Lack of access to contraception in Uganda costing thousands of lives

More than a half of all pregnancies in Uganda are unintended and nearly a third of them end in abortion a new survey has found.

More than a half of all pregnancies in Uganda are unintended and nearly a third of them end in abortion a new survey has found.

The survey released by Mulago hospital in Kampala, the US-based Guttmacher Institute and the Centre of Health, Human Rights and Development, found 26% of all maternal deaths to result from unsafe abortions. It also found that on average Ugandan women wish they had at least two children less, a phenomenon known as ‘excess fertility’.

The results were unveiled by Dr Kiggundu Charles, a consultant gynecologist at Mulago hospital, who told a fully- packed press conference: “Probably half of all of you seated in front of me today were not intended by your parents.’’

The survey, based on an analysis of Uganda’s 2011 Demographic and Health Survey, found Ugandan women are giving birth to an average of 6.7 children each. This is high even by Sub-Saharan African standards.

Essentially, at the centre of the millions of unintended pregnancies in Uganda is the issue of contraception. Only an estimated 25% of women in Uganda have access to a modern contraception method, which points to a staggering lack of access to modern and safe contraception. One in three married women in Uganda have an unmet need for contraception according to the survey results.

Clearly, investing in increasing access to family planning and contraception for women of reproductive age would save the country phenomenal sums currently spent on treating post abortion complications. Fewer births would also mean families would have fewer mouths to feed and educate, and it would be kinder for the environment. If Ugandan women had their wish and had two less children than they currently have, gains in per capita income would be made and a better quality of life achieved for millions of Ugandans.

It emerged at the meeting that myths and misconceptions about modern contraception methods, such as the perception that they can cause cancer and fibroid problems, are widespread. This creates another barrier to utilising contraception for Ugandan women.

‘’The traditional medicine men have hijacked contraception education. There are several programmes on local radio and television stations that are misinforming many women on safe contraception in preference for crude, riskier methods,” said Dr Zainab Akol of the Ministry of Health.

Dr. Akol said he regretted the current situation in which Uganda’s medical profession has conceded ground to ‘medicine men’ when it comes to supplying information on contraception. He added that many rural and uneducated women only have access to inaccurate advice from traditional medicine men when making decisions on birth control and family planning.

‘’Unsafe abortion and contraception are human rights, public health, legal and moral issues in Uganda that must be addressed,’’ said Moses Mulumba, head of the Centre for Health, Human Rights and Development.

Professor Ben Twinomugisha, Dean of the School of Law at Makerere University, emphasised that human beings have a right to enjoy sex and that, when debating issues surrounding abortion, “the woman should be at the centre” of the debate.

Other research carried out by the Guttmacher Institute found a co-relation between restrictive laws on birth control and increased abortion. Countries that have a liberal stance on birth control, such as many in Europe, have fewer deaths from unsafe abortions and spend less on post abortion complications.

Dr Mugisha’s results show that Uganda spends about 4.7% of the national health budget on post abortion complications – money that could be used to treat other conditions were the number of unintended pregnancies to fall.

Annociata Kampaire, head of Alliance for Integrated Development and Empowerment, called for the legalisation of abortion in Uganda, which according to Article 22 of the Uganda constitution is illegal except under strict conditions defined by the law.

Uganda is a conservative country and Prof Twinomugisha reminded those present that the religious and conservative lobby defeated attempts to legalise abortion in the Kenyan constitution of 2010. He called for a human rights-based approach to the debate on contraception and abortion in Uganda but emphasised that both sides of the spectrum – a woman’s right to access safe abortion and a woman’s right to continue with an unintended pregnancy on religious and moral grounds – should be equally respected.

‘’Unintended pregnancy is the root cause of most abortions, and the injuries and deaths that often follow. Providing better family planning services would dramatically improve maternal health in Uganda,” Mulumba added.