▶️ Is contraception way to go in battle against teenage pregnancy?

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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. 

 Jacky Achan writes about if using contraceptives is a fail-safe strategy in winning the fight against teenage pregnancy.

Sixteen-year-old Shabuhu Katono is in S1 and is a mother of one. Becoming an adolescent mother was not her dream, but it happened to her during the COVID-19 pandemic.

In January last year, after nearly two years of closing schools, children were allowed to go back. Katono was required to get a COVID-19 jab before she could be allowed back to school.

Unforunate incident

As Katono walked alone to the clinic in between sugar plantations in Nawandyo village, Kamuli district, she was waylaid by a man and defiled.

“He dragged me to his makeshift house in the sugarcane plantation. When he was done, he told me to dress up and leave,” she reveals.

Unaware of the likely repercussions, she did not tell anyone what had happened to her. She feared the wrath of her parents.

“I had seen how they treated other girls at home who got pregnant, they were harassed and married off to the men forcibly,” Katono says.

Back at school, Katono started feeling unwell, but did not know what she was suffering from.

Confiding conunsellor 

One day a counsellor visited their school and one of the things she talked about were the symptoms of pregnancy.

Katono approached the counsellor who took her for a pregnancy test which came back positive. She was asked to return home and break the news to her parents and she refused.

The counsellor volunteered to tell her parents, but was met with hostility.

“They said, ‘we do not have fees for her, let her go and marry,” Annet Kafuko, a counsellor reveals.

Kafuko works with Coalition for Health Promotion and Social Development (HEPS- Uganda), a non-governmental organisation that promotes the health and socio-economic rights of vulnerable individuals, groups and communities.

“I came back and told her that her... your parents want you to marry and she said no,” Kafuko says.

Katono then pleaded with the counsellor to give her a home and keep her in school. So Kafuko took her on.

Katono gave birth to her baby at a tender age

Returning to school 

She gave birth on September 4, last year and two weeks later, returned to school. She was in P7 at Bugulumbya Primary School in Kamuli.

Katono had to put in extra time for study, she had Primary Leaving Examinations (PLE) to sit. I would take her to school early in the morning and pick her up at 10:00pm. She passed PLE with aggregate 21.

Kafuko encouraged Katono to go back home, but she refused knowing they would force her to get married.

“I went to Bugulumbya Senior Secondary School to ask for a vacancy and Katono is now S1,” she adds.

However, Kafuko has a family of her own to care for.

“I have four children, when I add on Shabuhu and the baby, we are seven. My husband said it is okay to have the addition in the family, but there are challenges of school fees. I do not have a well-paying job besides counselling, we get up early in the morning, go to the garden and come back home and sit,” she explains.

“Nonetheless my wish is to care for her until she completes her education,” Kafuko says.

Dire situation 

While Katono may be lucky that someone took her in and enabled her to return to school after being sexually abused and impregnated as a teenager, other adolescent mothers are having their future destroyed as they are subjected to early marriage.

In 2020, the spread of the coronavirus caught the nation by surprise. The pandemic ravaged the country for nearly three years.

Even more agonising was the sharp rise in teenage pregnancies reported during the pandemic. Reports show for 15 years, teenage pregnancy stagnated at 25% even when the country aimed to get that figure to 15% by 2020. But with the arrival of the COVID-19 pandemic, cases spiralled.

Statistics

A total of 354,736 teenage pregnancies were registered in 2020 and 196,499 in the first six months of 2021, the United Nations Population Fund (UNFPA) disclosed.

Even worse 250 children below the age of 15 got pregnant monthly in 2021, according to the Economic and Social Burden of Teenage Pregnancy in Uganda: The Cost of Inaction report.

Also, the figures could have been higher given that not all girls attend antenatal care used to derive the numbers.

The highest number of teenage pregnancies were in Wakiso district at 10,439 followed by Kampala with 8,460 cases.

This was followed by Kasese with 7,317 cases, Kamuli with 6,535 reported cases and Oyam with 6,449.

Other districts that recorded many cases were Mayuge, which had 6,205 and Mukono with 5,535 cases of teenage pregnancies.

One outcome of the teenage pregnancy is girls dropping out of school.

For instance, 1,888,000 children entered Primary One in 2016, but by the time they were sitting Primary Leaving Examinations (PLE) in 2022, they were only 830,000.

“The question is where did the entire one million children go? Many of them got pregnant and dropped out of school,” the commissioner for youth and children at the gender ministry, Mondo Kyateka, says.

Of the 830,000, who did PLE, only 300,000 sat for the Uganda Certificate of Education (UCE)examination and from that number only a measly 100,000 plus sat the Uganda Advanced Certificate of Education (UACE) exams last year.

The challenge 

Even with the law and provision for severe punishment in Uganda, teenage pregnancies occur in one quarter of adolescents, and half of it is unintended.

The rate is higher in rural areas at 27%, according to available data, and it is lower in urban centres at 19%.

The disparity is caused by lack of information in rural areas, the MP for Bunya East in Mayuge district, James Kubeketerya, says.

Today, the six most affected regions are Busoga, north- central in Buganda, Lango, south-central in Buganda, West Nile and Toro.

Meanwhile, Busoga sub-region is faring poorly when it comes to teenage pregnancy and marriage.

Mayuge and Kamuli districts take the lead and are the most affected.

“We have girls getting married and pregnant as young as nine to 13 years old,” Kubeketerya says.

Baroda Kayaga Watongola, the MP for Kamuli Municipality, says the problem is parents who are giving out their children for bride price.“Poverty is the major problem that has caused early pregnancy and marriage for the young girls in Kamuli and Mayuge,” she says.

To fight the trend, Wantongola says communities need to be sensitised regularly, especially about sexual and reproductive health and rights (SRHR).

The law 

The Ugandan law defines defilement as the act of having sex with a girl under 18. It is an offence punishable by both imprisonment and death.

When the victim is over 14, the adult offender is liable, on conviction, to imprisonment for 18 years. If the victim is aged days old to 14, the adult offender is given a more serious punishment which is a maximum sentence of death.

Article 31 of the Constitution sets the minimum age for marriage at 18 years old. Marrying and getting intimate with a girl before she is 18 amounts to defilement.

Parental involvement 

Lack of parental involvement is another enemy that has to be dealt with, Kafuko says.

She explains that in Kamuli, parents do not talk to their children, but are also reluctant for them to go to health facilities for SRHR information.

“When you go into the community and ask why young people do not come for SRHR, they say our parents say when we come to visit the facility, you give us family planning. They do not want their children to be on family planning yet we do not only give family planning commodities, but also educate and counsel them to live responsibly,” she says.

Those who are ignorant on how to protect themselves from unwanted pregnancies have fallen victims of the unfortunate trend, says the Kamuli district chairperson, Charles Mugude Kuwembula.

Expert guidence 

Dr Peter Ddungu, the deputy country director at Marie Stopes Uganda says: “Many times, people come to health facilities and we address issues there and they have to go back into the community.

In communities, they do not get any help and are even fearful of being reprimanded for seeking the information and services.

This time we have come to the community with special focus on young people and their access to sexual and reproductive health and rights (SRHR) services.”

Ddungu adds that CARE International Uganda has expertise in empowering young people to improve their livelihood and render economic support plus life skills so that they are able to stand on their feet in terms of the decisions they make.

“We shall reach individuals with SRHR information and service, we will also train them on how to earn a living, empower themselves, take decisions, and be more informed as young people, but we will need support from leaders and community,” he explains.

Way forward 

Watongola calls for tougher punishments for offenders in teenage pregnancy and in the same breath for contraception services.

“It is a good thing, but we need to take precaution before taking them. It is best to always consult the experts on what is suitable before starting on them,” she says.

If teenage pregnancy is not addressed, maternal deaths will persist in the society, where women are left behind, cautioned Dr Mary Otieno, the UNFPA Uganda country representative in an earlier interview with New Vision.

She also warned that intergenerational poverty will prevail because a young child is getting another child.

However, Dr Otieno admitted that not everybody is on board when it comes to population, family planning, gender and human rights issues.

“But there can always be a consensus, people can agree that the benefits outweigh the differences,” she explains. This is in addition to drawing examples and good practices from other parts of the world.

Otieno said people do not want to emulate the western world and think their girls do not have sex.

“They are more liberal and are protected. They know they can take the pills, use the condoms and they can go to any store and buy. That is why they can go to school and they are hardly getting pregnant, she said.

“It is because the society realised this is the only way to go. We are not saying girls or boys should just have sex, in fact few are having sex but those who are, how do we protect them?,” Otieno asked.

“We need to inform parents on family planning for us to end teenage pregnancies and early marriages,” Kafuko says.

Men need to take the conversation on ending teenage pregnancy and marriage in their circles to curb the vice, Watongola advises.

She also called on men to spare young girls from teenage pregnancy and marriage. “Let us look at them as our daughters, they are our children, let them study,” she says.

There is need to restore the status of girls in Uganda, “their rights are being abused,” advises the Kamuli deputy chief administrative officer for Kamuli, Badru Sentongo Waliggo, says.

Entrepreneurs explaining to the Kyabazinga, Gabula Nadiope and others officials about their products during the launch of the EYE Universal SRHR Project in Kamuli district

Meanwhile, the Kyabazinga of Busoga, William Wilberforce Gabula Nadiope IV says: “We need to see them having a bright future.”

The Kyabazinga adds that the youth are the strongest pillars in the kingdom and form the largest population.

He says the problem is the same across the kingdom.

Marie Stopes, which provides a wide range of contraception, reproductive health and family planning services, partnered with CARE International in Uganda and Naguru Teenage Information and Health Centre with vast expertise in handling young people.

They have been brought together by the United Nations Population Fund (UNFPA) and funded by the Norwegian government for three years to ensure that sexual and reproductive health and rights information and services are closely given to the young people in Kamuli and Mayuge.

This is being done as a pilot, to make certain teenage pregnancy, child marriage and school dropout come to an end.

The goal is to reduce maternal death, teenage pregnancy, marriage, school dropout as well as ensure universal access to adolescent and youth-friendly SRHR information and services.

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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