“It’s preferable to have one child than many,” Nyekuch, 28, at the Pagirinya health Centre III family planning section in Adjumani district, explained.
This is the counsel she provides to both men and women, yet she has had a totally different experience.
She married at the age of 14 and gave birth to her first child a year later, before the war in Sudan forced her to Uganda as a refugee. Before then, she was not required, like many other child brides, to seek an education, thus she never learned to read or write. She now has five children, all of whom she wishes to have a totally different destiny than she had.
“I hope that when my daughter is at least 22 years old, she will make the correct decisions and become a mother,” Nyekuch remarked. “By then, she’ll have completed her university education.” All of my children, I hope, will be able to receive an education.”
Nyekuch embodies the plight of Uganda’s vulnerable village women in many ways. According to the 2020 State of World Population report, the country’s fertility rate is five (4.6) children per woman, and on average 25% of women give birth while still teens.
The maternal mortality rate in the country is high, in part because health risks increase as women have more pregnancies. According to a recent joint United Nations study, over 368 women die during giving birth for every 100,000 owing to pregnancy-related causes.
Contraceptives reduce the risk of maternal injury and death by lowering the number of unplanned pregnancies, which account for 43% of all pregnancies in Uganda. Couples can also determine the appropriate family size for their situation by using family planning. Despite this, many people are wary of using family planning.
“This is due to a lack of comprehensive information, inadequate counselling skills among health service providers, limited access to contraception, users’ fear of side effects, and misinterpretation of religious doctrine regarding family planning,” Dr. Peter Ibembe, Reproductive Health Uganda Director of Programs, explained.
Some cultural influences, such as the inclination and desire to have a big family, by some couples also play a key role.
Advance Family Planning (AFP) initiative is working closely with the Reproductive Health Uganda (RHU), Ministry of Health to ensure a reliable supply of contraceptives to government health facilities. RHU also trains health workers and provides technical support to health facilities, like the family planning units at health centers in Uganda, through its 20 clinics and branches spread across the country.
RHU, in partnership with AFP is also increasing the family planning choices available to women, but also executing out advocacy activities among policy makers, media and the community. At the centre in Uganda’s vulnerable communities, women are able to select from a variety of safe, reliable contraceptive methods, including condoms, pills, injections, implants and bi-tubal litigation or vasectomy.
Contraception is steadily gaining traction in this traditionally conservative society. According to a government survey, barely 30% of married Ugandan women employed contemporary techniques of family planning in 2016. As per Performance Monitoring for Action (PMA) reports, 40% of married women utilized contraception by 2020.
Most of the women Nyekuch knows take injections, implants, or tablets, according to her. “Only a handful couples I know employ alternative ways. I, too, utilize the injection “she stated
However, there is still considerable skepticism. Contraceptive implants, for example, are feared by many people, despite the fact that they are safe and provide long-term protection against unintended pregnancy. “People are reluctant to use them, and husbands won’t let them because they’re worried their wives won’t be able to have children again,” Rhoda Namukwana, a registered midwife at RHU Bwaise branch, stated.
Nkonanyi, was also visiting the RHU outreach family planning Centre in Kyangwali refugee camp. She was married at only 13, and her first baby was born the following year. Now, at age 25, she has two children and relies on family planning.
“We barely scrape by,” Nkonanyi explained, revealing that the family relies on her husband’s salary as a community digger to make ends meet. “If I send my son to school, we will want more funds for his school uniform, books, notebooks, and other necessities.” That’s something we can’t afford.”
She wants both of her children to expect more from life. For instance, she hopes her daughter will not get married until she is 20, and Nkonanyi herself wants to wait before having more children.
“I’d like to wait at least three years before having another child.”
Aldon Walukamba G, the author, is the RHU Media Advocacy and Documentation Coordinator.
