Reproductive Health Policy and Community Health Systems in Northern Uganda

This article examines the implementation of reproductive health policy within community health systems in post-conflict Northern Uganda, drawing on a critical synthesis of policy documents, programme evaluations, and peer-reviewed literature. The study employs a qualitative policy analysis framework, integrating the World Health Organization's health system building blocks and a gender equity lens to assess how community health workers (CHWs) mediate policy uptake, particularly in contexts of fragile statehood and cultural patriarchy. Key findings indicate that while national policies articulate progressive reproductive health goals, their translation into community-level practice is constrained by chronic underfunding, inadequate training of CHWs, and gendered power dynamics that limit women's autonomous decision-making. The analysis reveals a persistent gap between policy rhetoric and grassroots implementation, exacerbated by weak referral pathways and the commodification of reproductive health services. The article contributes a novel conceptual model linking policy coherence, community agency, and gender-transformative programming, arguing that sustainable improvements require decentralised governance and the deliberate inclusion of men as allies. This synthesis advances scholarship by demonstrating that reproductive health outcomes in Northern Uganda are shaped less by policy content than by the socio-political and economic capillaries through which policies are enacted.