Namulaba Health Center Project

Namulaba Health Center Project

Annual Report Year-IV

1 August 2012 to 31 July 2013Date of Report: 31st March 2014Contact Persons:

Director

Chairperson Namulaba CBO NetworkDr Samuel Kalibala

Mrs. Margaret KizitoP.O. Box 2598 Kampala, Uganda

Tel +256 751 933 462Uganda Cellphone 256 772 638 540Kenya Cellphone 254 722 514 371Skalibala@hotmail.comSource of Funding: Funded by the kindness of Inger and Claes Ortendahl of Arholma in Sweden plus a number of friendsTable of Contents

3PREAMBLE.

4Brief background information about Namulaba Health Center

5Summary of this report

7Detailed Report.

7The Midwives House: Muzadde Center

8Muzadde Center Service Statistics December 2011 to July 2012

8Ante Natal Care (ANC)

9Labor and Delivery

10Birth Certificates

11Photos of Babies

13Service Statistics for the Main Medical Clinic Aug 2012 to July 2013

13All Clients Seen in the Main Medical Clinic

15General Medical Clients

16Clients Tested for HIV

17Patients Tested for Malaria

19Service Statistics of Nurses Clinic

22Vote of thanks

PREAMBLE

In the first four years of this gift we served a cumulative number of 6,127 clients (figure-a).

We provided HIV counseling and testing to a cumulative total of 1167 clients (figure-b)

We provided malaria testing to a cumulative total of 1877 clients (figure-c)

Brief background information about Namulaba Health CenterThe Namulaba Health Center project is located in an eight-room health center built on a farm in Namulaba village. The project serves the Nagojje sub-county which has a community of about 30,000 people living in about 6,000 households in Mukono District in central Uganda but the project is called Namulaba because this is the name of the village center where the clinic is located. On your way from Kampala, the capital city of Uganda, to Jinja town, the source of the River Nile, you turn left at a township called Namataba which is located 35 Km from Kampala. From Namataba, you drive 8 Km on an earth road to reach Namulaba. The journey from Kampala to Namulaba takes about 1.5 hours by car if the traffic on the highway is light. The project started providing medical services in June 2007. The main clinic operates on the last Saturday of every month. The staff includes two clinical officers, two laboratory technicians, two HIV counselors and three nurses. The services provided include primary health care and HIV counseling and testing. On the first three Saturdays of the month a nurse operates a community pharmacy which enables community members to purchase medicines for simple illnesses. The pharmacy is managed by the Namulaba Network of Community Based Organizations (CBOs). The money for buying the first stock of medicines was obtained from a local fundraising event that was organized by the CBO Network and attended by the area member of parliament. The medicines are sold at almost cost price and this enables the pharmacy to re-stock its supply. The salary of the nurse is paid by our project. The nurse also examines and treats patients who come seeking care. On these Saturdays the clinic is also used as an outreach post for the ministry of health to provide family planning and child immunization services. In December 2011 we added maternity services to the services we provide.The project is currently funded out of the kindness of a Swedish couple, Inger and Claes Ortendahl of Arholma in Sweden since July 2009. At the celebration of Ingers birthday in 2009 Inger and Claes made a commitment to fund this project for five years. They chose to help Namulaba as a way of thanking God for Ingers happiness. On behalf of the community served by this project, we are very grateful to Inger and Claes. Inger and Claes have been joined by a number of friends who contributed to the project especially to the construction of the maternity building. The contributors are listed in the vote of thanks at the bottom of this report. They include the 65 residents of Arholma Island, Sweden, where Inger and Claes live as well as other friends of theirs including those living in Germany. We are grateful for these kind hearts. The project was started by the Director (Dr Samuel Kalibala) on his farm land in February 2005. He was prompted by the number of patients who would come to him for help whenever he visited the farm. In February 2007 the project got its first external funding which came from AVERT, a UK based charity. This funding helped with the purchase of equipment and the clinic became operative from June 2007. The project provides a full range of primary health care services at the clinic and in the community. Summary of this report

Our annual funding cycle starts on 1st August of every year. This report covers the fourth year of the gift from Inger and Claes (1st August 2012 to 31st July 2013). Maternity Wing: The highlight of this reporting period is the maternity wing called Muzadde center. Given that Muzadde center started in December 2011 we would like to report its statistics using the annual calendar of January to December in order to pick up its small but growing numbers of clients served. In this report we show that the number of Ante-Natal Care (ANC) visits increased from an average of 8.5 per month in 2012 to an average of 22.7 in 2013. We are also glad to report that the number of babies delivered at the maternity increased from an average of 1.6 per month in 2012 to 2.8 per month in 2013.

Main Curative Clinic: We have continued providing curative care in the main clinic which we operate on the last Saturday of every month. The service statistics of this clinic are summarized below.

Summary of clients served on the main clinic day (August 2012 to July 2013)

In this reporting period 1501 patients received general medical care. This is an increase from 1,270 seen in the previous reporting period.

309 received HIV counseling and testing at the clinic which is an increase from 287 in the previous reporting period.

469 received testing for malaria which is almost similar to 461 in the previous reporting period.

Nurses Clinic: On the three Saturdays of the month when we are not operating the main medical clinic, a nurse opens the clinic and provides medical care to patients paying at a subsidized rate. In addition this nurse also provides immunization, vitamin-A supplementation and de-worming tablets to children and family planning to women. The supplies for these preventive services are provided to us by the government-run Nagojje Health Center-III and in this aspect we function as an outreach site of Nagojje Health Center III. In the period August 2012 to July 2013 the Nurses clinic provided curative services to 388 clients, immunization to 297 children and family planning to 121 women. Very few children received Vitamin-A supplementation or de-worming tablets due to shortage of supplies from the government health center.

Looking into the Future with HopeAs mentioned above the kind gift from Inger and Claes is sadly ending in July 2014. Inger and Claes are very concerned to ensure that there are plans for continuation of this vital service to the impoverished needy people of Namulaba village. For this reason Claes made a visit to Namulaba in May 2013 during which he met with local political leaders, district health authorities, religious leaders and the health manager of a business company in the locality to examine options for future financing of Namulaba Health Center. Claes and Inger are planning to make another visit in March 2014 during which they plan to meet with insurance companies to explore the issue of community based health insurance (CBHI). Detailed Report

The Midwives House: Muzadde Center Muzadde Center is the name we gave to the maternity wing of Namulaba Health Center because the word Muzadde means parent. Due the fact that Muzadde Center is a new component of our services we prefer to report about it starting from its initiation even though it was initiated before the current reporting period. Hence the data presented below is not restricted to the funding period August 2012 to July 2013. This project is the main highlight of this reporting period. We are grateful to Claes and Inger for extending beyond their original commitment and making extra personal contribution to ensure the construction of the midwife house. In addition to the personal contribution, they went out of their way to raise money from their 65 neighbors on Arholma Island in Sweden plus other friends in Sweden and Germany. This contribution started at Ingers birthday party in 2009. When she told her neighbors about the Gift she and Claes had given to Namulaba, the neighbors reacted by contributing the equivalent of US $ 2,300. This was the money used to start the foundation of the building. Part of the building is now ready for use and we started providing antenatal care (ANC) in December 2011 and had the first baby delivered on 28th March 2012.

Inger and Claes have continued to work hard and raise funds for Namulaba. Please see list of donors at the end of this report. One of the methods Inger has used is to host a tea club and at the end of it, the guests make a small contribution in a cup. In May 2011, we received Swedish Kronna 1120 from the tea club. We are grateful to Claes and Inger Ortendhal; Mrs. Kerstin Lindgren and Family; Ingela rtendah; Kristina and Torbjorn Paulin; Dr Susanne Richert; the Arholma Syjunta; and the Family of Jurgen and Hella Richert plus all friends of Namulaba for enabling us to provide the services below to the community of Namulaba.

The Tea Club Members, the Arholma Syjunta:

The cup used to collect the contributions:

Muzadde Center Service Statistics December 2011 to July 2012

Ante Natal Care (ANC)

The center opened on December 1st 2011 and in that month it received 6 pregnant women who were attending ante natal care (ANC) for the first time plus one who had started attending ANC somewhere else. Figure-1a shows the ANC attendance in the year of 2012 which averaged 2.3 new ANC per month, 6.2 repeat ANC visits per month and 8.5 total ANC visits per month. The highest number of new ANC was 6 in December and the highest number of repeat visits was in 10 in the month of October. In general ANC attendance varied from month to month although there appears a tendency to have high numbers in Apr-May and in September-October suggesting a seasonal variation.Figure-1a: ANC visits in 2012

Figure-1b shows that on average there were 5.4 new ANC visits per month, 17.3 repeat ANC visits and 22.7 total ANC visits per month. The peak of ANC visits was in the months of June-September where the total ANC ranged from 30 to 37 per month. Figure-1b: ANC visits in 2013

The figure below shows that there was a great increase in the overall ANC attendance from 102 visits in 2012 to 272 visits in 2013. The biggest increase was in repeat visits from 71 visits in 2012 to 207 visits in 2013. The number of new ANC visits also increased from 31 visits in 2012 to 65 visits in 2013.Figure-2: Total ANC visits in 2012 Vs 2013

Labor and Delivery

The first delivery took place on 28th March 2012 when a baby girl was born. So far we have had 45 deliveries. Figure-3a shows that sixteen babies were born between March and December 2012 giving an average of 1.6 births per month.

Figure-3a: Number of births in 2012

Figure-3b shows that in the twelve months of January to December 2013 a total of 33 births occurred giving an average of 2.8 births per month. Figure-3b: Number of births in 2013

Comparing the number of births in 2012 to the number in 2013 it can be seen that the number of births per month has increased from an average of 1.6 per month to 2.8 per month. We believe that this shows that the community has become confident of the services provided at Muzadde Center. Birth Certificates

We have started the process of getting birth certificates for babies born at our maternity. Please see below one of the birth certificates:

In Uganda very few children ever get their birth certificates usually because the procedure is too cumbersome and rather expensive for the parents since each birth certificate costs Shs. 15,000 (US $6.52). In the Uganda Demographic Health Survey of 2006 only 21.0% of children under five years had their births registered of whom 10.5% did not have a birth certificate, another 6.1% the parents claimed they had birth certificates but could not show them to the interviewers and interviewers were only able to see birth certificates for 4.4% of the children. We are thus proud that we are giving these children this gift. Photos of Babies

Another gift we proudly give to the babies is a photo taken on the day of their birth. This again we feel is a rare article to find in impoverished communities. Many people did not have the opportunity to have a photo taken when they were babies. Here below are some baby photos taken on the day of birth.

Figure-4 shows that of the 49 babies born in Muzadde Center so far we have provided birth certificates to 26 (58%). The rest of the babies have not yet got their birth certificates because of the slow process of issuance of documents from the office of the sub-county chief. We were able to take birth photos for 37 (82%) out of the 49 babies because some babies could not be photographed due to non-availability of the photographer. The center does not yet have its own camera so currently the photos are taken by a commercial photographer who is called whenever a baby is born. Sometimes he is not able to avail himself before the baby and mother are discharged. Figure-4: Babies who have received birth certificates or photographs

Service Statistics for the Main Medical Clinic Aug 2012 to July 2013All Clients Seen in the Main Medical ClinicNamulaba Health Center operates a free primary health care clinic for all community members on the last Saturday of every month. The information presented here is for 12 months from August 2012 to July 2013/ The annual funding cycle of Namulaba starts in August since this is the month when the five-year gift from Inger and Claes Ortendhal started in the year 2009. Figure-5a shows that the total number of clients seen on the last Saturday of every month varied between 89 patients in August 2012 of whom 30 were males and 59 were females to 164 patients seen in July 2013 of whom 55 were males and 109 were females. These patients received primary health care in the way of diagnosis and treatment of common illnesses including fevers, diarrheas, worms, skin diseases as well as malaria. The services also included HIV counseling and testing as well as provision of Septrin (Cotrimoxazole) to people living with HIV which helps to prevent opportunistic infections. HIV positive clients needing CD4 testing are sent to Kawolo Hospital together with a community health worker who directs the patient and ensures payment for CD4 testing using funds provided from our health center. Those found eligible for ARVs are put on ARVs which they continue to receive from Kawolo hospital but they attend our clinic to obtain Septrin and to receive treatment for any opportunistic infection they may have. Figure-5a: All Clients Seen August 2012 to July 2013.

In figures-5b it is shown that in this reporting period we saw a total of 1,501 clients of whom 537 (36%) were males and 964 (64%)were females. Thus females form the majority of our clients.

Figure 5b: All clients by Sex

Distribution of Clients by Type of Service

As shown in figure-5c the majority of clients came for general medical care (1442) and of these 469 (32.5%) were tested for malaria which means that they came complaining of a fever. In Uganda the commonest cause of fever is malaria and hence if a patient is complaining of fever the first disease to test for is malaria. And as is shown later in figure-8b between 31% and 74% of those tested for malaria are found positive depending on the season since the occurrence of malaria is highest in the rainy season.

Figure-5c: Distribution of Clients by Service

General Medical Clients

Figure-6 shows the clients who received treatment at the clinic. This excludes those who only received HIV testing and did not receive any treatment.

Figure-6a: General Medical Patients

In figure-6b it is shown that the patients who received medical care in the 12 months of reporting were 1,442 of whom 517 (36%) were males and 925 (64%) were females. Figure 6b: General Medical Clients by Sex

Clients Tested for HIV

We provide HIV counseling and testing to clients who come seeking just that service and to patients who may have other illnesses but also want to be tested for HIV. Figure-7 shows that the total number tested for HIV on the last Saturday of every month varied from 11 in December 2012 to 43 in July 2013.

Figure-7a: Clients Tested for HIV

HIV Positivity

Figure-7b shows that over the reporting period a total of 309 clients of whom 120 were males and 189 were females received HIV testing. Among the males 5 (4%) were HIV positive and among the females 15 (8%) were HIV positive. These figures are almost similar to the prevalence of HIV in the general population which according to a recent sero-survey is 6.1% among males and 8.3% among females. Figure-7b: HIV Positivity

Patients Tested for Malaria

In spite of international and national efforts to control malaria, it remains a major killer disease, especially for children. Many patients die of malaria because they do not have access to accurate diagnosis and if they get diagnosed many patients can only access drugs such as chloroquine or fansidar against which the malaria parasite has already developed resistance. One of the key services we are most proud of providing is the use of a simple microscope to accurately diagnose the disease and provide the effective Artemesinin Combined Therapy (ACT) which we believe saves many lives and reduces suffering due to un-diagnosed malaria or poorly treated malaria. We are grateful to the kind gift of Claes and Inger which enables us to provide this Cadillac model of care in a rural remote community. Figure-8a shows that the number of clients tested for malaria in the clinic on the last Saturday of every month varied from 27 in August 2012 to 61 in April 2013.Figure-8a: Patients Tested for Malaria

Malaria Positivity

In figure-8b it is shown that the positivity rate from malaria testing, shown in red, varies by season. Malaria positivity was lowest in the period of November to January probably because this is usually the period with the least rainfall. This is expected since mosquitoes breed in water ponds and other water collection points which are more abundant during the rainy season. Figure-8b: Malaria Positivity

Figures 8c shows that the male clients tested for malaria were fewer than females (150 Vs 319). Figure 8d shows that the positivity rate of malaria was similar between males (60%) and females (57%).Figures 8c Malaria Test clients by sex and 8d Malaria Positive Clients by Sex

Service Statistics of Nurses Clinic

As mentioned above, on the three Saturdays of the month when we are not operating the main medical clinic, a nurse opens the clinic and provides medical care to patients paying at a subsidized rate. In addition this nurse also provides immunization, vitamin-A supplementation and de-worming tablets to children and family planning to women. The supplies for these preventive services are provided to us by the government-run Nagojje Health Center III and in this aspect we function as an outreach site of Nagojje Health Center III. It is shown in figure-9 that the number of adult men served ranged from 3 in the month of September 2012 to 18 in the month of May 2013. The adult females ranged from 7 in August 2012 to 33 in March 2013. The children ranged from 7 in August 2012 to 79 in July 2013. Figure-9: All patients served in the Nurses Clinic

In figure-10 is shown the number of patients who received curative services in the nurses clinic. The adult males ranged from 3 in the month of September 2012 to 18 in the month of May 2013. The adult females ranged from 6 in November 2012 to 19 in March 2013. And the children ranged from two in October 2012 to 13 in July 2013.

Figure-10: General Medical Patients Seen in Nurses clinic

In figure-11 it is shown that the females provided with FP services ranged from three in November 2012 to 15 in April 2013. Figure-11: Females who received FP services

In figure-12 it is shown that during this reporting period very few children received de-worming tablets or Vitamin-A. This was due stock outs at the government health center. However, we provided childhood immunization services for most of the months in the reporting period. The number of children immunized ranged from 13 in the month of May 2013 to 58 on the month of November 2012.Figure-12: Services in Well-Child Clinic

In figure-13 it is shown that the largest number of clients seen in the Nurses clinic was for curative services (388) followed by children coming for immunization (297) and women receiving family planning (121).Figure-13: Total number of clients by type of service

Vote of thanks

The Director and the Chairperson, on behalf of the Namulaba community, would like to express their gratitude to Inger and Claes for the five year commitment to fund Namulaba activities. In addition, we are very thankful to the following friends who have made donations to us through Inger and Claes:

Members of the Arholma Syjunta (Arholma Tea club)

Hella and Jrgen Richert from Grnwald Germany Mrs. Kerstin Lindgren and Family of Sundsvall Sweden Ingela rtendahl of Enskededalen Sweden

Kristina and Torbjorn Paulin of Stenhamra Sweden Dr. Susanne Richert of Gauting Germany

We would also like to thank our friends from AVERT UK for the seed funding that enabled us to function during the first year of our project. We are also grateful to the local council (LC) members at all levels LC-1, LC-2, LC-3 and LC-5 who have given us unconditional support since the beginning and the District Medical Officers office which continues to provide supervisory support and use of Namulaba as an outreach for childhood immunizations. We are also grateful to all the friends of Namulaba who have visited us and encouraged us to push on. Last but not least, we are grateful to the people of Namulaba as well as the political and religious leaders who have let us join them to work together to make a difference in peoples lives.

Celebrating Four Years out of Five Years of the Gift of Health Care from Inger and Claes Ortendahl and other Friends of Namulaba.

God had blessed Namulaba Health Center, through His servants Inger and Claes, with steady funding for five years from August 2009 to July 2014.

Muzadde is a word in the Luganda language which stands for Parent.

Patients are asked to pay Uganda Shillings 1,000 (US $0.43) for the visit. This represents 10% of the actual cost of care. Women, children, adolescents and people living with HIV and those seeking HIV testing are exempted from this fee. Very poor patients who dont belong to these groups are given a waiver based on assessment by the Sister In-Charge.

11

_1455804483.xlsChart1

111627

102131

103444

112435

172239

53136

102333

102131

273461

172441

83644

143347

Male

Female

Total

Patients Tested for Malaria

Main Clinic

All Clients SeenGeneral Medical PatientsClients Tested for HIVClients HIV PositivePatients Tested for MalariaPatients Positive for Malaria

MaleFemaleTotalMaleFemaleTotalMaleFemaleTotalMaleFemaleTotalMaleFemaleTotalMaleFemaleTotal

Aug-12305989305989891704411162771118

Sep-123990129388912710162601110213151621

Oct-125085135488513311193011210344452227

Nov-12387010835691041014240001124353811

Dec-1256861425485139561100017223971118

Jan-13538914249841331423371235313641418

Feb-1340601003858967111801110233381624

Mar-1337609737599651116022102131101020

Apr-1357961535789146132033000273461121628

May-1336559135538891423123172441121426

Jun-134610515143901331615311128364461925

Jul-135510916453105158123143112143347112435

Total537964150151792514421201893095152015031946990181271

All Clients Seen

MaleFemaleTotal

Aug-12305989

Sep-123990129

Oct-125085135

Nov-123870108

Dec-125686142

Jan-135389142

Feb-134060100

Mar-13376097

Apr-135796153

May-13365591

Jun-1346105151

Jul-1355109164

General Medical Patients

MaleFemaleTotal

Aug-12305989

Sep-123889127

Oct-124885133

Nov-123569104

Dec-125485139

Jan-134984133

Feb-13385896

Mar-13375996

Apr-135789146

May-13355388

Jun-134390133

Jul-1353105158

Clients Tested for HIV

MaleFemaleTotal

Aug-128917

Sep-12101626

Oct-12111930

Nov-12101424

Dec-125611

Jan-13142337

Feb-1371118

Mar-1351116

Apr-13132033

May-1391423

Jun-13161531

Jul-13123143

MaleFemaleTotal

Total Tested for HIV120189309

Total Positive51520

Percent +Ve4%8%6%

Patients Tested for Malaria

MaleFemaleTotal

Aug-12111627

Sep-12102131

Oct-12103444

Nov-12112435

Dec-12172239

Jan-1353136

Feb-13102333

Mar-13102131

Apr-13273461

May-13172441

Jun-1383644

Jul-13143347

Malaria Positivity

TestedPositivePercent +ve

67Aug-12271867%

68Sep-12312168%

61Oct-12442761%

31Nov-12351131%

46Dec-12391846%

50Jan-13361850%

73Feb-13332473%

65Mar-13312065%

46Apr-13612846%

63May-13412663%

57Jun-13442557%

74Jul-13473574%

Malaria Positivity

TestedPercent +ve

Aug-122767

Sep-123168

Oct-124461

Nov-123531

Dec-123946

Jan-133650

Feb-133373

Mar-133165

Apr-136146

May-134163

Jun-134457

Jul-134774

Distribution of Clients to Services

Male and Female

All Clients1501

General Medical1442

HIV Testing309

Malaria Testing469

All Clients by Sex

MaleFemale

537964

General Medical Clients by Sex

MaleFemale

517925

HIV Test Clients by Sex

MaleFemale

120189

HIV Positive Clients by Sex

MaleFemale

Tested120189

Positive515

Prevalence4%8%

Malaria Test Clients by Sex

MaleFemale

150319

Malaria Positive Clients by Sex

MaleFemale

Tested150319

Positive90181

Prevalence60%57%

MaleFemale

Number tested150319

% Positive6057

Main Clinic

All Clients Seen Male

All Clients Seen Female

All Clients Seen Total

All Clients Seen

Nurse's Clinic

Male

Female

Total

General Medical Patients

Sheet3

Male

Female

Total

Clients Tested for HIV

Male

Female

Total

Patients Tested for Malaria

Total Tested for HIV

Total Positive

Percent +Ve

HIV Positivity

Male and Female

Distribution of Clients by Service

All Clients by Sex

General Medical Clients by Sex

HIV Test Clients by Sex

Malaria Test Clients by Sex

Number tested

% Positive

Malaria Testing and Positivity

Tested

Percent +ve

Malaria Positivity

General Medical CareImmunizationFamily planning (all methods)CondomsDewormingVitamin AAll Clients Seen

Adult MalesAdul FemalesChildrenTotalChildrenAdult FemalesAdult MalesChildrenChildrenAdult MalesAdul FemalesChildrenTotal

Aug-121013730000001013730

Sep-1231592707000322934

Oct-1251322027110005242958

Nov-1296823583000996684

Dec-12111693620900011252965

Jan-131616941241100016273376

Feb-138942120130008222454

Mar-131119838201400411333280

Apr-1313141239381500113295194

May-1318121040131400018262367

Jun-1312161038211302212293578

Jul-137151335561102872679120

Totals1231641013882971210415123285417840

All Clients seen in Nurse's Clinic

Adult MalesAdul FemalesChildren

Aug-1210137

Sep-123229

Oct-1252429

Nov-129966

Dec-12112529

Jan-13162733

Feb-1382224

Mar-13113332

Apr-13132951

May-13182623

Jun-13122935

Jul-1372679

General Medical Patients seen in Nurse's Clinic

Adult MalesAdul FemalesChildren

Aug-1210137

Sep-123159

Oct-125132

Nov-12968

Dec-1211169

Jan-1316169

Feb-13894

Mar-1311198

Apr-13131412

May-13181210

Jun-13121610

Jul-1371513

Reproductive Health Services provided to Females in the Nurse's Clinic

FP

Aug-120

Sep-127

Oct-1211

Nov-123

Dec-129

Jan-1311

Feb-1313

Mar-1314

Apr-1315

May-1314

Jun-1313

Jul-1311

Services in well-child clinic

ImmunizationDewormingVit A

Aug-12000

Sep-12000

Oct-122700

Nov-125800

Dec-122000

Jan-132400

Feb-132000

Mar-132004

Apr-133801

May-131300

Jun-132122

Jul-135628

Gen. Medical CareFamily PlanningChild ImmunizationsChild DewormingChild Vit A

388121297415

Adult Males

Adul Females

Children

All Clients seen in Nurse's Clinic

Adult Males

Adul Females

Children

General Medical Patients seen in Nurse's Clinic

Immunization

Deworming

Vit A

Service in well-child clinic

FP

Females who received FP in Nurse's Clinic

Total number of clients served in nurses clinic (N=825)