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Uganda’s fertility rate highest in Africa

By Vision Reporter

Added 10th July 2009 03:00 AM

“Be fruitful and increase in number; fill the earth and subdue it,” says the Bible, in Genesis 1:28. Over 10,000 women in Uganda can be said to have taken this message to heart. They have produced more than 15 children in their lifetime, according to

“Be fruitful and increase in number; fill the earth and subdue it,” says the Bible, in Genesis 1:28. Over 10,000 women in Uganda can be said to have taken this message to heart. They have produced more than 15 children in their lifetime, according to

By Lydia Namubiru

“Be fruitful and increase in number; fill the earth and subdue it,” says the Bible, in Genesis 1:28. Over 10,000 women in Uganda can be said to have taken this message to heart. They have produced more than 15 children in their lifetime, according to data from the 2002 population census.

The small tribes of Vonoma, Mvuba, Bahehe, Dodoth and Babwisi have the highest percentage of women with 15-plus children. About one out of every 50 Vonoma mothers falls in this category.

“In Uganda, we have women who begin having children as early as 14. If you start that early and are producing children every two years, by 40 years you will have very many children,” says Hannington Burunde, the head of information at the Population Secretariat.

Some women continue producing until they are about 45. A woman who starts child bearing at 14 and gets one child every two years will, by the age of 46, have 15 children. The number could even be bigger if she had multiple births or if she spaced by less than two years.

With an average of seven children per woman, Uganda has the highest fertility rate in Africa and the third highest in the world, according to World Bank data.

Whatever the reasons for the high fertility, some facts came out clearly in the Uganda Demographic and Health Survey of 2006. Village women produce more children than those in towns. The wealthier and the more educated tend to produce fewer children.

One immediate effect of this high reproduction rate is that the population grows faster than the pace at which the Government can create new schools, hospitals and hydro-electric power dams. Within 11 years from now, the number of Ugandans will exceed 50 million, according to World Bank projections.

Because of the high number of children per woman, Ugandan parents grapple with a high number of dependants. More than half of Ugandans are below 15 years. Another one fifth is aged 15-24, many of whom are also dependants.

According to the World Bank, Ugandan workers bear the highest level of dependency in Africa. This compromises their ability to save and invest.

The growing population is already causing a crisis as the available land in some parts of the country will not be able to support the growing number of peasants.

Eastern Uganda will start experiencing this crisis as early as next year, according to the latest State of the Environment Report by the National Environment Management Authority. The body warned that the land crisis would gradually spread to the rest of the country by 2022.

Despite all the disadvantages of producing a lot of children, many women, particularly in the rural areas, choose to have large families.

Jennifer Asiimwe Kasabiiti, a Makerere University researcher, found that more than half of 423 women interviewed in Rukungiri and Kanungu were not using contraceptives because they wanted to have many children.

While Burunde of the Population Secretariat advocates for manageable families, he acknowledges that people who choose large families have their reasons. “People with many children are not fools,” he says.

According to him, they produce many children hoping that some will survive to till the land, create wealth for the rest of the family and look after parents in their old age.

As such, high fertility is driven by factors such as high infant mortality rates, an agro-based economy, lack of alternative social security for old age and uncertainty about success in life.

However, Uganda also has the highest percentage of unintended pregnancies in East Africa. Almost half – or 46% - of all pregnancies are either mistimed or unwanted. This translates into 900,000 unintended pregnancies a year. The average Ugandan woman has two children more than she would like to have.

In comparison, a quarter of all pregnancies in Tanzania are unwanted and one third in Ethiopia.

The reasons for unintended pregnancies are many but lack of, or improper use of family planning methods is the greatest contributor. Rural health centres may run out of modern family planning drugs for months.

Women have also been reported to use these methods inconsistently, either because of adverse side effects or ignorance. A report by the Guttmacher Institute quotes a group of women who revealed that some of their colleagues only take the pill on the days they have sex.

Despite many years of family planning advocacy, an average Ugandan woman still produces about seven children, nearly the same as 40 years ago.

Kenya and Tanzania, who were at the same level as Uganda in the 1960s, have managed to reduce their fertility rate to 5 and 5.7 respectively, according to the World Bank. “We are lagging behind,” Burunde admits.

He says whereas the technocrats advise low birth rates, politicians often give contradicting messages.

As recently as June 25, The New Vision quoted President Yoweri Museveni advising a couple to have many children since a big population provides market for goods. “People are getting mixed messages about the issue because it has been politicised,” Burunde laments.

He also cites the high infant mortality rate as reason why people are having many children. “If you could assure them that their children will survive, they would not have so many.”

According to Burunde, there needs to be a change in the marketing of family planning methods to include the traditional ones that are more acceptable in rural areas.

“In Teso region, for example, when a woman gave birth, she was sent back to her ancestral home, only to return when her child was old enough to run around. This helped in child spacing.”

Myths about real or imagined side effects of contraception are also undoing the campaign for family planning, says Burunde.

“Some women believe that modern contraception can make you have children with deformities. Others suffer side-effects which were not explained at the time they started the method. When this happens, they just abandon the method and tell all the women around them to avoid it.”

The Population Secretariat, therefore, encourages service providers to have clear and frank discussions with their clients in order to build trust.

Other experts like Kasabiiti, propose that efforts to reduce fertility should focus on sensitisating the masses on the need for smaller families and encouraging alternative economic activities, away from agriculture, which breeds dependency on family labour.

The challenges not withstanding, Burunde predicts that the total fertility rate of Uganda might fall to 5 in the next 15 to 20 years.

That, he stresses, will happen if the current universal secondary education succeeds in keeping girls in school up to at least senior three, political leaders begin preaching a uniform message against high fertility and family planning methods become available to all.

Only then will Uganda manage to reduce its high fertility and dependency rate, which eats up household incomes, prevents saving and traps many families in poverty.

Uganda’s fertility rate highest in Africa

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