Uganda hosts the world’s third-largest refugee population, and unmet need for family planning is higher in refugee settlements than the national rate of 22%. In Bidibidi and Palabek, home to more than 300,000 refugees, adolescent girls face stigma, distance, provider bias and limited autonomy. SheCares, a six-month pilot, gave girls and young women ages 15 to 24 counseling, self-injection training and access to contraception through 18 health facilities and community channels.

Over half of clients were new to family planning, and the share of new users ages 18 to 24 grew. SheCares reached 7,398 new users and delivered 23,744 couple-years of protection (CYP) at US $14 per CYP and US $43 per new user. WISH2ACTION, the IRC’s earlier large-scale program in the same settlements, reached US $13 and US $39 only after growing from 28 to more than 90 facilities.

The pilot had no control group and ran too briefly for every component, including drug shop distribution, to mature. Continued implementation, careful cost tracking and replication in other displacement settings should come before scale-up. Funders can support 12-month replication research, and implementers can gain efficiency by adding facilities, engaging drug shops and village health teams early and strengthening supply chains.

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