Bridging Participation Gaps: A Community-Led Inception for Integrating Comprehensive Adolescent-Friendly Family Planning and Post-Abortion Care (CAFFP–PAC) into Primary Healthcare Facilities in Northern Uganda
Bibliographic record
Abstract
Eustes Kigongo,1 Emmanuel Ekungu,2 Acheka Edmonton,3 Anna Grace Auma,2 Morris Chris Ongom,4 Udho Samson,5 Maxson Kenneth Anyolitho,6 Amir Kabunga,7 Odette Murara,8 Judith Abal Akello,9 Bernard Omech10 1Department of Environment Health and Disease Control, Lira University, Lira, Uganda; 2Department of Nursing, Lira University, Lira, Uganda; 3District Health, Lira, Uganda; 4GLOFORD_UGANDA, Lira, Uganda; 5Department of Midwifery, Lira University, Lira, Uganda; 6Department of Community Health, Lira University, Lira, Uganda; 7Department of Psychiatry, Lira University, Lira, Uganda; 8Faculty of Social Work, University of Calgary, Calgary, Canada; 9Department of Commerce and Business Management, Lira University, Lira, Uganda; 10Coordinator for Centre for SET-SRHR Lira University, Lira, UgandaCorrespondence: Amir Kabunga, Email amirkabs2017@gmail.comBackground: Conventional top-down health interventions often exclude adolescents and community stakeholders from service design and implementation, resulting in low uptake and a mismatch with young people’s needs. The CAFFP–PAC initiative in Northern Uganda sought to explore how a community-led, adolescent-centered inception process could support integration of adolescent-friendly family planning and post-abortion care into primary healthcare services.Methods: A participatory qualitative design was employed during an inception meeting in Lira City on April 1, 2025, guided by principles of community-based participatory research and citizen science. A total of 110 purposively selected stakeholders including adolescents, youth mentors, parents, educators, health professionals, and cultural and religious leaders engaged in dialogue circles, breakout sessions, simulations, and visual storytelling to co-develop integration strategies. Data were collected through audio recordings, field notes, and participatory tools, and analyzed using Braun and Clarke’s thematic analysis framework.Results: Six themes emerged: (1) meaningful participation of adolescents and stakeholders; (2) adolescent-friendly and confidential service environments; (3) health system readiness and provider attitudes; (4) addressing socio-cultural and gender norms; (5) integration strategies for CAFFP–PAC in primary care; and (6) sustained engagement and feedback mechanisms. Adolescents emphasized safe, private, and respectful care environments, while stakeholders stressed community ownership, trust-building, and reliance on local structures. Youth mentors, cultural leaders, and school clubs were identified as key enablers for service uptake.Conclusion: A community-led inception process centered on adolescents and local voices is feasible and essential for successful CAFFP–PAC integration in Northern Uganda. Findings highlight the need to shift from provider-centered models to inclusive, participatory approaches that leverage community assets, foster adolescent agency, and ensure sustained engagement. Such approaches are vital for enhancing service accessibility, responsiveness, and sustainability in resource-constrained settings.Keywords: adolescents, family planning, post-abortion care, community participation, reproductive health, citizen science, gender norms, primary healthcare integration
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.021 | 0.024 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.009 | 0.003 |
| Scholarly communication | 0.004 | 0.004 |
| Open science | 0.005 | 0.026 |
| Research integrity | 0.002 | 0.004 |
| Insufficient payload (model declined to judge) | 0.007 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".