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Global Youth Connect Project Calls for Small Grants Applications
Introduction:
Reproductive Health Uganda (RHU) under funding from the International Planned Parenthood Federation (IPPF) on the Global Youth Connect project announces the call for applications of project proposals through the small grant scheme.
About the Global Youth Connect Project:
Global Youth Connect is a digital platform established by the International Planned Parenthood Federation (IPPF) and hosted by Reproductive Health Uganda (RHU). It is centered on empowering diverse young people with vast, accurate, and age-appropriate information on sexual and reproductive health hence improving their well-being. The platform, whose major strategy is meaningful and inclusive youth engagement/ participation takes on the form of an online information portal that features a website with vast interactive features and linkages with other IPPF youth communication channels.
The global youth connect platform performs explicitly three core functions:
- Collation, sharing, and debating youth participation practice (tools, standards, policies, ideas)
- Connecting and amplifying IPPF youth communications channels
- Scanning for and sharing opportunities to advance the IPPF youth agenda i.e. training, grants, advocacy forums, etc.
What does the small grants scheme seek to achieve?
The scheme seeks to support youth-driven initiatives and innovations that advance adolescents and Youth Sexual and Reproductive Health across the federation. We believe that young people have the ability to develop and implement solutions geared towards improving their own sexual and reproductive health and being provided with a financial stimulus, their capability would be accelerated.
Who should apply? The scheme targets:
Young people (10-24years) within or attached to the IPPF Member associations are interested in designing and implementing interventions aimed at improving the SRHR of fellow young people.
Themes under which the application should be based: Note: Your application can be directed in any of the themes listed below.
- Creative Artistic Art or videos to promote SRHR for adolescents and young people
- Strategies to increase SRHR for vulnerable populations, especially Persons with disabilities (PWDs), Young people LGBTQI+, Young people living with HIV, Young people living in poverty, young people using drugs, etc
- Strategies/ideas to increase access to Comprehensive Sexuality Education for adolescents and young people
- Using digital media to amplify youth networks and empower young people with SRHR information across the federation
Please note:
- Your proposal should be in pdf format
- Your submission should be shared in English
- Your proposal should include all the details included in the project proposal summary
- There should be no administration costs as per budget.
- Young people can apply either as individuals or groups. Only young people affiliated with IPPF associations are eligible.
Duration: 6 Months (December 2022 –May 2023)
Grant amount: $5,000
Deadline: 20th November 2022
Download the PDF's below
Call- English, French, Spanish
All proposals should be sent to info@youthsconnect.org. Please also keep in copy rhu@rhu.or.ug
RHU signs Memorandum of Understanding with Lango Cultural Foundation
On October 18, 2022, cabinet leaders from the Lango Cultural Foundation (LCF) in northern Uganda signed a five-year memorandum of understanding (MoU) with Reproductive Health Uganda (RHU).
According to Robert James Ajal, LCF Prime Minister who led the cabinet delegation, integrating sexual reproductive health (SRH) into the LCF plan for 2022 to 2026 is critical in order to manage the LCF population and harness development in homes and as a foundation.
“Lango Cultural Foundation will educate and sensitize communities about sexual reproductive health and family planning, as well as strengthen the enforcement of existing laws against gender-based violence, defilement, child neglect, marriages, and land conflicts. Encourage and support the education of girls,” Ajal said.
The signing of the MoU was witnessed by the Lira district local government and the office of the Presidency, which vowed to protect the partnership and thus reached and birthed between RHU and LCF.
Dennis Otim Otto, Principal Assistant Secretary from the Office of the Chief Administrative Officer, pledged to support the partnership which aims to achieve demographic dividends for Lira district local government and also the Lango sub-region of Northern Uganda.
“We will support the partnership between Reproductive Health Uganda and Lango Cultural Foundation because it aligns with the Government of Uganda’s development goals like the NDP III, vision 2040, and the Parish Development Model pillar number four (4),” Otim said.
In his remarks, Jackson Chekweko, RHU Executive Director, said that as we climax with what we started in 2020 with the Lango Cultural Foundation (LCF), a resolution to promote family planning was jointly signed. LCF is now ready to cruise on its own.
“We are now putting in place a framework that will help our relationship progress. Our partnership with the Lango Cultural Foundation is based on work that improves the lives and social welfare of Lango residents and the foundation,” Chekweko said.
RHU and LCF signed a group resolution before, to promote family planning in September 2020, with support from Advance Family Planning (AFP).
The resolution, which focuses on educating communities about family planning and incorporating family planning into the LCF’s budget and development plan, has had an impact on all eight districts in the Lango region.
Cultural leaders in the Lango Kingdom are stewards of local traditions and powerful influencers of community values and health-seeking behaviors.
Dr. Buchan Patrick Ocen Lira, district health officer, disclosed that the signing of the MoU will help achieve Family Planning commitments 2030 by reducing the unmet need for family planning in the Lango region, now at 27.4% among married women and girls [1]. Cultural preferences for large families and substantial dowries for young brides have traditionally hampered family planning. This all contributes to a teen pregnancy rate of 35.2% in the region, which is higher than the national average [2].
While closing the signing ceremony, Lawrence Egole, Resident City Commissioner for Lira City, stated that Lira and the Lango subregion have many street people because parents were not guided about how to many children’s birth and care in the community.
He encourages other cultural, religious, and educational institutions in Uganda to join efforts to capitalize on demographic dividends.
Advance Family Planning (AFP) local partner Reproductive Health Uganda (RHU) has supported family planning advocacy in the Lira district of Lango since 2017. In 2019, during a meeting with the Lira district advocacy working group, a local district speaker identified the challenge of cultural leaders speaking negatively about family planning within the community. In August 2020, the National Population Council (NPC), a national governing body, held a meeting in Lira with representatives of the Lango Cultural Foundation, the kingdom’s governing body, on how to engage with cultural leaders to promote family planning. They identified the council of clan chiefs, overseen by the paramount Chief, His Highness the Won Nyaci me Lango Yossam Odur Ebii, as key to their advocacy efforts.
The writer of this article Aldon Walukamba is the RHU Media Advocacy and Documentation Coordinator
References
Uganda Bureau of Statistics (2016). Uganda Demographic and Health Survey 2016. Retrieved from https://dhsprogram.com/publications/publication-FR333-DHS-Final-Reports.cfm
Uganda Ministry of Health. Uganda District Health Information System (DHIS) 2. Accessed October 2022.
In Uganda nearly a third of all women become mothers during adolescence
As we celebrate the International Day of the Girl Child 2022, under the theme: “Our time is now – our rights, our future” research released by UNFPA, the UN sexual and reproductive health agency, reveals that nearly a third of all women in developing countries begin childbearing at age 18 or younger, and nearly half of first births to adolescents are to children or girls aged 16 or younger.
While global fertility has declined, the UNFPA data showed that women who began childbearing in adolescence had almost 5 births, with Uganda having 4.8 by the time they turned 40 in 2020.
“When nearly a third of all women in Uganda are becoming mothers during adolescence, it is clear the country is unknowingly ruining the future of adolescent girls,” said Dr. Peter Ibembe, Reproductive Health Uganda (RHU) Director of Programs.
“The repeat pregnancies we see among adolescent mothers are a glaring signpost that they desperately need sexual and reproductive health information and services” said Bishop Kipto Masaba of Sebei Diocese.
This is evident in the Butaleja district, where Uganda’s youngest grandma, aged 27, was born in 2021.
Additional childbirth in adolescence is frequent among child moms after having their first kid. Nearly three-quarters of females who have their first child at the age of 14 or less have a second child in adolescence, and 40% of those who have two children have a third before leaving adolescence.
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. The youngest child mothers face the most dangers.
There is positive evidence of decreased levels of motherhood in childhood and adolescence over the world. However, the rate of reduction has been frighteningly sluggish, frequently falling by barely three percentage points every decade.
“Governments need to invest in adolescent girls and help expand their opportunities, resources, and skillsets, thereby helping avoid early and unintended pregnancies,” said UNFPA Executive Director Dr. Natalia Kanem. “When girls can meaningfully chart their own life course, motherhood in childhood will grow increasingly rare.”
The report makes policymakers recommendations such as providing comprehensive sexuality education, mentorship, social support, and quality health services to girls, as well as providing economic support to families and engaging local organizations, all within a supportive policy and legal framework that recognizes the rights, capacities, and needs of adolescents, particularly marginalized adolescent girls.
We think, in collaboration with our partners, that girls are ready for a lifetime of rapid progress. It is time for all of us to take responsibility – with and for girls – and invest in a future that values their agency, leadership, and potential.
A call to action
From October 2022 through October 2023, we will urge for increased focus, investment, and action on:
- Supporting teenage girls’ leadership at the forefront of change initiatives, including hearing their views, responding to their requests, and creating places for their involvement in decision-making
- Increasing resources and investments in teenage females, including networks and organizations that advocate for excellent, inclusive education and promote their well-being
- Improving access to and utilization of inclusive teenage girl-centered services at all times, but particularly during crisis response and recovery
The writer of this article Aldon Walukamba is the Media Advocacy and Documentation Coordinator at Reproductive Health Uganda
In Uganda safe spaces, toll free line offers SRHR information for young people
Uganda – “We’ve been told that our clinics bear peace – the clinic and what is offered in it,” said Demeter Margaret Namuyobo. She is the Medical Coordinator at Reproductive Health Uganda (RHU), where we present a safe space for women and young people in Uganda, to access sexual reproductive health services and information (SRHI).
Over the past 65 years, millions of marginalized and underserved people have entered Uganda, including internally displaced persons (IDPs), refugees, young people, and migrants fleeing economic and political instability in Sudan, South Sudan, Ethiopia, Somalia, the Democratic Republic of the Congo (DRC), Burundi, and Rwanda.
New Patient care Centres in all 19 static RHU clinics and a toll-free line (0800299003), assist new arrivals in gaining access to SRHI services and information, as well as addressing urgent needs such as protection, shelter, food, and counseling.
Amid the noise, crowds, and queues at community outreaches and the static clinics, there is a door marked with the words
“This is the RHU safe space” – a place where young people and survivors of gender-based violence can come for guidance, care, and referrals to local networks of public services as well as resources on sexual and reproductive health.
“The people who come here have SRHI issues that require urgent attention, in most cases privately. They don’t understand most of the dialects spoken in Uganda, they haven’t eaten properly for a while, they hitchhiked – they are anxious and distressed,”. Namuyobo explained.
New arrivals, particularly women and young people, are welcomed into the safe space at the end of often long and difficult journeys.
While comprehensive data are unavailable, research and news reports have indicated women and young people face threats of gender-based violence and a lack of SRHI as they seek out better lives in the country.
To address these rights violations, RHU maintains 19 safe spaces across the country and the toll-free line (0800299003), where staff offer SRHI and work to identify instances of gender-based violence, offer case-management support, and refer survivors to corresponding public services. Teams also work with survivors to access health services, build safety plans, and monitor cases until resolution.
“RHU’s toll-free line and humanitarian response in Uganda is important to guarantee the health rights of marginalized and underserved people, especially young people, women, and girls,” said Tom Kulumba, who heads the RHU Gender and Youth department in Uganda.
In addition to sexual and reproductive health advice and gender-based violence support, each space accommodates breastfeeding mothers, and infant beds and provides free condoms and educational videos and games. Everyone is welcome, and the door is always open.
“Hundreds of vulnerable and underserved people have benefited from calling the RHU toll-free line,” Talent Emily, RHU toll-free line officer said. She contends that the callers are interested in family planning, infertility management, HIV, location of RU clinics, making appointments, and sexually transmitted infections (STI) management.
For some, this makes all the difference. “During an appointment, one woman mentioned her desire to use family planning,” Demeter Namuyobo recalled. “She put both hands on the table and said, ‘You are the first person so far who has looked at me, so I felt safe to open up – I think this is what sets us apart.”
As Ugandans face ongoing threats to their SRHI safety in some places – from a lack of essentials such as spaces, toll free lines, and medicine to political and socioeconomic crisis – RHU will continue its critical work of providing marginalized and vulnerable persons in their diversity a safe place to rest and recover.
The author Aldon Walukamba is a Media Advocacy and Documentation Coordinator at Reproductive Health Uganda
Why Family Planning Is Beneficial to Uganda’s development stride
Given the state of Uganda today, it is urgent that humanity and nature exist in balance. The burden, of course, is on the people to make this happen. In a country of 42.9 million people that could grow to 100 million by 2050, we are making this more difficult.
It doesn’t have to be that way. We know what must be done, but we must find the political and societal/cultural will to make it happen, in a manner that supports having a proper conversation about the best approaches. The solutions to attaining a healthy population count are grounded in the principles of rights and empowerment and are things the world should be doing anyway.
One of the first things to do is to invest in young people, who make up more than 75% of Uganda’s population and a population of 24 million women in health, particularly by providing deliberate and voluntary family planning services. This is often referred to as “low-hanging fruit,” because it is the right thing to do, relatively simple to provide, and something that most women and men desire. Everyone should have the right to plan if and when to have a family, and have the tools, resources, and access to do so, or not do so.
There are more than 23.19 million women in Uganda, including 10 million that are of reproductive age, but 17% want to delay or avoid pregnancy but are not using a modern contraceptive method. It is also true that 46 percent of Uganda’s estimated 36 births per thousand pregnancies in 2020 were unintended (PMA,2020).
The estimated current annual cost of providing modern contraceptive services in Uganda has gaps, including direct and indirect costs.
According to the National Family Planning (FP) Cost Implementation Plan (CIP) II (2021/22–2024/25), the overall funding need for FP commodities is the US $332.3 million. The government’s overall commitment to the reproductive health (RH) supplies budget over this time period, however, is the US $ 25 million. If this were to be expanded and improved to address all men and women’s needs for modern contraception in Uganda, a funding gap of US $ 307.3 million needs to be avoided.
Just to put that in perspective, the total per capita consumption of pure alcohol is 23.7 liters in Uganda. This approximately accounts for 480,000 shillings spent on alcohol by each Ugandan.
The government allocated a total of UGX 3.722 trillion for healthcare delivery in the financial year (FY) 2022/23. This has been largely geared towards the COVID-19 vaccination.
The good news is that with the celebration of 13 years of the Advance Family Planning initiative (AFP) in Uganda, the citizens know what to do, how to do it, and why to do it concerning family planning access. Let’s look at just two examples of why investing in family planning can make a huge difference in people’s lives in Uganda.
Most of the districts in Uganda are experiencing the highest rates of population growth in the world. In fact, Uganda’s population is expected to double, from 42.9 million today to 100 million by 2050. (UBOS, 2020)
One of the country’s fastest-growing populations in Wakiso. Its current population of 2.9 million is projected to reach 5.1 million by 2050, and it is one of Uganda’s youngest and most urbanized districts, with over 88 percent of the population under the age of 30. The district also has a number of street children and destitute.
One in four girls between the ages of 15 and 19 in Uganda has given birth or is carrying her first child, according to the United Nations Population Fund (UNFPA) country’s 2020 report. Reducing teen pregnancies will result in greater education and economic opportunities for young people. Meeting the reproductive rights and needs of youth through education, outreach, and access to services is imperative. Local organizations such as Reproductive Health Uganda and partners are working with youth to raise awareness and access to contraceptives and family planning services.
Unplanned teenage pregnancies account for 25% of all pregnancies in Uganda (PMA, 2020). The district of Iganga worked to change this situation through the Iganga Family Planning Initiative, which provided training, support, and low-or no-cost long-acting reversible contraceptives (LARCs) to low-income women, especially teens through the AFP and other interventions.
The Iganga district made more progress than any other district in using family planning to reduce unplanned pregnancies (UBOS, UNFPA, 2020). The district department of Health reported that teen pregnancies were nearly cut in half and that, ” the AFP initiative and other interventions empowered thousands of Iganga women to choose when and whether to start a family” Iganga’s experience is a model for other districts. They can now educate, treat and do other development activities with fewer, but manageable family sizes. If replicated, with fewer resources required to manage families, the surplus can go to agriculture, and business and help achieve Uganda’s national development plan III and vision 2040 indicators.
As we celebrate this year’s World Contraceptive Day on September 26, 2022, let’s focus on family planning as a development issue; make it visible; budget for it; and make policies that allow for its access in Uganda. It is good for the child, mother, father, and family.
The author of this opinion story Aldon Walukamba is a Media Advocacy and Documentation Coordinator at RHU
CONSULTANT TO CONDUCT THE REPRODUCTIVE HEALTH UGANDA (RHU) REORGANISATION, JOB EVALUATION AND GRADING, SALARY REVIEW AND PAY STRUCTURE
Reproductive Health Uganda (RHU) is a Member Association of the International Planned Parenthood Federation (IPPF), and its core mandate is to champion, provide and enable universal access to Sexual and Reproductive Health and Rights (SRHR) information and services to vulnerable and underserved communities, especially young people.
The Association has over 150 members of staff and over 4000 volunteers working with and for communities and individuals. RHU is also
committed to Universal Health Coverage (UHC) by contributing to the achievement of equitable access to life-saving, quality sexual and reproductive health care for all, including to the most marginalized and hard-to-reach population groups.
We are looking for a consultant/ firm to recommend a new or improved structure with roles that align well with the
organizational strategy, as well as conduct a Job Evaluation and Job Grading exercise, and Salaries and benefits review.
Application Process
Interested persons/consultancy firms must submit technical and financial proposals by Friday 24th June 2022 by 5:00pm to:
Office of the Executive Director, Reproductive Health Uganda Plot 2 Katego road, Off Kiira road, P.O Box 10746 Kampala
Tel: +256312207100/041 540658 Or Email: rhu@rhu.or.ug
RHU will contact persons with whom further discussion is sought. Please note that we may be unable to respond to applicants who have not been selected for interview.
RHU AND PARTNERS HOST THE UK ALL PARTY PARLIAMENTARY GROUP
RHU AND PARTNERS HOST A STUDY TOUR FOR THE UK ALL PARTY PARLIAMENTARY GROUP ON POPULATION, DEVELOPMENT & REPRODUCTIVE HEALTH
By Fortunate Kagumaho
A snap shot of the visit: LR; Jackson Chekweko attending to the head of the delegation. In the middle, Baroness at an RHU outreach. Hon Mp Luwero speaking to the Boda Boda men at the outreach
Earlier this month, Reproductive Health Uganda (RHU) and partners (Mariestopes and UNFPA) hosted the UK all party parliamentary group for a study tour. The team had an opportunity to visit the Uganda parliament, Ministry of Health and also some of our implementation sites
The visiting team was represented by Baroness Sugg. Baroness, a UK Parliamentarian, House of Lords and leader of the UK Parliamentarians delegation, said both Uganda and the UK need to support issues of women and girls, for the growth and development of both countries.
Baroness shared a tweet about her visit to the RHU outreach site
“We visited a busy UKAid supported RHU-WISH2ACTION clinic in rural Luwero. They run multiple education sessions every day – designed for youth, women only, men only, couples and general health education” Reported Baroness on her verified twitter handle.
She noted that the UK had developed an international development strategy, which among other highlights commitment made on programs on global health.
“We need to support their (women and girls) empowerment, prevent violence against women and girls and also help to educate girls. Our foreign secretary has made a commitment for more funding towards women and girls especially on issues of child marriages and female genital mutilation,” Baroness said.
Dr. Charles Ayume, the chairperson Parliamentary committee on health, told the meeting that there is need to invest in quality and healthy population for the development and growth of respective economies.
In response about the impact of COVID19 on the projects and how RHU handled, Dr Annet Nagudi (Project Director –WISH2ACTION) said,
“We experienced reduction in the number of clients at static service delivery points at the beginning of the lockdown. Team Resilience and positivity kept the project team going.” Said Dr Nagudi. “Travel clearances thanks to great collaboration with Ministry of Health -Uganda and the Districts, made our work even easier.” She added
“Our RHU team integrated COVID I9 in SBCC messaging and Budget adaptation thanks to donor flexibility which facilitated smooth continuity. We also RHU set up COVID 19 response team that guided continuity of services. We adopted National SOPs and disseminated these to all service delivery points. Community Outreach services and training of VHTs to deliver DMPA-SC facilitated continued access to Services.” Dr Nagudi said
Women’s Integrated Sexual Health Lot 2 Project (WISH2ACTION) is IPPFs flagship project aiming to transform the lives of millions of women and girls. Funded by The Foreign, Commonwealth & Development Office (FCDO), WISH2ACTION seeks to provide integrated and holistic reproductive healthcare to 2.2M additional users of contraception across 15 countries in Africa and South Asia from 2018 to 2022.
In Uganda, the project is implemented through its 6 consortium partners (Reproductive Health Uganda IPPF’s Member Association in Uganda, Marie Stopes International Uganda, International Rescue Committee, Development Media International, Humanity and Inclusion and Options working in 77 districts of Uganda aims to increase access to family planning services of the most marginalized including young people, people living in poverty and people with disabilities.
In collaboration with the Reproductive Health Directorate and other stakeholders such as community leaders, policy maker and CSOs the programme works towards enhancing a supportive legal, financial and policy framework for sustainable family planning and a conducive environment for SRHR for all women and girls so that they face fewer risks during pregnancy and childbirth.
Fortunate Kagumaho is the Communications Coordinator at Reproductive Health Uganda
Menstrual health needs surge among vulnerable people in Uganda
Uganda – The 2021 outbreak of violence in the Equatorial region of South Sudan has displaced inside South Sudan, nearly two million people while outside the country there are now over two million South Sudanese refugees, mainly in Ethiopia, Sudan, and Uganda. Many have fears of imminent attack or struggle with food insecurity, sexual reproductive health issues, trauma, and menstrual health among young girls and women. People were forced by over 35,000 to flee to Uganda, roughly 75 percent of refugees from South Sudan are women and children.
Women and girls displaced by conflict face extraordinary hardships in most refugee camps and urban areas of Uganda. Many endure grave risks, including gender-based violence, which can escalate in humanitarian settings. Most are thrust into poverty – cut off from education and life-saving health services, including menstrual health.
Displacement exacts another huge toll on women and girls. In the refugee camps and Uganda’s urban areas, their most intimate and taboo health needs are often overlooked, to devastating effect.
“I had my first period here at the settlement,” said Joyce Tabaria, 12, whose family now lives in the Ayillo II settlement, home to over 39,000 refugees. “I had no idea what was happening. For me, that day was sad and shameful.”
Stigmas surrounding menstruation have existed across cultures in Uganda, also affecting indigenous people and history has it that most people in the community neglect or don’t care about issues of menstrual hygiene. And it’s not uncommon for women and girls to internalize these destructive myths.
A report published by International Rescue Committee (IRC) earlier this year details the extent to which lack of menstrual care, period shame, and misinformation reinforce gender discrimination, rendering women and girls vulnerable to poverty, violence, and harmful practices.
The IRC report reads, “Out of the 79% women and girls that indicate experiencing menstrual pain, only 28% have access to pain killers. While right and adequate menstrual health hygiene (MHH) information are limited. For school girls, a major source of information is schools (61%), peers (45%), workmates (37%), and CSOs/NGOs (27%)”.
In Uganda, the idea that menstruating women and girls are unclean contributes to their exclusion not only from family life but also from education and employment.
Dr. Peter Ibembe, Reproductive Health Uganda (RHU) Director of Programs says that in some places, isolation and expulsion from the home can be dangerous, exposing women and girls to extreme weather and sexual violence.
“In others, the onset of menstruation is associated with child marriage, which heightens the risk of adolescent pregnancy and life-threatening complications before, during, and after childbirth” says Dr Ibembe.
According to some vulnerable refugees and displaced people in Uganda, displacement magnifies these conditions.
“When I’m menstruating, I usually use strips of absorbent cloth, but in the settlement, it is difficult to get this cloth,” Hellen Aleyo in Kasese told RHU.
The unmet needs for sexual and reproductive health services intensify for women and girls in exile. Refugees need to receive adequate care and access to dignity kits in the settlements.
Harmful conditions in evacuation sites can wreak havoc on women’s sexual and reproductive health, while lack of access to hygiene supplies limits their mobility and heightens their vulnerability to sexual violence. Girls who do not have the ability to manage their menstrual health are also at greater risk of missing school or dropping out entirely.
Hellen Furaha, is the recipient of one of the sexual reproductive health and rights (SRHR), menstrual health training, and dignity kits distributed to women and girls in the Muhookya internally displaced people’s settlement in the Kasese district. The kits contain essential hygiene items such as sanitary pads, underclothes, soap, toothbrushes, and toothpaste.
As we celebrate menstrual health month 2022, it is important to note that RHU works with partners SRHR Alliance with support from Rutgers to deliver dignity kits to women and girls around Uganda in schools and in women’s and girls’ safe spaces. These safe spaces provide more than sexual and reproductive health services.
Aldon Walukamba G, the author, is the RHU Media Advocacy and Documentation Coordinator.
Child bride and fistula survivor becomes an advocate for change
Uganda : Rachael Wotali, was just a teenager, married at 17, when she nearly died in childbirth.
It was the year 2015 in eastern Uganda’s Iganga District. Wotali, as a young bride, may have been biologically unprepared for motherhood.
Her labor was extended and blocked, which may have been fatal. Her access to emergency treatment was also critically hampered. She recalls her mother yelling with the health care provider over their extended wait for help.
Unfortunately, the baby died at birth, leaving Wotali with an obstetric fistula, a hole in the birth canal that rendered her incontinent and exposed to a variety of other medical issues, including infections.
“I never enjoyed being a woman in marriage since I had this condition,” she later recalled. “It was tough to live.”
Today, the 23rd April 2022 is International Day to Put an End to Obstetric Fistulas. Fistulas are one of the most dangerous and devastating delivery injuries, and they are virtually totally avoidable. Access to competent maternal health care, particularly Caesarean sections to treat obstructed labor, can save both women’s and their kids’ lives and health.
Although the prevalence of obstetric fistula in Uganda stands at two percent, a 2016 study by the Ministry of Health estimates 200,000 women are living with fistula, and 1,900 new cases occur each year.
Yet more than two million women in the developing world are estimated to be living with this condition. Its persistence is a sign that health and protection systems are failing women and girls.
Wotali lived with an obstetric fistula for six years. In that time, she had a son and a daughter. But, like many fistula survivors, she was isolated, enduring ridicule if she left home. She was unable to do community work, attend funerals or visit church, she told Reproductive Health Uganda (RHU), while receiving family planning.
Nothing appeared to work towards improving the situation. “Traditional herbalists tried everything, and we had been told to do lots of things but the condition was never healed,” she recalled. “When you are in that situation, you try almost everything.”
But one day, one year ago, her sister was chatting with community members at a nearby borehole. Someone mentioned that a woman in the district had received treatment for chronic urinary incontinence. It turned out a fistula repair camp was taking place at Iganga district hospital.
She rushed to tell her mother.
Over 25 women received treatment during the government – private partnership supported event, including Wotali.
“I am now dry. I have no problem,” Wotali said. “This is how a woman should be.”
Many of the women, like her, have endured the condition a long time. One Alowo, lived with fistula for 28 years in Mayuge district but was also treated.
We all need to take action against obstetric fistula. It is estimated that two per cent of women in the country have experienced an obstetric fistula, according to a 2016 survey.
Since her treatment, Wotali has become an advocate for fistula survivors, helping multiple women receive repairs.
She says she still thinks back to the fateful day that she learned there was hope and help for women with obstetric fistula.
“That morning when my sister went to draw water saved my life,” she said.
Aldon Walukamba G, the author, is the RHU Media Advocacy and Documentation Coordinator.
Girls fleeing from FGM in Uganda are directed to Safety
Uganda, Kampala – “With no safe houses- schools, girls will be genitally mutilated,” said 21- year old Ruth Chelangat a community mobiliser, who mobilizes girls against female genital mutilation (FGM) in Kwosir sub county in Kween district of Uganda’s largely rural Sebei region.
“You can’t receive protection in the neighborhood during the cutting season,” she stated.
In areas of Uganda where FGM is performed, the “cutting season” usually coincides with school holidays, as it is this year. FGM, which includes damaging or modifying the female genitalia for non-medical reasons, can have a variety of severe health repercussions for girls who are exposed to it, including pain, infections, hemorrhaging, and death.
But when Betty Cheboi, was 22 years old, she implored her parents not to have her cut. They didn’t listen, and she had no safe place to run to. She nearly bled to death from her wounds.
Afterwards, she made her close relatives promise not to cut her younger sisters. For Cheboi, it was the beginning of a lifetime of activism to end FGM.
After receiving training from the Right Here, Right Now II (RHRN II) and the United Nations Population Fund (UNFPA), several youth teams in the Karamoja and Sebei regions are spreading the word that girls can find refuge at the safe houses operated in Amudat and Kween districts through, school programs, young people’s safe spaces at health centers, and community outreach.
“this is part of our effort to change negative values, norms and rituals abusing the enjoyment of sexual reproductive health and rights, in addition to young people’s gender justice,” Cheboi said.
However, according to Joseph Cheptegei, Kwosir sub-county Community Development Officer, when a cry for aid comes in, whether from a girl at risk or a concerned community member, identifying the girl can be difficult. This is due to the geography in the Sebei area, extensive unmapped land in Karamoja, and a lack of connectivity, with settlements of up to 5,000 people without plots and never appearing on Google maps.
“We are coming together to widen our network to unite people against FGM from across the Karamoja and Sebei regions,” said Cheptegei.
RHRN II, UNFPA through Reproductive Health Uganda (RHU), has organized the volunteer network’s efforts to teach young people so that activists on the ground can better protect girls since 2016.
Samuel Musani, RHRN II officer in Sebei region says that trained volunteer mobilisers, peer educators and young advocates comb through villages of rural Sebei and Karamoja regions, tracing for girls at risk or threat of FGM. They are then referred to safe houses and schools constructed by Action Aid – Uganda, Ministry of Gender, Labor and Social Development (MGLSD).
RHU works with government and other private partners like Reach a Hand Uganda (RAHU), Action Aid and Kapchorwa Civil Society Association.
During the 2021, over 2,000 volunteers in over 60 sub counties were trained under the RHRN II and UNFPA programmes by RHU and its partners.
As more and more communities abandon FGM, programming needs to zero in on remaining hotspots, noted Jackson Chekweko, RHU Executive Director.
When the cutting season is complete, most girls return home after two months. Volunteers, community social welfare personnel, and specially trained police engage with families and communities to alter attitudes, a step toward changing the societal norms that maintain FGM.
“We talk to parents,” said Chebot. “We show them that FGM has effects and is illegal in Uganda.”
Girls can return home if their parents promise to honor their requests not to be cut off and to help them in continuing their education. Every three months, the program does a check-in with the girls.
Girls whose families refuse to reconcile are housed in safe houses, where they get therapy and continue their education. Chebot, on the other hand, does not give up attempting to persuade their families to alter their beliefs.
“We are not stopping,” she said. “We keep visiting those families, talking to them so we can have reconciliation.”
While officiating the anti FGM day celebrations in Kapchorwa, on 20th April 2022, Uganda’s State Minister for Gender and Culture Peace Regis Mutuuzo, pledged that the 2010 anti FGM law will be revised to curb the new trends, that aid FGM to be done in countries neighboring Uganda.
Aldon Walukamba G, the author, is the RHU Media Advocacy and Documentation Coordinator.