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

Today, Agnes Kyotalengerire sheds light on what Uganda is doing to tame teenage pregnancy.

Teenage pregnancy has over the years remained one of Uganda’s biggest challenges, with data revealing that the national teenage pregnancy rate has stagnated at 25%, according to the Uganda Health Demographic Survey 2016 report, despite commitments to reduce the fi gure to 15% by 2020. 

However, all is not doom for the teenage girls and young women, as communities, development partners and various government sectors have put in place interventions to curb it. 

For instance, Kamuli district offi cials are engaging the community and the key stakeholders to discuss causes of teenage pregnancy and its associated complications, says the district health offi cer, Dr James Waako. 

During the meetings, discussions are centred around keeping girls in school, given that it is the safest place to guard them from the reach of the preying men, Waako says. 

Kamuli district in Busoga sub-region is notorious for registering high numbers of teenage pregnancy. 

In 2021, the district registered a total of 6,511 teenage pregnancies, and in 2022, the number dropped to 6,314, according to data from the division of health information system. 

In addition, the district has taken a multi-sectoral approach, they are encouraging the education department, religious and cultural leaders, as well as the security department to always talk about the issue of teenage pregnancy on their platforms whenever they get an opportunity.

Civil Societies embrace fight  

A number of agencies have embraced the fi ght to ensure that teenage mothers are given a second chance. 

Cissy Kaamu, the technical adviser of health at Plan International Uganda, says their area of implementation is around preventing teenage pregnancy and child marriages, which they achieve by providing information to make the girls knowledgeable and encourage change in practice and attitude towards different sexual reproductive issues, including teenage pregnancy. 

In addition, teenagers and adolescents who are sexually active are encouraged to utilise family planning services. Those who become pregnant are discouraged from getting married and are instead encouraged to go back to school through the re-entry programme, Kaamu says. 

Worth noting is the fact that Plan International Uganda also offers information about body changes, including menstrual management and hygiene. 

They also distribute and teach both girls and boys how to make re-usable sanitary pads. On top of the agency piloting how to use menstrual cups, it has also built incinerators for those not using re-usable pads and also ensures that the toilets are gender sensitive. 

It also ensures that the girls have where to change from during their menstrual periods and that there is clean water. The young people are encouraged to abstain from sex and the negative consequences of getting pregnant early communicated to them, Kaamu says. 

African Youth Development Link (AYDL) is also working to promote the good health and well-being of adolescent mothers living with HIV and their children in Bugiri and Busia districts. 

These adolescents face multiple challenges, that is, they are teenage mothers battling with HIV at the same time. 

The head of programmes, Toepista Kizza, says the major intervention has been geared towards building their capacity to be self-reliant and able to live and promote positive living among peers, establishing community-based mechanisms tnurture and help them access healthcare and parenting. 

It has also been aimed at promoting and linking them to quality Sexual Reproductive Health and Rights (SRHR) service provision, as well as creating an enabling environment for the adolescent mothers living with HIV and their children. 

Through this initiative, the agency sensitises and counsels teenage girls not to fall victim and, for those who are already affected, to regain hope and consider taking a career or starting a business. 

As a result of this, some of the victims have since been taken back to school by their parents, with most of them being supported to start income-generating activities from which they can earn money to support themselves, their children and their families. 

Through the initiative, the district AIDS committees in Bugiri and Busia have been re-activated and have since included two adolescents as representatives of the committees. 

This has provided a platform through which adolescents can channel the challenges they face to the committees. 

Menstrual hygiene and management 

The consequences of failure to access menstruation commodities and services cannot be underestimated. 

Lack of pads and menstrual facilities is linked to absenteeism and dropping out of school, consequently leading to early marriage or teenage pregnancy. Research by Build Africa revealed alarming statistics and the impact menstruation has on girls’ retention in schools and completion. 

On average, the report revealed, of the 80 days allocated to a school term, 29.7% of the adolescent girls they spoke to said they miss a minimum of four days per cycle. 

Another 24.3% admitted to being stigmatised whenever they stain their uniforms, so they opt to stay at home until they are done with their period. 

The United Nations Educational Scientific and Cultural Organisation’s Global Monitoring report of 2010 showed that by secondary level, boys’ enrolment was higher, with 83 girls enrolling for every 100 boys. 

The girls’ completion rate fell further, with only 31% girls completing Senior Four. The reasons cited included menstruation. 

With the aim of keeping the girl-child in school while promoting sensitisation and appreciation of good menstrual health practices, in August last year, Uganda Electricity Generation Company Limited (UEGCL) distributed sanitary pads to 1,390 girls in Busaana secondary school, St Peter’s Kibuzi Secondary School in Kayunga district, Buzaaya secondary school and St Andrew’s Kiyunga in Kamuli district. 

Edgar Kansiime, the public relations manager of Isimba hydropower project, says the drive was aimed at laying a foundation for alleviating the lack of sanitary pads as one of the causes of the current schoolgirl dropout rates in the country.

Sexual and gender-based violence (SGBV) 

Frank Mugabi, the communication specialist at the gender ministry, notes that the ministry has enhanced dialogue with key actors, including religious and cultural leaders, as custodians of the socio-cultural norms for transformative approaches to gender-based violence prevention and response. 

Students of Buzaaya secondary school in Kamuli district receiving reusable sanitary pads from Uganda Electricity Generation company Limited staff in August last year.

In addition, it has strengthened local initiatives and networks of stakeholders to address GBV, Mugabi notes. It is worth noting that agencies have stepped up a number of interventions. 

For instance, Nyonga women’s shelter in Jinja registers cases of sexual and gender-based violence. These include physical, sexual, economical and psychological abuse. Uganda Women Network (UWONET) has set up two SGBV shelters in Namutumba and Kamuli district headquarters. 

The role of the shelter is to rehabilitate both young girls and women. As such, they have set up a safe space to mimic a home setting. For the last eight years, the shelters have been admitting victims — survivors aged nine and above. 

Sexual and gender-based violence is a health and development crisis. It is a fundamental abuse of the rights of the girl-child and woman,” says the executive director of UWONET, Ritah Achiro. 

She says when a young girl or a woman experiences SGBV in form of rape or defilement, she is at risk of becoming pregnant, yet her body is not ready for child birth. 

As such, many of the young girls end up losing their lives and, at times, their babies, hence the increased rate of maternal deaths in the country, Achiro says. 

Achiro warns that SBGV poses a development challenge because it cuts their future short. And since they are unable to achieve their full potential after being rejected, they consequently drop out of school.

Transactional sex 

The effects of transactional sex go beyond health and stretch to social impacts. Cultural, traditional and religious norms regard sexual intercourse as sacred. 

Engaging is such risky sexual behaviour makes the young girls lose self-esteem and self-worth, for instance, if she sleeps with several men, notes Moses Nahamya of skilled and Empowered Youth Uganda. 

Transactional sex also exposes young girls to gender-based violence, especially if one who already has a boyfriend is caught having sex with another man. 

Richard Makai Ssekimpi, the chairperson of Kyeyunga zone in Kawempe division, a Kampala suburb, says under the LCI management, he has constructed a community vocational centre and equipped it with eight hand driers for such vulnerable girls to train in hair dressing and tailoring. What is missing are the sewing machines. Ssekimpi appeals to good Samaritans to donate the machines. 

Through Makerere Women Development Association, Nuruh Nabunya, the team leader of the agency, enrols and trains teenage mothers in the Kikoni slums of Kampala in tailoring and jewellery-making. 

Sexuality education framework

The education ministry, through the secondary curriculum, has started rolling out the sexuality education framework. 

Rosette Nanyanzi, who works at the gender and equity budgeting unit of the education ministry, says the curriculum was revised and sexuality education integrated in topical subjects such as general science, biology and religious education, so that each child is aware of what exposes girls to teenage pregnancy. 

She explains that the framework articulates issues related to their growth and maturation and equips them with the life skills that will enable them go through these stages.

Govt sectors embrace fight

Rosette Nanyanzi, who works at the gender and equity budgeting unit of the education ministry, notes that during the lockdown, the unit developed messages targeting girls, focused on teaching them how to manage growth and sexual maturation challenges, including menstruation. 

Due to the knowledge gap among parents and the community on menstrual hygiene issues, the messaging approach also focused on encouraging parents to provide basic requirements for the girls.

“A national strategic plan involving other sectors, such as the gender, health, water and environment ministries, has been developed. The interventions will support women and adolescent girls,” Nanyazi notes. The gender ministry is running a five-year programme dubbed GROW, to enable the young girls and women to access economic and empowerment opportunities, given that failure to access economic aspects will expose these girls to teenage pregnancy. 

The Government has employed structures through which it is working with local communities on parenting issues. As such, the gender ministry has come up with a family policy. 

“Lately some of the issues of teenage pregnancy and early marriage are coming up because things have gone wrong in the family,” Nanyanzi explains. 

Therefore, the policy highlights issues of families being able to take care of their children, being supportive and having economic activities to make families thrive amidst any challenges. 

The policy is being drafted and, currently, the ministry is into consultations with different actors. Ruth Muguta, the head of the family unit at the department of family and culture at the gender ministry, says they are using cultural institutions to identify the negative cultural practices that promote the vices, so that they can denounce and make commitments on ending them. 

The department is also emphasising issues of parenting to ensure parents are able to understand, talk and communicate with their children. Muguta says the biggest issue around parenting is that parents do not provide basic needs to their children, but also do not find time to talk to them so as to appreciate their problems. 

It is worth noting that these challenges do not start at adolescence, they surface much earlier. As such, Muguta blames the vices of teenage pregnancy and early marriage on poor parenting practices, especially during childhood. 

She says the unit is also engaging religious leaders, through their structures of fathers’ and mothers’ union. 

They are also reaching out to communities through radio programmes, as well as a national parenting training manual that they developed and are disseminating through lower structures of civil society organisations. 

The unit also works together with the health and education ministries, through their village health team members and para-social workers. 

It also uses the community development officers in sub-counties and districts to tighten cultural norms in the regions of Karamoja, Lago, Teso, Bunyoro and Toro. 

The health ministry has also rolled out key family care practices, including how to take care of adolescents to ensure they live in a safe and conducive environment. 

Additionally, the Government, through the human capital development programme, together with the health and gender ministries, has come up with a referral and linkage system through which children undergoing abuse can access social and health services. 

The gender ministry is also spearheading community mobilisation and mindset change. 

One of the things that government is fronting to ensure that stakeholders know their roles is the right to education as stipulated in the country’s national child policy.

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

However, the views are not those of the sponsors.

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