Why young people shun family planning

May 12, 2016

"Young people keep away from services because of “lectures from adults”, long distances to services and myths and misconceptions."

By Catherine Mwesigwa Kizza

Every time Ronald Tibita a Global Health Corps alumni, now working with USAID Assist project in Gulu hears a midwife tell a mother, "Marie Stopes pe, meaning ‘implants supplied by Marie Stopes, have run out' he is saddened.

He is disappointed that yet another mother who desired to prevent an unwanted pregnancy has to go away without a contraceptive method of choice.

He is sad that another missed opportunity for Family Planning services has gone by.
Marie Stopes is a non-government organisation that supports the government of Uganda to reach communities with family planning and reproductive health services. Local communities have tended to brand all contraceptives ‘Marie Stopes'.

"When a mother leaves without a family planning service, the next time you see her will be when she is returning with another pregnancy," he said.

Such a mother may not be so lucky to go through child bearing that time round. Over 6,000 women die due to preventable pregnancy-related complications in Uganda every year.

Uganda did not achieve the Millennium Development Goal to reduce maternal deaths by 75% by 2015.

United Nations agencies' reports indicate the maternal mortality ratio went down to 343 in 2015, failing to get to 131, the targeted MDG reduction.

The target to achieve universal access to reproductive health is no better. Only three in ten married women are using a method of contraception while a third of married women had an unmet need for contraception.

"Family Planning is to women survival as immunisation is to child survival," Dr Jotham Musinguzi, the Director General of the newly formed National Population Council, told the GHC fellows and alumni.

r iana ambatya subuga essica ack and r onathan usinguzi receive r hris aryomunsi inister of tate for ealth to address a partners meeting ahead of  the fellows training on ay 6 Dr Diana Nambatya Nsubuga, Jessica Mack and Dr Jonathan Musinguzi receive Dr Chris Baryomunsi, Minister of State for Health to address a partners meeting ahead of the fellows' training on May 6.


He pointed out that the current child survival success levels spurred by the immunisation interventions of the early 90s would not have been possible without pragmatic leadership at the highest level.

He underlined the role of leaders who in many cases in our society are men, in improving access to Family Planning services.

"Leaders are important whether they vote money or resources," he said.

Tracing the child immunisation success story, he said that in 1995 when decentralisation was rolled out, immunisation programmes had started to fail.

"District leaders diverted resources for the cold chain management to pay councillors' allowances. The results were disastrous. Many children were not being immunised effectively. We told the president to do something and he did. The diversion stopped. Today we see the impact of that," he said.

Dr Jesca Nsungwa Sabiiti, the Ministry of Health Assistant Commissioner Child Health highlighted the importance of Family Planning in reducing the high numbers of mothers dying due to preventable pregnancy-related complications and the poor child survival rates.

"Women get many children because they expect some to die. Children are having children and young people are having children early curtailing their personal development. Family Planning can help resolve these challenges," she said.

Speaking about the barriers to contraception use and access among young people, Nargis Shirazi Baguma, founder of Wo-Man foundation and a GHC alumni explained that young people keep away from services because of "lectures from adults", long distances to services and myths and misconceptions.

‘The term Family Planning' does not make sense to young people because they do not have families though they might be sexually active and in need of services. I like to use the term contraception instead," she said.

She also highlighted the lack of age-appropriate information and messages on sex and contraception and the frustration of reaching out to the young and vulnerable.

"How do you educate an eight-year-old girl who is peddling sex in Kimombasa slum? All the Family Planning messages do not make sense to her" she said.

David Balikitenda a fellow with ACODEVfrom Kasese said that reproductive health messages to primary school pupils were generic yet there is a diverse age range.

"In some schools, ten year olds are studying with 18-year-olds. You cannot give them the same message," he noted.

Andrew Opio a fellow at FCDE, Kasese pointed out that messages on radio were in English and not in local languages leaving out many in the audiences.

Ronald Kagimu an alumni noted that messages were too strong against men and were alienating them.

Addressing the fellows, Dennis Luwedde, the Programme Manager for Advocacy and Research at Naguru Teenage Centre noted the importance of restructuring the mindset of men in reproductive health since they make most of the family decisions yet they are ignorant.
"We need to start to check our masculinity, seek to understand rather than fear to be vulnerable," he said.
He noted the need for people to put what is written down into action. On his part, he has started a program to engage boys.
"Every Saturday, we meet and talk men stuff like growth, fitness," he said.

In respect of the challenges, Jessica Mack, the senior director for advocacy and communications called on the fellows to explore all channels of communication to reach out to fellow youth on issues of Family Planning.

Barbara Kayanja, the GHC Africa Regional Director urged the youth to embrace Family Planning so that they can be able to plan their future better.

Dr. Diana Nambatya Nsubuga, the GHC Uganda country manager called on government to embrace Family Planning programs as low cost yet effective method of handling high maternal deaths.
Jackson Chekweko, the executive director of Reproductive Health Uganda observed that young people do not see Family Planning as part and parcel of their future.
"If young people become passionate about it, things will move," he said.

And this seemed to be the vibe as they set out, making action plans to incorporate Family Planning messages in their programming and using different means to pass on the message.

The Global Health Corps was founded by Barbara Bush, wife to former American president. The one year paid fellowship mentors young people aged 21 to 30 years in leadership to address global health inequity. Fellows are attached to health organisations and government agencies in Rwanda, Burundi, Uganda, Malawi, Zambia and the United States to identify solutions to global health challenges.

 

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