The Clinical Officer who is changing the face of adolescent health in Nebbi
29-year-old Rogers Okullo
Jupanziri Health Centre III is on the lips of every political and health administrator in Nebbi District. Amid constraints common to all health facilities in Nebbi, Jupanziri is thriving unlike any other, particularly in provision of adolescent-friendly services. The health centre has designated days for adolescent antenatal care, an adolescent youth group that meets weekly for exclusive health education and a fully operational labour ward for adolescents.
‘Provision of adolescent-friendly services is not catching up in other facilities but in Jupanziri it has taken off with minimal support from us’, Jane Manano, the Assistant District Health Officer reports.
With every mention of Jupanziri, another name comes up; Rogers Okullo.
“That boy is good!”
One health centre in Nebbi has reduced teenage pregnancy in its community by 33 per cent in nine months, hosts a thriving adolescent youth group with an active SACCO and has designated adolescent health corners. Every finger points at one person.
29-year-old Rogers Okullo who studied clinical medicine, has been in charge of Jupanziri Health Centre for three years. Jupanziri is the best performing of 15 health facilities supported by UNICEF to provide adolescent friendly services in Nebbi district. The support from UNICEF, funded by SIDA, includes procuring of medical equipment, infrastructure development and capacity building of health providers, and places emphasis on quality improvement of health services and facilities.
‘After receiving quality improvement (QI) trainings under UNICEF, I took it upon myself to bridge existing gaps by setting targets.’
Okullo is particularly keen on the principle of using data in decision making. Various typed and handwritten charts are plastered on the walls of the main block, indicative statistics on reproductive health for the past eight months highlighting the red areas, antenatal care uptake for the past three months and more statistics. One of the targets set was reducing teenage pregnancy from 44 per cent to 10 per cent by December 2019. The same data indicates that by September 2019, nine months into the target, the rate of teenage pregnancy had dropped to 11.3 per cent.
Despite a 2019 UNICEF situation analysis that points out some of the key bottlenecks in the health sector as low motivation, low capacity of healthcare staff and insufficient infrastructure, at Jupanziri Health Centre, Okullo works with what is available to create adolescent spaces. The adolescent group holds its weekly meetings in the out-patient department of the facility while the outdoor games are played on the small lawn adjacent to entrance of the health centre.
At a Tuesday meeting with clan and local council leaders, Okullo points out that adolescents need special support because of the numerous psychological and biological challenges and the resulting predisposition to early marriage, sexually transmitted infections, and pregnancy. His fondest memory is when the Jupanziri adolescent group was awarded a contract to construct a road. This to him was a step towards improving the economic livelihoods of the group members, which ultimately would have a positive impact on their health. Through drama shows, the adolescent group is working towards sharing their experience with other communities, to scale impact and learning.
Despite the glowing praise from everyone, Okullo acknowledges the commitment of his team; ‘One person cannot drive a facility. We have a quality improvement team that always uses data to identify gaps and then addresses them.’ To sustain team motivation, Okullo instituted a quarterly reward for the best performing department and village health team (VHT). The VHT is appraised on issues such as community hygiene and sanitation, community mobilization and engagement. Leading by example, Jupanziri health facility is clean, with well-trimmed lawns, an incinerator and well-marked rooms. The laboratory door has a chart with projected timelines for each test and at the bottom, the phone contact of the laboratory in-charge.
In 2018, Nebbi was ranked number 12 in Uganda, in performance on all health indicators. The district health team is certain that the spread of commendable leadership practices will push Nebbi to the top of the health ladder, particularly for adolescent health.
The elders call him ‘boy’, the community calls him ‘doctor’, some adolescents call him ‘uncle’, by whichever name he is called, Rogers Okullo is the new face of commitment, leadership and action for adolescent health in Nebbi District.