With generous support from Population Connection, Conservation Through Public Health (CTPH) has been able to increase access to modern family planning methods to communities around Bwindi Impenetrable National Park (BINP), home to an estimated half of the world’s endangered mountain gorillas. Mountain gorillas are threatened by habitat degradation, disease and poaching of other wildlife in their habitat, as well as conflict with humans, a root cause of which is poverty and high human population growth.

Bwindi Mountain Gorilla | Photo by Jo-Anne McArthur

A key program, central to CTPH’s multisectoral Population, Health and Environment (PHE) model, is our work with Village Health and Conservation Teams (VHCTs). VHCTs are networks of community volunteers who were previously operating as Village Health Teams (VHTs) under the Ministry of Health — primarily bringing health information and services to community members at the household level. Through a CTPH initiative, supported by Population Connection and other donors, the VHTs around BINP have transitioned to incorporate conservation information and services into their community work, enabling them to disseminate combined health and conservation information and services at the community and household level. In an area where public health and conservation are so closely interlinked, poor health among community members can have a direct negative impact on wildlife survival through the transmission of zoonotic diseases between people and closely related gorillas; and habitat loss due to high human population densities. Negative environmental consequences such as soil degradation and flooding can also impact severely on people’s daily lives therefore it is imperative that we find innovative ways to link these two fields, which are usually addressed independently.

VHCT leader Christopher Kubarigyira giving a flip chart presentation to NAPHENET members

Through Population Connection’s support, CTPH has been able to equip VHCTs with the information and skills needed to sensitize households on key PHE issues including the need to have manageable families that you can provide with adequate health care, food, and education, as well as sensitizing communities about the importance of gorillas and forest conservation, sustainable agriculture, tree planting, and reporting homes visited by gorillas and other wildlife. VHCTs also implement a referral system for community members with potentially serious symptoms of diseases. Importantly, VHCTs have also been trained to distribute modern contraceptive methods, including administering injectable contraceptives, making this simple family planning method both accessible and available for marginalized community members around Bwindi Impenetrable National Park, whose capacity to manage their own fertility was previously limited by lack of awareness and scarce contraception options available to them.

The uptake of voluntary family planning has increased among women in the Bwindi communities from 22% in 2007 to 67% in 2017, considerably overtaking the national average that increased from 24% to 48% in the same ten-year period.

VHCT member Feredasi Nganwa giving a Depo-Provera injection to a client in Bwindi

Family planning reinforces CTPH’s One Health approach that addresses human, animal, and ecosystem health together, enabling community members to access their rights to information on sexual and reproductive health and plan for the number of children that is manageable for their personal circumstances. Reduced fertility rates have clear and proven benefits for family income and health, and through our PHE approach, we are seeing benefits for gorilla conservation and environmental sustainability.

The VHCT network, initiated in 2007, in two parishes at Bwindi’s northern sector, Mukono and Bujengwe, has expanded to Nteko and Rubuguri Parishes in the southern sector of Bwindi and Buremba and Mpungu parishes in the eastern sector of Bwindi and currently incorporates 270 VHCTs, including marginalized Batwa pygmies in Bwindi Impenetrable National Park. The VHCTs with support from CTPH, have also established Population, Health, and Environment (PHE) model households around Bwindi, demonstrating best practices for other community members.

Through the VHCT program, a number of other improvements have also been documented, including an increase in adoption of hand washing facilities outside the pit latrines, where the number of households with pit latrines increased from 77% to 98%. There have also been improvements in identification and referral of suspected patients with malnutrition, TB, scabies, and other diseases.

The program has also led to an increase in the number of households planting trees, using energy efficient stoves, and a reduction in human-wildlife conflict around Bwindi Impenetrable National Park.

Also with support from Population Connection, CTPH hosted an educational field trip for the Uganda National PHE Network (NAPHENET) members in Bwindi in February 2019. Recognizing that CTPH is leading the way in implementing PHE approaches, with its One Health model, the NAPHENET Chair, Uganda’s National Population Council, embraced the opportunity for NAPHENET’s members to see CTPH’s activities in action with a view to sharing lessons learned, expanding the pool of PHE knowledge and replicating successful interventions, where appropriate.

NAPHENET members pose for a photo with CTPH staff after a lecture at the Gorilla Health and Community Conservation Center

CTPH also attended the Ugandan World Population Day celebrations on July 11, 2019, in Adjumani district, with support from Population Connection.

World Population Day, which seeks to focus attention on the urgency and importance of population issues, provides an opportunity to network, collaborate and share information with key players in the PHE field. CTPH used the opportunity to showcase its PHE work in Bwindi, Mount Elgon, and Budongo Forest, and learn from others in the field.

This year’s national theme was “Renewing the Promise: Empowering Uganda’s Youth to Drive Socioeconomic Transformation.”

CTPH is truly grateful to Population Connection for their support and partnership and hopes to see the collaboration continue, as we continue to work together to address key population, health, and environment issues in and around protected areas in Africa.

CTPH Monitoring & Evaluation Officer Edwin Ainerukundo (L) with other NAPHENET members at the NAPHENET stall during World Population Day celebrations in Adjumani District

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