By Evalist Mpamizo
Fort Portal: Young mothers in Fort Portal Tourism City have blamed misconceptions about modern family planning services in the area for the increasing cases of teenage and unplanned pregnancies, which affect child and maternal health.
They say that while they prefer to be in charge of their reproductive health, most of them are always discouraged from using modern family planning methods because of misconceptions in their communities, which leads them to make unprecedented choices with devastating effects on their lives and future.
A 20-year-old, Joyce Tusiime, a mother of two and a resident of Kitumba, Central Division, in Fort Portal City, narrates how she survived death after conceiving her second pregnancy six months after a cesarean section (C-section) birth. “After the first birth, my husband said he would use withdrawal (a traditional method). However, I later realized that I was pregnant again. It was a stressful moment for me; I almost died because the scar had not yet fully recovered,” Tusiime said.
She adds, “Of course my husband could not allow me to procure an abortion, so I carried this pregnancy for around seven months, and I was operated on again. I had to stay in the hospital in Buhinga (Fort Portal Regional Referral Hospital) with my premature baby while the firstborn suffered from malnutrition because he did not get enough time to breastfeed.”
According to Tusiime, she was advised by a health worker to seek family planning services at the facility where she was introduced to implant contraceptives. “This has enabled me to effectively raise my two children and plan for my livelihood and future before conceiving the third pregnancy,” she said.
Just like Tusiime, many young mothers in Fort Portal have gone through the same experience. They believe that society is washed with misconceptions about modern family planning methods, which discourages them from embracing the services. Such services include oral contraceptive pills, implants, injectables, contraceptive patches, vaginal rings, intrauterine devices (IUDs), and female and male condoms, among others.
Similarly, Juliet Natugonza got her first child while on Senior Four vacation and was chased from home as soon as she gave birth. Natugonza believes that young women like her need information on their reproductive and sexual health to fully exercise their right to choice and to keep themselves, their partners, and their children healthy.
Statistics from the Fort Portal City Health Department indicate that in the financial year 2020/2021, at least 5,607 females of reproductive age between 15 and 59 years sought modern family planning services in different health facilities in the city. The number increased in 2021–2022, to 6,326. This, however, dropped to 5,362 in the financial year 2022-2023.
Dr. Solomon Asiimwe, the Fort Portal City Health Officer (CHO), said that although family planning is one of the strategies being implemented in the promotion of child and maternal health, it has been affected by local myths that scare potential clients. Dr. Asiimwe attributed high cases of malnutrition in the city to “children born by chance, not by choice.”
“Family planning helps in child spacing and planning for the wellbeing of your family; if you have a big family that you can’t feed well, the children will automatically get malnourished, and this frustrates our efforts in the promotion of child and maternal health,” Dr. Asiimwe said.
Data at the City Health Department show that 4,817 children were diagnosed with malnutrition in the financial year 2020/2021. Dr. Asiimwe acknowledges the low level of family planning used to create false impressions.
Health experts in Fort Portal Tourism City also say that the low-level use of family planning is influencing the fertility pattern and population growth rate in the city suburbs, derailing the otherwise healthy development of young women and adolescents into adulthood.
Annet Kabahenda, the Family Planning focal person in Fort Portal Tourism City, says the number of people seeking family planning services remains low and attributes this to the low level of men’s involvement. However, she believes that myths have greatly affected modern family planning services.
Angela Merice Kusiima, the In-Charge of Reproductive Health Uganda (RHU) Fort Portal, says that while nearly a third of all women in Uganda are becoming mothers during adolescence, it is clear the country is unknowingly ruining the future of young adolescent girls and women.
Kusiima says most adolescent girls are sexually violated by men older than them, meaning their first sexual encounters are not out of their decisions justifying why they need to have routine access to family planning services.
Dr. Richard Mugahi, the assistant commissioner in charge of reproductive and infant health at the Ministry of Health, says the government of Uganda recognizes the role family planning will play in the achievement of Uganda Vision 2040’s target to reduce the population growth rate from 3.2% to 2.4%, which will result in reaping the demographic dividend. He says that this is also in line with Sustainable Development Goal (SDG) Number Three of Good Health and Well-Being.
Uganda, under a plan developed by the Ministry of Health, committed to increasing the modern contraceptive prevalence rate (mCPR) for all women from 30.4% in 2020 to 39.6% by 2025 and reducing the unmet need for family planning from 17% in 2020 to 15% by 2025.
A survey, which was conducted jointly by the Ministry of Health, Uganda Bureau of Statistics (UBOS), and Makerere University School of Public Health in 2022, showed that 15 percent of the women in Uganda can’t access contraceptives.
Globally, in 2021, an estimated 14 percent of adolescent girls and young women gave birth before the age of 20, while in Uganda, 24.8 percent of the women aged between 15 and 19 years have begun childbearing, yet, according to studies, giving birth complications are a primary cause of mortality, with 368 deaths per 100,000 in Uganda (UBOS, 2021) and injury among teenage girls.
Steven Muhenda, the Fort Portal City health educator, says that the city health department is carrying out different strategies to mobilize and sensitize people about the positive impacts of family planning. “We are doing outreach in communities, telling people why they should embrace modern family planning. People think that family planning is about population control. No! It is about having a family that you can effectively provide for.” Muhenda said.
Dr. Solomon Asiimwe, the Fort Portal City Health Officer (CHO), said that “we are now implementing a multi-sectoral approach that brings on board all stakeholders, like local leaders, civil society organizations, and cultural leaders, to have one voice against misconceptions about family planning.”
Angela Merice Kusiima, the in-charge at the Reproductive Health Uganda Fort Portal, says that they are currently doing outreach programs in different communities to ensure that people can freely access modern family planning methods at a free cost.
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