SITUATION ANALYSIS OF SEXUAL AND REPRODUCTIVE HEALTH PARAMETERS AS THEY APPLY TO MARGINALISED IN UGANDA (PRIMARY HEALTH CARE SERVICES)

2012

SEXUAL AND REPRODUCTIVE HEALTH PRIMER

UGANDA PRIMARY HEALTH CARE SERVICES

SOCIO-DEMOGRAPHIC SITUATION	SEXUAL HEALTH ISSUES	TARGET SEXUAL-HEALTH RELATED SERVICES in PHC SETTING  (BASIC SERVICES)	REPRODUCTIVE HEALTH ISSUES	TARGET REPRODUCTIVE HEALTH in PHC SETTING	HEALTH BENEFIT/ GOAL	POLICY/ RIGHTS ENVIRONMENT/ ROLES OF STAKEHOLDERS	CRIMINALITY/ DANGERS  OF DENIAL	INFRASTRUCTURE RESOURCES AND SYSTEMS/ MEASURABLE ASPECT
SEXUAL- REPRODUCTIVE HEALTH ISSUES IN UGANDA	The status and  physical nature of a person	1.        Facility-Infrastructure 2.        Resources 3.        Systems 4.        Child Health Services 5.        Family Planning Services 6.        Maternal Health Services 7.        STI and Tuberculosis Services 8.        Malaria Services 9.        HIV/ AIDS Services	The status and  nature of  a person’s reproductive organs	1.        Facility-Infrastructure 2.        Resources 3.        Systems 4.        Child Health Services 5.        Family Planning Services 6.        Maternal Health Services 7.        STI and Tuberculosis Services 8.        Malaria Services 9.        HIV/ AIDS Services	Ensured social and cultural development of the Population	Objective XX of the CoU 1995 mandates Uganda as a state to take all practical measures to ensure the provision of basic medical services to the population. Collaborative advocacy for funding and implementation	Misdirection of all forms of development Disrepute	Full package of basic services including outpatient care, STIs management, temporary Family planning methods, ANC, Immunisation, Child Growth Monitoring is available in almost 5 of 10 facilities. Regular supply of water and electricity, client amenities Holding routine management meetings Functioning equipments and chemicals for sterilization or High Level Disinfection Adequate final disposal system for infectious and sharps waste.
DEMAND BY PREGNANT MOTHER and CHILD	Expectant female whose obstetric and gyneacological needs are higher Foetus about to be new-born that needs care.	1.        Facility-Infrastructure 2.        Resources 3.        Systems 4.        Child Health Services 5.        Family Planning Services 6.        Maternal Health Services 7.        STI and Tuberculosis Services 8.        Malaria Service 9.        HIV/ AIDS Services	Expectant Mother with enlarged uterus proceeding to term	1. Health Services 2. Family Planning Services 3. Maternal Health Services 4. STI and Tuberculosis Services 5. Malaria Services 6. HIV/AIDS Services	Normal delivery under trained/ qualified observation	All services should be provided without discrimination Drug manufacturing and delivery systems to address need for the appropriate paediatric formulations Ensure early TB diagnosis and treatment Assess and evaluate cormobidity conditions of malaria, TB and malnutrition Ensured pharmacovigilance system to expand existing ART to cover all in need. Improve on treatment strategies to ensure inclusion and eligibility for all. Reports are disaggregated by sex, ethnicity and race to support routine analysis of potential differences in pharmacokinetics and pharmacodynamics, treatment outcomes and adversity. Care , support and treatment scale up in various settings and levels Effectively impacting interventions at programme, facility, community and house-hold levels	Maternal/ new born deaths and near-misses.	-ANC -PPC -Immunisation -Visual Aids -ANC guidelines -Essential equipment and supplies -Medicines for managing pregnancy complications -Managing STIs -ANC registers Infection Control -Equipment/supplied for conducting normal delivery -Emergency respiratory support for newborns -Newborn health supportive practices -Reviews of maternal / child deaths Partner Notification -Pre/Post HIV test counselling -Infant feeding practices -Family Planning -Prophylactic ARV drug provision during labour Provision of ARV drug to newborn within 72 hours of birth -Referrals
DEMAND BY HIV+ PREGNANT MOTHER	Expectant female whose obstetric and gyneacological needs are higher Foetus about to be new-born that needs care.	1.        Facility-Infrastructure 2.        Resources 3.        Systems 4.        Child Health Services 5.        Family Planning Services 6.        Maternal Health Services 7.        STI and Tuberculosis Services 8.        Malaria Service 9.        HIV/ AIDS Services	Expectant Mother with enlarged uterus proceeding to term	1. Health Services 2. Family Planning Services 3. Maternal Health Services 4. STI and Tuberculosis Services 5. Malaria Services 6. HIV/AIDS Services	Normal delivery under trained/ qualified observation	All services should be provided without discrimination PMTCT should also be looked at as Prevention of Vertical Transmission in the context of de-stigmatising it.	Maternal/ new born deaths and near-misses.	- HIV testing facilities -Informed consent policy -HIV register -Records for providing HIV results -Youth friendly HIV testing -YFS trained provider -YFS Guidelines -Care and Support Services (CSS) -TB diagnosis and treatment -ART services offered -ART guidelines -PMTCT services -Primary prevention of HIV -Prevent unintended pregnancies among HIV+ -Use of comprehensive packages -Comprehensive care of mother/family -Clinical research on PMTCT and Paediatric treatment. -Clinical research on treatment issues for women -Operations research on treatment for women -operations and implementation research related to PMTCT, including paediatric care, treatment and support. Discordant couple counselling services Positive prevention practices
DEMAND BY MALE SPOUSE OF PREGNANT MOTHER	Expectant female whose obstetric and gyneacological needs are higher Foetus about to be new-born that needs care.	1.        Facility-Infrastructure 2.        Resources 3.        Systems 4.        Child Health Services 5.        Family Planning Services 6.        Maternal Health Services 7.        STI and Tuberculosis Services 8.        Malaria Service 9.        HIV/ AIDS Services	Spousal escort for expectant Mother with enlarged uterus proceeding to term	1. Health Services 2. Family Planning Services 3. Maternal Health Services 4. STI and Tuberculosis Services 5. Malaria Services 6. HIV/AIDS Services	Normal delivery under trained/ qualified observation Education on male involvement plans	All services should be provided without discrimination PMTCT should also be defined as Prevention of Vertical Transmission in the context of de-stigmatising it.	Maternal/ new born deaths and near-misses	-Facilitation and acceptance of accompaniment by spouse -Informed consent policy -HIV register -Records for providing HIV results -Youth friendly HIV testing -YFS trained provider -YFS Guidelines -Care and Support Services (CSS) -TB diagnosis and treatment -ART services offered -ART guidelines -PMTCT services -Primary prevention of HIV -Prevent unintended pregnancies among HIV+ -Use of comprehensive packages -Comprehensive care of mother/family -Clinical research on PMTCT and Paediatric treatment. -Clinical research on treatment issues for women -Operations research on treatment for women -operations and implementation research related to PMTCT, including paediatric care, treatment and support. Discordant couple counselling services Positive prevention practices
DEMAND BY FEMALE SPOUSE OF PREGNANT MOTHER	Expectant female whose obstetric and gyneacological needs are higher Foetus about to be new-born that needs care.	1.        Facility-Infrastructure 2.        Resources 3.        Systems 4.        Child Health Services 5.        Family Planning Services 6.        Maternal Health Services 7.        STI and Tuberculosis Services 8.        Malaria Service 9.        HIV/ AIDS Services	Spousal escort for expectant Mother with enlarged uterus proceeding to term	1. Health Services 2. Family Planning Services 3. Maternal Health Services 4. STI and Tuberculosis Services 5. Malaria Services 6. HIV/AIDS Services	Normal delivery under trained/ qualified observation Education on Spousal involvement plans	All services should be provided without discrimination	Maternal/ new born deaths and near-misses	-Routine cervical examination for cancer and STIs. -Family planning information, education and communication -Informed consent policy HPV Immunisation -HIV register -Records for providing HIV results -Youth friendly HIV testing -SMF trained provider -SMF Guidelines -Care and Support Services (CSS) -TB diagnosis and treatment -ART services offered -ART guidelines -PMTCT services -Primary prevention of HIV -Prevent unintended pregnancies among HIV+ -Use of comprehensive packages -Comprehensive care of mother/family -Clinical research on PMTCT and Paediatric treatment. -Clinical research on treatment issues for women -Operations research on treatment for women -operations and implementation research related to PMTCT, including paediatric care, treatment and support. Discordant couple counselling services Positive prevention practices
DEMAND BY BELOW 18 YEAR OLD FEMALE	Adolescent with sexual needs that need addressing through dialogue to reduce experimenting hazards	1.        Facility-Infrastructure 2.        Resources 3.        Systems 4.        Child Health Services 5.        Family Planning Services 6.        Maternal Health Services 7.        STI and Tuberculosis Services 8.        Malaria Service 9.        HIV/ AIDS Services	Teenage friendly Sexual-reproductive health services	1. Health Services 2. Family Planning Services 3. Maternal Health Services 4. STI and Tuberculosis Services 5. Malaria Services 6. HIV/AIDS Services	Normal delivery under trained/ qualified observation Education on Spousal involvement plans	All services should be provided without discrimination	Risk of infection due to peer pressure and experimenting	Preparatory Information, Education and Communication around:- -Pregnancy and conceiving -HIV/STIs transmission -Vaginal/Penile hygiene -PPC -Immunisation and its importance to health -Visual Aid messages - Key messages in ANC guidelines -Signs of pregnancy complications -Managing STIs -ANC registers Infection Control -Newborn health supportive practices -Maternal / child Health -Pre/Post HIV test counselling -Infant feeding practices -Family Planning Teenage friendly services -Prophylactic ARV drugs and their importance in checking HIV transmission. -Sexuality and orientation information, education and communication -YFS Services -Referral
DEMAND BY  ABOVE 18 YEAR OLD FEMALE	Teenage needs, emotional stability counselling and sexual  health education	1.        Facility-Infrastructure 2.        Resources 3.        Systems 4.        Child Health Services 5.        Family Planning Services 6.        Maternal Health Services 7.        STI and Tuberculosis Services 8.        Malaria Service 9.        HIV/ AIDS Services	Teenage friendly Sexual-reproductive health services	1. Health Services 2. Family Planning Services 3. Maternal Health Services 4. STI and Tuberculosis Services 5. Malaria Services 6. HIV/AIDS Services	Normal delivery under trained/ qualified observation	All services should be provided without discrimination Drug manufacturing and delivery systems to address need for the appropriate paediatric formulations Ensure early TB diagnosis and treatment Assess and evaluate cormobidity conditions of malaria, TB and malnutrition Ensured pharmacovigilance system to expand existing ART to cover all in need. Improve on treatment strategies to ensure inclusion and eligibility for all. Reports are disaggregated by sex, ethnicity and race to support routine analysis of potential differences in pharmacokinetics and pharmacodynamics, treatment outcomes and adversity. Care , support and treatment scale up in various settings and levels Effectively impacting interventions at programme, facility, community and house-hold levels	Teenage health un-met needs	Preparatory Information, Education and Communication around:- -Pregnancy and conceiving -HIV/STIs transmission -Vaginal/Penile hygiene -PPC -Immunisation and its importance to health -Visual Aid messages - Key messages in ANC guidelines -Signs of pregnancy complications -Managing STIs -ANC registers Infection Control -Newborn health supportive practices -Maternal / child Health -Pre/Post HIV test counselling -Infant feeding practices -Family Planning -Teenage-Health Friendly services -Prophylactic ARV drugs and their importance in checking HIV transmission.
DEMAND BY ABOVE 18 YEAR OLD MALE	Teenage needs, emotional stability counselling and sexual  health education	1.        Facility-Infrastructure 2.        Resources 3.        Systems 4.        Child Health Services 5.        Family Planning Services 6.        Maternal Health Services 7.        STI and Tuberculosis Services 8.        Malaria Service 9.        HIV/ AIDS Services	Expectant Mother with enlarged uterus proceeding to term	1. Health Services 2. Family Planning Services 3. Maternal Health Services 4. STI and Tuberculosis Services 5. Malaria Services 6. HIV/AIDS Services	Normal delivery under trained/ qualified observation	All services should be provided without discrimination Drug manufacturing and delivery systems to address need for the appropriate paediatric formulations Ensure early TB diagnosis and treatment Assess and evaluate cormobidity conditions of malaria, TB and malnutrition Ensured pharmacovigilance system to expand existing ART to cover all in need. Improve on treatment strategies to ensure inclusion and eligibility for all. Reports are disaggregated by sex, ethnicity and race to support routine analysis of potential differences in pharmacokinetics and pharmacodynamics, treatment outcomes and adversity. Care , support and treatment scale up in various settings and levels Effectively impacting interventions at programme, facility, community and house-hold levels	Maternal/ new born deaths and near-misses.	Preparatory Information, Education and Communication around:- -Medical male circumcision and its importance -Pregnancy and conceiving -HIV/STIs transmission -Vaginal/Penile hygiene -PPC -Immunisation and its importance to health -Visual Aid messages - Key messages in ANC guidelines -Signs of pregnancy complications -Managing STIs -Newborn health supportive practices -Maternal / child Health -Pre/Post HIV test counselling -Infant feeding practices -Family Planning -Prophylactic ARV drugs and their importance in checking HIV transmission.
DEMAND BY BELOW 14 YEAR OLD MALE	Teenage needs, emotional stability counselling and sexual  health education	1.        Facility-Infrastructure 2.        Resources 3.        Systems 4.        Child Health Services 5.        Family Planning Services 6.        Maternal Health Services 7.        STI and Tuberculosis Services 8.        Malaria Service 9.        HIV/ AIDS Services	Teenage sexual health needs	1. Health Services 2. Family Planning Services 3. Maternal Health Services 4. STI and Tuberculosis Services 5. Malaria Services 6. HIV/AIDS Services	Normal delivery under trained/ qualified observation	All services should be provided without discrimination. Drug manufacturing and delivery systems to address need for the appropriate paediatric formulations Ensure early TB diagnosis and treatment Assess and evaluate cormobidity conditions of malaria, TB and malnutrition Ensured pharmacovigilance system to expand existing ART to cover all in need. Improve on treatment strategies to ensure inclusion and eligibility for all. Reports are disaggregated by sex, ethnicity and race to support routine analysis of potential differences in pharmacokinetics and pharmacodynamics, treatment outcomes and adversity. Care , support and treatment scale up in various settings and levels Effectively impacting interventions at programme, facility, community and house-hold levels	Teenage sexual health un-met needs	Preparatory Information, Education and Communication around:- -Pregnancy and conceiving -HIV/STIs transmission -Vaginal/Penile hygiene -PPC -Immunisation and its importance to health -Visual Aid messages - Key messages in ANC guidelines -Signs of pregnancy complications -Managing STIs -ANC registers Infection Control -Newborn health supportive practices -Maternal / child Health -Pre/Post HIV test counselling -Infant feeding practices -Family Planning -Teenage health friendly services -Prophylactic ARV drugs and their importance in checking HIV transmission. -Sexuality and orientation information, education and communication
DEMAND BY 18 YEAR OLD MALE	Teenage needs, emotional stability counselling and sexual  health education	1.        Facility-Infrastructure 2.        Resources 3.        Systems 4.        Child Health Services 5.        Family Planning Services 6.        Maternal Health Services 7.        STI and Tuberculosis Services 8.        Malaria Service 9.        HIV/ AIDS Services	Teenage sexual health needs	1. Health Services 2. Family Planning Services 3. Maternal Health Services 4. STI and Tuberculosis Services 5. Malaria Services 6. HIV/AIDS Services	Normal delivery under trained/ qualified observation	All services should be provided without discrimination. Drug manufacturing and delivery systems to address need for the appropriate paediatric formulations Ensure early TB diagnosis and treatment Assess and evaluate cormobidity conditions of malaria, TB and malnutrition Ensured pharmacovigilance system to expand existing ART to cover all in need. Improve on treatment strategies to ensure inclusion and eligibility for all. Reports are disaggregated by sex, ethnicity and race to support routine analysis of potential differences in pharmacokinetics and pharmacodynamics, treatment outcomes and adversity. Care , support and treatment scale up in various settings and levels Effectively impacting interventions at programme, facility, community and house-hold levels such as male involvement	Maternal/ new born deaths and near-misses.	Preparatory Information, Education and Communication around:- -Medical Male Circumcision -Sexuality and orientation -Pregnancy and conceiving -HIV/STIs transmission -Vaginal/Penile hygiene -PPC -Immunisation and its importance to health -Visual Aid messages - Key messages in ANC guidelines -Signs of pregnancy complications -Managing STIs -ANC registers Infection Control -Equipment/supplied for conducting normal delivery -Emergency respiratory support for newborns -Newborn health supportive practices -Maternal / child Health -Pre/Post HIV test counselling -Infant feeding practices -Family Planning -Prophylactic ARV drugs and their importance in checking HIV transmission.
DEMAND BY  ABOVE 18 AUTISTIC DISABLED MALE	Disabled person whose sexual health needs consider disability conditions	1.        Facility-Infrastructure 2.        Resources 3.        Systems 4.        Child Health Services 5.        Family Planning Services 6.        Maternal Health Services 7.        STI and Tuberculosis Services 8.        Malaria Service 9.        HIV/ AIDS Services	Disability Person Sexual health needs	1. Health Services 2. Family Planning Services 3. Maternal Health Services 4. STI and Tuberculosis Services 5. Malaria Services 6. HIV/AIDS Services	Normal delivery under trained/ qualified observation	All services should be provided without discrimination	Maternal/ new born deaths and near-misses.	Preparatory Information, Education and Communication around:- -Disability, Pregnancy and conceiving -HIV/STIs transmission -Vaginal/Penile hygiene -PPC -Disability friendly services (DFS) -Immunisation and its importance to health -Visual Aid messages - Key messages in ANC guidelines -Signs of pregnancy complications -Managing STIs -ANC registers Infection Control -Newborn health supportive practices -Maternal / child Health -Pre/Post HIV test counselling -Infant feeding practices -Family Planning -Prophylactic ARV drugs and their importance in checking HIV transmission. -Sexuality and orientation information, education and communication
DEMAND BY  ABOVE 18 DYSLEXIC DISABLED	Disabled person whose sexual health needs consider disability conditions	1.        Facility-Infrastructure 2.        Resources 3.        Systems 4.        Child Health Services 5.        Family Planning Services 6.        Maternal Health Services 7.        STI and Tuberculosis Services 8.        Malaria Service 9.        HIV/ AIDS Services	Expectant Mother with enlarged uterus proceeding to term	1. Health Services 2. Family Planning Services 3. Maternal Health Services 4. STI and Tuberculosis Services 5. Malaria Services 6. HIV/AIDS Services	Normal delivery under trained/ qualified observation	All services should be provided without discrimination	Maternal/ new born deaths and near-misses.	Preparatory Information, Education and Communication around:- -Disability, Pregnancy and conceiving -HIV/STIs transmission -Vaginal/Penile hygiene -PPC -Disability friendly services (DFS) -Immunisation and its importance to health -Visual Aid messages - Key messages in ANC guidelines -Signs of pregnancy complications -Managing STIs -ANC registers Infection Control -Newborn health supportive practices -Maternal / child Health -Pre/Post HIV test counselling -Infant feeding practices -Family Planning -Prophylactic ARV drugs and their importance in checking HIV transmission. -Sexuality and orientation information, education and communication
DEMAND BY  ABOVE 18 VISUALLY IMPAIRED DISABLED	Disabled person whose sexual health needs consider disability conditions	1.        Facility-Infrastructure 2.        Resources 3.        Systems 4.        Child Health Services 5.        Family Planning Services 6.        Maternal Health Services 7.        STI and Tuberculosis Services 8.        Malaria Service 9.        HIV/ AIDS Services	Expectant Mother with enlarged uterus proceeding to term	1. Health Services 2. Family Planning Services 3. Maternal Health Services 4. STI and Tuberculosis Services 5. Malaria Services 6. HIV/AIDS Services	Normal delivery under trained/ qualified observation	All services should be provided without discrimination	Maternal/ new born deaths and near-misses.	Preparatory Information, Education and Communication around:- -Disability, Pregnancy and conceiving -HIV/STIs transmission -Vaginal/Penile hygiene -PPC -Disability friendly services (DFS) -Immunisation and its importance to health -Visual Aid messages - Key messages in ANC guidelines -Signs of pregnancy complications -Managing STIs -ANC registers Infection Control -Newborn health supportive practices -Maternal / child Health -Pre/Post HIV test counselling -Infant feeding practices -Family Planning -Prophylactic ARV drugs and their importance in checking HIV transmission. -Sexuality and orientation information, education and communication
DEMAND BY HEARING IMPAIRED DISABLED	Disabled person whose sexual health needs consider disability conditions	1.        Facility-Infrastructure 2.        Resources 3.        Systems 4.        Child Health Services 5.        Family Planning Services 6.        Maternal Health Services 7.        STI and Tuberculosis Services 8.        Malaria Service 9.        HIV/ AIDS Services	Expectant Mother with enlarged uterus proceeding to term	1. Health Services 2. Family Planning Services 3. Maternal Health Services 4. STI and Tuberculosis Services 5. Malaria Services 6. HIV/AIDS Services	Normal delivery under trained/ qualified observation	All services should be provided without discrimination	Maternal/ new born deaths and near-misses.	Preparatory Information, Education and Communication around:- -Disability, Pregnancy and conceiving -HIV/STIs transmission -Vaginal/Penile hygiene -PPC -Disability friendly services (DFS) -Immunisation and its importance to health -Visual Aid messages - Key messages in ANC guidelines -Signs of pregnancy complications -Managing STIs -ANC registers Infection Control -Newborn health supportive practices -Maternal / child Health -Pre/Post HIV test counselling -Infant feeding practices -Family Planning -Prophylactic ARV drugs and their importance in checking HIV transmission. -Sexuality and orientation information, education and communication
DEMAND BY DISABLED FEMALE ABOVE 18 YEARS	Disabled person whose sexual health needs consider disability conditions	1)       Facility-Infrastructure 2)       Resources 3)       Systems 4)       Child Health Services 5)       Family Planning Services 6)       Maternal Health Services 7)       STI and Tuberculosis Services 8)       Malaria Service 9)       HIV/ AIDS Services	Expectant Mother with enlarged uterus proceeding to term	1. Health Services 2. Family Planning Services 3. Maternal Health Services 4. STI and Tuberculosis Services 5. Malaria Services 6. HIV/AIDS Services	Normal delivery under trained/ qualified observation	All services should be provided without discrimination	Maternal/ new born deaths and near-misses.	Preparatory Information, Education and Communication around:- -Disability, Pregnancy and conceiving -HIV/STIs transmission -Vaginal/Penile hygiene -PPC -Disability friendly services (DFS) -Immunisation and its importance to health -Visual Aid messages - Key messages in ANC guidelines -Signs of pregnancy complications -Managing STIs -ANC registers Infection Control -Newborn health supportive practices -Maternal / child Health -Pre/Post HIV test counselling -Infant feeding practices -Family Planning -Prophylactic ARV drugs and their importance in checking HIV transmission. -Sexuality and orientation information, education and communication
DEMAND BY FEMALE SEX-WORKER	Child bearing and maternal health needs to be addressed	1.        Facility-Infrastructure 2.        Resources 3.        Systems 4.        Child Health Services 5.        Family Planning Services 6.        Maternal Health Services 7.        STI and Tuberculosis Services 8.        Malaria Service 9.        HIV/ AIDS Services	Expectant Mother with enlarged uterus proceeding to term	1. Health Services 2. Family Planning Services 3. Maternal Health Services 4. STI and Tuberculosis Services 5. Malaria Services 6. HIV/AIDS Services	Normal delivery under trained/ qualified observation	All services should be provided without discrimination	Maternal/ new born deaths and near-misses.	Preparatory Information, Education and Communication around:- -Pregnancy and conceiving -HIV/STIs transmission -Vaginal/Penile hygiene -PPC -Immunisation and its importance to health -Visual Aid messages - Key messages in ANC guidelines -Signs of pregnancy complications -Managing STIs -ANC registers Infection Control -Newborn health supportive practices -Maternal / child Health -Pre/Post HIV test counselling -Infant feeding practices -Family Planning Sex-worker friendly services -Prophylactic ARV drugs and their importance in checking HIV transmission. -Sexuality and orientation information, education and communication
DEMAND BY MALE SEX-WORKER	Person who depends on sex with same sex or different gender person	1.        Facility-Infrastructure 2.        Resources 3.        Systems 4.        Child Health Services 5.        Family Planning Services 6.        Maternal Health Services 7.        STI and Tuberculosis Services 8.        Malaria Service 9.        HIV/ AIDS Services	Sex as an income generating activity	1. Health Services 2. Family Planning Services 3. Maternal Health Services 4. STI and Tuberculosis Services 5. Malaria Services 6. HIV/AIDS Services	Friendly services	All services should be provided without discrimination	Misdiagnosed STIs and sexual health status	Preparatory Information, Education and Communication around:- -Pregnancy and conceiving -HIV/STIs transmission -Vaginal/Penile hygiene -PPC -Immunisation and its importance to health -Visual Aid messages - Key messages in ANC guidelines -Signs of pregnancy complications -Managing STIs -ANC registers Infection Control -Newborn health supportive practices -Maternal / child Health -Pre/Post HIV test counselling -Infant feeding practices -Family Planning Sex-worker friendly services -Prophylactic ARV drugs and their importance in checking HIV transmission. -Sexuality and orientation information, education and communication
DEMAND BY NON SEXUALLY ACTIVE  GAY MALE	Closeted life, attraction for same sex, coming out  issues	1.        Facility-Infrastructure 2.        Resources 3.        Systems 4.        Child Health Services 5.        Family Planning Services 6.        Male-Health Services 7.        STI and Tuberculosis Services 8.        Malaria Service 9.        HIV/ AIDS Services	Desire for sexual satisfaction with same sex	1. Health Services 2. Family Planning Services 3. Maternal Health Services 4. STI and Tuberculosis Services 5. Malaria Services 6. HIV/AIDS Services	Health Indicators relevant to sexual minorities: Weight issues Obesity Tobacco use Substance use Responsible sexual behaviour Mental health Injury Violence Access to care Burden of STIs	All services should be provided without discrimination	Stress Discrimination	Preparatory Information, Education and Communication around:- -Health, empowerment, legal and psycho-social issues -Life events/experiences -stage of life -disclosure issues -motivations and expressions for same sex practices -Adolescent health -Exploration of Knowledge, attitudes and skills -Depathologisation of homosexuality -Medical Male Circumcision -Sexuality and orientation -Pregnancy and conceiving -HIV/STIs transmission -HPV -HSV -Vaginal/Penile hygiene -PPC -Immunisation and its importance to health -Visual Aid messages - Key messages in ANC guidelines -Signs of pregnancy complications -Managing STIs -ANC registers Infection Control -Starting a family -Newborn health supportive practices -Maternal / child Health -Pre/Post HIV test counselling -Infant feeding practices -Family Planning -Prophylactic ARV drugs and their importance in checking HIV transmission.
DEMAND BY  NON SEXUALLY ACTIVE LESBIAN	Closeted life, attraction for same sex, coming out  issues	1.        Facility-Infrastructure 2.        Resources 3.        Systems 4.        Child Health Services 5.        Family Planning Services 6.        Maternal Health Services 7.        STI and Tuberculosis Services 8.        Malaria Service 9.        HIV/ AIDS Services	Sexual/ reproductive health expectations	1. Health Services 2. Family Planning Services 3. Maternal Health Services 4. STI and Tuberculosis Services 5. Malaria Services 6. HIV/AIDS Services	Non-discriminative services	All services should be provided without discrimination. Provide environment for understanding the complexity and multidimensionality of  gender and sexual orientation . Exploration of coping skills	Stress Discrimination	Preparatory Information, Education and Communication around:- -Medical Male Circumcision -Sexuality and orientation -Pregnancy and conceiving -HIV/STIs transmission -HPV -HSV -Vaginal/Penile hygiene -PPC -Immunisation and its importance to health -Visual Aid messages - Key messages in ANC guidelines -Signs of pregnancy complications -Managing STIs -ANC registers Infection Control -Starting a family -Newborn health supportive practices -Maternal / child Health -Pre/Post HIV test counselling -Infant feeding practices -Family Planning -Choice of surrogacy -Choice of siring partner -Hormonal replacement -Prophylactic ARV drugs and their importance in checking HIV transmission.
DEMAND BY FEMALE TO MALE TRANSGENDER	attraction for same sex, coming out  issues	1.        Facility-Infrastructure 2.        Resources 3.        Systems 4.        Child Health Services 5.        Family Planning Services 6.        Maternal Health Services 7.        STI and Tuberculosis Services 8.        Malaria Service 9.        HIV/ AIDS Services	Sexual/ reproductive health expectations	1. Health Services 2. Family Planning Services 3. Maternal Health Services 4. STI and Tuberculosis Services 5. Malaria Services 6. HIV/AIDS Services	None Discriminative services	All services should be provided without discrimination	Stress Discrimination	Preparatory Information, Education and Communication around:- -Pregnancy and conceiving -HIV/STIs transmission -Vaginal/Penile hygiene -PPC -Immunisation and its importance to health -Visual Aid messages - Key messages in ANC guidelines -Signs of pregnancy complications -Managing STIs -ANC registers Infection Control -Newborn health supportive practices -Maternal / child Health -Pre/Post HIV test counselling -Infant feeding practices -Family Planning Hormonal replacement -Prophylactic ARV drugs and their importance in checking HIV transmission. -Sexuality and orientation information, education and communication
DEMAND BY MALE TO FEMALE TRANSGENDER	attraction for same sex, coming out  issues	1.        Facility-Infrastructure 2.        Resources 3.        Systems 4.        Child Health Services 5.        Family Planning Services 6.        Maternal Health Services 7.        STI and Tuberculosis Services 8.        Malaria Service 9.        HIV/ AIDS Services	Sexual/ reproductive health expectations	1. Health Services 2. Family Planning Services 3. Maternal Health Services 4. STI and Tuberculosis Services 5. Malaria Services 6. HIV/AIDS Services	Same sex –friendly services	All services should be provided without discrimination	Stress Discrimination	Preparatory Information, Education and Communication around:- -Pregnancy and conceiving -HIV/STIs transmission -Vaginal/Penile hygiene -PPC -Immunisation and its importance to health -Visual Aid messages - Key messages in ANC guidelines -Signs of pregnancy complications -Managing STIs -ANC registers Infection Control -Newborn health supportive practices -Maternal / child Health -Pre/Post HIV test counselling -Infant feeding practices -Family Planning -Hormonal replacement -Prophylactic ARV drugs and their importance in checking HIV transmission. -Sexuality and orientation information, education and communication
DEMAND BY INTERSEX	Sexual/genital health  status	1.        Facility-Infrastructure 2.        Resources 3.        Systems 4.        Child Health Services 5.        Family Planning Services 6.        Maternal Health Services 7.        STI and Tuberculosis Services 8.        Malaria Service 9.        HIV/ AIDS Services	Intersex person desiring to have or not have children	1. Health Services 2. Family Planning Services 3. Maternal Health Services 4. STI and Tuberculosis Services 5. Malaria Services 6. HIV/AIDS Services	Same sex Friendly services	All services should be provided without discrimination	Stress Discrimination	Preparatory Information, Education and Communication around:- -Pregnancy and conceiving -HIV/STIs transmission -Vaginal/Penile hygiene -Vaginal/Penile growth and development -PPC -Immunisation and its importance to health -Visual Aid messages - Key messages in ANC guidelines -Signs of pregnancy complications -Managing STIs -ANC registers Infection Control -Newborn health supportive practices -Maternal / child Health -Pre/Post HIV test counselling -Infant feeding practices -Family Planning -Hormonal replacement -Prophylactic ARV drugs and their importance in checking HIV transmission. -Sexuality and orientation information, education and communication
DEMAND BY GAY DISABLED MALE	Sexual-genital health needs	1.        Facility-Infrastructure 2.        Resources 3.        Systems 4.        Child Health Services 5.        Family Planning Services 6.        Maternal Health Services 7.        STI and Tuberculosis Services 8.        Malaria Service 9.        HIV/ AIDS Services	Same sex loving person probably in the closet and with low self esteem	1. Health Services 2. Family Planning Services 3. Maternal Health Services 4. STI and Tuberculosis Services 5. Malaria Services 6. HIV/AIDS Services	Same sex and Disability friendly Services	All services should be provided without discrimination	Stress Discrimination	Preparatory Information, Education and Communication around:- -Pregnancy and conceiving -HIV/STIs transmission -Vaginal/Penile hygiene -PPC -Immunisation and its importance to health -Visual Aid messages - Key messages in ANC guidelines -Signs of pregnancy complications -Managing STIs -ANC registers Infection Control -Newborn health supportive practices -Maternal / child Health -Pre/Post HIV test counselling -Infant feeding practices -Family Planning Same sex/Disability friendly services -Prophylactic ARV drugs and their importance in checking HIV transmission. -Sexuality and orientation information, education and communication
DEMAND BY LESBIAN DISABLED FEMALE	Sexual-genital health needs	1.        Facility-Infrastructure 2.        Resources 3.        Systems 4.        Child Health Services 5.        Family Planning Services 6.        Maternal Health Services 7.        STI and Tuberculosis Services 8.        Malaria Service 9.        HIV/ AIDS Services	Same sex loving person probably in the closet and with low self esteem	1. Health Services 2. Family Planning Services 3. Maternal Health Services 4. STI and Tuberculosis Services 5. Malaria Services 6. HIV/AIDS Services	None discrimination services	All services should be provided without discrimination	Maternal/ new born deaths and near-misses.	Preparatory Information, Education and Communication around:- -Pregnancy and conceiving -HIV/STIs transmission -Vaginal/Penile hygiene -PPC -Immunisation and its importance to health -Visual Aid messages - Key messages in ANC guidelines -Signs of pregnancy complications -Managing STIs -ANC registers Infection Control -Newborn health supportive practices -Maternal / child Health -Pre/Post HIV test counselling -Infant feeding practices -Family Planning Same sex/Disability friendly services -Prophylactic ARV drugs and their importance in checking HIV transmission. -Sexuality and orientation information, education and communication
DEMAND BY  DISBALED TRANSGENDER (FTM)	Sexual/ Genital health needs	1.        Facility-Infrastructure 2.        Resources 3.        Systems 4.        Child Health Services 5.        Family Planning Services 6.        Maternal Health Services 7.        STI and Tuberculosis Services 8.        Malaria Service 9.        HIV/ AIDS Services	Same sex loving person probably in the closet and with low self esteem	1. Health Services 2. Family Planning Services 3. Maternal Health Services 4. STI and Tuberculosis Services 5. Malaria Services 6. HIV/AIDS Services	Non discriminative services	All services should be provided without discrimination	Maternal/ new born deaths and near-misses.	Preparatory Information, Education and Communication around:- -Pregnancy and conceiving -HIV/STIs transmission -Vaginal/Penile hygiene -PPC -Immunisation and its importance to health -Visual Aid messages - Key messages in ANC guidelines -Signs of pregnancy complications -Managing STIs -ANC registers Infection Control -Newborn health supportive practices -Maternal / child Health -Pre/Post HIV test counselling -Infant feeding practices -Family Planning -Prophylactic ARV drugs and their importance in checking HIV transmission. -Sexuality and orientation information, education and communication
DEMAND BY DISBALED TRANSGENDER (MTF)	Sexual / Genital Heath needs	1.        Facility-Infrastructure 2.        Resources 3.        Systems 4.        Child Health Services 5.        Family Planning Services 6.        Maternal Health Services 7.        STI and Tuberculosis Services 8.        Malaria Service 9.        HIV/ AIDS Services	Same sex loving person probably in the closet and with low self esteem	1. Health Services 2. Family Planning Services 3. Maternal Health Services 4. STI and Tuberculosis Services 5. Malaria Services 6. HIV/AIDS Services	Non Discriminative services	All services should be provided without discrimination	Stress Discrimination	Preparatory Information, Education and Communication around:- -Pregnancy and conceiving -HIV/STIs transmission -Vaginal/Penile hygiene -PPC -Immunisation and its importance to health -Visual Aid messages - Key messages in ANC guidelines -Signs of pregnancy complications -Managing STIs -ANC registers Infection Control -Newborn health supportive practices -Maternal / child Health -Pre/Post HIV test counselling -Infant feeding practices -Family Planning -Prophylactic ARV drugs and their importance in checking HIV transmission. -Sexuality and orientation information, education and communication
DEMAND BY POST MENOPAUSAL FEMALE	Female whose obstetric and gyneacological needs should be addressed side by side with post menopausal issues/ anxieties Ability to enjoy sexual intercourse with no procreation Should be done safely without HIV/STI transmission	1.        Facility-Infrastructure 2.        Resources 3.        Systems 4.        Child Health Services 5.        Family Planning Services 6.        Maternal Health Services should include safer sex practices for Post  menopausal females 7.        STI and Tuberculosis Services 8.        Malaria Service 9.        HIV/ AIDS Services	Issues around libido, sexual function and hormonal replacement Menopausal status	1. Health Services 2. Family Planning Services 3. Maternal Health Services 4. STI and Tuberculosis Services 5. Malaria Services 6. HIV/AIDS Services	Counselling for safer sex practices	All services should be provided without discrimination	Safer sex practices advice reduces on risky behaviour.	Preparatory Information, Education and Communication around:- -HIV/STIs transmission -Vaginal/Penile hygiene -PPC Continued protective family planning methods -Immunisation and its importance to health -Visual Aid messages - Key messages in ANC guidelines -Signs of pregnancy complications -Managing STIs -ANC registers Infection Control -Maternal / child Health -Pre/Post HIV test counselling -Family Planning -Prophylactic ARV drugs and their importance in checking HIV transmission.
DEMAND BY SPOUSE OF POST MENOPAUSAL FEMALE	Sexual needs of spouse and child-bearing status	1.        Facility-Infrastructure 2.        Resources 3.        Systems 4.        Child Health Services 5.        Family Planning Services 6.        Maternal Health Services 7.        STI and Tuberculosis Services 8.        Malaria Service 9.        HIV/ AIDS Services	Issues around libido, sexual function and hormonal replacement	1. Health Services 2. Family Planning Services 3. Maternal Health Services 4. STI and Tuberculosis Services 5. Malaria Services 6. HIV/AIDS Services	Normal delivery under trained/ qualified observation	All services should be provided without discrimination	Safer sex practices advice reduces on risky behaviour. Point out child-bearing needs and gauge expectations. Counsel around this.	Preparatory Information, Education and Communication around:- -Pregnancy and conceiving -HIV/STIs transmission -Vaginal/Penile hygiene -PPC -Immunisation and its importance to health -Visual Aid messages - Key messages in ANC guidelines -Managing STIs -ANC registers Infection Control -Newborn health supportive practices -Maternal / child Health -Pre/Post HIV test counselling -Infant feeding practices -Family Planning -Prophylactic ARV drugs and their importance in checking HIV transmission.
DEMAND BY THE SENIOR PERSON (AGED/ ELDERLY)	Issues of child-bearing and obstetric health	1.        Facility-Infrastructure 2.        Resources 3.        Systems 4.        Child Health Services 5.        Family Planning Services 6.        Maternal Health Services 7.        STI and Tuberculosis Services 8.        Malaria Service 9.        HIV/ AIDS Services	Issues around libido, sexual function and hormonal replacement	1. Health Services 2. Family Planning Services 3. Maternal Health Services 4. STI and Tuberculosis Services 5. Malaria Services 6. HIV/AIDS Services	Normal delivery under trained/ qualified observation	All services should be provided without discrimination	Immuno-suppression, neuropathy and various other old age (geriatric) related illnesses are nearly missed as old age related issues and not HIV related.	Preparatory Information, Education and Communication around:- -HIV/STIs transmission -Vaginal/Penile hygiene -PPC -Immunisation and its importance to health -Visual Aid messages - Key messages in ANC guidelines -Signs of pregnancy complications -Managing STIs -ANC registers Infection Control -Elderly health supportive practices -Pre/Post HIV test counselling -Infant feeding practices -Prophylactic ARV drugs and their importance in checking HIV transmission.