15th October 2017
Team Leader – Uganda Youth and Adolescents Health Forum
Uganda today is home to nearly 10 million adolescents aged 10-19 years – 24.3% of the country’s total population and majority live in rural areas (2016 National Housing Census Data).
Adolescence characterised by rapid biological, emotional and social development – is a critical life stage during which a person must have the opportunity to develop the capabilities required for realizing their full potential and achieving a productive health and satisfying life.
With the onset of puberty, a child moves into adolescence and their social exposure begins to expand. Various pressures to try new things and to take risks, and various impositions, particularly for girls such as child marriage and non-consensual sex – intensify.
An analysis of data from the Uganda Demographic Health Survey 2016, indicates that more than 1.1 million Ugandan aged 15-19 years are sexually active, – they are either married unmarried and had, had sex in the last three months or they are union (i.e married or leaving together). On average, adolescents who had sex before their age 20, adolescent girls first had sexual intercourse at age 16.1 years and adolescent boys at 16.4 years (UDHS 2016/ Uganda data WHO factsheet).
Today one 1 in every 4 girls aged 15 -19 years is already a mother or pregnant with her first child (UBOS 2016) and (UDHS 2011).
Flavia Najjembe 16 years in the company her colleagues from Kintate Hill School at the Uganda She Decides Open House. Flavia was speaking at the Panel. On the Right is a UYAHF info-graphic on the choices that girls want.
But for many of these girls, pregnancy has little to do with informed choice. Often times, it is a consequence of discrimination, rights violations (including child marriage, rape, and defilement), inadequate education or sexual coercion, limited access to and contraceptive services among others. The African Reproductive and Sexual Health scorecard released in 2010, showed that Uganda has the highest adolescent fertility rate in East Africa and scores 8th in Africa, with an adolescent fertility rate of 159 births per 1,000 young women.
25% of adolescents aged 15-19 in Uganda have begun childbearing: As expected, the proportion of women age 15-19 who have begun childbearing rises rapidly with age, from 3% among women age 15 to 22% among women age 17 and 54 percent among women age 19.
More than 300,000 teenagers who get pregnant annually also account for the bulk of unwanted pregnancies, which end up in unintended births and unsafe abortions. Actually, 24% of girls aged 15-24 years have had an abortion (Guttmacher institute Report 2013 – Unintended pregnancy and abortions in Uganda). Majority of these are unsafe abortions that end up in maternal mortality and morbidity due to stigma, fear, isolation and criminalization.
The issue of adolescent fertility is important on both health and social grounds. Children born to very young mothers are at increased risk of sickness and death. Teenage mothers are more likely to experience adverse pregnancy outcomes and are more constrained in their ability to pursue educational opportunities than young women who delay childbearing. Adolescent childbearing is more common in rural than in urban areas (27 versus 19 percent, respectively). There is regional variation, with Teso subregion having the highest proportion of adolescents who have begun childbearing and Kigezi subregion having the lowest (31 and 16% respectively).
But it’s important to note that, the proportion of teenagers who have started childbearing decreases with increasing level of education: slightly more than one third of teenagers age 15-19 with no education (35%) have begun childbearing compared with 11% of those who have more than secondary education (UDHS 2016)
Sr. Miriam Namugere the adolescent health focal person speaking at the She Decides Opne House panel.
In 2011, Ministry of Education and Spots reports indicated that about 34% of teenage girls drop out of school due to pregnancy related complications, while in Africa 3 out of 10 girls drop out of school due to pregnancy and child birth related issues (UNICEF 2011 report on the State of the Girl Child)
Girls who have dropped out of school lack employable skills. This leads to law productivity which in a long term contributes to poverty. Teenage pregnancy and early and forced marriages also put girls at a high risk to HIV infection. HIV infection is also a big burden among young people in Uganda.
While at a She Decides Open House organized by Uganda Youth and Adolescents Health Forum in partnership with the Uganda Parliamentary Forum on Youth Affairs, Uganda Women Association for Parliamentarians, RHRN Uganda Platform and National Population Councile on 11th October 2017 at Fair Way Hotel in Kampala, young people people called on the ministry of health to immediately conclude the review process and, pass and adopt the National Policy for the Health of Adolescents and to reinstate, passing of the National Guidelines and Standards for Sexual Reproductive Health and Rights which are designed to focus attention on the service delivery needs of young women and girls aged 15-19.
Dr. Jotham Musinguzi the Executive Director National Population Council, MPs from the Parliamentary Forum on Youth Affairs and the Uganda Women Association for Parliamentarians and the Swedish and Dutch Ambassadors in Uganda speaking at the Open House.
Ministry of Health has been reported over the media making inaccurate claims that they “had not been consulted” and that the guidelines intend to distribute contraceptives to 10 year olds. But by the virtural of it’s mandate, the ministry of health played a coordination and convening role in the development of the national guidelines and standards for SRHR a process that lasted for over 16 months.
The open house organized as build up for the international Day of the Girl celebrated every 11th October was organized under the theme; “When She decides, the World is Safer, Stronger and Better”
Young people, CSO partners. community and opinion leaders listening to the panel discussions at the She Decides Open House.
Inspiring, Visionary and Interactive, the SheDecides Open House was an opportunity to spotlight the SheDecides Movement to the wider circles of policy makers, legislators and the CSO fraternity working around issues of Sexual Reproductive Health and Rights (SRHR) in Uganda, and to show how SRHR issues of women and girls including; access to contraceptives and family planning are central to the SheDecides Agenda. She Decides is a Global Movement that advances for a World where all women and girls can freely decide what to do with their bodies, their life and their future. Additionally, SheDecides movement promotes, provides, protects and enhances the fundamental rights of very girl and woman including their right to SRHR services.
Hon. Adeke Annah Ebaju the National Female Member of Parliament while speaking at the Open House called on government of Uganda to expand access to quality and age appropriate SRHR information and services for adolescents and invest in policies and programs that protect the rights of women and girls from all forms of sexual and gender based violence. She also called on government to revamp the justice system to address the justice needs of women and girls by bring to book all culprits of defilement, rape and sexual assault “The law must be seen to be active and harshly dealing with with culprits”, noted Hon. Adeke.
Hon. Adeke Anne Ebajju the National Female Youth MP and Chair of the Parliamentary Forum on Youth Affairs makes her remarks at the She Decides Open House in Support on Expanding access to adolescent and youth SRHR services and information and promotion of the rights of women and girls.
Despite Uganda’s high teenage pregnancy rates, the country has one of Africa’s highest unmet need for family planning for adolescents ages, 15-19 estimated at 30.4% with total demand of 52.3% and unmet need of 29.3% for young women 20-24 years with a total demand of 63.3%.
Teenage pregnancy continues to contribute greatly to the maternal deaths and injuries in Uganda to about, 24%, with pregnancy and child birth related complication being the major leading cause of deaths among adolescent girls of 15-19 years.