Addressing gaps in sexual reproductive health and rights

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Okello Jaspa and Atala Hurriet from Alebtong are a young couple just about to wed. Aged 22 and 18 respectively, their dreams of building a family are vivid.

In Uganda, the legal age of consent to marriage is 18.

For a traditional marriage, Okello must work hard to raise money for the four cows requested as dowry by his fiancée’s family.

He dropped out of school when he was just about to write the primary leaving examinations in 2018. So, finding work to put food on the table is not easy.

But this is not the only problem these young lovers are facing. To access healthcare services, they must travel far. And, they know very little about sexual and reproductive health.

Atala, who dropped out of school in primary five, says she wants five children. Asked if she knows about family planning, her response while giggling was “what is that? I have never heard about it.”

Her fiancé would like to have three children, but fears the responsibilities that come with children.

Many young people in Uganda, like Atala and Okello, start having children without knowledge of sexual and reproductive health rights.

Despite decades of interventions, Uganda continues to face significant sexual and reproductive health challenges, including high maternal mortality and limited access to services.

Key issues include teenage pregnancy, HIV, unwanted pregnancy, reproductive cancers, and gender-based violence. Research into sexual and reproductive health rights (SRHR) outcomes, mental health, male SRH needs, and improving access for marginalised groups is crucial to informing effective policies and interventions.

One of the leading voices on evidence-informed SRHR policy and programmatic action in Uganda has been the International Centre for Research on Women (ICRW).

For more than ten years now, they have carried out research focused on how to fill the gaps in sexual and reproductive health and rights. In keeping with their mission to “generate and share policy-relevant evidence on critical socio-economic and health issues in Uganda,” they recently shared emerging insights as well as evidence gaps on SRHR.

A panel of experts was hosted on the live Vision Podcast on X Spaces to discuss burning issues and sustainable solutions.

Dr Chima Izugbara, ICRW's Africa Director of Global Health, Youth & Development, has over 20 years of experience in research, program implementation, and capacity building, focusing on health and rights in developing countries.

He was joined by Dr Stellah Bosire, a feminist, medical doctor, lawyer, and researcher, leading the Africa Centre for Health Systems and Gender Justice to promote gender-equitable, technology-driven healthcare systems across Africa.

Faith Mairah is an independent gender, adolescent, and youth SRHR consultant with over nine years of experience, focusing on youth empowerment, gender-transformative approaches, and SRHR programming across East Africa and globally.

We asked Dr Bosire about the most significant barriers to accessing sexual and reproductive health services in Uganda, particularly for marginalised groups like youth and people with disabilities.  “At the household level, the question that we ask ourselves is what are the issues that would bar young people from accessing services like contraception,” she explains. 

She highlighted the patriarchal society we live in and how it makes decision-making for women difficult.

Issues affecting young women often stem from decision-making. “Access to reproductive services for young people is limited,” she goes ahead to debunk the misconception that “if we avail such information to young people, it will make them promiscuous, not true,” said Dr Bosire.

How can Uganda better integrate community engagement to tackle the SRH challenges, especially given the influence of cultural norms and societal expectations?

Mairah worries, “Uganda has some of the best policies, but they are not implemented.” She is calling for the integration of SRH into the education framework, but to achieve it, “there is capacity building needed.”

Reproductive cancers are becoming a growing concern in Uganda. How can research into patient demographics and care-seeking behaviours be used to improve access and treatment?

Dr Izugbara says, it is important to understand the “characteristics of people at risk of such cancers.”

What gaps in research on male SRH needs should be prioritised in Uganda to improve health outcomes for men?

From the perspective of the current research, Dr Izugbara says, men too experience difficulties when it comes to seeking and accessing quality SRH information, and that it is important to “work with men to improve sexual reproductive health by targeting their risks of infection.”

How can Uganda address the pervasive issue of gender-based violence and its impact on women’s SRH rights and outcomes?

Mairah defines gender-based violence as “violence inflicted on someone because of their gender. She suggests strengthening the GBV shelter system and legal framework.

Atala and Okello’s story is a mirror reflecting the realities of many young Ugandans, full of hope, yet limited by systemic gaps in sexual and reproductive health services.

While policies and research efforts are in place, the disconnect between planning and practical implementation continues to cost lives and futures.

Bridging these gaps requires more than talk, it demands real investment in education, access, and community-driven solutions.

Until young people like Atala and Okello can make informed choices about their health and futures, the promise of equitable SRHR in Uganda remains unfulfilled.

Uganda continues to face serious sexual and reproductive health challenges, from teenage pregnancy to poor access to services and weak policy implementation.

Cultural norms, limited education, and high costs keep many, especially women and young people, from getting the care they need.

Experts stress the need for more targeted services, better data, and stronger community involvement.

Without these, the cycle of poor health outcomes and limited choices will persist for many like Atala and Okello.