In April 2019, Dr Hilary Graffy will challenge herself to undertake one of the world’s top marathons, the London Marathon. Hilary will be running to raise money for the Margaret Pyke Trust, coordinator of the Population & Sustainability Network, to help to improve sexual and reproductive health around the world.
Hilary has wanted to run the London Marathon for years and now, in 2019, she will achieve this goal! She has generously chosen to run for the Margaret Pyke Trust due to its ongoing support of sexual and reproductive health training in Uganda.
Last year, Hilary was working to support staff and patients at Bwindi Community Hospital in south-west Uganda, where the Trust is also working to support sexual and reproductive health training of healthcare workers and provide public education to community members, as part of its USHAPE programme.
“The average number of children a woman living near Bwindi Community Hospital will have is 6.9, and it is much higher in rural areas! I have chosen to run for the Margaret Pyke Trust, a charity supporting ongoing training and resources in sexual and reproductive health at the hospital, as I believe that providing sexual health education as well as improving access to appropriate contraception can help elevate families from poverty. I am proud to be running for them.” explains Hilary.
“We’re thrilled that Hilary has chosen to run the London Marathon for the Margaret Pyke Trust. She will be joining around 36,000 runners in one of the world’s most famous running events, taking her past some of London’s most iconic landmarks, and we’re honoured that she will be running to support the Trust”, said Kat Lloyd, Programmes and Operations Manager at the Margaret Pyke Trust.
Today in south west Uganda the team from the Margaret Pyke Trust, three conservation NGOs, and the local hospital, finalised the first stage of the design work on a new style of conservation project suited to the era of the Sustainable Development Goals (SDGs). The Trust and its partners’ work is being supported by a Darwin Initiative Scoping Award.
The wetlands around Kabale, in south west Uganda, are a classic example of how increasing pressures on wetland ecosystems impact both the ability of people to maintain sustainable livelihoods, and the integrity of habitats on which threatened and endangered species depend. Local environmental problems include loss of ecosystem goods, such as papyrus, soil fertility decline reducing agricultural productivity, and a reduction in access to clean water as wetlands become less able to undertake their natural functions. Wetland degradation is also impacting threatened biodiversity including Uganda’s national bird, the endangered Grey Crowned Crane.
The African Crane Conservation Programme (a partnership between the Endangered Wildlife Trust and International Crane Foundation) and NatureUganda are already supporting local communities to develop sustainable livelihoods. But Kerryn Morrison, of the African Crane Conservation Programme, knew Kabale families were reporting that barriers to family planning mean they are having larger families than they would ideally choose. This increases pressures on families themselves, and local ecosystems, and so Kerryn contacted the Margaret Pyke Trust. A cross-sectoral partnership begun to evolve, recognising that generating sustainable livelihoods alone might not be enough for either the cranes or the local communities.
David Johnson, Chief Executive of the Margaret Pyke Trust said, “We know from our experience elsewhere in Africa that integrating sustainable livelihood interventions benefitting ecosystem health, with human reproductive health interventions benefitting human health, is an effective way to help both rural communities and the non-human species relying on the same local ecosystems. We believe that by integrating improvements in family planning provision, with the development of sustainable livelihood opportunities, we will be able to generate greater environmental, health and gender outcomes than if we only focussed on one of those sectors.”
Kerryn Morrison explained, “Successful biodiversity conservation requires taking into account people, our health, and our interactions with the natural world. Integrating ecosystem and human health actions responding to population pressures to enable sustainable utilization of wetland ecosystems really is a win-win.” The project hospital partner is Rugarama Hospital and Dr Gilbert A. Mateeka, their Medical Superintendent, explained, “the need for greater community reproductive health knowledge is acute. Integrated programmes provide one way of reaching more people through outreach, as well as being a way to engage men – who are often one of the barriers to women exercising their right to choice. This is something we will address in this project.”
In addition to the health and conservation actions, the academic partner is the London School of Hygiene & Tropical Medicine. Professor Susannah Mayhew, who is also a Trustee of the Margaret Pyke Trust said, “We want to analyse the project outcomes, to determine whether the project partners’ assumption that projects integrating human and ecosystem health interventions generate greater positive outcomes compared to single sector health or environment projects is correct.” Achilles Byaruhanga the Executive Director of NatureUganda concluded, “We are working together to develop an integrated programme which will respond to the connected local environmental, health and livelihood challenges. Securing long-term sustainability of wetlands contributes not only to Convention on Biological Diversity goals, but also our need to have a twenty first century approach to conservation, acknowledging the cross cutting nature of the SDGs, and the demographic realities of a world with a fast growing population.”Grey crowned cranes in the wetlands around Kabale, Uganda
The International Conference on Family Planning is the leading global reproductive health conference. This year, members of the Population & Sustainability Network were represented in significant numbers. For the first time, at this biennial conference, there was explicit reference to and focus on Population Health and Environment programmes, with the Network heavily involved in significant events focussed on this approach.
The International Conference on Family Planning (ICFP) was established in 2009, with funding from John’s Hopkins School of Public Health and the Bill & Melinda Gates Foundation. ICFP is the world’s most important conference focussed on reproductive health and population. At the 2018 ICFP there were over 3,700 participants, including the Prime Minister of Rwanda, the Secretary of State at the UK Government’s Department for International Development, Jane Goodall, and many others besides.
Five events at ICFP focussed on Population, Health and Environment (PHE) programmes. PHE programmes integrate reproductive health, conservation, and sustainable livelihood interventions. The Margaret Pyke Trust, the Population & Sustainability Network, and collectively its members were involved with all five. The events demonstrate the growing interest in PHE, and increasing understanding of why the removal of barriers to family planning is a relevant consideration in conservation policy and programme design.
Two new Network affiliates, the African Crane Conservation Programme (which is a partnership of the Endangered Wildlife Trust and the International Crane Foundation) and NatureUganda featured at PHE events. Dr. Harriet Davies-Mostert, of Network member the Endangered Wildlife Trust, was one of the speakers at a PHE evening session. ICFP has never previously hosted an event where a conservation leader opened her presentation by making connections between sexual and reproductive health and rights, and the conservation of Africa’s lion.
In further news from ICFP, FP2020 published its latest Progress Report. The report includes an interview with David Johnson, the Network’s Chief Executive. Some of the interview reflects the contents of his presentation forming part of the Network’s ICFP panel, which also included representatives of the London School of Hygiene & Tropical Medicine, NatureUganda, the Endangered Wildlife Trust, Pathfinder International, and DSW.
Thanks to the Environmental Funders Network Rapid Response Mechanism, the support of which was critical for several PHE activities at ICFP.
A little over two years ago Population & Sustainability Network members the Endangered Wildlife Trust, Pathfinder International, and Network coordinator the Margaret Pyke Trust, designed and began working on a new Population, Health and Environment programme. Two years on from the launch of “A Re Itireleng” Pathfinder International has published a brief on the project, which can be downloaded here.
USAID feature the Margaret Pyke Trust’s USHAPE programme: Sexual and reproductive health training in south-west UgandaOctober 4, 2018
On 3 October 2018, USAID featured the Margaret Pyke Trust’s USHAPE programme on its ‘Training Resource Package for Family Planning’ blog. You can read the original article on USAID’s website here, or alternatively below.
We are excited to once again feature USHAPE (Uganda Sexual Health and Pastoral Education) on the Family Planning Training Resource Package website as it begins a new chapter under the management of the Margaret Pyke Trust. The Margaret Pyke Trust is based in the United Kingdom and has around 50 years of history providing sexual and reproductive health services along with implementing research and training for health care workers. They have the broadest range of sexual and reproductive health training courses in the UK for health care staff. In the last few years, the Margaret Pyke Trust have started working internationally to address the need to advance sexual and reproductive health services and trainings in low- to middle-income countries. Taking over the management of USHAPE only seemed natural, since USHAPE was originally created by UK based volunteer doctors. It has been an optimistic transition for USHAPE to come under the Margaret Pyke Trust as there has been a continued effort to increase capacity of USHAPE’s training programs.
In the past few years, we have noted USHAPE’s adaptations of the TRP and its use in pilot training programs at Bwindi Community Hospital and Kisiizi Hospital to build knowledge among family planning service providers and expand the ability of providers to deliver services to the community. The Margaret Pyke Trust funds a full time family planning nurse at Bwindi Community Hospital in order to strengthen and ensure a sustainable future for the current implemented USHAPE program. Moving forward, the Margaret Pyke Trust is finalizing the USHAPE pilot training program into an adaptable and expandable model. The hope is to start replicating the model in different settings, with each institution leading on its implementation of USHAPE. Preparing for this capacity building feat includes thorough monitoring and evaluation to measure the significant impact of contraceptive prevalence rates, family planning uptake, etc. Kat Lloyd, the Program and Operations Manager at Margaret Pyke Trust, commented, “It is a time of reflection and consolidation [for us], and we are hoping that this will prepare us for the [USHAPE] expansion in the coming years.”
Meanwhile, UK based doctors continue to act as short term volunteers at the USHAPE-implemented sites. One of these volunteers and the USHAPE Clinical Lead, Dr. Clare Goodhart, provided us insight on the TRP influence on creating and continuing to update the USHAPE training program: “When we first started developing the USHAPE 'Whole Institution Approach to Family Planning', we were keen not to 'reinvent the wheel'. We searched the internet and were excited to come across the Training Resource Package because it aligns to the guidance of the Family Planning Global Handbook, which we knew needed to be central to our training. Importantly, the TRP makes it clear that you can freely adapt its materials. We were able to pick out the PowerPoint presentation, role plays and case discussions, which are needed to teach the available family planning methods.
"It took quite a lot of work to reduce the TRP materials so they fit into the different levels of USHAPE training, as we needed to build in other modules to address real life scenarios, such as adolescent-friendly contraception, HIV, sexual infection, cervical screening, post abortion care etc. We put a lot of emphasis on counselling and outreach to the community and felt we had to move beyond the suggestions of the TRP to achieve this. We also vary USHAPE training by integrating short films, which helps with the quality of teaching and reduces pressure of the trainers. However, the TRP has been a great starting point for creating USHAPE training and we often return to it when creating outreach materials, refresher training or for the training of trainers. We are keen to continue to work with the John Hopkins team to move family planning training forward worldwide.”