By Dr. Peter Ibembe

Officially, the COVID-19 virus has infected almost 80,000 people in the country and more than 1,900 have lost their lives.

However, the full extent of this catastrophe may be incalculably higher.

Uganda’s community and health systems have been stretched to the limit. The economy has been adversely affected. Vulnerable and underserved girls and women have been disproportionately affected and reproductive health services have been curtailed, with gender-based violence on the increase in Uganda.

July 11 is marked annually as World Population Day. This is a moment to raise awareness concerning the sexual and reproductive health needs of people around the world.  We call attention to the vulnerability and needs of women and girls amid the Covid-19 pandemic. Efforts should be made to secure their sexual and reproductive health and human rights in Uganda.

But that is not all. According to the Uganda Bureau of Statistics (UBOS), Uganda’s population stands at 41.6 million people. It has one of the highest fertility rates in the world where each woman gives birth to no fewer than 5-6 children in her lifetime. In comparison, the global fertility rate stands at 2.3 births per woman.

No individual, family, community, organisation or district of Uganda can reduce the fertility rate alone because there are increased reproductive health challenges vulnerable women face due to the pandemic.

Health workers, most of whom are women, some actively providing sexual and reproductive health rights services, also face a more direct risk of illness from COVID-19 as they are at the frontline.

But other women and girls outside the health sector also face serious risks. In refugee camps, in slums and other unplanned settlements; in other hard to reach areas. Communities that require sexual and reproductive health services may be anxious about exposure to the virus at health facilities, and some forgo reproductive health services entirely. Others have been unable to access care due to inter-district movement restrictions.

Several hospitals and health centres have reported a slump in the number of women and girls receiving critical sexual and reproductive health care, including maternal and childbirth services, family planning and counselling about reproductive health.

RHU and its partners estimate that as a result of three months of service disruption, 2.2 million women in Uganda will go without contraceptives leading to an additional 20,000 unintended pregnancies. The number of maternal deaths is also expected to increase resulting from the curfew and travel restrictions that were instituted to combat Covid-19.

RHU and its partners are working to ensure continued access to reproductive health services and supplies but the challenge remains. Some health care providers in other private and public facilities do not have ready access.

Circumstances are even more disturbing in humanitarian settings.

Regular medical supplies and stocks have been necessary to strengthen the health system, which was already strained before the pandemic broke out in March 2020. For instance, humanitarian support has been essential for 18 -year-old Furaha Kamate, from Namiganda village in Kikuube district, who faced life-threatening pregnancy complications in the Kyangwali, refugee camp.

RHU and partners organised special and emergency services for her to deliver her fourth child. The entire process took a week of planning and another week for travel. Finally, Kamate, arrived at Rwenyawawa health Centre III in Kyangwali refugee camp, where she delivered a daughter through Caesarean section.  

Although she is relieved to have had a safe delivery, she remains fearful about COVID-19 as well as conceiving another unplanned child.

In other places in Uganda, during the COVID 19 lockdown, women are also reporting an increase inGender-Based Violence.

During the curfew and lockdown period, I have I have interacted with women in the Albertine region, Busoga and West Nile, who have experienced violence at the hand of their husbands and partners.

To make matters worse, access to anti GBV shelters and in-person counselling has been limited by reduced movement during the lockdown though RHU and her partners are striving to continue offering services for survivors wherever possible.

.New forms of violence may be increasing, including online digital communication violence. This is another area of violence that needs further assessment and investigation

This is a new area of violence that needs further assessment and investigation.

The writer is the director of programmes at Reproductive Health Uganda (RHU) and  researcher in education, maternal and reproductive health.