 were adolescents.

Similarly, there is also a tremendous effort in the education sector. Between January and September 2025, about 325 pupils and 225 students were returned to Primary and Secondary schools respectively.  Adjumani has 155,361 in school adolescents and 104,984 out of school adolescents.

In his presentation, Lulu Henry Leku, the Assistant District Health Officer in charge of Maternal and Child Health, said one of the best practices of the multi sectoral approach is utilizing the adolescent mentors to take services to where the adolescents are instead of expecting them to all come to the Adolescent/Youth Friendly Corner.

“We are now confident that the 7 well trained Adolescent mentors and 153 health workers trained on SRHR will provide a well-coordinated and collaborative responsive and surveillance even after all implementing partners leave the district. They help us to use a multisectoral approach by building synergies between government and all the partners implementing SRHR interventions,” Lulu confidently boosted.    

Lulu also said that in Adjumani all stakeholders acknowledge that teenage pregnancy is a reality and different platforms needs to be utilized because it is costly not to do so.

“We recognize that adolescents are actively involving in sex and thus teenage pregnancy is not only a reality but inevitable. Between 2012 and 2024, about 1,735,792 children are estimated to have dropped out in due course of transition from primary one to senior six. Our country loses about 645 billion due to school dropout with teenage pregnancy being one of the drivers,” Lulu said. 

Lulu further added that the recognition is relieving for Adjumani because the worst 23 districts with the highest teenage pregnancy burden are expected to share response progress reports to the Ministry of Health every Friday and also attend sessions online where the best performing districts share good practices.

Some of the best Sexual and Reproductive Health response practices by Adjumani related to adolescents also include: capacity building of all stakeholders for provision of adolescent responsive SRHR services and Gender Based Violence prevention, creating a safe and gender responsive learning environment, sensitization on existing education policies, roll out of prevention and management of teenage pregnancy guidelines, mentor child mothers for school re-entry, and functionalization of the District Committee on Adolescent Health.

While congratulating the district on the zoom call attended by over 200 stakeholders from other districts, Dr. Irene Mwenyango, Assistant Commissioner Adolescent and Sexual Health – Ministry of Health, thanked Adjumani for being a model district even as they grapple with hosting refugees. She also thanked the partners in Adjumani for choosing to support the communities to reduce teenage pregnancies by promoting sexual and reproductive health rights for adolescents. 

“I want to thank the leadership of Adjumani for ensuring that the district is a role model for teenage pregnancy surveillance and response. While the Ministry is looking at the target of 15% teenage pregnancy by 2030, I am glad that Adjumani is already tending towards it. I urge the rest of the districts on the call to pick the good practices,” Dr. Irene said. 

Henry Ssemakula, the Assistant Commissioner School health at the Ministry of Education and Sports, who was moderating the discussion also congratulated Adjumani for being one of the best performing districts in responding to teenage pregnancies and urged other districts to emulate the best practices. 

“You can imagine that 200 people are on the call to learn from you. We want to hear from you how Adjumani has for many year tried to maintain a low teenage pregnancy rate amidst many challenges like COVID-19 and hosting a large number of refugees,” Ssemakula said.

Similarly, Jovine Atima, Program Officer Adolescent and School Health Division – Ministry of Health, appreciated the district leadership saying that their achievement is unique to other districts with many non-governmental organizations. She also expressed gratitude to the district for putting in place a district committee on adolescent health before their other counterparts.

“I want to extend my gratitude to the district leadership. I have heard some people say that the success is because of many SRHR partners but we have seen districts where they have similar funding and many partners and yet they are not performing well,” Atima Said.

In affirmation, Annah Muhawe, a Senior Medical Officer at Right to Play, said that Adjumani has a very supportive leadership that has made it easy to not only implement interventions but also have strong and fruitful collaborations and coordination.

“We implement in many districts but Adjumani is unique. They have a unique sense of cooperation. They make it easy for the SHARE partners to implement, support and work together with government structures,” Annah said.

Indeed the biggest contributor to this success has been the 4 year long interventions under the Sexual Health and Reproductive Education (SHARE) project. Active since 2022, the implementation is led by Right To Play in partnership with the Forum for African Women Educationalists (FAWE), and WaterAid, with technical support from FHI 360, and financial support from Global Affairs Canada.

Through the project, adolescents and young people between 10 – 24 years old and can access mentorship groups that equip them with the skills and knowledge to advocate for their health-related rights, and promote gender equity within their personal lives and communities.

So far, the SHARE project has: formed 65 school health clubs, trained 33 Social Behavioral Change mentors, trained 200 teachers, conducted 900 dialogues, trained 129 VHTs, supported 43 Health Centres, supported 08 secondary schools and formed 104 community groups that are now Village Loans and Savings group.

Cumulatively, as of March 2025, Adjumani and its partners had reached out to over 11,851 adolescents and young persons with SRHR information and referred them to the nearest health facilities according to records at the District Health Office.

Meanwhile, the statistics in Adjumani still need more efforts from all stakeholders as some of the sub counties have a high teenage pregnancy rate. The teenage pregnancy rate in Adjumani stands at: Adropi (21.8%), Ofua (20%), Arinyapi (19.6%), Pakele Sub County (16.9%), Pakele Town Council (16.6%), Ukusijoni (16%), Ciforo (15.7%), Dzaipi (15.3%), Itirikwa (14.9%), Pachara (14.5%), and Adjumani Town Council (12.3%).

The estimated population of Adjumani according to National Population and Housing Census 2024, is about 452,648 with 240,000 as nationals and 212,648 as refuges. Adjumani has 52 health centres with 40 of them government aided, 3 non for profit, and 9 privately owned. The district also has 383 schools with 171 nursery centres, 180 for primary level, 24 for secondary level and 8 tertiary institutions.

END.

By Anzoo Evaline

Adjumani – In a bid to improve adolescent access and utilization of health services, Right to Play in partnership with WaterAid and FHI360 under the Sexual Reproductive Health and Rights (SRHR) project have distributed sports materials to all the 43 health facilities across Adjumani district.

The intervention follows growing concerns over low revisit rates by adolescents to health facilities, largely attributed to the absence of adolescent-friendly corners that make health centres welcoming to young people.

Speaking during the handover, Othman Bagonizi the project officer working with right to play has emphasized the purpose of the materials and citied that the aim of the sport materials is to keep the adolescents busy when they visit the health facilities

“Under the SRHR Project, Right to Play in particular has provided the sports materials that’s football, netballs, volleyballs and volleyball nets that will be given to all the health centre facilities across the district to support adolescent to easily reach or seek for services from the health centres as they engage in sports activities”, said the project officer Othman.

The package of sports materials delivered includes footballs, netballs, volleyball and volleyball net to enhance peer-to-peer engagement among youth during health facility visits.

The District Assistant health officer in charge of maternal health care Dr. Lulu Henry Leku welcomed the donation and said that it has been a challenge to them since the revisit of the health facility by the adolescents.

“These particular materials that we have received are going to be used in all the health facilities in the district, we have witnessed increased OPD attendance by the Adolescent accessing our services. Our biggest challenge has been the revisit many young people don’t go back and one of the feedback we have got is that they do not have any service that can keep them at the facility”, The DHO stressed.

The deputy RDC Emmanuel Okwere commended the effort, and pledged proper monitoring by his office to ensure proper utilization. “I want to commend the good work our partners are doing in the district in ensuring improved standard of living, and I want to pledged we as a government monitors in the district, we are going to play our part in ensuring that this sports equipment we are receiving here today are properly utilized”, said Deputy RDC.

With the new approach, stakeholders are optimistic that revisit rates among adolescents will improve significantly, ensuring they receive continuous care and support in areas of sexual reproductive and health rights.

By Anzoo Evaline

Adjumani District has received adolescent health materials from Naguru Teenage Information and Health Centre with funding from the Danish Embassy to strengthen youth-friendly services across the West Nile and Acholi sub-regions. The handover ceremony took place at the district headquarters, with leaders and health workers commending the initiative as a timely boost to adolescent health and rights.

The materials delivered include “wheels of knowledge,” board games, television sets, policy guidelines, flash disks containing educational films, and demonstration kits, all aimed at improving the delivery of Sexual and Reproductive Health and Rights (SRHR) information and services. These resources will be distributed to 18 health facilities in the district, where they are expected to play a vital role in engaging young people.

Speaking during the handover ceremony, the Executive Director of Naguru Teenage Centre Dr. Rogers Ampuera said that, the intervention is part of their broader mission to empower adolescents with accurate health information while making health facilities more youth.

“This program is called the say program which is in five districts in West Nile and Acholi sub-region.

The main aim is to strengthen access to health services by adolescent girls and young women, but also taking into care of the young boys and men to have a comprehensive access to sexual productive health, but also address gender-based violence within those five districts.

We are doing this to make sure that we have safe spaces for young people through what we call youth friendly corners. So, as Naguru Teenage Centre, our commitment is to make sure that we support uh districts to be in position to deliver uh youth-friendly services in a comprehensive manner,” said Dr, Rogers.

 Adjumani district Assistant health officer Dr. Lulu Henry Leku welcomed the donation, stressing that it will go a long way in addressing gaps in adolescent health service delivery.

“We have observed increasing the number of adolescent and young people getting aware of their sexual reproductive health needs and number of them holding us accountable and demanding for these services. And arising from this, they have requested us to ensure we have facilities that can keep them at the health center. Facilities that can help them so that they can initiate conversation around SRS and TBV. So, it is on that basis that this facility will be able to attract, retain, motivate, but also more importantly contribute to the empowerment.

of our adolescents and young people on issues of sexual reproductive health and GBV while getting care in our healthcare care facilities”, Said the Assistant DHO Dr. Lulu Henry.

The secretary for Health Adjumani district Hon. Sabuni John, applauded Naguru Teenage Centre for the initiative and pledged their total support in utilizing the materials for its intended use.

“I want appreciate Naguru teenage and information centre for this support which is very crucial to our young girls and boys and I want assure you that we are going to make sure this equipment is well utilize”, said Sabuni John.

Apio Sharon Ruth Baru the assistant RDC of Adjumani appreciated the partners and the health workers for their recommendable effort in ensuring that the young people remain healthy and in school and urged the health workers to display the material in an open place for easy access by the adolescents.

“I am very grateful for this initiative in ensuring that Adolescents girls and boys are kept safe. I want to say that under the SRHR project, our young people have really benefited in different ways so I want to appealed to the health workers to make sure this materials are display in an open space”, Said Apio Ruth Baru.

The materials have totalled up to 152 million shillings targeting 71 health facilities in West Nile and Acholi sub-regions supported by the SAY project to empower the adolescents and youths in the districts of Adjumani, Obongi, Moyo, Lamwo and Kitgum.

By Anzoo Evaline

The health sector in Adjumani District has registered tremendous progress in maternal and child health, attributed to the ongoing interventions under the SHARE Project. District health officials have revealed that between July 2024 and May 24, 2025, the district recorded only two maternal mortality deaths out of 13,577 deliveries, signaling a significant improvement in safe motherhood.

Dr. Lulu Henry Leku, the District Health Officer in charge of Child and Maternal Health, described the outcome as a milestone. He explained that of the 13,577 deliveries, 13,575 were safe, reflecting a drop in maternal deaths from 41 per 100,000 live births to 15 per 100,000 live births, now aligning with the national standard.

“We have seen progressive reduction in our institution of maternal mortality ratio. From the last financial year, 41 per 100,000 life birth to the current 15 per 100,000 life birth. To put that into perspective, from the month of July up to the 24th of May 2025, we lost two mothers out of 13,577 mothers that came for delivery. And that means the 13,575 were saved. All of them had safe delivery. And that shows the kind of progress we have made as a district because of the collective effort including the contribution of the share project towards this indicator”, The DHO emphasized.

The share project is a sexual health and reproductive education project. it’s a five-year project which on a broader perspective is being implemented in three countries in Africa. Uganda is one of the countries., Ghana and then Mozambique. In Uganda, Right to play is the lead partner of the project, forum for African women educationalist (FAWE), WaterAid and then Family Health International 360 degrees.

The project is looking at a total target of 44,671 beneficiaries of young women and 29,825 young men out of school. 14,769 girls and 9,846 boys in school. So, the project targeted adolescence in school and adolescence out of school.

Adjumani District currently has 43 health care facilities, all of which have benefited from the SHARE Project. “And so, through this initiative, we have established 43 health facilities that is able to appropriately respond to the needs of adults and girls and young women and all women of reproductive age. So, we want to report to the public that Since then, we have seen improvement in access and utilization of adolescent health services”, said Dr. Lulu Henry.

These initiatives have not only improved maternal outcomes but also boosted outpatient attendance among adolescents, leading to a notable decline in teenage pregnancies, which now stand at 15.7%. “We have also seen improvement in our key adolescent health indicators, our teenage pregnancies as well be at 15.7% compared to the national average of 24%”, He added.

Dribareo Agnes one of the VHTs from ciforo sub county whose capacity has been built under the project explained that. “ Before our capacity have not been built, we have being doing things anyhow, we don’t care whether we shall conduct infections because for us we don’t bother to use the gloves when treating a patient but after the training by Water and other partners, we are now doing well, on 20th , June 2025, I even referred on mother to the hospital when she was in labour pain” Dribareo explained.

A representative working with WaterAid based in Adjumani district particularly implementing the WASH project under SHARE project that focuses much in the 43 three health care facilities said that.

“In Maijji B Health Centre 2, we rehabilitated their only surviving sanitation facility which was in a very horrible state., we went ahead to support them with a motorized water supply system and in Ofua but Ofua had a bigger challenge than Maijji B because their only sanitation blocks which were there were already full and they are non-drainable So we give them two more block of sanitation facility. Each block has the washroom attached to them. Then we also got for them a permanent hand washing facility. The maternity ward was not in a very bad state. The ceiling was almost falling. The cracks were too much. So, we rehabilitated the ceiling for that ward, but we realized the entire ceiling was not done well. So, we did the entire block. This is to ensure that we eliminate the challenges of our inpatient having no where to bath from. That’s number one. Number two, to support our adolescent girls and young women. When they come to get health care services and they are into their period. They will need to clean themselves. They will need to change their pads. So, where would they do it? That’s why constructed those facilities”, He said.

Uthman Bagonza the project manager working with right to play also said that. “as Right to Play, we are the lead partner as far as the share project is concern and focused much in ensuring that the Adolescent girls and boys have access to services like education, health though we much focused in the primary school sector as FAWE deals with the secondary schools but also under health we  have managed to supply sport materials to all the 43 health centres to improve on the re visit of the facilities by the adolescents”, said Uthman.

With this progress, Adjumani District is positioning itself as a model for maternal and child health improvement in Uganda. Authorities say the focus will remain on strengthening health systems, expanding adolescent-friendly services, and enhancing community awareness to reduce preventable deaths and health risks further.

By Bazio Doreen.

Most Ugandan women attend Antenatal Care (ANC) late, at five months of pregnancy on average, and do not complete all four visits recommended. Inadequate ANC usage contributes significantly to Uganda’s persistently high maternal and newborn death rates which stands at 189 per 100,000 live births, with a one (1) in 66 lifetime risk of maternal death.

However, for Ofua HC III, this is now history. With support from WaterAid, one of the partners implementing the Sexual Health and Reproductive Education (SHARE) project in Adjumani District, the facility renovated the maternity ward which has increased the antennal coverage from 83% to 98%. Ofua HC III is located in Ofua Sub County, Adjumani District.

This intervention is key for Ofua because it is one of the sub counties with the highest Teenage Pregnancy rate of 20% against a district average of 15.7%. Of the 226 mothers delivered in the financial year (FY) 2024/2025, 33 were teenagers. Also, out of 3,936 Family planning users in Ofua in the same FY, 187 were teenagers.

According to Mindra Hellen Tilli, the Senior Assistant Chief Administrative Officer – Ofua Sub County, the high teenage pregnancy rate in the area is facilitated by poor parenting and stereotypes on child marriage.

“We have many child headed facilities that is worsened by poor parenting. It is believed in Ofua that people should get married when they are very young and active so as to have a fruitful marriage and grow together with their children,” Mindra says.

Tako Stephen, the Health Facility In charge Ofua HC III, now says that the renovation of the maternity ward has not only helped to create a safe environment for antennal, deliveries and post natal but also encouraged more teenage expectant mothers to come to the health facility.

“Before the intervention by WaterAid, we had a collapsing ceiling board in the maternity ward. This created fear to both the patients and the mid wives because they felt it would collapse any time. The renovation has now created comfort for the mothers. It has also helped to reduce stigma for teenage mother because they are now attended to easily and they leave,” Tako revealed.

Indeed, Iziku Juliet, 17, one of the teenage mothers who has received antennal care at the facility says that now she feels comfortable coming to the facility because the nurses and midwives are more motivated to work.

“Before the renovation, I feared to come here because the nurses would work on us slowly. The queues were very slow and we felt uncomfortable getting glaring eyes from the older women. But also I was afraid that the ceiling could collapse on us anytime,” Iziku said.

Similarly, David Livingston Onen, the SHARE Project Officer – WaterAid based in Adjumani, indeed affirms the maternity ward was in a dilapidated and worrying state which was not only affecting service delivery but access to Sexual and Reproductive Health Rights services and information.

“The maternity ward was in a very bad state. The ceiling was almost falling. The cracks were too much. So, we rehabilitated the ceiling for that ward, but we realized the entire ceiling was not done well. So, we had to renovate the entire block,” Onen explained.

Indeed the problem was far from over. A lot more was still at stake. The placenta pit was also renovated and concrete work surfaces/tops constructed in the laboratory and maternity ward. These work surfaces include: water points like sinks and cabinets for storing medical equipment.

These provide a safe working space for midwives and laboratory personnel which prevent infections opposed to wooden tables. The cabinets also improved storage of medical samples and equipment which has created an improved quality and accurate diagnosis.

Under the SHARE project support, WaterAid also constructed an 8 stances of drainable latrine, and 8 bathrooms including those for persons with disabilities.  

Onen says that while the initial plan of WaterAid was to renovate the maternity ward alone, they discovered that the WASH situation at the health facility was equally worrying.

“We found out that the only sanitation block of the health facility were already full and yet they are non-drainable. So, we decided to give them two more blocks of sanitation facility. This is to ensure that we eliminate the challenges of our inpatients/adolescents and young women having nowhere to bath during their period,” Onen explained.

Onen added “They will need to clean themselves. They will need to change their pads. So, where would they do it?”

In a Water, Sanitation and Hygiene (WASH) assessment done by WaterAid between January to March 2025, the health facility scored 78% with the worst score being in health care waste management. Ofua HC III serves a catchment population of 7,330 and treats about 1,800 – 2,400 patients on average each month.

Tako also says they plan to improve their WASH performance in this financial year 2025/2026 through: facility based training; procurement of bins; printing and displaying Standard rules of procedure for waste management; monthly mock assessments and recruitment of volunteers.

The health facility developed a WASH improvement plan which has become an advocacy tool. The plan is now enabling the facility employ 4 volunteers who are paid shs 100,000/= each every quarter. These are helping the facility improve their WASH since they only have one cleaner. While cleanliness and infection control at the facility is paramount, health assistants and inspectors need to equally ensure that communities adhere to basic disease prevention mechanisms.  

As explained by Edema Richard Draciri, the Principal Chief Administrative Officer, medical supplies and drugs given by the Ministry of Health are inadequate and thus many times drug stock out is inevitable.

“What the Ministry of Health gives us is just a drop in the ocean. People now think that health workers steal drugs because of the frequent drug stock outs and high disease burden. So prevention is more sustainable. We need to reduce the number of people lining up for medicines. It is unfortunate that we have recruited more health assistants but the performance of WASH keeps deteriorating,” Edema observes.

Edema also informed the participants that resources to local governments are now allocated based the annual National Assessment by the Office of the Prime Minister adding that under Health, the WASH component is assessed and facilities to be visited are selected on random. 

WaterAid is currently implementing the Sexual Health and Reproductive Education (SHARE) project in Uganda, with support from the Government of Canada through Global Affairs Canada. Water, sanitation, and hygiene (WASH) play a critical role in achieving Sexual and Reproductive Health Rights (SRHR) for women and girls, especially as it relates to personal health.

The five-year SHARE project that ends in 2026 seeks to advance gender equality and increase the enjoyment of health-related human rights by vulnerable right-holders, particularly adolescent girls and young women. Through SHARE, WaterAid has been partnering with the district to rehabilitate WASH systems in healthcare facilities including: installing hand washing units to prevent the spread of disease; restructuring sanitation facilities to ensure that toilets are inclusive and gender sensitive; training healthcare workers in healthcare facilities and in the community on WASH infection prevention and control; installing safe waste disposal systems; and training healthcare workers on proper waste management. 

END.

By Anzoo Evaline

The future of underprivileged children in West Nile received a major boost as the Jewel Michaels Foundation for Education was officially launched in Adjumani District. The initiative, spearheaded by Miss Teen Pearl of Africa 2024, Jewel Michaels Anzoa, seeks to transform the lives of disadvantaged children by ensuring they have the opportunity to go to school, stay in school, and successfully complete their education.

The colorful launch was graced by General (Rtd) Caleb Akandwanaho commonly known as Gen. Salim Saleh, who commended Jewel Michael for championing a cause that resonates deeply with Uganda’s vision of empowering the next generation. Gen. Saleh pledged his personal and institutional support through the Operation Wealth Creation (OWC) programme, emphasizing that education and agriculture must move hand in hand to secure the region’s future.

“As OWC, we made a proposal to the Ministry of Education. We had offered to use all the schools with land to be able to start the wealth creation around the schools. So, thank you, Jewel, for bringing me to the education sector through my way of agriculture. The other groups can contribute in their own way, but if I can get this partnership between the education system and agriculture, then I’m ready to collaborate with you,” Gen. Saleh promised.

To demonstrate his commitment, Gen. Saleh contributed 35 million Uganda shillings to support the foundation’s programs, a gesture that was met with overwhelming applause from the community and leaders in attendance.

“With these few words, I hereby launch the foundation and we shall contribute 35 million shillings for the foundation,” Gen. Saleh said.

Queen Jewel Michael, in her speech, expressed her gratitude to the people of Adjumani and West Nile, pledging to use the foundation as a platform to break barriers to education, particularly for girls and children from vulnerable families.

“My dream is to see every child in West Nile have equal access to education. This foundation is not about me, it’s about giving hope and creating opportunities for children who would otherwise be left behind, so our guest of Honor, while recognizing the positive progress, the high dropout rate is attributed to social, economic, cultural, and structural problems” she said. “Guest of Honor, we the children of West Nile called upon you and all the prominent persons, the president of the Republic of Uganda, the minister of education and sports, to hold annual education campaign events in West Nile and sub-regional public dialogue on improving education outcomes in West Nile sub region,” Queen Jewel added.

The District Chairperson of Adjumani district, Hon. Anyama Ben, appreciated the general for honoring his invitation and of the family. Anyama further applauded the family of Maj. Gen. (rtd) Ondoga Michael for acknowledging that they are Madi from Adjumani.

“General Saleh, I want to thank you very much on behalf of my people of Adjumani and on my own behalf for accepting my invitation and the family of Queen. I want to thank Major General Ondoga and the family for first of all for accepting to recognize that you are Madi. Because there are many Ma’di people who have achieved bigger things but they have never brought it home here. Meaning they disassociated themselves from us,” said Hon. Anyama.

“General you are liberator, you are revolutionist, and every Uganda is having peace because of you accepting to sacrifice in the bush. Today you are here to address the issue of Adjumani and West Nile, to bring peace and education in our country and in the district. I thank you,” Anyama added.

Kojoa Cynthia Princess, a student of St. Mary’s Assumpta, said that. “Today that we have been inspired by the Queen Jewel Michaels that this foundation can make students in Adjumani district go to school, to stay in school and complete school. As you know that the rate of dropout in Adjumani district is high”.

The foundation will work closely with schools, parents, and local leaders to tackle challenges such as school dropouts, early marriages, and poverty-related barriers that keep children out of classrooms.

By Anzoo Evaline.

 The dream of transforming the future of underprivileged children in West Nile is taking shape with the official launch of the Jewel Michaels Foundation for Education, an initiative spearheaded by Miss Teen Pearl of Africa, Queen Jewel Michael. The foundation, whose mission is to ensure that vulnerable children have the opportunity to go to school, stay in school, and complete school, will officially be launched on Friday, September 5, 2025, at Paridi Stadium in Adjumani District.

In preparation for the grand launch, a pre-event meeting was held on Thursday, September 4, 2025, at Adjumani District Council Hall, bringing together heads of department, political leaders and opinion from the fourteen districts across the West Nile sub-region. The dialogue cantered on the current state of education in the region, where stakeholders identified poor parental attitudes towards children’s education as one of the most pressing challenges. They urged parents to adopt a more supportive mindset and prioritize education as a key investment for their children’s future.

Queen Jewel Michael expressed her passion for education during the press conference, noting that many children in West Nile drop out of school due to poverty, neglect, and early marriages.

“I would like to tell you why I choose education. As a 15-year-old child, I have seen myself that very many children in Uganda starting with my own district, which is Adjumani district, are struggling with education. There are so many limitations that stop them from going to school, staying in school, and completing school. I have four cousins who have been in and out of school because of lack of finances, poverty.

I have another cousin who dropped out of school because of teenage pregnancy. And you might ask yourself, if you have four cousins and you go to school, why not help them?

And you ask yourself, why is this happening? In 2025, we have children who are being forced into marriages, little children. In 2025, we have children dropping out of school because of peer pressure. And you ask yourself why is this happening? I am 15 years old and I want to advocate for children who do not have a voice because. I’m able to be here and advocate for all of them. Education is not It shouldn’t be asked for because it is a right. It is something that we should have. And that is why I am starting the Jewel Michaels Foundation for education”, said Miss Teen pearl of Africa.

The Queen Mother Ambassador Lucy Michael has appealed to the parents more especially the mothers to support their children’s education. “Motherhood is a responsibility and the responsibility is towards the family and towards the community and the family is where our children are nurtured first. So, beginning right from the time a child is born. It’s very important first of all for mothers to watch over their health and make sure that they start school at the time they should start school at UPE, which his excellence the President of Uganda has made sure is actually accessible and it is free. So, that is a responsibility of a mother that the key milestones of a child’s life. At the beginning of life, early childhood is fulfilled. The next responsibility of mothers of West Nile would then be towards managing the teen ages of children during puberty. When children are at puberty, they have a lot of emotional and psychological, social economic needs”, Queen mother Lucy emphasized.

The retired Major Gen. Odonga Michael the father to miss teen pearl of Africa also emphasized on the importance of education. “Somehow one may wonder as to why this soldier is so much now engrossed in issues of education. Education made a big contribution to our lives, but still, we have issues and one of them is a poor education or even lack of it, which is a big problem. So, I see education as a critical tool of social transformation and development, and I am what I am because of education”, said Maj Gen. Odonga.

The launch event at Paridi Stadium is expected to draw large crowds, with Gen. Caleb Salim Saleh serving as the Guest of Honour.  

Drani Ronald the senior Education officer of Arua city in charge of Ayivu division welcomed the initiative and said. “We clearly know that West Nile has been the epitome of education in the whole of Uganda. We have very many alumni who have finished their all level from West Nile. In army, in different offices, people used to come from different regions of Uganda to come and study in our region when we went to school, there was emphasis on preparing children to read and write right from P1. And actually, it started even from the church. And that literacy which was emphasized where children were taught to first read and write in their own mother tongue, gave them the power to easily understand English and also to begin to write on their own and to read to interpret.

Our greatest challenge in West Nile, which is causing poor performance is poor reading culture. I want to start from there. Most of our primary schools that are performing like the RDC of Obongi said are from private schools. The reason is these pupils start the education from ECD’’, said Drani. He added “So, many parents complained they are poor. That poverty mindset has affected simple provision of education. And most of our homesteads people are growing Marungi, opium. And the children who are supposed to go to school, these young girls and boys, they first go and pluck this Marungi to get some 1,000, 2,000 shillings. And some of the parents send them to go and sell them. And the parents who are selling this Marungi are actually abusing, they’re chewing it and the children begin to abuse this drug. And now what happens is the children when even they’re in primary, they’re very indiscipline. They’re hostile even to teach they don’t listen to advice. So, drug abuse has greatly. The rate of strikes which we witnessed in West Nile immediately after Covid-19 was the effect of the drug abuse,” Drani added.

The RDC of Obongi district Samuel Mpibaza Hasaka has appealed to the stakeholders to work together as team in ensuring the success of the program

“I want to bear that at the end of this program launch let’s be serious let’s work together Let’s see how we can help out. The girls are suffering. The girls are being defiled. The girls are being married off at a very young age. so happened that we are having this educational campaign in West Nile, let us let work together ladies and gentlemen”, said RDC Hasaka

With the backing of stakeholders and the enthusiasm of the community, the Jewel Michaels Foundation for Education promises to be a beacon of hope for thousands of children whose educational journeys have been threatened by poverty and neglect.

By Bazio Doreen.

Authorities in Adjumani District are concerned about the rising cases of HIV infections among young people, especially adolescents. Records at the District Health Office reveal a concerning rise in new HIV infections among the population in Adjumani District from 2021 to 2024 with young people disproportionately affected.

New HIV cases among the population in Adjumani district increased from 327 in 2021 to 437 in 2024, marking a 33.6% rise over four years. The young people in Adjumani district account for over 40% of the new HIV infections.

Worse still, according to records the District Health Office captured between January and March 2025, six new HIV infections among adolescents (10-19 years) were registered, with one yet to be linked to HIV care. This underscores the urgent need for intensified Sexual and Reproductive Health and Rights (SRHR) interventions to curb this trend. 

According to Inyani Mane Dolorence, the District HIV Focal Person, several factors contribute to the rising HIV incidence among youth in the district including: limited access to comprehensive SRHR education; inadequate youth-friendly health services; and socio-economic challenges such as poverty and unemployment increase vulnerability.

He also adds that stigma and misconceptions around HIV and sexual health discourage young people from seeking testing and treatment services.

“Adjumani’s youthful population, coupled with many vulnerabilities, creates a critical environment where HIV transmission can escalate if not addressed promptly. The increase in new HIV infections highlights the gaps in effective outreach, counselling, and provision of preventive tools such as condoms and pre-exposure prophylaxis (PEP),” Inyani observed.

Indeed some of the Adolescent Friendly corners at some health facilities are dilapidated and now other rooms/space is being improvised to encourage young people to access SRHR services. This is concerning because teenage pregnancies in Adjumani increased by 1% in March 2025.

The Teenage pregnancy rate among nationals increased from 15.6% in financial year 2023/2024 to 16.3% in financial year 2024/2025. Data at the District Health Office also indicates that the teenage pregnancy rate in financial year 2020/2021 was 14.4%.

Irama Steven Leku, an Enrolled Nurse and Adolescent Focal Person at Pagirinya I HC III, says that the Adolescent Friendly Corner has become so dilapidated that it can’t accommodate patients and fulfil their needs.

“Our Adolescent Corner has since become so open. It is now the poles that are remaining. There is no privacy. People can see whoever has come in and even sometimes predict what might have brought them to the facility. For now we are improvising the breast feeding corner but this is not sustainable. Most of our clients are refugees. Their culture doesn’t shun teenage pregnancy but they need protection from stigma that can be exerted by the host communities,” Leku explained.

In affirmation, Dipio Frances, Senior Social Welfare and Probation Officer, also observes that having a comfortable space for an Adolescent Friendly Corner is key because many young people are still afraid to speak up about their SRHR problems.

“Many young expectant mothers find it difficult to open up when they are in OPD. They prefer corners. Unfortunately, World Food Program has stopped its NutriCash program, it used to map even those who fear to come to the health facility so as to receive the supplementary feeding support. We are aware that many now have aborted due the halt,” Dipio observed.

The increase in HIV is also being linked to Gender Based Violence (GBV). This is worrying because Sexual violence can lead to HIV infection directly, as trauma increases the risk of transmission. More importantly, GBV increases HIV risk indirectly. Victims of childhood sexual abuse are more likely to be HIV positive, and to have high risk behaviors. This sometimes is due to the SRHR challenges faced by health facilities.

Meanwhile, the district finds it hard to harmonize GBV data. This is because of the multisectoral duty bearers involved; different reporting lines for partners and conflicting GBV registers at the health facility.

Steven Tako, Ofua HC III Facility In charge, says that some implementing partners want the health facilities to capture GBV data in separate registers other than the one provided by government as as a result, some cases remain unresolved.

“We have conflicting registers at the health facility. The partners need to adopt the one of government so that we harmonize our reporting system. It is also worth noting that a lot of GBV cases that are reported to police are not resolved,” Tako explained.

However efforts have been made to streamline interventions on SRHR. The District recently commissioned a 20 member Committee for Adolescent Health (DICAH).  This is in line with a District Local Action plan (2025 -2030) that seeks to reduce GBV from 27% to 17% within the next five years targeting 9,135 beneficiaries. However, the DICAH is also charged with resolving all SRHR issues.

For adolescents and young people specially, some capacity building trainings have been done between January to March 2025. However, the targets are yet to be met. Only 12 out of 60 Primary School teachers trained, 8 out of 21 Secondary School teachers trained, 40 out of 44 Health In charges trained, 40 out of 120 senior men/women teachers trained, 720 out of 1800 in school peer educators trained, and 110 out of 592 out of school peer educators trained. Through these efforts, over 11,851 adolescents and young persons have been reached with SRHR information and referred to the nearest health facilities.

Although this is encouraging, Inyani, observes that the district and its SRHR partners still have more to do to empower young people through socio –economic programs that can help them overcome risky behaviors.

“We must create an enabling environment where young people feel supported and informed to make safer sexual health choices. We need to strengthen youth-friendly health services to offer confidential, stigma-free HIV testing, counselling, and treatment,” said Inyani.

The DICAH was commissioned with support from Right to Play (RTP) under the Sexual Health and Reproductive Education (SHARE) program. Funded by Global Affairs Canada, the SHARE project is being implemented by a consortium led by Right to Play, in partnership with WaterAid, the Forum for African Women Educationalists (FAWE) and FHI 360. The 5 year program ending in March 2026 seeks to empower 325,000 adolescents and youth aged 10-24, particularly girls and young women, both in and out of school, to demand better sexual and reproductive health care through a gender-transformative and rights-based approach.

In Adjumani, the SHARE Project is being implemented in 66 Primary schools, 8 Secondary Schools, 43 Health Centres and through four 30 member mentorship cohorts. These all target young people between 10 -24 years.

END.

Access to medical care at Arua Main Prison Health Center III is now being hampered by the increased security measures at Arua Main Prison.

The Arua Main Prison Health Center III has long offered vital medical services, having been established as a public health center to assist both prisoners and the local population soon after Arua Main Prison was built in 1930.

However, regular security measures, a lack of public knowledge of the facility’s existence, and other circumstances have led to the public’s underutilization of it.

Authorities implemented stricter security measures throughout the prison grounds in response to growing concerns about smuggling and disturbances. These included heightened patrols, stringent limitations on movement, and thorough security inspections at every point of entry.

Although these precautions were taken to keep the staff and prisoners safe, they unintentionally interfered with the health center’s regular operations because they are housed in the same property.

According to conversations with medical staff at Arua Main Prison Health Center III, the facility is completely functional, stocked with enough medications, and outfitted with diagnostic equipment for conditions like diabetes, HIV, TB, malaria, ulcers, and more. The usage is still low in spite of this.

According to Sharon Munduru, who at the time of writing brought her child with a fever, cough, and illness, the facility’s services are quick and easy to access, and the medical staff is friendly and accommodating to patients.

Because we live close to prisons, Munduru explained, “you find a lot of people at Police Health Center III. For us, we just come here and it’s just a matter of carrying your national ID to enter from the gate. Their services are very fast, easy, and you can’t go without having your medication.”

Records from the facility reveal that, on average, about 700 patients with various illnesses are registered weekly. Of these, approximately 100 patients come from outside the prison community this is primarily due to fears related to data collection and security checks conducted by security personnel.

The most common ailments seen at the outpatient department include respiratory tract infections, peptic ulcers, tuberculosis, malaria, and diabetes.

Hellen Dejang, Enrolled Nurse at the facility they conduct variety of services including immunization campaigns, Nutritional assessments, General body checkups Antenatal Serveries though they don’t conduct deliveries due to inadequate space, other services including Family planning and Reproductive Health services, Maternal Child Health services and emergency care.

The facility receives supplies from National Medical Stores, Joint Medical Stores and equally from General stores of Uganda Prisons Services in Luzira. It has variety of equipments in the laboratory including the Gene expert Machines, SD4 count Machines, Microscopes, Diabetes Machine, Afino Machine with exception of the CBC-Complete Blood Count Machine and Chemical Analysis Machine whose services are sort from either Oli Health Center III or Arua Regional Referral Hospital.

SP Herbert Muhangi, the Officer in Charge of Arua Main Prison, stated that the security protocols are designed to maintain order and safety, given that the health facility is situated within a secure installation.

“The nature of the Health Facility is situated under a Security institution, so perhaps you have to adhere to the security protocols that are in place, we only require proper identification,, and we register you, usher you in, and serve you. The challenge we have is when you ask some people about their national Identity Cards for identification, they don’t just turn away any other identification, so we get challenged on how to really manage security and this person who is a stranger. If the general public could carry any form of identification, we are good to go.” Muhangi said

The facility is staffed by 16 personnel and primarily serves the catchment areas of Kenya and Awindiri Wards in Arua City.