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New Vision is highlighting the challenge of teenage pregnancy in Uganda with a view to finding a solution to the problem that costs Ugandan taxpayers up to sh250b a year in healthcare. 

Robert Adiga writes about the struggle of these ‘children’, some of whose parents have unfortunately turned their dilemmas into wealth opportunities through brideprice.

Eighteen-year-old Katrin Dawa, a refugee from South Sudan living in block 1 Ofua III village in Rhino camp refugee settlement, early this year had her dream to become a nurse shattered. 

Dawa, who had just joined Senior Two at Ofua Secondary School, was made pregnant by a refugee, who is a bodaboda rider at the settlement, with whom she has had a relationship for three years. 

She says she was forced to abandon her younger siblings she was taking care of as the household head. 

Her parents, who are in South Sudan, after learning about her condition, forced her to go and live with the person responsible for her pregnancy. 

“Two months after impregnating me, the boy ran back to South Sudan. I am living with my mother-in-law, who is incapacitated to take care of me, but I have no choice. My siblings are living with my uncle’s wife,” Dawa said. 

To ensure a safe pregnancy and delivery, she said she used to visit a health facility for antenatal care and had built rapport with the nurses. 

However, she got uncomfortable going there because the adult expectant mothers kept rebuking her for getting pregnant and dropping out of school. 

Dawa said this caused her more trauma than she once considered an abortion. She says she has not lost hope of achieving her dream if given a chance to go back to school. 

Rose Wuya's story  

At the age of 15, in 2019, as Rose Wuya returned from a market, she was dragged to a bush and raped by a fellow South Sudanese. 

The 19-year-old Wuya is a resident of block B, Ofua III in Rhino camp refugee settlement. 

“When I reported the rape to my father, he promised to take the matter to the Police, but he instead took me to the boy’s home as a wife.” 

Wuya said she almost committed suicide after the unfortunate incident. She now has two children and their father returned to South Sudan. “I am living with my mother-in-law with little support for the children.’’ 

‘‘Their father sometimes sends only sh10,000 per month,” Wuya said. She was forced to drop out of school in Primary Six. 

The challenge of teenage pregnancy is not only prevalent in refugee communities in West Nile; nationals have not been spared either. 

Viola Ayikoru dropped out of school in Senior Two, saying there was no one to pay her school fees. 

Rose Obiga

“It started with frequent bouts of malaria. Little did I know I was pregnant,” Ayikoru, a 19-year-old in Vurra sub-county in Arua district, says. 

Upon realising she was pregnant, her family negotiated a bride price of two cows from the man responsible.

“When I got married, my mother-in-law did not receive me well. I am living in a hostile environment yet I cannot go back to my relatives because they already took bride price.”

Beatrice Anyuarach (not real name), 19, from Aporo village, Olyevu parish in Powor sub-county, Madi-Okollo district is among the victims of sexual gender-based violence. 

She was locked up and raped by two men in a shop at the trading centre as she went to buy medicine for her sick father in 2021. She got pregnant.

Anyuarach, however, says the perpetrator, who was known to her and arrested, escaped prison after he reached an agreement with her father to pay two goats and an unspecified amount of money.

Fortunately, she has returned to school through the support of NutriCash, a non-government organisation that enabled her acquire basic dietary needs for the baby. 

She is in Primary Seven in Pumit Primary School, Wadelai sub-county in Pakwach district.

The statistics  

The United Nations Population Fund (UNFPA) report on teenage pregnancy in 2021 indicates that West Nile is among the top six regions with the highest numbers of teenage pregnancies, with the most affected districts being Arua (4,705 cases) and Yumbe (3,973 cases). 

In 2021, after lifting the first COVID-19-induced lockdown, West Nile region had registered over 14,500 cases of teenage pregnancies. Most of the affected are school-going children aged 14-18 years living with single parents or relatives. 

Yumbe had the highest number of teenage pregnancies registered between March and September 2021 with over 7,000 cases followed by Zombo with 2,186 cases, Pakwach with 1,011 cases, while Arua had 678 cases. 

At Arua Hospital, between January 2020 and November 2021, over 6,500 cases of teenage pregnancies were recorded for both refugees and host communities. 

“We registered over 3,000 cases of teenage pregnancies after the lifting of the lockdown and this is mainly attributed to cultural practices among the Lugbara, where girls are seen as source of wealth and thus do not report cases of defilement to the authorities,” Edward Endraa, the senior probation and Welfare Officer Arua district local government, said.

In Arua district, from mid-2022 to 2023, there have been over 3,000 cases of teenage pregnancies recorded.

Wilfred Saka

What went wrong? 

Many stakeholders attribute teenage pregnancy to high poverty levels in the region. Girls are regarded as sources of wealth through bride price.

This is coupled with illiteracy among parents who do not value education, opting to marry off their teenage daughters. Poor parenting has also been held responsible for the unfortunate trend. 

Parents are not being keen on the upbringing of their children who are left to roam the village for night discos, Charles Mokili, a village health team officer in Tukaliri village, Tukaliri parish in Lobule sub-county, Koboko district said.

The region also has night markets that the teenagers visit, where they are either lured into sexual relationships or defiled, according to local officials. 

Police in West Nile have registered over 170 cases of defilement in the last six months. 

“Between January and June this year, we have registered over 170 cases of defilement, which have been followed with many perpetrators being prosecuted, while other cases die after the complainants lose interest in them. 

Majority of the cases remain unreported by the parents and only come to Police when they have failed to negotiate the bride price,” Josephine Angucia, the Police spokesperson for West Nile sub-region, said.

Obstacles on the way 

Felix Ade, the Refugee Welfare Council One chairperson for Ofua III village, says they have initially liaised with the Police to have the defilement cases reported and handled to their logical conclusion. However, he explains these efforts have been frustrated by the Police releasing the perpetrators before the cases are concluded. 

“Of late, many parents have resorted to resolving defilement cases at homes with the families of the perpetrators. In addition, when we report the cases to the Police, they want us to take responsibility by following up. Without facilitation, it becomes difficult for us,” Ade added. 

He challenged the local leaders and partners to increase facilitation for refugee leaders and offer protection to the victims since cases of defilement are sensitive. 

Flavia Rwabuhoro

Impact 

Medical personnel in the region say the health sector is bearing the brunt of teenage pregnancy, especially in managing the risks and other challenges that come with it. 

Adolescent mothers are at a high risk of health complications, such as prolonged labour, physical deformations, and obstructions, among others, Dr Victor Afayo, a gynaecologist at Arua Hospital and Victory Women Hospital Arua, said. 

“Their bodies are not yet ready to sustain the stress of carrying a pregnancy and many of them end up with pre-term labour. They are prone to other infections because their immunity is low. 

Those who end up delivering at home get birth injuries, which may include obstructions, resulting in injuries to the bladder and rectum. These are the girls who, with time start leaking stool or urine through their private parts,” he noted. 

Going into labour pre-term coupled with underdeveloped pelvic bones lead to adolescents requiring caesarean sections to deliver their babies. 

Arua Hospital, which serves 12 districts and one city in the West Nile region, is grappling with the challenge of caesarean section operations which is costly. 

Arua Hospital’s deputy director Dr Gilbert Aniku said on average, the facility delivers over 500 mothers every month with 40% undergoing C-sections. 

He added that in a year, the hospital delivers over 6,000 mothers with more than 2,500 undergoing C-sections and these are mainly teenage mothers.

What more needs to be done?

There is a need for mindset change in the region, according to Rose Obiga, the woman MP for Terego. 

“Occasionally, I travel at night to my constituency and sometimes I find young girls outside in trading centres at 3:00am. This calls for a mindset change for the youths,” Obiga said. 

The Government, Obiga adds, should set up rehabilitation facilities in West Nile to counsel the girls who have gone through some of traumatic experiences, such as defilement and forced marriage, among others. There is need to skill and provide tools for adolescent mothers to guard against creating another percentage of employed citizens, advises Kabahenda. 

Women councils, Kabahenda emphasised, need to be empowered to identify the men who are responsible when adolescents get pregnant and ensure they take care of the children.

Stemming the tide 

In July 2019, aware that many girls continue to have babies when they are still children themselves, the leaders from the then 11 districts in the region signed a memorandum of understanding to fight the trend. 

The leaders, who signed the MOU, were from Adjumani, Arua, Koboko, Maracha, Yumbe, Moyo, Pakwach, Nebbi, Zombo, Madi-Okollo and Obongi districts. 

Charles Mokili

In the MOU, the leaders committed to: 

• Support investments to harness the demographic dividend by domesticating and integrating interventions in local government development plans, sector work plans and annual budgets. 

• Ensure all children of school-going age, including girls, are at school at all times. 

• Support provision of adolescent and youth-friendly services at learning institutions. 

• Enact bylaws and ordinances against child marriage and teenage pregnancies. 

• Work with cultural, traditional and religious leaders to advance against early marriage and teenage pregnancy. 

• Increase young people’s access to sexual and reproductive information and services. 

• Enforce implementation of laws and policies to fight substance and alcohol abuse in the communities. 

With the support of partners like the Plan International, Save the Children, United Nations Development Programme and UNFPA, among others, local leaders and other stakeholders are conducting community sensitisation drives. 

The partners have also supported teenage girls with scholastic materials to keep them in school, Edward Endraa, the senior probation and welfare officer Arua district local government, said. 

According to Wilfred Saka, the district chairperson for Terego, the partners are also giving teenage mothers life skills as the district prepares to mainstream the issues of teenage pregnancies in their development plans. 

“We are also trying to ensure that teenage mothers are considered in the different government and social protection programmes, such as NutriCash, Development Response to Displacement Impact Project and the Parish Development Model, among others. Secondly, community services have been energised with awareness outreaches on the teenage pregnancy issues in the district,” Saka said. 

Flavia Rwabuhoro Kabahenda, the chairperson of the Uganda Parliamentary Forum on Social Protection, who is also the chairperson of the parliamentary committee of gender noted that the National Council for Women, the statutory body of government in the gender ministry, has introduced skilling for child mothers in all the districts and giving them tools. 

“We are taking to the finance ministry and development partners that these programmes should not be so rigid about age so as to attract youth who may not yet be 18 years old, but can work. 

The Employment Act says, somebody of 16 years can be employed and we are also training the leadership of the council for women at parish level to give them skills on how to identify young mothers to benefit from Government programmes,” Kabahenda added. 

“We always work with sub-county health assistants and we organise regular sensitisation dialogues where we teach parents and youths, including teenagers, on the dangers of early pregnancy and child marriage as well as the importance of taking girls to school,” Charles Mokili, a village health team officer in Tukaliri village, Koboko district, said.

This story was produced with support from WAN-IFRA, Women In News, Gender Equality, Diversity and Inclusion (GEDI) grant. 

However, the views are not those of the sponsors.

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