More than 50 percent of Ugandan women are not able to exercise their wish of postponing or stopping pregnancy altogether largely due to poverty, strong cultural and religious beliefs and limited access to contraceptives, a new report has established.

The report titled: "Benefits of meeting the contraceptive needs of Uganda women," released this week by the Guttmacher Institute and the Economic Policy Research Centre (EPRC) of Makerere University shows that every year more than one million Ugandan women get pregnant without their choice.


The report strongly advocates for the scaling up of conceptive services - including pills, condoms, as key in reducing unwanted pregnancies which is the underlying reason for abortions and the associated dangers including death of mothers and the huge burden on health system.

The news is a harsh reminder of the prevailing reproductive health challenges mostly faced by women in this country, despite the continued talk as well as funds that been directed at efforts to improve reproductive health on Ugandan women.

The report argues that because of the high levels of unwanted pregnancies, more women are taking ever riskier steps in their effort to stop the pregnancies which often result into deaths while at the same time, while on the other hand, those that decide to keep the pregnancy to term greatly contribute to the country's fast population explosion.

According to the report absence of contraceptive services especially for rural women, has enormous consequences besides compromising the health of the mother.

The report further reveals that some Ugandan women are able to have the number of children they want when they want to have them. However, majority lack full access to reproductive health services including quality contraceptive services.

As a result, many women bear children before they are ready to and have more than they can care for. Others resort to abortion, which can have dire health consequences.

Fredrick Mugisha,a senior research fellow of EPRC estimates that just half of Uganda's women's unmet need for modern contraceptives, that is providing modern methods to just 50% of the women who wish to avoid a pregnancy but currently use no method or use an ineffective method, would yield dramatic health benefits.

There would be 519,000 fewer unintended pregnancies each year which is a 42% decline and 1,600 fewer maternal deaths from unsafe abortions and various obstetric emergencies of at least 21% drop.

"Meeting 100% of Ugandan women's unmet need for modern contraceptives would have an even more dramatic impact. It would reduce unintended pregnancies including induced abortions, by roughly 85% over current levels and maternal deaths drop by about 40% from current levels," the report reads.

Of all women who want to avoid pregnancy, 57% desire to wait at least two years before having a child or another child and 43% want to stop childbearing altogether. Yet despite their desire to avoid pregnancy, only 31% use an effective, modern method of contraception. Some use traditional methods mostly withdrawal and periodic abstinence and 61% use no contraceptive method at all.


Uganda is one of the countries with the highest fertility rate of 6.7 children per woman and low contraceptive use has been highlighted as one of the factors leading to frequent births. Statistics show that only 24% of women in reproductive age use contraceptives which leads to about 1.2million babies born in a year.

Though many anti-pregnancy methods are introduced year after year, population secretariat's communications officer Hannington Burunde says that lack of access to modern contraceptives and information are some of the reasons for poor family planning.

"You find that some people particularly women will want to use the modern contraceptives but they lack vital information about them hence fearing to put their lives at risk thus getting unwanted pregnancies," Burunde says.

According to Burunde, politicians used to oppose family planning methods due to their political reasons but after realizing the benefits of having a quality population, they have also embarked on sensitizing people about the need to control and plan for their families.

 "By enabling more women to have only the number of children they want, increased use of modern contraceptives will contribute directly to attaining three Millennium Development Goals (MDGs) of promoting women's empowerment and equality, reducing child mortality and improving maternal health," Mugisha adds.

Fulfilling unmet need would also save money. Though increasing family planning services require increased investment, it ultimately results in considerable cost savings.

The report estimates that every dollar spent on contraceptive services saves more than three dollars that would be spent treating postabortion complications and providing maternal and new born care related to unintended pregnancies. Fully meeting Ugandan women's need for modern contraceptives would result in annual net savings of us$ 112 million (more than 194 billion shillings).

"Investing in contraceptive services saves lives and money," said Michael Vlassoff of the Guttmacher Institute," the short term costs and benefits alone are dramatic. In the longer term it could result in improved family health, reduced poverty and a greater ability to meet development goals,"

It is estimated that Uganda spends $22 million on modern family planning methods and a big portion of such amount is got from donors.

By Henry Mulindwa

 

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