'When I was given Depo-Provera, my heart beat increased and yet I had high blood pressure'
Grace Akello a resident of Barr sub-county in the Northern district of Lira has seven children. From her standing, one can tell that parenting anguishes are draining her down.
She is one example of the many women in Lira district who are affected by lack of choice, due to limited Family planning methods provided at health facilities.
Akello explained that she tried using Depo-Provera as a birth control measure, but had to stop after realising that the contraceptive increased her heart beat.
“When I was given Depo-Provera, my heart beat increased and yet I had high blood pressure” narrated Akello.
Akello said after taking Depo-Provera, her periods took a while to resume after her last child, prompting her to make a decision to breastfeed her child for a year thus relying on breastfeeding as a means of natural family planning.
She wished there were other available methods of birth control, but every time she goes to the local government health facility, she is asked to use either pills or injector plant.
“There are a variety of family planning commodities, however, despite the existence of other methods of family planning we, at the local level, have very limited choices”, said Akello.
Recounting her ordeal, Akello said: “Whenever we seek family Planning services from the government facilities, midwives end up providing short term family planning commodities such as pills and injector plants just because long term family planning commodities are always out of stock.
According to Akello, women need to have a wide range of family planning methods so that they can choose what works best for them and they also need clear information because a lot of myths and misconception surround family planning.
Josephine Amono, the assistant in charge of Abunga Health Centre II in Barr sub-county, said as a facility, they have spent almost four months without being supplied with long term family planning methods such as implants that stretch for three to five years.
“We have been consistently receiving injectaplans, pills and condoms, despite the fact that we have them in plenty,” she explained.
Grace Aber, a midwife at Barr Health Centre III, said some of the mothers who seek alternative family planning methods other than Depo-Provera, are not able to access them.
She told New Vision that while other clients prefer long-term family planning methods such as Implants or Jadelle, they are not always available, especially at the HC-II and HC-III levels.
“The best we can do is to refer them to the district hospital or tell them to wait for outreaches done by NGOs such as MarieStopes”, said a midwife at Aber.
The Lira district health officer (DHO), Patrick Buchan Ocen, confirmed there is limited choice when it comes to the number of family planning methods supplied by National Medical Stores (NMS) and available at the health facilities.
He said in most of the health facilities across the district, long-term methods are supplied by development partners such as PACE, UNFPA and Marie Stopes.
“Long term contraceptives stock outs in public health facilities has led to low family planning intake in the district, especially in the rural setting, which has resulted into high population,” said Dr.
Dr. Bucha pointed out that the contraceptive prevalence rate in Lira district currently stands at 43 %, which means there is unmet need of family planning.
In order to improve on contraceptive intake in the district, Dr. Ocen urged the Government to ensure proper distribution of family planning commodities to curb the rampant stock outs and provide a variety of choices for women to access.
“It is a high time we lobbied for long-term methods if we are to contribute towards a manageable population based on our economic growth and avoid relying on NGOs for FP commodities because that is not sustainable in the long run,” added the DHO.
According to the 2016 Uganda Demographic and Health Survey released by the Uganda Bureau of Statistics (UBOS) Uganda has registered improvement in family planning and reproductive health over the last five years.
The new UDHS reveals an increase in the contraceptive prevalence rate
(CPR) from 30% in 2011 to 39% in 2016.
Injectables remain the most commonly used contraceptive method at 19% for married women and 21% for sexually active unmarried women.
Today, 28% of Ugandan women have an unmet need for family planning, a decline from 34% in 2011.
Uganda’s target is to reduce unmet need for family planning to 10% and increase CPR to 50% by 2020. Current information indicates that the economic growth is at 3% per annum, therefore, it also calls for control of child birth to align it with the economic growth.