Poor roads, myths still barriers to family planning

 

The long distances to health centres characterised by rugged roads are an impediment for women who need family planning services in Kanungu district. 

 

The roads deteriorate more during the rainy season and become almost impassable, yet health centres are on average about five miles (eight kilometres) from people’s residences. 

 

As if that is not bad enough, mothers have many misconceptions on the different methods of family planning. Talk of contraceptives causing cancer and barrenness among women and deformities among newborns is rife among mothers in Kanungu, according to medics. 

 

Therefore, mothers prefer to have more babies than using contraceptives despite the average number of children per woman being seven with some having as many as 15. Donatira Kwikiriza, 30, is a mother of six children and she would like to use contraceptives, but fears them. After giving birth, mothers conceive within one to two years.

 

The resident of Nyamirama, 14km north of Kanungu district headquarters, says stories of prolonged menstrual periods among women, who have used injectables scare her. “I do not want to use pills because my husband will get to know and he does not approve of family planning methods,” she confesses. 

 

When Kwikiriza heard of a camp organised by Reproductive Health Uganda at Kambuga Hospital, she trekked from her home to ask the experts about her fears. Kwikiriza says she has a hernia, and wants to have a break from childbearing. “Can I use contraceptives? Won’t I have a deformed baby if I get pregnant again?” she asks. 

 

But Dr. Tony Kapsandui, the coordinator medical services at RHU allays her fears. Kapsandui tells Kwikiriza that they have to treat her infections before administering a family planning injection. “As for hernia, there is no problem when you have an injection for family planning with it. But you have to go for an operation to remove it,” advises Kapsandui. 

 

Evas Ariheihi, a mother of six from Katete, about five miles from Kambuga Hospital, came because she had infections. Kapsandui said many women who start using contraceptives when they have infections get side-effects, which they blame on contraceptives.

 

“If a woman has infections such as pelvic inflammatory diseases and they take contraceptives, chances are high that they will get side-effects. That is why we recommend that women should first get tested for infections before taking contraceptives,” he explains.

 

Located about 420km southwest of Kampala, Kanungu has a population of 245,800, according to statistics at the district. Of the entire population, 20.2% (49,652) are women of childbearing age, says Benon Kansiime, the district health inspector. 

 

But the district with 46 health centres lacks enough medics to cater for the population. “Since the number of medics is not enough, services such as family planning are not given priority. This makes mothers to go back home unattended to,” says Kansiime. 

 

Kansiime reveals that 60% of the medical posts in the district are still vacant, and worse still, only 165 medics are on the ground of the 175 that were recruited in 2010. Medics would have perhaps gone to Kanungu but such demoralising stories as the exclusion of some workers from the list of the beneficiaries of the hard-to-reach allowance, makes them think twice.

 

Maari Karungi, the district health educator says; “Kanungu is one of those hard-to-reach areas, but some of us have been excluded from the hard-to-reach areas’ allowance for unknown reasons yet a few of our colleagues get it.” 

 

He adds that although they carry out health education on radios, at health centres and in communities, it is not enough to equip mothers with relevant information about family planning. This, he argues, is due to lack of funds to enable them to effectively carry out sensitisation.