Youth from Karamoja have reportedly said the condoms that health officials are currently distributing are short and tight, which has made several youth abandon them.
Tons of condoms are being supplied in Karamoja region but they are not being used by the people.
“Condoms are being supplied but are being dumped. Even other contraceptives being supplied to girls are thrown away,” said Remegio Achia, Member of Parliament for Pian County in Nakapiripirit district.
This was during a debate on the report of the Public Accounts Committee (Local Governments) on the Auditor General’s report for the financial year 2016/17 on 115 district local governments, 41 municipal councils and 63 town councils.
The report said most health units in local governments are insufficiently equipped in terms of the requisite machinery needed to provide the services expected of them.
It said more than two thirds of districts in Uganda do not have district hospitals. The committee was further concerned that a number of health centre IVs functioned like highway hospitals yet they still get supplies meant for health centre IVs.
It said districts on the borders of Uganda experience a huge influx in the number of patients without a corresponding increment in medical supplies.
Achia said the health centre IVs in Karamoja have experienced an influx of Pokots, Turkana from Kenya yet there were no major hospitals that could handle serious cases.
Dr Ruth Acheng, minister for health said the ministry would review the supply of condoms to Karamoja. Acheng said there were districts suffering shortage of condoms like Masaka and Gulu that the excess supply in Karamoja could be directed to.
“We shall find out why condoms and contraceptives are not being used in Karamoja,” Acheng said on Thursday.
A security official who spoke on condition of anonymity said there was poor information and education on the use of condoms in Karamoja.
The official said the language used was too indirect and sometimes the expressions used are interpreted differently.
“People from Karamoja think you should wear condoms the whole day. Some have done that and found it uncomfortable. Some walk for miles wearing condoms hoping to use it at the point of arrival, say at a town,” he explained.
He added that male condoms are worn on bananas to demonstrate the use of condoms but the information does not go far enough to show when to use the condoms.
He further said this was because the educators were being indirect and trying to overcome the cultural sensitivities about the language on sexual related topics. Condom use is not considered a topic for discussion for families and villages.
Youth from Karamoja have reportedly said the condoms that health officials are currently distributing are short and tight, which has made several youth abandon them. They want the manufacturers to manufacture bigger size condoms.
Reports show that some men among the remote IK and Tepeth communities in Karamoja have never seen a condom and cannot visualize how it is used.
The Karamoja region consists of seven districts in Northeastern Uganda namely Kaabong, Kotido, Abim, Moroto, Napak, Amudat and Nakapiripirit.
Karamoja is classified as one of the world’s poorest areas, with high rates of malnutrition and a disproportionate number (61 percent) of its 1.2 million people, living in absolute poverty.
In 2014, the members of Parliament on the parliamentary committee on HIV/AIDS discussing the condom issue noted that it was important to listen to the complaints, as condom use prevents HIV infection.
MPs warned that condoms that don’t fit properly could raise the risk for HIV infection among the population.
“My wife doesn’t want to hear about a condom and I can’t risk taking it home because she will think I am cheating on her. In my village, people associate condoms with prostitution and even when they are brought by partners, they turn them into bangles or balloons for children,” a report said.
Experts say many factors including attitude, culture and religion have affected condom use in the country. The population of Karamoja is young with the average age being 15 years (Census 2014). Out of the total population of 1.2 million people, half are females.
The region has the highest total fertility rate (TFR), with women of reproductive age (15-49 years) giving birth to an average of 8 children, higher than Uganda’s of 5, and three times above the average of 3 children per woman in Kampala (UDHS, 2016). The health sector in Karamoja region is lagging behind the rest of Uganda. There is limited access to health facilities in Karamoja.
According to the United Nations Population Fund report key bottlenecks to contraceptive use include: limited access to services due to inadequate number of skilled staff to provide a wide range of methods, stock outs at health facilities, limited community-based service outlets, myths and misconceptions, limited male support, negative socio-cultural and religious values. Information flow and access, a key ingredient in behavior change.
The report entitled ‘Leaving no one behind in Karamoja’ said Karamoja is far way behind in ICT use, significant channels through which information on benefits of contraception can easily be accessed especially through social media.
The HIV/AIDS prevalence rate increased from 3.4 percent to 3.7 percent between 2011 and 2017. If no deliberate efforts are undertaken to reverse this trend, the region is likely to experience a sustained upsurge in the number of new HIV infections.
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