By Jane Kisha
In Uganda, hundreds of women lose their lives while others risks reproductive morbidity due to lack of contraceptive use.
Like women in developed countries such as USA, Ugandan women too desire having fewer children but this isn’t possible due to uncontrolled adversities like poverty, poor access to health care services, low uses of contraceptives.
In Uganda, more than six in 10 pregnancies are unplanned and among married women, use of contraceptives is poor and as a result, only 26% of married women use contraceptives to avoid unwanted pregnancies.
According to a research titled “Estimating the costs of induced abortion in Uganda: A model-based analysis” carried out in 2011 by Babigumira et al, women who decide to abort often resort to untrained and usually unskilled practitioners who practice in illegal and hidden clinics and often provide unsafe abortion procedures that result in a high rate of complications and sometimes death.
According to the research, unsafe abortions are estimated to be the cause of 21% of all maternal deaths in Uganda compared to about 13% of all maternal deaths globally.
Dr. Steven Adea, a Gynecologist said that most married women fail to acquire contraceptives and although they very much desire to delay giving birth, they still end up with unwanted pregnancies and in most cases abort.
“Sexually active, unmarried women and school girls usually go for procedures of unsafe abortions on learning they carry unwanted pregnancies. This put their lives and status of their reproductive status health at risk” Adea quoted
Mark Onen of Zion Clinic Layibi, Gulu said there are a number of factors making most women quite relaxant in using contraceptives. He said among barrier factors are that most women can’t access services and aren’t acquainted with necessary information.
Onen said some women also have unmet needs for contraception and mostly in villages.
“Male partners discourage their women from using contraception. Those in rural areas believe contraceptives can cause health problems such as cancer while others believe contraceptives encourage their women to have extra-marital affairs.
He adds that some women fear the unknown reactions or side effects.
“For me, I simply comfortable with breastfeeding. While am still breastfeeding, I believe am controlling” Brenda Apio, a mother said.
While maternal mortality has declined in the last decade, it remains very high in Uganda and recent WHO estimates suggest that 310–438 women die of pregnancy-related causes per 100,000 live births, and that Ugandan women have a 3% lifetime risk of dying from such causes.
Furthermore, for every maternal death, there are six Ugandan women who suffer severe morbidity, often as a result of unsafe abortion. A hospital-based study in Kampala estimated that 21% of maternal deaths were due to unsafe abortion.
In 2019 the Ministry of Health estimated that abortion-related causes accounted for 26% of maternal mortality, a figure considerably higher than the World Health Organization’s estimates for the Eastern Africa sub region which is at 18% and for the world as a whole.
Statistics from the Ministry of Health indicate that 15 out of every 1,000 Ugandan women of reproductive age were treated for abortion complications. Treatment includes hospital care, blood transfusions, and antibiotics among others.
According to a recent WHO study, screening all women for family planning concerns could help prevent the large numbers of unintended pregnancies and unsafe abortions.
WHO warns that without adequate counselling, improved quality of service, expansion of effective and acceptable contraceptive choices and respect for the rights of all women and girls, the cycle will continue. “Access to high-quality, affordable sexual and reproductive health services and information, including a full range of contraceptive methods, can play a vital role in building a healthier future for women and girls, as well as contributing to attainment of the Sustainable Development Goals,” said Dr Ian Askew, Director of the Department of Reproductive Health and Research at WHO.
A research carried out by Babigumira et al titled “Estimating the costs of induced abortion in Uganda: A model-based analysis indicates that the government of Uganda can reduce unsafe abortions by increasing contraceptive coverage or providing safe, legal abortions.