Population rise: Family planning a good weapon

At an estimated 34.9 million people, Uganda's population should worry everyone.   

Even worse, according to the Uganda Demographic and Health Survey (UDHS) 2011, a whole 59% of Ugandans are minors; below the age of 18 years.  

The country has 11.2 million people between 10-24 years, 7.3 million women of reproductive age. And as such, 1.5 million babies are born in Uganda every year. 

Christopher Arinaitwe, a service provider with Reproductive Health Uganda, based in Kabarole district, says family planning can be used as a tool for achieving a quality population. "All our clients have not more than four children and this is because they started using family planning services late," he starts. 

Arinaitwe says previously, their clients sought family planning because they had had many children and wanted to stop.  "Today, however, people seek family planning so they can have a number of children they can manage," he says. To achieve this, he says, it has taken continuous mass sensation on the services around the region. 

However, Allen Nankunda, the executive director of Communication Development Foundation (CDF), believes that targeting leaders who will in turn influence their respective communities will work.  

"Better communication is needed at the grassroots to reach the men who occupy most leadership positions so that we can increase demand for reproductive health commodities and services," she said.  

Government commitment 

In 2012, President Yoweri Museveni, not only embraced Family Planning but pledged support, in a Bill and Melinda Gates organised Family Planning Summit in London. It was cemented at the Ministry of Health-organised Family planning conference, supported United Nations Fund for Population Advancement (UNFPA) and other development partners in 2014. 

Museveni announced a $25m commitment towards family planning for the next five years. "The Government will increase budget allocation for family planning supplies from $3.3m per annum currently to $5m per year for the next five years," he said. 

So between 2015 and 2020, Government told of plans to spend, $235m to ensure that family planning supplies and services are availed to everyone who needs them! The goal was simple, cut the country's unmet need for contraception currently at 34% to 10% by 2020.  

Uganda's reality 

Data released by the US Population Reference Bureau (PRB) in 2013, shows that 10% of Ugandans between ages 20 and 24, were married by 15 years, a whole about 40% by the time they were 18 years! 

Even worse, PRB found that of every 1,000 adolescent girls aged 15 to 19 years, 124 have had children. No wonder, between 2002 and 2014, Uganda's population increased from 24.2 million to 34.9 million. Experts project that by 2025, it will rise to 47.4 million and more than double to 100 million by 2050. 

Speaking to New Vision recently, Isaiah Mbuga, a population health advocate, formerly with the Population Secretariat speaks about the issues in the health sector.  "Uganda's health sector is driven by aid. The Government is not free to think on its own, but rather bounces to the donor decision." 

He speculates that the reason this has gone on for long is because donors fund a huge part of the health budget. Sadly, in the 2015/2016, 24 trillion budgets, government was only funding 44.5%, a thing that in away had decisions determined by the funds. 

Reproductive health Uganda's Dr Peter Ibembe, had often made it clear that for a matter as sensitive as contraceptives, government had shown, little commitment. "I would like to see even more commitment, it is a very important tool in dealing with population rise and quality!" he said.   

A little hope maybe 

Convinced, the President spoke; "We need to build the economy and provide adequate health and education facilities, develop infrastructure and handle unemployment, which is a major problem that affects the quality of the population." He then explained; "A big population is not the problem but what quality of people the country is producing. Do they have access to essential services? Do they meet their needs?" 

To show support, Members of Parliament rejected the Ministry of Finance strides towards taxing health commodities, whereof contraceptives like pills and condoms had an 18% value-added tax and an additional 6 % withholding tax. 

In their manifesto NRM, family planning is interlinked with the critical maternal and child health programs. "The NRM will continue to implement the sharpened reproductive, maternal, neonatal and child health plan, and provide emergency obstetric and neonatal, antenatal care and family planning services at all Health Centre IVs and Health Centre IIIs," it states. 

A known believer in women taking control of their bodies, UNFPA country director, Esparence Fundira was optimistic that it would get better, especially since now there was a political will. "Women should have children, when they want, and not just living it to chance," she spoke at what should have been a Fistula event. "Mostly, they should have children that they can take care of!"