Adolescent Sexual and Reproductive Health in Uganda

John David Kisuule and Paul Bukuluki (Makerere University, UiO, OsloMet)

Research Objective and Methodology 

Overall objective

The main objective is to explore adolescent sexual and reproductive health challenges and the mechanisms that are in place to address these challenges.

Study methodology

Basically, the study is qualitative but students are free to use mixed methods

Project Description

Population and Sexual Activity in Uganda

This project provides very good insights on reproductive health among teenagers in Uganda where the young population is over 80% of the total population. Out of this nearly one-quarter is aged between10 and 19 years. Many Ugandan teenagers (girls and boys) aged 15–18 have ever had sex. Among 18–19-year-olds, the proportion is much higher for both sexes: 77% and 59%, respectively.

Pregnancies Among Teenagers

According to the Ministry of Health, 25% of the Ugandan teenagers become pregnant by the age of 19.  About 49% are married before their 18th birthday and they start getting babies until their mid 40s. Therefore for many teenage girls in Uganda, realizing their future dreams can be a formidable challenge. Thus early school dropouts due to unwanted teenage pregnancies and marriages are a common occurrence.

Abortion and STI

In addition adolescents face a host of other sexual and reproductive health challenges. For example, complicated child births and abortions often requiring Emergency Obstetric Care are widespread. Sexually Transmitted Infections (STIs) including HIV infection are also common. Large families with poorly spaced children define a typical Ugandan rural community.

Although adolescents constitute the highest demographic segment in Uganda, sexual and reproductive information and access to services to meet their needs are limited.

For example, local studies suggest that abortion occurs among adolescents, although national data do not exist to assess the frequency. Most abortions are performed under unsafe conditions because abortion is illegal in Uganda, except to save a woman’s life.

A survey in Mbarara district found that 78% of female adolescents knew someone who had aborted. More than two-thirds of patients receiving care for abortion complications at a local teaching hospital were 15–19-years. Although many teenagers aged 15–19-years old approve family planning, a much smaller proportion of sexually active teenagers use a modern method of contraception.

Major SRH Challenges in Uganda

1) Lack of information

People need to have access to accurate information. Thus, they must be informed and empowered of how to protect them-selves from sexually transmitted infections e.g HIV/AIDS etc. The Ministry of Education and Sports should integrate life planning skills education into the primary schools curriculum.

2) Lack of access to services

People must have access to safe, effective, affordable and acceptable contraception method of their choice including abortion. Counseling, access to family planning and services are among the packages needed to prevent unwanted pregnancies and sexually transmitted infections.

When women decide to have children, they must have access to services that can help them have a fit pregnancy, safe delivery and healthy baby. During the COVID 19 lockdown and also after access to SRH services has become more difficult for the youth.  There is a need for Uganda government together with civil society organizations to incorporate SRHR into covid-19 responses from the outset. This will support the youth to access information and services related to SRHR with the view of having services that would cater for the even unemployed youth, and this could reduce the challenges being faced by the youth.

3) Lack of government commitment

The Ministry of health has many good government policies regarding SRH but the government does not allocate funds for implementation. It is mostly local and international NGOs which are engaged in SRH interventions.  

4) Poverty

Many Ugandans are living below poverty line earning less than one USD per day. Many girls cannot afford pads etc. Therefore, because of economic survival, they cannot negotiate safe sexual terms.

5) Cultural and religious challenges

 The overall lack of adequate reproductive health knowledge and services are often paralleled by the existence of cultural and religious beliefs and health seeking behavior. Issues related to; sexual culture, gender power relations, importance of having children, infertility, witchcraft and ancestoral power etc are common barriers and coping mechanisms.    

Status of the project

The project is conducted in collaboration with Makerere University which is a well-known University in Africa and the world as a whole. Therefore students will have the opportunity to work with other researchers at this University.  

Supervision and contact persons

During data collection in Uganda, a student will get a

supervisor/contact person. It is also possible for her/him to attend

seminars that may be relevant to the theme.

Contact persons: 

1. John David kisuule

Em: global.dev.net@gmail.com

Mob: +47 98059288

2. Paul Bukuluki

Em: pbukuluki@gmail.com

Mob: +256 772462100

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