The situation of Adolescent Health in Uganda is at stake

In 2016, the Ministry of Health with support from Civil Societies Organisations and other key stake-holders from the development sector embarked on the review of the National Guidelines and Services Standards for Sexual Reproductive Health and Rights

Unfortunately passing the guidelines hit a dead rock after the Health Minister refused to launch it in September 2017 at the National Family Planning Conference. The ministry indicated that the guidelines had not been developed following the due process

In 2018 the Ministry of Health in collaboration with partners instituted a consultative process to review the draft policy. The members of the Health Committee of Parliament were among key stakeholders that were consulted in April 2018 and contributed to the content of the draft Sexual and Reproductive Health Policy 2018

In June 2018, the National Policy for Sexual Reproductive Health and Rights draft was presented to the Ministry of Health Senior top Management and approved it, and was forwarded to Cabinet for adoption. Unfortunately, since then young people, Advocates, adolescents and Civil Society Organisations have waited for it but all in vain, there is no information, no updates on the policy.

On the other hand, the Ministry of Education launched the National Sexuality Education Framework in 2018 after a long and concerted consultative process involving multiple stakeholders. The framework was however rejected by sections of Ugandans especially the religious leaders sighting inappropriate content

It brought attention and the Minister of Education withdrew, and suspended the use of the framework in Ugandan schools until consultations and agreement is reached with the dissenting parties. However for more than a year now, the process of consulting and subsequent revision of the framework has not been completed, leaving adolescents and young person at risk

Uganda’s population has drastically grown from 34.6 million in 2014, and recent estimates put it close to 40 million. The annual growth rate of 3% reflects the high fertility rate, currently at 5.4 and a steep decline in under-five mortality rate from 90 per 1,000 live births in 2011 to 64 per 1,000 live births in 2016 UDHS.

The high fertility rate is also influenced by a high unmet need for family planning 28%, low contraceptive use 39%, high teenage pregnancy rate 25% and a high desire for large family size 5.7 for men and 4.8 for women). The maternal mortality ratio decreased from 435 per 100,000 live births in 2006 to 336 per 100,000 live births in 2016

Approximately 28% of maternal deaths occur among young women aged 15-24 years. Meeting women’s contraceptive needs is a critical strategy to help women avoid unintended pregnancies. Universal access to safe abortion services will also end abortion-related maternal deaths

A contributing factor to unsafe abortion is teenage pregnancy, which increased from 24% in 2011 to 25% in 2016 among women age 15-19 years, with the median age at first birth among women aged 25-49 years reported at 19.2 years, UDHS 2016.

The proportion of women aged 15-19 years who have begun childbearing increases dramatically with age, rising from 3% among women aged 15 to 54% among women aged 19. Teenagers in rural areas are more likely to have started childbearing 27% women age 15-19 than those in urban areas 19%.

The main drivers of teenage pregnancy is a large sexually active youthful generation with limited access to contraceptives and sexuality education. Among women and men age 15-19, 10% of women and 17% of men had sexual intercourse by age 15 in 2016, UDHS 2016

Recent media reports have also indicated rising teenage pregnancies in some of the most appalling areas in Uganda; in Kamuli district has so far registered 7,070 teenage births in 2018. The recently released Kamuli District Annual Deliveries Report shows that of 35,509 delivered in 2018. 7,070 were delivered by teenage mothers.

Photo credit: CEHURD. Advocates holding placards showing teenage pregnancy statistics in Kamuli District.

Kamuli and Butaleja are one of the districts in Uganda that have the youngest grandparents in the world at 26 years and recently media reported a 14- year old primary 6 pupils from Nawandyo Primary school in Bugulumbya Sub- county giving birth to triplets

Efforts by various stakeholders to intervene effectively to address the above undesired situation in the country are currently hampered by the lack of policy and guidance from the Ministry of Health and the Ministry of Education and Sports

Therefore, there is an urgent need for the Ministry of Health to finalize, adopt and implement a national policy for Sexual Reproductive Health and Rights and a National Adolescent Health Policy to guide provision of quality SRHR and adolescent related services and information

The Ministry of education on the other hand needs to engage stakeholders who rejected the sexuality education framework to ensure that their concerns are addressed in order for the guidelines to become operational. It is notable that both Ministries have drugged their actions far beyond the expected time while the problem of adolescent pregnancies gets worse

Advocates and Civil Society Organisations have introduced a new campaign online called #PassThePolicy which is aimed at amplifying the adolescents voices and telling the stories on how the delay of the School Health Policy has affected young people in Uganda and they are calling upon the movers of the policy to act and here are some of the online reactions on the delay of the policy;

The deliberate delay in passing the School Health Policy interferes with and undermines young people’s ability to achieve high standards of health, education and future economic well being” – AJ Ruth, @AJRuth3

Achieving SDGs by 2030 is only possible if we provide young people with the age appropriate SRHR information to better inform their choices for an empowered generation: let’s act now, pass the School health policy and actualize sexuality education” -Dorothy amuron,@Ugnewsluv

With the school health policy in place and an actual law on School Health passed by the Parliament of Uganda, young people’s ability to learn and complete school free from health problems will be increased” – Esther Dhafa, @EstherDhafa

Photo credit: Esther Dhafa holding a placard

Teachers need to be empowered on how to communicate sexual reproductive health information to their students. They need to be trained with age appropriate information for these adolescents’‘ – Doreen Nelly Kyampeire, @DorahNellyK 

The government needs to pass the School Health Policy to enable a great learning space that is safe for our sisters and brothers” – Katende Erick, @FrostProUg

We need the school health policy because it bridges the gap between provision of information on health which is where emphasis is placed, for adolescents, to provision of health services for adolescents”Rose Wakikona, @WakieRose

Frank Byaruhanga is a human rights activist with years of experience in community dialogues, digital communication, advocacy and digital campaigns. He specializes in Media Relation Work, Management and Training with sufficient knowledge in Governance, Accountability, Sexual Reproductive Health and Rights, Youth-led research, Content developer, Creative Activism, Social Media Management and documentary photography.

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