Women’s Health in Uganda
Reported, December 15, 2011
Kampala Amelia, a 30-year-old Sabiny woman and mother of six, who lives in the remote fringes of Bugimotwa village in Kapchorwa district, would like to stop giving birth, but due to lack of contraceptives, she is unable to.
This has led to high fertility rates – with women producing up to seven children. About 90% of pregnancies in this village are unintended.
“I once carried out an abortion and bled to near death. We have been hearing that abortion is illegal so we do it secretly with local doctors,” Amelia says.
As if that is not bad enough, she has to be carried on a stretcher for over 40kms to the nearest hospital to get post-abortion care. She was advised to have a balanced diet, especially foods containing iron in order to replace the blood she had lost, something she could not afford because of poverty.
Poor nutrition
When she left hospital, Amelia contracted marasmus (a health condition as a result of malnutrition) and was advised to have a balanced diet, something she could not afford.
According to the 2008 Human Development Index, about 12% of women in Uganda are malnourished, 38% of children are underweight, 16% are stunted and 6% are wasted.
The report says food insecurity, lack of a balanced diet or lack of education on proper nutrition are the main causes of malnutrition. It added that about 38% of children are malnourished because their mothers wean them before the first six months after birth.
The need for family planning
According to the 2006 Uganda Demographic Health Survey, over 1.4 million women in Uganda would like to delay pregnancy, space children or stop child bearing, but do not have access to contraceptive methods. Only 24% of Uganda’s married women aged 15-49 use family planning.
The survey identifies lack of accurate information about the benefits of family planning, poverty, cultural/religious beliefs and lack of empowerment as the hindrances to contraception in Uganda.
High number of maternal deaths
Ugandan women are among the most fertile in the world. The survey puts the average number at 6.7 children. Four out of 10 women would like to stop or space their next birth but are not using any family planning method.
Statistics from a study, done by the Guttmacher Institute, indicates that this high fertility rate has led to about 42% (775,000) unintended pregnancies annually, putting many women’s health at risk.
The study says unintended pregnancies are the primary source of induced abortions. It adds that a total of 65,000 out of 297,000 women in Uganda, who have an abortion suffer complications that require medical care but do not get treatment.
Other factors like poverty, fear of health care staff and poor understanding of health risks of unsafe abortion hinder women from seeking post-abortion care.
Women hardest hit by HIV/AIDS
Dr. Martin Mwambu, a reproductive health expert at Mbarara University of Science and Technology, quoted the Guttmacher study, which suggests that some women affected by HIV/AIDS consider some pregnancies as ‘unwanted’ because they fear transmitting the infection to the newborn baby.
These also opted for abortion.
Women in Uganda have been hit hard by the HIV/AIDS virus and many suffer violence at the hands of men, who accuse them of bringing the virus to the family.
As a result, many women do not get treatment because of the fear of revealing their status to their partners.
According to the 2004-2005 National Sero-Behavioral Survey, an estimated 7.5% of Ugandan women aged 15-49 are HIV -positive compared to the national rate of 6.4%. The survey also indicates that 440,000 women of reproductive age were HIV-positive in 2005.
The Guttmacher study adds that the prevalence of HIV among Ugandan women aged 15-34 is higher than that among their male counterparts, which underscores the higher risk of this infection among women in their prime child-bearing years.
Dr. Mwambu says because women fear to reveal their status, many get pregnant and do not get treatment, especially to prevent mother-to-child transmission of HIV/AIDS.
Domestic violence
When HIV-positive women produce HIV-positive children, the men deny any involvement in the situation and become violent towards the women.
A survey done by Action Aid International in Pallisa district in eastern Uganda indicates that gender-based violence is high at over 80%, which has negatively impacted women’s health.
The survey reveals that a sexually or physically abused woman is three times more likely to contract HIV/AIDS than any other person. Such women may shun treatment or prevention of mother-child- transmission of HIV/AIDS due to fear.
Mubarak Mabuya, the programme component manager, at the gender ministry, the most common form of physical and sexual violence is manifested in beatings and rape respectively.
According to the 2006 UDHS, 25% of women between the ages of 19 and 49 had their first sexual experience against their will. Domestic violence is high in Busoga, eastern Uganda, with two out of three people reporting physical abuse.
The way forward
According to the health minister, Dr. Stephen Mallinga, the Government of Uganda has built health centres in most sub-counties throughout Uganda.
“The women are supposed to go there to get antenatal checkups so that their health is monitored. However, over 60% of the mothers still deliver from home, which has led to high mortality rate,” Mallinga says.
He says the ministry still needs to sensitise women about the need to seek medical help. The ministry delivers essential drugs for malaria and for pregnancy-related complications like misoprostol, to save mothers’ lives.
The United States Agency for International Development has donated food worth sh60b in the past to improve the nutritional status of HIV-positive women’s nutritional status.
It is five years to the 2015 MDG target to reduce the number of women and children that die during child birth.
With 6,000 women still dying every year, only 42% of women getting skilled attendance at delivery and only 18% of women using modern contraceptives, will Uganda achieve the target?
Women are vulnerable
About 80% of the women in Uganda -whether sick or healthy – carry the burden of domestic work.
According to the 2006 statistics from UNICEF, about 75% of Uganda’s population has access to safe water.
In rural areas like Karamoja, only about 20% have access to clean water.
Since 90% of the women in the rural areas collect water and firewood from isolated places, they are exposed to risks like rape, defilement and smoke-related health hazards from firewood.
Credits:Frederick Womakuyu 7 March 2010
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