Limited Access to Family Planning Services Blowing Away Dreams of Young Women in Bughendera County
By; Basaijja Idd
Journalist at Uganda Radio Network-URN.
Limited access to family planning services in Bughendera County in Bundibugyo district is accounting to the increasing cases of early pregnancies and shuttering of dreams of young women.
Health experts in the area say, the low-level use of family planning is a major factor influencing the fertility pattern and population growth rate in the district but more so derailing otherwise healthy development of young women and adolescents into adulthood and have negative impacts on their education, livelihood and health.
Globally in 2021, an estimated 14 percent of adolescent girls and young women give birth before the age of 20 while in Uganda 24.8% of the women aged between 15-19 years have begun childbearing.
Giving birth complications are a primary cause of mortality, 368 deaths per 100,000 in Uganda (UBOS,2021) and injury among teenage girls, but being an adolescent mother may also result in grave abuses of their human rights and serious societal implications, such as child marriage, intimate-partner violence, and mental health concerns.
Development partners and health care providers blames the limited access of critical health services like family planning on the remoteness of the area and limited health facilities.
Bughendara county for is an incredibly mountainous and some communities there are almost totally isolated. These villages are so remote that they may not have access to people outside of their community for weeks.
Young women in the county say that while they prefer to be in charge of their productive health, lack of services mean they make unprecedented choices.
Lillian Vumulia, from Bugombwa in Busaru Sub County dreamt of becoming a nursing officer after her education, however her dream was cut short after she got an unwanted pregnancy and later abandoned by her man at the age of 18-years.
While Vumulia was sexually active at a tender age and heard about family planning, she could not manage to trek more than 20 kilo meters to the nearest health in her area to access the service.
Today she is a single mother doing odd jobs to take care of her child.
Literally translated…
“I produced when I was still young, when I got pregnant I feared to tell my parents and had to run away from home, gave birth from a friend’s place and my boyfriend abandoned me, if I had these services maybe I would have met my dream to be a nursing officer.” Vumulia said
Similarly, Agnes Namara got her first child while in primary seven while on her dream journey to complete senior four and become a nurse too.
She says after giving birth from a young relationship she was chased away from home. Namara believes young women like her need information on their reproductive and sexual health to fully exercise their right to choice and to keep themselves, their partners, and their children healthy.
Literally transplanted…
“In the village, we don’t have family planning providers and that means someone has to walk long distances to the main hospital, today I need the services so that I can be able to control getting a second pregnancy.” Namara said
Jackline Kabugho aged 19-years is a mother of two who blames her early motherhood to limited information, access to planning services and poverty in her family.
She shared with URN reporter, that despite being in sexual relationship at a young age, she feared to go to the health facility in her area to get family planning services arguing that government and partners to create friendly points for young people where they can get such services without fear.
“If the services were closer to me, ofcourse I would have accessed them and wouldn’t have given birth to these children at my age, I could maybe be a school teacher because it all that I desired while in school…” Kabugho narrated.
Racheal Kabugho had to sell-off her retail shop in Ntandi town council after she got complication while giving birth in 2022. The 20-year-old who got pregnant from her possessive boyfriend is now living with her old grand mother as she struggles to raise her child.
“I had no intentions of giving birth at 19, not at all but as you know men, they often take advantage of girls and that is what happened to me, I had attempted to get family planning but our facility did not have short term methods and I feared those long one’s because he could findout. “Kabugho narrated
Sarah Kabagenyi working with Bundibugyo Women with Disabilities living with HIV Association says there is concerns that PWD’s have never been prioritised when offering family planning services.
For example, those with hearing impairments and mobility challenges never access these services and yet they are often sexually exploited by men.
Because PWDs have limited access to family planning, she says they are never in control of the number of children they want to have and many are struggling to raise children as single parents.
Winnierose Masika, incharge of family planning services at Bupomboli HCIII in Harugale Sub County says shortages of contraceptives and the health workers to provide them coupled with unfriendly service providers create another barrier.
She adds that most medical distribution systems have not been digitized to address the geographical challenges in Bughendera while the village health teams-VHT are not fully motivated to do the work.
Peace Muhindo, a health worker at Bukangara HCIII in Bukonzo Sub county, says the number of young mother’s coming for family planning services remains low attributing it to little level of men involvement.
However, she agrees that there is limited excess to these survives pointing out to her sub county that serves other remote sub counties of Kirirumya and Mbatya.
Annah Kukundakwe, a senior programme officer, Partnership and Networks at Centre for Health Human Rights and Development -CEHURD says that while, nearly a third of all women in Uganda are becoming mothers during adolescence, it is clear the country is unknowingly ruining the future of young adolescent girls and women.
She says most adolescents girls are sexually being violated by men older than them meaning their first sexual encounters is not out of their decisions justifying why they need to have routine access to family planning services.
Because young women lack access to such reproductive services like family planning, Kukundakwe argues that the country is raising a population that is highly dependent, uneducated without employable skills which is having an impact on the general national development agenda.
She wants government to enforce laws on sexual violence to make it difficult for men to abuse young girls and women but also enable them access reproductive health services more effectively.
Josephine Babungi, the women member of Parliament for Bundibugyo district says government is committed to ensure there is improved access to all sexual reproductive health services for all.
In the survey which was conducted jointly by the Ministry of Health, Uganda Bureau of Statistics (UBOS), and Makerere University School of Public Health in 2022, fifteen percent of the women in Uganda can’t access contraceptives.
