By Uziah Tusaasire
Uganda’s Sexual and Reproductive Health and Rights (SRHR) service delivery system for sex workers shows relatively strong coverage in some areas but continues to face critical gaps in quality, access, and commodity availability, according to findings from a recent UNESO mapping exercise.
The study was conducted by the Uganda Network of Sex Worker-led Organisations (UNESO) between February and May 2026, with support from the Commonwealth Foundation. It assessed 127 health facilities and 36 community-based organisations (CSOs/CBOs) across 13 districts in Western, Southern, and Central Uganda. The findings were presented during a dissemination meeting held on 30 June 2026.
The report indicates that services such as HIV testing, condom distribution, antiretroviral therapy (ART), and antenatal care are widely available across many facilities. However, significant gaps remain in other essential SRHR services, including cervical cancer screening, infertility diagnosis, comprehensive STI treatment, and access to safe abortion-related information.
In addition, the study highlights persistent commodity stockouts that continue to undermine service delivery. Key supplies such as condoms, family planning commodities, STI drugs, PrEP, PEP, and emergency contraception were frequently unavailable in several health facilities. Isingiro District and Mbarara City recorded some of the highest stockout rates, raising concerns about the reliability of SRHR services in high-need areas.
The mapping further revealed notable disparities in service readiness and quality across districts. While some health facilities demonstrated strong capacity and trained personnel, others lacked sufficient skills and systems to provide sex worker-friendly services.
Confidentiality emerged as a major barrier to access. The report found that fear of stigma and inconsistent privacy practices continue to discourage many sex workers from seeking care. In some districts, health facilities were classified as having weak or unreliable confidentiality systems.
Despite these challenges, community-based organisations (CSOs/CBOs) were identified as critical service bridges. They provide peer education, psychosocial support, legal assistance, and referral services, helping to connect sex workers to available health facilities.
The mapping exercise recommends strengthening referral systems, improving client-friendly services in health facilities, expanding training for health workers, and ensuring the regular restocking of essential SRHR commodities.
Speaking at the dissemination meeting, the Director of Programmes, Ms. Naomi Mujuni, noted that the findings will be used to develop a validated referral database. She added that this will improve coordination between health facilities, CSOs, and peer networks, with the aim of building a more responsive and inclusive SRHR system in Uganda.
