Government launches guidelines to reduce related deaths
That young people are engaging in risky sexual behaviour may be seen as a public secret. But what many may find surprising, though, is that they are doing so because they find difficulty accessing contraceptive items.
According to Dr Charles Kiggundu, president of the Association of Gynaecologists and Obstetricians of Uganda, lack of information on contraceptives, myths about side effects, stigma and limited control of contraceptive choice especially for young women are big blockades.
National statistics show that only nine per cent of adolescents are using some form of contraception, implying that majority still put themselves at risk through unsafe sex.
Resultantly, every year in Uganda, 850,000 women get unwanted pregnancies, with many either dying or sustaining related health complications. The national unmet need for contraception stands at 40 per cent, meaning that four in 10 people who would want to use contraception cannot.
“When a woman gets pregnant, she has put one of her legs in the grave because there is a one-in-16 chance of dying in pregnancy currently. Unfortunately, for some, the second leg joins the first one in the grave totalling to about 6000 deaths due to pregnancy or childbirth,” said Dr Kiggundu during the launch of the standards and guidelines for reducing maternal morbidity and mortality due to unsafe abortion in Uganda at Sheraton hotel last week.
He added that many young people cannot walk into a clinic or health centre and request for a contraceptive because some providers feel they are ‘too young’ to be using them.
Globally, the Guttmacher Institute estimates that 40 per cent of pregnancies which occurred worldwide in 2012 were unintended and a disproportionate amount of these pregnancies occurred among young, unmarried girls who often lack access to contraception.
The institute’s 2014 report titled: ‘Intended and Unintended pregnancies worldwide in 2012 and recent trends,’ notes that approximately 85 per cent of sexually-active women who do not use contraception become pregnant within one year of initiating intercourse.
Additionally, of the 213 million pregnancies that occurred worldwide in 2012, about 85 million were unintended and 50 per cent of these ended in abortion, 38 per cent in unplanned births and 13 per cent in miscarriages.
In Uganda, the abortion rate is on the rise as is the number of unintended pregnancies. Approximately 40 per cent of admissions for emergency obstetric care in Uganda are a result of unsafe abortion.
“About 800 abortions happen in Uganda everyday translating into about 300,000 abortions annually and about 1,200 of these die from unsafe abortions. When a mother dies, the surviving baby has 10 times the risk of dying before reaching one month,” said Kiggundu.
Uganda has had persistently high preventable maternal deaths due to unsafe abortion estimated at 26 percent, making it one of the top contributors to maternal mortality.
In a bid to reduce morbidity and mortality from unsafe abortion, the ministry of Health on June 4 launched the standards and guidelines on reducing morbidity and mortality from unsafe abortions. The guidelines incorporate aspects of prevention of unintended pregnancies through promoting and increasing access to safe, effective and appropriate quality family planning counselling and contraception services.
“Efforts to ensure contraceptive access for young people coupled with comprehensive strengthening of all core components of the health system, especially human resource availability, would ensure that women would get quality reproductive health care,” said Prof Anthony Mbonye, director for health services in charge of clinical and community health in the health ministry.