The government health centers in Uganda have been encouraged to provide youth friendly sexual reproductive health services however only 5% of the health centers try to do that. Still on that note 65% of the young people were not happy with the services they received at the health centers. UNICEF annual report.
14% of teenage girls aged 15-19 years do not use contraceptive methods due to having limited access to contraceptives and 27% of the adolescents in rural areas are childbearing.
Poverty, HIV and AIDS, early marriage, teenage pregnancy, gender-based violence and low participation in secondary education make it difficult for young people to fulfil their potential.
Adolescent girls, in particular, face multiple vulnerabilities. Adolescent girls are severely and unevenly at risk of HIV infection – two thirds of all new HIV infections are contracted by adolescent girls. Many girls also drop out of school as a result of unwanted teenage pregnancy and early marriage. According to the Ministry of Health, 25 per cent of Ugandan teenagers become pregnant by the age of 19. Close to half are married before their 18th birthday and continue having babies into their mid-40s.
Complicated births and abortions, often requiring emergency obstetric care, are all too common among adolescent girls. But many teenage mothers do not have access to adequate reproductive health care and die while trying to give life. Uganda has one of the world’s highest maternal mortality rates, with 18 mothers dying every day in pregnancy or during and after childbirth. The traditional practice of child marriage and female genital mutilation/cutting (FGM/C) also persists in many communities. In 2013, Uganda ranked 16th out of 25 countries with the highest rate of child marriages. In the Pokot community in Amudat district (Karamoja), almost all girls (95 per cent) have been cut to make them more ‘marriageable’. Both practices are devastating for girls’ physical and mental health.
One of the best ways out of vulnerability, poverty and exclusion is education, but access to secondary education is low in Uganda. Only a fifth of adolescents of the right age are enrolled in secondary schools. In addition to teenage pregnancy and child marriage, school fees and other related costs are key factors that keep adolescent girls out of school. Violence is another barrier to girls’ education. Instead of having protective and safe learning spaces, many girls face sexual harassment and rape in schools. A study on gender-based violence against children in Acholi and Karamoja in 2013 found that the majority of primary and secondary school children had experienced sexual abuse. Most were abused by a male teacher. Bullying and caning were also prevalent, despite corporal punishment being outlawed in schools.
Two years of lock-down and staying out of school exposed teenage girls to unwanted pregnancies and Bukedea District in Uganda was ranked number one in having the highest number of teenage pregnancies during this period. Poverty in their homes made them soft targets from mature men as they had to accept sex in exchange for some money to make ends meet. This did not just expose them to sexually transmitted infections, but it has also caused many unwanted pregnancies in this helpless group. Many risk to drop out of school completely.
In Bukedea District, there are unprecedented levels of commercial sex among girls organized in informal groups such as -Team No Sleep, Team No Size” and ‘Team No Condom” among others ( COVID19 Parliamentary Task Force; The District Community Development Officer). (https://www.galaxyfm.co.ug/2021/08/03/bukedea-mps-report-commercial-sex-on-rise-among-team-no-sleep-team-no-size-team-no-condom-informal-girl-groups/)
Martha Agwang Foundation, established a medical and teenage Centre that will give access to sexuality education for adolescents while helping pregnant girls to get the care they need when and where they need it in collaboration with the local health centre IV. This centre will complement other programs we are already running that provide youths with important skills to help them to break out of poverty and survive. The centre screens for sexually transmitted infections and Identifies high risk cases and collaborates with the local health facilities for their management. All youths that drop out of school are attached the Vocational Institute to provide them with skills that empower them economically.
The Martha Medical and Teenage center’s efforts were and are timely to make a contribution in ensuring that every young person in Uganda particularly Bukedea District can access the accurate information to aid and direct them in taking that crucial life decision regarding their live skills and development, behavior change communication and sexual reproductive health and rights and HIV/AIDS prevention.
