Health and Population experts advise on the high rate of unintended pregnancies in Uganda

By Zurah Nakabugo

Uganda is faced with a high number of teenage pregnancies which calls for new and different family planning interventions through sensitization and prevention an health and population expert Dr Jotham  Musinguzi has said.

“ In Uganda 45% of pregnancies are unintended and of these (pregnancies), 60% happen in adults of less than 18 years.  It is a clear manifestation , that there is a lot of sexual activity among young people which increases cases and consequences of unintended pregnancies within the country,” Dr. Musinguzi, also the Director General of the National Population Council (NPC) stated .

He said that as a result of  unintended pregnancies in young people there is a high number of girls dropping out of school which limits  their opportunities for future employment and rises the cycle of poverty within the families of  the victims.

“The council looks at the issue of family planning for adolescents as a development matter. We have realized that a lot is at stake as girls remain underpowered and yet they are already sexually active,” he said.

Dr Musinguzi  explained that when girls conceive at a young age, they not only risk dropping out of school but also raise the cost of access to care as many will develop complications requiring them to deliver through caesarian section which may not be readily available, especially in rural areas.

Dr. Musinguzi was speaking at the African Health Leaders’ meeting at Speke Resort Munyonyo, to plan acceleration of family planning in Sub-Saharan Africa.

Studies from the Ministry of Gender indicated that one in four Ugandan women aged 15-19 have given birth or are pregnant with their first child by the age of 18.

“Uganda is among the countries with the highest teenage pregnancies and policies need to be in place to avert the teenage pregnancy crisis,” according to the report.

According to  research done by Frontiers in Reproductive Health, in February, 2023, in Sub-Saharan Africa, one in every five young women becomes pregnant, and 50 percent of these are unintended.

The study further says, pregnancies in Adolescent Girls and Young Women (AGYW) are associated with poorer maternal and neonatal outcomes and a high abortion rate, yet data are still limited on incident pregnancies among AGYW in vulnerable situations.

According to the research done by National Library of Medicine in Feb, 2023,  in Uganda, unintended pregnancies are responsible for one in three births with harmful consequences, a situation that worsened during COVID-19. The study examined unplanned pregnancy and its associated risks in Oyam district, northern Uganda during the COVID-19 epidemic.

Our study shows that unwanted pregnancies among adolescent girls remain a public health issue in Oyam district with more than two-thirds of adolescents having unwanted pregnancies during the crisis of COVID-19.

According to UN report, some 3.9 million unsafe abortions occur each year to girls aged 15-19 in developing regions. Adolescent pregnancy can also have negative social and economic effects on girls, their families and communities. Unmarried pregnant adolescents may face stigma or rejection by parents and peers as well as threats of violence

The United Nations Children’s Fund (UNICEF) defined teenage pregnancy as “a teenage girl, usually with the ages of 13–19, becoming pregnant.  Some complications associated with teenage pregnancy include preterm birth, growth retardation, and low birth weight.

“Early pregnancy puts a mother’s health and that of her unborn child at serious risk. Adolescents in the age group of 15–19 are two times more likely to die due to pregnancy and childbirth-related causes as opposed to older women. Also, children born to adolescent girls have a 50 percent likelihood of dying before one year compared to those born to mothers in their twenties,” report says.

UN report says, between 2015 and 2019, there were over 121 million unplanned pregnancies worldwide, with 64 unwanted conceptions per 1000 women between the ages of 15 and 49 on average. These unwanted pregnancies predominately happen in the sub-Saharan Africa region.

Uganda and other African countries now need guidelines for adolescents and young people  and there are proposals to allow  access to contraceptives- especially for school-going adolescents . However access and use of contraceptives remains controversial in Uganda and other conservative African countries.

Dr. Samukeliso Dube, the Executive Director of Family Planning (FP) 2030, says, there is an urgent need for family planning policies if countries like Uganda are to meet aspects of the UN Sustainable Goals(SGDS).

“There is need for countries to share ideas on how they want their young people to be offered family planning services and information. Many of them are slow which affects family planning targets,” she said.

Betty Amongi, the Minister of Gender, recently said, the teenage pregnancy rate in Uganda stands  at 25 percent, which is the highest  in East Africa.

The resultant education cost for children born by teenage mothers of over Ug.Shs.53bn ($14.9m) will be saved, if the strategy to end child marriage and teenage pregnancies is fast tracked and the percentages reduced from 25% to 10% as envisaged in the current Health Sector Development Plan.

The Ministry of Gender in June last year launched the National Strategy to End Child Marriage and Teenage Pregnancy 2022/2023-2026/2027.

Sheikh Abdallah Semambo said family planning activists should invest more in providing information that allows young people to appreciate the dangers associated with early sex and early conception.

According to Dr Richard Mugahi, the Assistant Commissioner in charge of Reproductive Health ,family planning will only be given to girls who are sexually active and they are trying to make religious leaders understand this.

“The public has been misled to think that allowing adolescent girls to access family planning means getting drugs and throwing them around without proper guidance, which is not true. Girls are sensitized about family planning issues to avoid unintended pregnancies which puts their lives at risk,” he said.

UNESCO estimates that 132 million girls are out of school in Africa. And among girls who enter primary school, only a small percentage finish secondary school.

 It also estimates that 21 million adolescent girls become pregnant each year, and out of them, 12 million give birth, which is a major problem that  prevents them from finishing secondary school.


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