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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. 

In the second of 12 stories, Agnes Kyotalengerire looks at the factors driving the practice.

The national teenage pregnancy rate has stagnated at 25% for years, according to the Uganda Health Demographic Survey (UDHS) 2016 report. That is, one in four girls countrywide has had a child or is pregnant. 

This is despite efforts that the country invested to reduce the indicators to 15% by 2020. When the COVID-19 pandemic hit, the number of adolescents getting pregnant skyrocketed because of exposure to sexual abuse following the closure of schools. 

A United Nations Population Fund report revealed that in 2021, a total of about 31,565 pregnancies were registered monthly, a figure higher than the 29,557 recorded monthly in 2020. 

This means that the country recorded about 1,052 teenage pregnancies daily, compared to the 985 pregnancies in that same period in 2020. A new report dubbed The Economic and Social Burden of Teenage Pregnancy In Uganda – The Cost of Inaction, shows that about 250 children below 15 years got pregnant every month in 2021.

Busoga region most affected 

A review of the report showed that Busoga region registered the highest number of pregnancies in girls below 15 years in 2021 and 2020. 

The Kamuli district health officer, Dr James Waako, says teenage pregnancy is still a challenge, although the numbers have slightly dropped compared to the period when schools were closed during the COVID-19-induced lockdowns. 

Estimates from Kiyunga Health Centre IV in Luuka district reveal that about 20% of the mothers who attend the first antenatal care clinic are teenage girls.

This is a reduction from the 26% that was recorded during the COVID-19 lockdown, according to the district health officer, Dr Chris Wandera.

He explains that the greatest driver for this trend is early marriage, a practice that is traditionally accepted in the region. 

“Even before the COVID-19 pandemic hit, the region was recording high numbers of young girls being married off at the age of 16, 17 and 18,” Wandera notes. 

Failure to pay their school fees and provide them with basic needs also pushes parents into marrying off the girls early. 

In the same breath, Waako cites poverty with its associated negative outcomes, such as school drop-out as the other drivers. 

It is a tradition in Busoga region for poor parents to marry off their daughters early, in exchange for bride price to cater for their basic needs as opposed to the well-off families. 

He explains that girls from poor families in Busoga are easily enticed with small gifts by bodaboda riders, taxi drivers, workers in sugarcane plantations, as well as petty traders. 

Shockingly, when the girls become pregnant and the men responsible are arrested, the parents try to negotiate out of court. Eventually, they accept little money and small gifts, such as sugar and soap, and let their daughters get married, Waako says.

Lango sub-region not spared 

Ten districts, plus Lira city in Lango region, registered over 30,000 teenage pregnancies in 2022. 

Data from the region indicates that Kole district is taking the lead in teenage pregnancy. Information from health facilities indicates that out of 10 mothers delivered, at least three are teenagers. 

This implies that the indicator is way above the national figure of 25%. The Lira district health officer, Dr Patrick Buchan Ocen, notes that at the height of the lockdown, specifically, within a period of eight months, over 13,000 in Lira district became pregnant. 

In Alebtong, in the 2022/2023 financial year, the district recorded 3,002 cases of teenage pregnancy, according to data from the local district. 

The Kole district health officer, Moses Ogwang, blames the high number of teenage pregnancies on the high school drop-out rate. 

“When girls drop out, they become vulnerable and start engaging in sexual activity so early,” Ogwang says. 

A report released by the United Nations Education, Scientific and Cultural Organisation (UNESCO) indicates that Uganda has the highest school drop-out rate (70%) in East Africa, followed by Kenya, then Tanzania. 

Data from the World Bank’s collection of development indicators in 2016 indicates that primary school completion rate in Uganda stands at 52.6%. This means that for every 10 pupils who enrol for primary school, only five sit Primary Leaving Examinations. 

Another World Bank study found that in Africa, each year of school raises average earnings by 11.3% for men and 14.5% for women. 

Just like in Busoga, early marriage is the main driver of teenage pregnancy in the Lango sub-region. From media reports, young girls are often forced to marry older men. 

According to the UDHS 2016 report estimates, about 20% of girls are married before their 18th birthday. 

The unnerving reality is that religious and local leaders in Kole district preside over the marriage ceremonies of teenage girls, says Ogwang.

“You find local chairpersons in family meetings to witness and write down the bride price or solve the issues, they should be reporting it to Police,” he says Poor parenting during the period when schools were closed is another factor that experts blame for the high teenage pregnancy rate.

“When girls are at school, teachers counsel and mentor them. Unfortunately, while they are at home, they learn many bad practices, including indulging in sexual relationships,” Buchan says. 

He blames this state of affairs on poor parenting, where parents have shunned their responsibility. 

“Parents no longer balance home roles and work. They wake up so early and go to work. They do not have time to talk to their children and advise, and provide the basic needs for them Buchan,” he says. 

Poverty is the other driver as majority of the girls that get pregnant are from poor families. For instance, there seems to be a link between household poverty and teenage pregnancy. 

Teenage pregnancy, Buchan says, is more pronounced in sub-counties such as Aromo, Agweng, Barr and Mach in Lira district. 

He blames it on weekly markets, which begins on Thursday and winds up on Saturday. 

The markets attract people from as far as southern Sudan. Barr is the other big market on the Lira-Kitgum highway and also pulls crowds.

Buchan says desperate parents take advantage of the crowding and engage in negotiations to marry off their young daughters illegally. 

“They sit in small groups and negotiate bride price, and if one does not know, they will think people are just drinking and chatting,” he notes. 

The Alebtong district health officer, Dr Tony Odung, says the high number of gender-based violence that leads to families breaking up is another driver of teenage pregnancy. 

He is quick to add that after families break up, the children fail to fend for themselves and also pay school fees. 

Consequently, they drop out of school and end up engaging in sexual relationships for monetary gains. 

A teenage mother in labour being examined in hospital. (All Photos by Agnes Kyotalengerire)

Mubende officials blame internet and technology

It is difficult to find a girl who is out of school and is not either pregnant or carrying a baby, says Bosco Vito Ssendikadiwa, the Mubende district health officer. 

Ssendikadiwa estimates the teenage pregnancy rate for Mubende district to stand at 22%, which is slightly lower than the national figure of 25%. 

He blames social media as the other driver, given that lately, with advancement in technology, young people can access all sorts of information, including pornography through smartphones. 

Hotspots for transactional sex 

Previously, transactional sex was happening along the trace corridors and at border lines, such as Busia, Malaba and the surrounding districts of Mbale, not forgetting landing sites around Namayengo and Mukono because of the fishing activities. 

Lately, the trend is shifting from those hot spots to slums and busy town centres, where there are large pools of young girls doing nothing, yet they need money in their pockets. 

Lira district health officer Dr Patrick Buchan Ocen notes that Lira, being a Metropolitan town for the Lango sub-region, attracts many young girls from as far as Amolatar, Dokolo, Alebtong and Oyam. 

The girls converge in the town, which has many truck drivers and recreational activities, such as clubs. 

In so doing, the young people get swayed into those bad practices, such as transactional sex to earn a living. 

Ogwang explains that Kole district is peri-urban and that everyone struggles to live a decent urban life. As such, the girls become vulnerable once they drop out, and the men start luring them with money into sexual relationships. 

Transactional sex shot through the roof when schools were closed to manage the spread of COVID-19, explains Richard Makai Ssekimpi, the chairperson of Kyeyunga zone in Kawempe division. 

He adds that even after schools opened, out-of-school girls have continued to engage in sexual relationships with older men in quest for financial and material gains. 

“The young girls are desperate. They sell their bodies in exchange for money to buy small things, such as sanitary pads and food simply because their parents cannot provide,” he says, adding that the shocking bit is that some engage in transactional sex for as little as sh2,000.

Similarly, Nulu Nabunya, the founder of Makerere Women Development Association, a community-based organisation, says the situation of young girls engaging in transactional sex, especially in Katanga zone, a slummy Kampala suburb, has gotten out of hand. 

“Young girls complain of unemployment and they are so desperate to the extent that some sleep with the men on credit, with the hope of getting paid later on,” she notes. 

Nabunya also blames the vice of transactional sex on peer pressure. “Some young girls stay in slum communities, where commercial sex is practiced openly and, as such, are lured into the practice,” she notes. Nabunya partly blames parents and guardians who send the young girls to vend food items by the roadside in the evening, consequently exposing them to potentially risky situations. 

As such, the girls encounter men who make advances on them or get influenced by peers already engaged in the trade. 

A teenage mother breastfeeding her child.

Dr Betty Kyadondo, the director of family health department at National Population Council, says information about sex education has not been brought to the attention of young people. 

Parents and religious leaders are shy to talk about the issues. As a result, young girls cannot make informed decisions on how to interface and respond to sexual advances and when they do, how to protect themselves against teenage pregnancy.

Rape and defilement 

According to a Police report, over 4,442 cases of defilement were reported between January and April 2020. SAUTI (116 Uganda Child Helpline) reported 800 cases of sexual abuse between January and May 2020, including increased cases of teenage pregnancy. 

However, some cases may not be reported. The 2021 annual crime report indicates that defilement cases shot up in 2021, compared to 2020. 

About 14,570 cases were reported in 2021 as opposed to about 14,230 cases in 2020. It is worth noting that some of these defilement cases resulted in teenage pregnancy.

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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