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Media

News Article: Family planning helps women … and slows climate change

News Article: Family planning helps women … and slows climate change

The Guardian (London UK)
Poverty Matters Blog
5 January 2021
By Jotham Musinguzi

Family planning helps women … and slows climate change

With women empowered to plan their pregnancies, the world's population will grow more slowly, as will carbon emissions

We've long known that giving women the family planning services they want and need would be a boon for the health of families throughout the world. Today, in every country, far too many go without. Short spaces between births can make women more vulnerable to poverty, illness and even death. This is a human rights and health issue for hundreds of millions of women around the world.

In my home country of Uganda, women with an unmet need for family planning face major challenges. Among them are distances to health clinics, the costs of contraceptives, the hostile attitudes of some demotivated health providers, socio-cultural barriers, and a lack of supplies.

Mrs Kizito, 29, a mother of six, travelled 7km from her home in rural eastern Uganda to her nearest clinic for a check-up and her next dose of contraceptive pills. After her regular blood pressure check, she was told by the nurse that the type of pills she normally takes were not in stock. Her second and third next most suitable alternatives were not available either.

Instead, she was offered male condoms and advised to persuade her husband to use them until her regular stock of contraceptives were available – at least a few of months. She returned home, not knowing whether she would convince her husband to use the condoms, and well aware of her husband's ambivalent attitude towards family planning.

These challenges, however, are solvable. Take Mrs Kyomugisha, 24, a mother of three from rural western Uganda, 10km away from the nearest health centre. Four years ago, Family Health International (FHI), an NGO working with Uganda's ministry of health, began providing family planning services.

Kyomugisha narrates how she and her husband had been stressed by the coming of their three children one after another, until the visit of a community health worker shortly after the birth of their third child. The health worker explained that injectable Depo-Provera was now available.

Mr Kyomugisha said this was the best news they had heard for a long time. Since then, the family has used the injectable method to prevent additional pregnancies. Voluntary family planning allowed the Kyomugishas to fulfil their wishes for the size of their family, while reducing pressure on their limited family food supply.

Where voluntary family planning is available, families are empowered. Where it is not, the lack of access takes a heavy toll. In Uganda, 435 women die for every 100,000 babies born. Dying as a result of pregnancy is the leading cause of death for women. High maternal death rates such as Uganda's are an indicator of an inadequate healthcare system, which is clearly a violation of women's fundamental rights to life, health and self-determination.

This violation is not a complicated puzzle to solve: investing in access to voluntary family planning reduces maternal deaths by up to 40%. And meeting the demand for birth control – enshrined by the UN as a millennium development goal – would enable dramatic progress in achieving not only the maternal health development, but all the other MDGs as well.

We now know that meeting women's needs for family planning not only strengthens the health and rights of families around the world, but will also help slow dangerous climate change.

Recent research suggests that simply meeting existing "unmet need" would deliver up to one-seventh of the carbon reductions essential to slow global warming, and at a very low cost. With women empowered to plan their pregnancies, the world's population grows more slowly, as do carbon emissions.

We have an opportunity to address two critical objectives at once: improving the health and lives of women and children and, simultaneously, helping to slow dangerous climate change. In addition, we need to remain aware that poor countries with the least adaptive capacity are expected to suffer most from the adverse effects of climate change, including hurricanes, devastating floods, and melting ice caps.

Any strategy that enhances human health, dignity and empowerment while also reducing global warming is not just advisable, it's essential at this stage. There is no time to lose.

Of course, it is naive to think any single idea or programme will yield the results we need to address global climate change. Yes, wealthy, industrialised countries must reduce their consumption; yes, nations around the world must reduce dependence on fossil fuels; yes, we must develop more effective, environmentally sustainable technologies, and yes, use energy more efficiently.

But it's time to pursue all possibilities and combining efforts. The facts are clear: funding that empowers women to access voluntary family planning is a win-win for women, men, children and climate change.

Source: http://www.guardian.co.uk/global-development/poverty-matters/2011/jan/05/family-planning-women-population

 

News Article: Champion of Public Health in Africa to Address UAlbany School

Champion of Public Health in Africa to Address UAlbany School

Dr. Jotham Musinguzi, first MPH graduate, Led Ugandan Fight to Quell AIDS Epidemic

ALBANY, N.Y. (December 03, 2020) -- Dr. David Carpenter, dean of the School of Public Health in 1990, knew something special had occurred when Dr. Jotham Musinguzi entered the School's new Master of Public Health (MPH) program that year. Dr. Musinguzi arrived with a medical degree from Makerere University Medical School in Uganda and had already dedicated himself as a public health physician to fighting the scourge of AIDS in his native land.

Dr. Jotham Musinguzi, MPH '91, a leader in African efforts at population growth and reproductive health, will speak at the School of Public Health on Thursday, Dec. 9.

He would become UAlbany’s first MPH graduate in 1991, return to Uganda and become a major factor in the nation waging the most effective national response to AIDS of any African country. He has become an international voice on behalf of reproductive health and family planning, as well as HIV/AIDS.

On Thursday, Dec. 9, the School of Public Health welcomes him back as he delivers an address as part of the School’s 25th Anniversary Distinguished Speaker Series. Dr. Musinguzi, now regional director of Partners in Population and Development of the Africa Regional Office Statistics House in Uganda, will speak on Attaining the United Nations Global Millennium Development Goals by 2015: Opportunities and Challenges.

"The School of Public Health is honored to have Jotham as an alumnus and as a distinguished alumni speaker during our 25th anniversary celebration," said Dean Philip Nasca. "For more than 20 years, he has been a leader in Africa in the fields of population studies, the fight to stem HIV/AIDs, maternal and child health, and in many important areas of reproductive health."

The program begins at 3:30 p.m. in the SPH auditorium. Event registration can be made by email at This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

"Jotham is one of our program's most distinguished graduates, and it was a remarkable coincidence that he happened to be the first one," said Carpenter. "It was certainly a good standard to set for everyone else."

Carpenter is not surprised by the magnitude of Musinguzi's career, or that his longtime friend would remain loyal to SPH and its programs. "I knew him even then as a fantastic individual — very motivated, very idealistic, and he's gone on to have an extraordinarily distinguished career. He came from a country that was among the very first to be hit severely by the AIDS epidemic, and today it has done an outstanding job of controlling the spread of the disease.

"He was also the first student from any African country to enter our school. Since then, we have had at least 10 students from Uganda, and all because they were recruited by Jotham."

For many years director of Uganda’s Population Secretariat, Musinguzi is currently a trustee of the Population Council of New York and a board member of the Africa Population and Health Research Centre based in Nairobi, Kenya. He has been president of Uganda Medical Association, chairman of the International Council on Management of Population Programmes, based in Kuala Lumpur, Malaysia, and has represented Uganda on most major international meetings, including many U.N. summits.

As a member of these groups, Musinguzi has consistently advocated for inclusion of strong and clear language on reproductive health and HIV/AIDS in all official documents.

Source: http://www.albany.edu/news/10963.php

 

News Article: MPs FORUM: More needs to be spent on reproductive health

MPs FORUM: More needs to be spent on reproductive health
Guest Writers
Written by Sarah Nyombi Nansubuga  
The Observer (Uganda)
Sunday, 24 October 2020 17:13

Sarah Nyombi Nansubuga, Ntenjeru County Every year, about 6,000 Ugandan women die from pregnancy related causes and a total of 297,000 women have induced abortions, most of them unsafe.

Up to 40% of these deaths and 84-85% of induced abortions could be prevented if all women in need of modern methods of contraception were able to access them. But these contraceptives are in short supply. As a result, at 41%, Uganda is among the countries with the highest unmet need for family planning and total fertility rate of 6.7 children per woman, putting the population growth rate at over 3% per year, the third highest in the whole world.

Due to efforts by Members of Parliament and civil society organisations, Uganda received a loan from the World Bank of $130m of which 30m was allocated to reproductive health. On September 30, 2010, MPs under their umbrella forum Network of African Women Ministers and Parliamentarians (NAWMP-U) and the Reproductive Health Supplies Advocacy Network, led by Reproductive Health Uganda, met with the Minister of State for General Duties, Richard Nduhuura, to discuss allocations to reproductive health under this loan.

The MPs were reliably informed that the World Bank funds are to be spent on four major interventions under the reproductive health component. These are: increasing access to Emergency Obstetric Care, ensuring skilled attendance at birth, scaling up of Family Planning and focused antenatal care.

In total, $18,949,654 (about Shs 42bn) which is 63% of the $30m is allocated to procurement of reproductive health supplies, including Emergency Obstetric Care, and equipment, long term and permanent method commodities (lUDs and implants) and Family Planning equipment, as well as procurement of oral contraceptives.

While it is commendable that the government has secured this loan, we as Members of Parliament together with our partners, Reproductive Health Uganda, call upon the government to increase its own expenditure on reproductive health supplies, particularly family planning supplies.

We also appeal to the government to go beyond allocation of funds for procurement of reproductive health supplies and ensure that what is allocated is actually spent on supplies. Historically, only a small percentage of the allocation for reproductive health is actually spent; for instance only 6.4% of the 1.5 billion shillings allocated to procurement of contraceptives by the government in 2008, was actually spent.

As Members of Parliament, we undertake to exercise our oversight role on this one and will keenly follow up the funds to ensure that they are spent on procurement of reproductive health supplies and that losses are minimised.

We also appeal to the media to continue taking a keen interest in matters of reproductive health. The media can help us by writing stories that stimulate public debate and create widespread awareness, and hold the government accountable in fulfilling its role in promoting and protecting the reproductive health of our population.

Once we do this, we believe we shall go a long way in reducing the unmet need for family planning, improve maternal health situation in the country and save the lives of our mothers and, in the long run, contribute to national development.

As recorded by DAVID TASH LUMU

Source: http://observer.ug/index.php?option=com_content&task=view&id=10644&Itemid=66

 

News Article: Government to release MDG report

News Article: Government to release MDG report
By Evelyn Lirri
Monitor (Uganda)
Monday, October 4 2010
Kampala, Uganda

Uganda will today release its report on the Millennium Development Goals which is expected to show mixed progress in achieving the goals. Uganda’s MDG score card report 2010, the third in a series to be published jointly by the government and the United Nations Development Programme (UNDP), reveals that the country is on track in meeting its targets on poverty reduction, promoting gender equality and increasing access to safe water coverage, but is trailing on health-related goals of reducing maternal and child deaths.

New strategy
Speaking at the MDG review summit in New York in September, President Museveni acknowledged that Uganda was unlikely to meet these two targets in the remaining five years. “It is only in the areas of maternal and child health that we may not achieve the set targets by 2015,” he said while addressing the 65th UN General Assembly. As a result, the government is today expected to announce a new strategy for achieving these elusive goals in the remaining five years.

Known as the National Millennium Development Goal Acceleration Framework, it spells out a series of practical solutions which government hopes if implemented would significantly drive progress, including making available emergency obstetric care, skilled attendance at birth, family planning and effective antenatal care.

Achievable goals
Development experts including Dr Jotham Musinguzi, say huge investment in health infrastructure will be key to meeting the maternal and child-related goals. But it’s not only maternal and child health targets that are off-track. According to the report, efforts to ensure children complete a full course of primary schooling are slow.

While primary school enrolment figures have sky rocketed with figures climbing from 2.2 million pupils in 1997 to 8.2 million by 2009, a low completion rate and increasing failure rate have affected the programme.

But the report shows that despite the uneven progress, the goals are still achievable.
It further shows that in the area of HIV/Aids, significant challenges in sustaining past gains, including an increase in new infections, stand in the way of meeting the Aids-related targets. “Population growth is adding to the absolute numbers of new infections, as is transmission of HIV between older age groups, especially those that are married or cohabitating,” reveals the report.

Source: http://www.monitor.co.ug/News/National/-/688334/1025486/-/cn1aciz/-/index.html

 

News Article: More investment needed to end maternal deaths - experts

More investment needed to end maternal deaths - experts
Monitor (Uganda)

By Evelyn Lirri
Thursday, September 30 2010

Huge investment in family planning and reproductive health for women will be crucial to achieving UN targets on maternal and child heath, experts say.

The Millennium Development Goals, especially those related to reducing child and maternal deaths, are falling behind schedule with development experts saying Uganda will miss them.

At a two-day regional meeting of parliamentary committees on Health in East and Southern Africa that concluded in Kampala yesterday, Dr Jotham Musinguzi, the regional director for Partners in Population and Development, called for increased investment in family planning.

“Family planning helps to have healthy women and children, breaking the cycle of poverty and accelerating the achievement of the internationally agreed MDGs,” Dr Musinguzi said.

Health experts say if unmet need for contraceptives were satisfied, maternal mortality would drop by 40 per cent.

Family planning

But only 41 per cent of women in Uganda have access to family planning while contraceptive prevalence stands at just 24 per cent.

With Uganda’s maternal mortality rate currently standing at 435 deaths per 100,000 live births, a 40 per cent reduction would mean having 160 deaths per 100,000 live births-a closer figure to the MDG target of reducing deaths to 131 per every 100,000 live births by 2015.

At the meeting, Deputy Speaker of Parliament Rebecca Kadaga, called on the private sector to invest in the country’s reproductive health programmes.

Source: http://www.monitor.co.ug/News/National/-/688334/1020872/-/cn4ntjz/-/

 

News Article: When childbirth becomes a deadly gamble

When childbirth becomes a deadly gamble
By Evelyn Lirri
Daily Monitor (Uganda)
Posted Sunday, August 15 2010

In Uganda, childbirth can be deadly. With 435 deaths for every 100,000 births, lack of modern family planning methods, a poor health care system and battered infrastructure means every pregnancy is a gamble,writes Evelyn Lirri:-

Ms Margaret Ajok is expecting her sixth child. The 26-year-old resident of Awere Sub-county in Pader District had come for antenatal checkup when I met her at Awere Health Centre. It is her fourth visit since she became pregnant.

A midwife at the health facility said Ms Ajok’s pregnancy has so far progressed well and there is no danger to the child and mother. But Ms Ajok’s experience of childbirth has not been without incident. When she was pregnant with her fourth child, she never attended any antenatal care.

“It was very expensive for me to move from home up to here. I have to walk more than 10 kilometres to access the health facility,” she said. And when it was time for her to have the baby, the journey to the hospital was too long, she decided to give birth at home - only with the help of a traditional birth attendant. It was a still birth.

While Ms Ajok said she had given birth to her other four children at the health facility, the daunting cost and expenses she needed to travel had forced her to deliver at home.

Slight improvement
According to the Uganda Demographic and Health Survey 2006, there has only been a slight improvement in the proportion of mothers who deliver in health facilities from 38 per cent in 2001 to 41 per cent.

“Now I don’t want to take any risk again. I have already saved some money for transport when the time to deliver this baby comes,” she said. A journey from Ms Ajok’s home to the health facility costs Shs5,000 on a boda boda.

But in a country where more than 10 million people live on less than a dollar or Shs2,100 a day, being pregnant can be potentially tragic for women like Ms Ajok who come from rural areas- and where services are scarce or expensive.

Pregnancy and childbirth-related complications are the leading causes of death among women in Uganda, where for every 100,000 women who get pregnant, 435 or 44 per cent die.

Daily deaths
This translates to an average of 16 deaths everyday. Most of these deaths result from complications of unsafe abortion, prolonged or obstructed labour where the woman’s body is too small for the baby to pass through the birth canal, massive bleeding, high blood pressure, malaria and HIV/Aids.

But often the underlying cause of death is the high cost of maternal care. Maternity care, like all other health services in Uganda, is supposed to be free but pregnant women are asked to provide their own delivery items like gloves, razor blades, cotton wool and birth sheets.

Dr Jotham Musinguzi, the African regional director for Partners in Population and Development (PPD), said many of the women are dying from causes easily preventable with basic medical care.

“Maternal mortality is not purely a health issue. If we want to get results, we need to have well functioning facilities in place with health workers. There must be good roads in order to transport women incase of emergencies and generally, there should be real investment in the health sector,” Dr Muzinguzi said.

Without a trained, experienced midwife on hand, women are more likely to die from complications like severe bleeding and obstructed labour. “If you have a skilled health worker with a mother during delivery, it will help her to detect if there is any complication and immediately do something to save the life of the baby and mother,” said Dr Hassan Mohtashami, the deputy representative of the UN Population Fund (UNFPA) in Uganda.

“If a mother needs specialised and sophisticated care by a doctor such as caesarean and blood transfusion, then there should be a centre equipped with these facilities where mothers can be referred,” he added.

This, intervention, according to Dr Mohtashami, has the potential of saving up to one-third of women who would otherwise have died. But saving lives of mothers requires more than just medical intervention.

Sensitisation lacking
Ms Thoraya Obaid, the executive director of UNFPA, told Sunday Monitor in an interview that the underlying reasons which make women not access information on reproductive health issues should also be addressed.

“We see that poor, uneducated young women have the least information and services, and the highest rates of death or injury during pregnancy and childbirth,” she said.
She said that poor sexual and reproductive health is a leading killer in Africa and the consequences are felt every day.

Explaining the task of reducing maternal deaths, Dr Musinguzi said while leaders have made several commitments to reduce maternal and child deaths, little effort has been put to realise the actual results. “If you are to look at the statistics, we are far from achieving the MDGs on maternal and child health,” he said.

To achieve the MDGs by 2015, countries must reduce the number of mothers who die in childbirth by 75 per cent. This means Uganda will have to significantly reduce this figure to 131 per 100,000 from the current 435 - a figure that already looks out of reach given the five years left to the MDG deadline.

Health and development experts say action on maternal and child health will do well to focus on family planning and basic care and to ensure women do not have too frequent or too early pregnancies that increase their risk of death.

But in Uganda contraceptive use among sexually active women has remained at a low 24 per cent, which is below the minimum needed to impact on fertility while the unmet need for family planning is 41 per cent.

“Family planning services enable women not only to plan their families but also to plan the rest of their lives. If a woman cannot decide voluntarily on the number and spacing of her pregnancies, then she cannot decide on anything in her life,” said Ms Obaid.

Many women admit they want to space or stop producing more children than they already have but they do not have access to contraceptives - especially long term contraceptive methods because of frequent stock-outs in public health facilities.
The result has been the high number of unwanted pregnancies, which have consequently led to a high number of induced abortions-297,000 every year, according to a study conducted by the Guttmacher Institute and Mulago Hospital.

According to the Uganda Demographic and Health Survey, at least 16 per cent of the estimated 6,000 annual maternal deaths are due to abortions.
The report reveals that 56 per cent (519,000) of the 1.2 million births that occur in Uganda every year are unintended.

Averting danger
The report says these births could be averted if all the women who wanted family planning services had access to them. Ms Margaret Akello, the in-charge of the Family Planning Unit at Lira Regional Hospital for instance said because of stock outs, they have registered a high number of women with successive unintended pregnancies.

Health experts say more women now prefer the long-term birth control methods, usually given in a single jab or fitting because it’s convenient and more effective than the oral contraceptives which must be taken every day to prevent pregnancy.

Ms Aidah Edonga, a 35-year-old mother of seven children for example said she wanted a long term method but she could not get it at the health facility. This forced her to resort to a private clinic. But even here, she said the cost was very high.

Part of the problem is that policy makers are sometimes reluctant to make long term birth control methods part of the mix of contraceptive method because of perceived cost barriers.

On the other hand, short term methods are readily available - even through commercial outlets and community distribution programme.
At a clinic run by Reproductive Health Uganda in Lira Town, a senior clinical officer, Mr Geoffrey Lapat, said contraceptives like Pills cost Shs500 while longer term birth control methods like inplants go for as high as Shs20,000.
“When the women come here and find the costs for the long term methods are high, they just leave without taking it. The next time you will probably see them again is when they are pregnant,” said Mr Lapat.

Studies show that addressing the unmet need for family planning in Uganda can potentially avert some 16,877 maternal deaths and more than 1.1 million child deaths by 2015.

Meeting the unmet need for contraceptives can also potentially reduce maternal deaths by 40 per cent while unplanned pregnancies and induced abortions would decline by 84 per cent.

Because of the huge unmet need for family planning, fertility rates have also remained high with each woman having on average seven children - some even more over their reproductive lifetime.

The Guttmacher report shows that when women delay their next birth or have fewer children, the rate of population growth declines and the potential to educate, train, and meet the economic demands of a young population becomes easier.
“Slower population growth can yield savings on the costs of providing health, clean water, sanitation, and social services,” the report reveals.

To address the huge challenge of maternal deaths, health experts say more investment will be needed in the health sector. “Leaders will have to make reproductive health a priority and devote 15 per cent of their budgets to health as they agreed in Abuja.”

“They also need to invest resources in training doctors, nurses and midwives to tackle the gap of health workers,” said Ms Obaid. In Uganda only half of the jobs in the health sector are currently filled while health budget spending is 9.7 per cent of the national budget far below the commitment agreed to in Abuja in 2001.

According to a report by the Population Secretariat, the body that advises government on population policy issues, the high population is already having huge implications on the health sector.

It shows that currently there is one nurse for every 4,000 people while for every 9,500 people, there is one health facility. Ms Obaid said reducing maternal deaths eventually will require commitment and funding and a functioning health care system.

Source: http://www.monitor.co.ug/News/National/-/688334/976568/-/x3avu0/-/

 

News Article: Fertile Women, Impotent Nation

Fertile Women, Impotent Nation
The Observer (Uganda)
Written by Shifa Mwesigye  
Sunday, 08 August 2020

To modernise, Uganda must  start aggressively promoting and funding family planning services

When Sicola Nassuuna started living with her boyfriend, she had a dream, and a plan to secure this dream. She was 15, and in love. She believed that her husband would love her forever, and that if she gave him as many children as he wanted, he would love her even more. Despite counselling from a midwife at Mulago hospital’s ward 5B that she should use a family planning method to limit her births or space her children, Nassuuna stuck to her plan.

By 27, Nassuuna had seven children, a one-roomed rental in Katanga slum, in Kampala, no job and no husband. After the cost of looking after a big family shot up with each child, her lover ran off with another woman.

Now working as a tailor in a small shop in Katanga, Nassuuna says she waited for six years before falling in love again. By mid 2009, she had added her eighth child to Uganda’s estimated 33 million people. Yet her new relationship has no future.

“He cannot allow me to go (move into his house) with my children,” Nassuuna says of her new lover. “Where do I leave them?”

Nassuuna’s neighbour, Becca Katimbo, 45, knows all too well the problems that come with large families on meagre resources. When Katimbo’s parents died, they left behind 20 children, two houses and three wooden shacks on half an acre of land in Katanga. The boys, now men, insist the property belongs to them. The girls – married, divorced or single mums – often return home with children when they have nowhere else to go. “Everyday they chase us from our home but where can we go? We just ignore them,” says Katimbo who shares one house with five families.

Yet it is not just Nassuuna or the Katimbo family. Experts warn that Uganda is sitting on a population time-bomb, producing many more children than we can cater for. On average, each Ugandan woman produces nearly seven children in her lifetime. If the population continues growing at 3.2%, Uganda will have 55 million people by 2025. That in itself is not a problem because any country would want young people to join the labour force; the problem, experts say, is that economic development will not match up. So, we are cruising into a future with a high quantity but poor quality population.

People will pour into urban centres with hope of finding a better life and the urban population is likely to reach 21.9 million. At current population growth projections, Uganda will require 4.3 million new urban housing units by 2037. The demand for land to accommodate the increase will reach 23 million hectares by 2025, yet Uganda’s geographical size remains 20.5 million hectares.

The situation with basic services is just as worrying. Although Uganda’s economy will grow at 8.4% this financial year, such impressive growth has not translated into development for people like Nassuuna or Katimbo. These are Ugandans who eat one meal a day, have to ration everything from water to costly toilet visits, and whose children’s schooling pinnacle is learning to read and write.

PIPE DREAM?
Although politicians like President Museveni want Uganda’s population to grow bigger, donors and experts are raising the red flag. Uganda, they say, needs a highly educated and productive labour force – not millions of unskilled people without money to buy goods and services.

While launching the National Development Plan recently, President Museveni spoke of his vision to transform Uganda from a peasant economy into a modern and prosperous society in 30 years. But available evidence suggests this will not happen if demographic issues continue to be ignored. A fast-growing population means slower improvements in health, education, agriculture, environment and urban development. Political intransigence on this matter is more puzzling when you consider that the richer people are having fewer children while the poor stretch village birth attendants and midwives.

Katimbo, too, would like her children to graduate from Makerere University. But she wishes she could afford better than Makerere Yellow Primary School, which is under the government’s tuition-free universal primary education. Today, the government can only afford to spend Shs 3,100 per UPE pupil per term, which is reflected in the poor performance in national exams.

UPE had about 7.5 million school pupils in 2007 and yet not enough teachers and classrooms to afford them quality education.

Population Secretariat figures show that UPE numbers will rise to 18.4 million pupils in 2037. Last financial year, the primary education budget stood at about Shs 451bn. By 2037, even before considering rising costs, this budget would rise to Shs 1.106 trillion.

But, according to the 2008 National Population Policy, if families had manageable numbers of children, the primary education budget would only rise slowly. This would free up hundreds of billions of shillings for enhancing teacher training, building more classrooms and improving the quality of education in government schools attended by majority of Uganda’s children.

In the health sector, the human resources situation is already critical, with only 51% of approved positions filled according to the 2009 National Health Policy.

For example, three years ago, Uganda had fewer than 8,000 nurses in service, which translated into one nurse for every 4,000 persons. This is below the national target of one nurse per 1,000 persons. Yet, if population growth remains unchecked, Uganda will need 88,800 nurses by 2037.
The country will also need 6,245 new health centres, to add to the existing 3,045 facilities. In the past, when Nassuuna went into labour, she had to wait in the corridors of Mulago hospital as labour progressed. Minutes after delivering, she moved to the floor, before being sent home hours later – so that other women could get in.

According to the Annual Health Sector Performance Report 2007–2008, only Shs 26,400 is budgeted for a Ugandan’s health every year. Not only is this amount too little, it is way off the policy’s target of reaching Shs 61,600 by 2007. So every time Nassuuna seeks treatment at Mulago, she has to pay for drugs.

PLAN FOR PROSPERITY
Nassuuna knows she could have ended up at least a little better off if she had planned her family better. So would millions of women and millions of children, if mothers could access, afford and embrace family planning methods.

According to the 2010 World Population Data Sheet by the Population Reference Bureau, only 24% of married women of reproductive age in Uganda use modern contraceptives. Yet 40% of those who want to space or stop having children don’t access them.

In keeping with its intransigence on population matters, the government contributes only 5% of the family planning budget, although even this fluctuates. For instance, in 2009 the government allocated Shs 1.5bn for contraceptives but only Shs 94m was actually released. The rest comes from donor agencies, which are frustrated with the government’s lack of commitment.

Dr Jotham Musinguzi, the Africa regional director of Partners in Population and Development, says Uganda will not achieve much unless it invests in the quality of its population.

Musinguzi, a former director of the Population Secretariat in the ministry of Finance, also knows that investing has to be accompanied by well planned families or else it will fail. To this end, President Museveni’s government should aggressively educate people about family planning and avail the services.

As Musinguzi says, the ideal situation is where parents have children “by choice not by chance.” That choice should be dictated by the capacity to properly feed, clothe and educate children, as well as give them good healthcare and employment. Otherwise for people like Nassuuna, Katimbo and their children, a prosperous modern Uganda will remain a pipe dream.

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Available at: http://www.observer.ug/index.php?option=com_content&view=article&id=9586:fertile-women-impotent-nation&catid=34:news&Itemid=59

 

News Article: African leaders seek solution to maternal and infant mortality

African leaders seek solution to maternal and infant mortality
Daily Monitor (Kampala)
By Evelyn Lirri
Posted Monday, July 19 2010 at 00:00

African leaders and health experts meet today at the 15th African Union Summit in Kampala amid reports that maternal and child health indicators are still poor.

The summit with a theme on maternal and child health, will seek ways to slash maternal and infant deaths across the African continent.

In 2000, African governments agreed to reduce by two-thirds the number of mothers and children who die annually from pregnancy-related complications and preventable childhood illnesses.

Ten years later, little has been achieved on that noble commitment, as statistics show an African woman’s risk of dying in child birth is still one in 11 compared to a 1 in 7,300 risk among women in developed countries.

Most women usually die from bleeding, infection, obstructed labour and preeclampsia, or pregnancy-induced high blood pressure: “If you are to look at the statistics across Africa, we are far from achieving the Millennium Development Goals on maternal and child health,” says Dr Jotham Musinguzi, the African regional director for Partners in Population and Development (PPD).

In Uganda maternal and child mortality rates remain unacceptably high at 435 per 100,000 live births and 137 deaths for every 1,000 births, respectively, since 2000 when MDGs were set.

Dr Musinguzi says sub Saharan African countries are particularly fairing badly in trying to reduce pregnancy related deaths compared to their Asian counterparts.

“Maternal mortality is not purely a health issue. If we want to get results, we need to have well functioning facilities in place with health workers, there must be good roads in order to transport women in case of emergencies and generally, there should be real investment in the health sector,” he says.

The deputy representative of the United Nations Population Fund (UNFPA) in Uganda, Dr Hassan Mohtashami, says: “We can save mothers from dying because of pregnancy by making family planning services available, ensuring women are attended to by skilled personnel and have emergency care when birth complications arise.”

Source: http://www.monitor.co.ug/News/National/-/688334/960318/-/x2k5cb/-/

 

News Artile: Parliament Asked To Help Re-position Family Planning

Parliament Asked To Help Re-position Family Planning
Date: 12-Jun-2010      

Ms Marian Kpahkpah, Acting Executive Director of the National Population Council, (NPC) on Saturday, requested the support of Parliament in repositioning family planning in national development affairs.

She said this had become important because of the considerable impact family planning had on population growth, socio-economic development and the well-being of both mothers and children.

Ms Kpahkpah was speaking at an advocacy seminar on Population and Development, in Ho, for the Parliamentary Caucus on Population and Development.

She said the rapid population growth and the relegation of family planning issues if not addressed adequately and urgently would bring a number of detrimental effects on national development and the quality of life.

"If our population continues to grow at the current rate in 10 years, by 2020, Ghana will have to increase its entire infrastructure for access to health, food production, education, housing and other services to maintain the quality of services we are enjoying today-not to talk of improvement," Ms Kpahkpah said.

She said family planning contribute greatly to reducing the unacceptable high rates of maternal mortality and underscored the need for Parliament to support the NPC to re-position family planning for the nation's rapid socio-economic development.

Ms Kpahkpah said family planning for instance could reduce maternal mortality by making pregnancy and delivery safer and reducing the number of unintended and unwanted pregnancies.

She said, "increased contraceptive use can significantly reduce the cost incurred in achieving some selected Millennium Development Goals, (MDGs) noting that Contraceptive Prevalence Rate (CPR) declined from 19 per cent in 2003 to 17 per cent in 2008.

Ms Kpahkpah stated that Ghana became the 24th member country of Partners in Population and Development, aimed at promoting South-South Cooperation in Population and Development and Reproductive Health, and called on Parliament to support the NPC in its work with other countries in the sub-region.

Mr Jude Edochie, United Nations Population Fund, (UNFPA) Representative in the Country, said the UNFPA remained committed to promoting the rights of every woman, man and child to enjoy a life of health and equal opportunity.

"UNFPA will continue to support countries in the use of population data to develop evidence-based policies and programmes aimed at reducing poverty and ensuring that every pregnancy is wanted, every birth is safe, every young person is free of HIV and AIDS, and every girl and woman is treated with dignity and respect," he added.

He commended the government for passing a range of relevant Human Rights-based legislations and encouraged the enforcement of those legislations.

Colonel Cyril Necku, (Rtd) Deputy Volta Regional Minister, said the current national population growth rate of 2.7 per cent posed a serious challenge to achieving accelerated socio-economic growth by 2015.

He, therefore, underscored the need for a policy to control population growth in the country.

Mr Abdul Rashid Pelpuo, Chairman of Parliamentary Caucus on Population and Development, said population issues were dear to government due to their linkage with development.

He said Parliament was aware of inadequate social amenities across the country due to the increasing population and assured that a policy would soon be formulated to promote the quality of life of the populace.

Source: GNA, http://business.peacefmonline.com/economy/201006/47264.php

 

News Article: First lady lauds family planning project

First lady lauds family planning project
New Vision (Uganda)
Monday, 26th April, 2010    
By Vision Reporter

THE First Lady, Janet Museveni, has welcomed the Advanced Family Planning (AFP) Project, which will help decrease maternal deaths in Uganda.

She noted that family planning, which is not only about spacing children but also preparing for birth, is a big component in maternal health.

Mrs. Museveni made the remarks while meeting the AFP project team from Baltimore, led by Prof. Buff Gillestie, at State House Entebbe recently.

The team, accompanied by Dr. Jotham Musinguzi, the regional director for partners in population and development Africa regional office, included Betgh Fredrick, Maureen Greenwood and Joan Koomson.

According to a State House statement, the officials briefed Mrs. Museveni about the increasing demand for family planning in Uganda and how the project could help increase resources to meet the demand.

Gillestie said the project aims at increasing funding and improving policy commitments at all levels.

The on-going activities include reproductive health advocacy, leadership development, knowledge and innovation.

The three-year project is a designed to help develop countries achieve universal access to reproductive health.

It is supported by the Bill and Melinda Gates Institute for population and reproductive health.

Source: http://www.newvision.co.ug/D/8/13/717668

 

News Article: Family Planning Groups engage Advanced Gear

Family Planning Groups engage Advanced Gear
The Observer (Uganda)
Thursday, 22 April 2020
Written by Simon Musasizi

A new collaborative effort aimed at upscaling family planning in Uganda was announced last Friday by John Hopkins Bloomberg School of Public Health in partnership with Partners in Population and Development Africa Regional Office in Kampala.
Advanced Family Planning is an evidence-based, advocacy effort designed to help developing countries achieve universal access to reproductive health.

The three-year programme in three countries; Uganda, Tanzania and Indonesia, aims to revitalise family planning programmes through increased and more effective funding and improved policy commitments at local, national and global levels.

According to Prof. Duff Gillespie, the Director Advanced Family Planning, the programme will support those working in family planning in Uganda to effectively advocate provision of quality family planning services for increased contraceptive use and healthy timing and spacing of births.

“Uganda is a focal country for Advanced Family Planning because of the great opportunities to increase access to family planning and meet the needs of Ugandan women and couples.

Universal access to family planning and reproductive health is essential for a better future and greater political commitment is key,” said Duff who is also a professor with the Bill and Melinda Gates Institute for Population and Reproductive Health at Johns Hopkins Bloomberg School of Public Health.

“The project is designed to help Uganda champion family planning and increase priority for family planning by creating more resources for family planning. We are looking at three areas as lobby areas to increase funding. First, is the district level because with decentralisation, many decisions and resources take place at the district level,” Duff said.

“Giving couples the ability to choose the number and spacing of their children will have tremendous life saving benefits. This is especially needed in Uganda where maternal mortality rate is still very high,” said Jotham Musinguzi, the Director of Partners in Population and Development, Africa Regional Office (PPD ARO).

“With the growing demand for family planning services, it is imperative to achieve greater political and financial commitment to support long-term availability of quality family planning services,” he explained. The project aims to capitalise on providing evidence to policy makers of how family planning stands to benefit the economy if they invested more resources.

“Women have the right to decide what they want to do with their bodies and providing them with information and services to do so cannot be overemphasised”, said Joan Koomson, the Programme Officer, African Women’s Development Fund.

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Source: http://www.observer.ug/index.php?option=com_content&task=view&id=8177&Itemid=89

 

News Article: Baby boom as contraceptives run out of stock

Baby boom as contraceptives run out of stock
The Observer (Uganda)
Wednesday, 21 April 2020
Written by Shifa Mwesigye  

Only 24% of women in Uganda use contraceptives, increasing chances of maternal mortality

Emerging from her one-room residence in Zone III, Bwaise, Edith Nakiganda looked like a girl. Yet at 24, Nakiganda has had four pregnancies. Her second baby came in 2008 and the third born, Terry Kalema, the following year.

Nakiganda found herself carrying two pregnancies in as many years because her local clinic in Bwaise had no contraception pills, leaving her with no alternative.

“Before I conceived my second pregnancy, I went to a clinic in Bwaise and asked the nurse to give me family planning pills but she said that they were out of stock. When I returned after two weeks, she gave me pills. But after four months I went for a checkup as I was feeling sick. I discovered that I was four months pregnant.”

Unfortunately, at six months, she suffered a miscarriage and the foetus looked deformed.

“The doctor said that the pills I was using while pregnant could have deformed the baby. I spent three months in Mulago Hospital because I couldn’t stop bleeding,” she said.

Nakiganda does not want another baby, but does not know what to use in order not to conceive again. Grance Nankya, a woman councillor in Zine III, Bwaise, says women in the area get unplanned pregnancies because health centres do not have a constant supply of contraceptives.

“These women deliver babies and throw them in dustbins, pit latrines and the drainage channels. Some women leave their children in the house with no food or treatment; so, the neighbours shoulder the burden,” Nankya says.

The KCC health centre IV in Kawempe that serves more than 1,000 women often goes without contraception medicines for many months.

“The primary healthcare fund is not coming to health centres and outreaches. People are sent here and when you tell them you are out of stock, they go and don’t come back,” a health worker said.

LIMITED INFORMATION
A two-day survey by The Observer in Mityana and Kampala shows that while many women would wish to get contraceptives, they lack the right information and options to choose from. In rural Mityana, nearly all women The Observer talked to use the pill or injectables.

At about Shs 1,000, the injectables are fairly user friendly because after three months, one can choose to stop or go back for another injection.

Women in the rural areas of Myanzi, Kitandwe and Naama said they have not heard of other methods.
Long-term methods such as implants, intrauterine devices or tubal ligation remain a mystery. Yet Ugandan women continue to die of reproductive health related issues with the maternal mortality rate at 435 deaths per 100,000 live births.

Only 24% of women in Uganda use contraceptives, according to Reproductive Health Uganda statistics. If all women had access to family planning choices, maternal mortality would go down because there would be fewer unintended and unwanted pregnancies and fewer abortions, experts say.

According to a 2009 study by the Guttmacher Institute, a US-based corporation working to advance sexual and reproductive health, addressing the unmet need for family planning would avert 40% of all maternal deaths and 10% of childhood deaths in Uganda.

With a growth rate of 3.2%, Uganda has one of the fastest growing populations in the world. Uganda’s population is projected to reach 38 million by 2015 and close to 100 million by 2050. This, experts say, has serious implications for livelihoods, food security, maternal and child mortality, and the environment.

Providing social services such as education and healthcare to a rapidly growing population puts enormous strain on both households and the public purse.

BUDGET SUPPORT
The biggest budget for contraceptive procurement in Uganda is shouldered by donor agencies such as United Nations Population Fund and the United States Agency for International Development, amounting to Shs 6.8 billion, according to Ministry of Health figures.

Yet under the Abuja Declaration 2001, African states set a target of allocating at least 15% of their total national annual budgets to the health sector to achieve universal coverage of reproductive health services by 2015.

This financial year, Uganda allocated Shs 734.6 billion, about 10% of the national budget. Statistics from the health ministry show that in 2009, government allocated Shs 1.5 billion for contraceptive procurement, yet only Shs 94 million was used.

Dr. Moses Muwonge, the national reproductive health commodity security coordinator at Uganda’s Ministry of Health, says what is allocated is not what is delivered. Some of the fund is diverted to other sectors like primary healthcare.

Jotham Musinguzi, the director of Partners in Population and Development Africa office, says Uganda will not achieve much if it doesn’t follow up on financial commitment.

Hasifa Naluyiga, an advocacy officer at Reproductive Health Uganda, says if the government invested more in satisfying unmet need for family planning, the country would benefit. Studies show that the cumulative cost saving would be approximately $101 million annually, with 16,877 maternal deaths and 1.1 million child deaths averted by the target date of 2015.

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Source:http://www.observer.ug/index.php?option=com_content&task=view&id=8212&Itemid=59

 

News Article: Ambitious plan to lobby Uganda gov't on population

Ambitious plan to lobby Uganda gov't on population
Sunrise (Uganda)
Saturday, 17 April 2020
Written by Henry Mulindwa

An initiative supported by Bill Gates Foundation aims at supporting local organisations to lobby the government and donors for increased funding of family planning services

A few months after delivering her baby, Cissy Nantumbwe (not real names), a resident of Butambala sub-county in Mpigi district had a dispute with her husband on when she would have another child.

Her husband wanted to have another child without much delay as opposed to Nantumbwe who wanted to take a break arguing that she wanted to raise their first child as they planned on having another one.

Nantumbwe's predicament is not an isolated incident but shared by millions of women in Uganda

who engage in constant disputes and sometimes ugly fights with their husbands behind the walls of their marital homes over the spacing of children.

The situation is even more dire in rural areas where most women are powerless. Faced with a situation similar to Nantumbwe's, most rural women tend to submit to the wishes of men and suffer the consequences associated with unwanted pregnancies.

According to the 2006 Uganda Demographic Health Survey, 41 percent of Ugandan women in reproductive age would not like to get pregnant and yet they do not use any family planning method.

Compared to only 24 percent of married women who use any form of contraception, the situation demonstrates the picture of a wide gap between those who want to access family planning methods but are actually unable to receive them.

This led to Dr. Jotham Musinguzi, the regional director of Partners in Population and Development Africa Regional Office and the former Population Secretariat to lament thus: "Availability of family planning methods throughout the country is still a big challenge to the government and the health ministry which has even forced some women who want it to use policies or methods which do bring some side effects."

It is for this reason that concerned agencies such as the Population Secretariat and John Hopkins University have joined hands with the view of devising strategies to close the gap by covering those who would want to use the services but are unable to.

Through a three-year programme dubbed Advance Family Planning (AFP), the agencies intend to scale up access to family planning services by empowering Ugandan institutions more to advocate for increased funding and improved policy commitments to family planning programs in Uganda and at global level.

The program will support those working in family planning in Uganda to effectively advocate for provision of quality family planning services for increased contraceptive use and healthy timing and spacing of births.

"We are going to work with different Ugandan experts and organisations to see how we can improve the availability of family planning services in the country," said Professor Duff Gillespie from Johns Hopkins University.

The initiative comes in face of government's apparent indifference to the runaway population growth rates in Uganda that has imposed unprecedented stress on natural and other resources in the country. Uganda has the second fastest population growth rats in the world at 3.4 percent. Uganda's population currently standing at 33 million, is expected to hit 50 million in twenty five years.

Given President Museveni's unwavering support for Uganda's fast population growth, it is clear that the new initiative faces considerable challenges including the lack of political will which is likely to affect the opportunity for securing funds and development of policies.

Musinguzi pointed to the kind of challenges currently being faced by those who work in planning sector which include meagre funding of a paltry Ushs 1.5 billion that is allocated to all the family planning projects in the country.

However, Gillespie revealed that consultations concerning this program will be made starting from the district level, national level going right up to the international level.

He adds that this program is to help all the concerned organisations about how family planning methods can be implemented to whoever needs or wants them.

"We shall help all the family planning organisations to look for donors such that their programs are implemented as they want them," Gillespie adds.

According to Gillespie, with the growing demand for family planning services it is imperative to achieve greater political and financial commitment to support long term availability of quality family planning services.

Musinguzi noted that Uganda is already off track in as far as attaining the Fifth Millennium Development Goals (MDGs) of reducing by two thirds the rate of maternal mortality.

Family planning programs are looked at as a way of achieving that goal through reducing unwanted pregnancies which calls for more effective funding and improving policy commitments at the local, national and global levels.

But Musinguzi is unwavering about his belief in the need to control population. He said: "Giving couples the ability to choose the number and spacing of their children will have tremendous life saving benefits. This is especially needed in Uganda where maternal mortality rate is still very high."

The US$ 12m dollar programme is to be supported by the Bill and Melinda Gates foundation and David and Lucile Packard foundation.

Source: http://www.sunrise.ug/news/national-news/476--ambitious-plan-to-lobby-uganda-govt-on-population.html

 

News Article: Uganda People News: Population experts blame Ugandan politicians

Uganda People News: Population experts blame Ugandan politicians
First published: 13 April 2020
Ugpulse (Uganda)

Population experts in Uganda insist that it’s wrong for politicians to continue advocating for a larger population.

They said stead of advocating for a larger population the government should focus on putting in place proper social infrastructures which will improve of the living conditions of the people.

The Director for Partners in population and Development Africa Region, Dr. Jotham Musinguzi warns that if the government continues to be adamant to solve the problem of rapid population the country is facing, it will be difficult to reduce the high maternal mortality rate in the country.

Dr. Musinguzi further says that the population boom may also deny the country chances of attaining the Millennium development goals.

He says the concerned people should continue advising the president about the need for a manageable population for the country.

Source: http://www.ugpulse.com/articles/daily/news.asp?about=Population+experts+blame+Ugandan+politicians+&ID=14157

 

News Article: Family planning efforts to be intensified

Family planning efforts to be intensified
The New Vision (Uganda)
Monday, 12th April, 2010
By Juliet Waiswa

FAMILY planning stakeholders in Uganda have launched a $12 million (about sh24b) project in order to meet the demand for family planning methods in the country.

Announcing the project at the Family Planning head office in Kampala, the director of Partners in Population and Development Africa, Dr. Jotham Musinguzi, said the project was initiated after realising the gaps in family planning methods.

“Many women in Uganda want to space their pregnancies but do not use contraception. Many couples do not have access to reproductive health supplies and yet the demand is increasing,” Musinguzi said.

He added that giving couples the ability to choose the number and spacing of their children will reduce the maternal mortality rate.

Source: http://www.newvision.co.ug/D/8/13/716054

 

News Article: Bush and Africa's baby boom

Bush and Africa's baby boom

Bush birth control policies helped fuel Africa's baby boom
Shashank Bengali | McClatchy Newspapers
The Real News Network

March 16, 2021

SIRAKANO, Uganda — At age 45, after giving birth to 13 children in her village of thatch roofs and bare feet, Beatrice Adongo made a discovery that startled her: birth control.

"I delivered all these children because I didn't know there was another way," said Adongo, who started on a free quarterly contraceptive injection last year. Surrounded by her weary-faced brood, her 21-month-old boy clutching at her faded blue dress, she added glumly: "I fear we are already too many in this family."

On a continent where fewer than one in five married women use modern contraception, an explosion of unplanned pregnancies is threatening to bury Adongo's family and a generation of Africans under a mountain of poverty.

Promoting birth control in Africa faces a host of obstacles — patriarchal customs, religious taboos, ill-equipped public health systems — but experts also blame a powerful, more distant force: the U.S. government.

Under President George W. Bush, the United States withdrew from its decades-long role as a global leader in supporting family planning, driven by a conservative ideology that favored abstinence and shied away from providing contraceptive devices in developing countries, even to married women.

Bush's mammoth global anti-AIDS initiative, the President's Emergency Plan for AIDS Relief, poured billions of dollars into Africa but prohibited groups from spending any of it on family planning services or counseling programs, whose budgets flat-lined.

The restrictions flew in the face of research by international aid agencies, the U.N. World Health Organization and the U.S. government's own experts, all of whom touted contraception as a crucial method of preventing births of babies being infected with HIV, the virus that causes AIDS.

The Bush program is widely hailed as a success, having supplied lifesaving anti-retroviral drugs to more than 2 million HIV patients worldwide.

However, researchers, Africa experts and veteran U.S. health officials now think that PEPFAR also contributed to Africa's epidemic population growth by undermining efforts to help women in some of the world's poorest countries exercise greater control over their fertility.

"It was a huge missed opportunity to integrate HIV/AIDS and reproductive health in ways that made sense," said Jotham Musinguzi, a Ugandan physician who heads the Africa office of Partners in Population and Development, an intergovernmental group that promotes sexual health in developing countries.

In some countries that received substantial PEPFAR funding, such as Uganda and Kenya, health surveys have found that fertility rates remained constant or even rose slightly over the past decade. In Uganda, where many men want large families and abortion is illegal except to save a woman's life, the average woman bears 6.7 children, one of the highest rates in the world.

This small nation of rolling hills and banana trees is at the epicenter of Africa's demographic boom. Uganda is roughly the size of Nebraska, but in 40 years its population is projected to triple to 96 million, surpassing Japan, according to the Population Reference Bureau, a Washington research center.

Stanching that tidal wave will require a dramatic increase in contraceptive use, currently practiced by only 18 percent of married women.

"There hasn't been a country in the world where the birth rate came down without it," said Carl Haub, a senior demographer with the population bureau.

AN UPHILL BATTLE

A woman has to be strong to have a small family in Uganda.

The high-fertility cues start from the top: The longtime president, Yoweri Museveni, has often said that a large population could turn his landlocked nation into an economic power. His wife, Janet Museveni, is a born-again Christian who's urged women not to use birth control because it goes "against God's clear plan for your life."

Opposition to birth control also comes from the Roman Catholic Church, the country's largest, and from husbands who consider big families badges of masculine accomplishment, health workers say.

In national surveys, 41 percent of married women say they want to practice family planning but aren't. Every year, some 775,000 Ugandan women get pregnant without intending to, according to the Guttmacher Institute, a New York-based reproductive-health advocacy group.

With these domestic challenges, "PEPFAR was like a death blow," said Angela Akol, the Uganda director for Family Health International, a reproductive-health aid agency.

While global U.S. family planning funding flat-lined at roughly $430 million a year, PEPFAR's 2003 authorization of $15 billion for five years created "a giant sucking sound" as governments and relief agencies rushed to grab chunks of the new AIDS funds, in the words of a former U.S. health official, who like several current and former U.S. officials requested anonymity in order to speak more candidly about the Bush policies.

PEPFAR pumped $285 million into Uganda this year, a flood of money in an extremely poor nation, which eventually helped pay for some nine out of 10 AIDS projects. By contrast, Ugandan health officials said they spent $7 million this year on family planning supplies such as injections and pills.

In three-quarters of the country's health clinics, at any given time, at least one type of birth-control device is out of stock, officials said. During one six-month period two years ago, the national medical warehouse had no supplies of Depo-Provera, a quarterly injection that's become the most popular form of female contraception in Uganda because it's simple, infrequent and discreet.

"The U.S. had been a major funder of family planning in the past. Their absence meant that a lot of programs suffered," said Musinguzi, the physician. "They don't get adequate supplies; training of health workers doesn't take place; the skills aren't there. The impact is great."

Last year in Kampala, the capital, one PEPFAR-funded agency conducted a series of counseling sessions with HIV-positive teenagers. Several of the girls turned up pregnant, and when they asked about birth control the counselors were stumped; they hadn't received any training on the subject.

Akol sighed: "We have a whole generation of counselors and project managers who know about HIV but not how it's linked to family planning."

'ADDING POVERTY TO POVERTY'

At a hospital in Busia, a sleepy town in the green hills of eastern Uganda, Agnes Lojjo, a matronly health worker, sat with a handful of pregnant women one recent morning and asked how many were practicing family planning.

Fewer than half the hands went up. One woman in her 30s, wearing a man's oxford shirt and a colorful wrap around her head, said that a mother who used birth control would bear a deformed child.

Lojjo cocked her head and shot the woman a disapproving look.

"Everyone just has children without thinking," she said afterward. "It's adding poverty to poverty."

In the nearby village of Sirakano, as roosters clucked and the acrid smoke of a charcoal cooking fire wafted from a hut, Beatrice Adongo seemed to be staggering under the weight of her family.

Adongo, who has short hair and serious, wide-set eyes, had her first child at 17 and spent the next three decades in a near-constant state of fertility, barely pausing between weaning one baby and conceiving the next.

Now 46, she has 10 children — three didn't survive infancy — and their one and a half acres can't sustain all of them. She and her husband recently began renting part of a neighboring plot, but two of their children were sent home from school recently because they couldn't come up with a few pounds of maize and grains to pay their tuition.

The family gets by thanks to the eldest child, 29-year-old Frederick, who works as a security guard in the capital. His monthly salary, barely $50, also has to help feed his wife and 2-year-old, however, who live on the family plot in Sirakano.

"This one must learn from me and produce fewer (babies)," Adongo said, pointing her chin at her daughter-in-law, who smiled nervously. "We don't have enough land."

Much of Uganda is starting to suffocate. Public school classrooms that were built for about 40 students often burst with 100 or more. Large families are dividing their farmland into smaller and smaller parcels for their children, running afoul of neighbors and triggering a growing number of land disputes in local courts.

"Population growth undermines everything we're trying to do here, all our development efforts as well as political stability," a senior American official in Uganda said. "The economy isn't going to have enough jobs for all the people we're saving through PEPFAR."

'IT'S NOT TOO LATE

When Congress reauthorized PEPFAR in July 2008, to the tune of $48 billion over five years, religious groups such as the U.S. Conference of Catholic Bishops fought to keep the family-planning restrictions.

Conservatives equated birth control with abortion, U.S. officials said, even though aid agencies are prohibited from spending federal money on abortions, and the procedure is illegal in much of Africa.

"Nobody is saying we shouldn't be putting money into HIV, but there was little done to mitigate the effects on the other health priorities," said the former U.S. health official, who served in the Bush administration U.S. Agency for International Development, which administers most American foreign aid.

President Barack Obama has begun to roll back some of the restrictions. In a sharp turnaround, the administration has called family planning "an important component of the preventive-care package of services" for HIV patients.

In March, Congress raised global family-planning funding by 18 percent, to $545 million, the first substantial increase after more than a decade of stagnation. The Obama administration has called for another 9 percent hike in 2010 and issued guidelines encouraging PEPFAR-funded agencies for the first time to link family-planning services with the anti-AIDS effort.

Ugandan officials said that with additional support they could educate more men and women about the need to keep their families to manageable sizes.

In 2004, after she delivered her third child in Busia, Catherine Naka began taking contraceptive shots over her husband's objections, calling a local health worker to her home while he was at work. A year ago, though, her husband found her hospital card, with the injection dates ticked off in ink, and ordered her to stop.

On a recent afternoon, with her fourth child nearly due, Naka, 29, sat in a bare concrete room in the Busia hospital, looking fraught. She was worried about feeding her family with her husband struggling for work and their patch of farmland threatened by drought.

"Can you help me?" she pleaded with a health worker.

Akol finds a glimmer of hope in stories such as these. "For many families, it's too late," she said, "but for many others, it's not too late."

Source: http://therealnews.com/t2/index.php?option=com_content&task=view&id=31&Itemid=74&jumival=4912&updaterx=2010-03-16+07%3A32%3A03

 

News Article: Uganda to benefit from sh21b project

Uganda to benefit from sh21b project
Friday, 20th November, 2009    
New Vision (Uganda)
By Raymond Baguma and Irene Nabusoba

UGANDA is among the nine developing countries in Africa and Asia that will benefit from a $12m (over sh21b) family planning and women’s reproductive health project.

The project was launched by the Johns Hopkins Bloomberg School of Public Health, in collaboration with the David and Lucile Packard Foundation, USAID and Bill & Melinda Gates Foundation.

The development was announced at the end of a three-day international family planning conference that attracted over 1,300 researchers and academicians at the Speke Resort, Munyonyo on Wednesday.

The other beneficiaries are: Ethiopia, Kenya, Senegal, Nigeria, Tanzania, India, Pakistan and Indonesia. Funding will be done on a country-to-country basis.

The three-year project will assist developing countries achieve universal access to reproductive health facilities and revitalise family planning programmes by increasing funding and improving policy commitment at local, national and global levels. This will be done by urging governments, donors and multilateral agencies to invest in family planning to reach 200 million women.

Dr. Michael Klag, the Dean of the Johns Hopkins Bloomberg School of Public Health, told journalists at a press conference that the collaborative effort was part of a long-term commitment to improving women’s health in developing countries.

The project will be implemented by Bloomberg School, Partners in Population and Development (PPD), the African Women’s Development Fund and the Future’s Group International. They will work with USAID, other bilateral donors, international and local non-governmental organisations and the private sector.

The project will establish a network on reproductive health for African women to reduce maternal mortality.

Source: http://www.newvision.co.ug/D/8/13/701822

 

News Article: Revival of Family Planning, Reproductive Health On the Horizon

Ghana:  Revival of Family Planning, Reproductive Health On the Horizon
Public Agenda (Accra)
19 November 2020

A collaborative effort to launch a project to revitalize the family planning and reproductive health global agenda was announced on Wednesday in Kampala by the Johns Hopkins Bloomberg School of Public Health, with support from the David and Lucile Packard Foundation, the U.S. Agency for International Development (USAID), and the Bill & Melinda Gates Foundation.

The goal of the three-year project is to empower developing countries to advocate for universal access to reproductive health as a critical component in achieving the Millennium Development Goals (MDGs) in health through increased funding, an improved policy environment, and increased visibility for family planning at the local, national, and global levels.

Supported by both the Bill & Melinda Gates and the David and Lucile Packard Foundations with combined grants totaling $12 million, the project will reach governments, international donors, and multilateral agencies about the urgent need to invest in family planning to reach the 200 million women who wish to delay or end childbearing, but do not have access to family planning services and supplies.

"The Bloomberg School of Public Health is proud to be a part of this collaborative effort as we continue on our long-term path and commitment to improving the health and well-being of women throughout the developing world," said Michael J. Klag, MD, MPH, Dean of the Johns Hopkins Bloomberg School of Public Health.

As stated by William H. Gates, Sr., Co-Chair, Bill & Melinda Gates Foundation, in his welcome remarks at the International Conference on Family Planning: Research and Best Practices conference in Kampala on November 15th, "Bill, Melinda, and I believe that universal access to family planning and reproductive health is essential to a better future. Men and women should be able to freely choose the number and timing of their children."

The project will build on past investments in family planning and ongoing activities in reproductive health advocacy, leadership development, knowledge generation, and innovative service delivery projects. The project's momentum will be fueled by the re-emergence of the United States and the continuing and growing interest of European donors in the issue of family planning.

"The success of this initiative will depend on strong leadership from local champions and political support for family planning,? noted Musimbi Kanyoro, director of the Population and Reproductive Health Program at the David and Lucile Packard Foundation. "We believe the initiative's focus on the global South could prove to be empowering for local communities in the South and also serve to transform the global conversation about family planning."

A unique aspect of the new evidence-based project is its emphasis on harnessing the voices of women and men in the global South to demand access to family planning and reproductive health services. The project will increase the volume of these voices from the South so they are heard at the local, national, regional, and global levels. It will also create platforms for advocates in the global South to network and organize, enabling organizations to more effectively collaborate and share best practices and lessons learned.

"The project is designed to create a sense of ownership about the importance of family planning among developing countries, especially in countries with the highest maternal and neonatal death rates as well as unmet need," said Jotham Musinguzi, the Director of the Kampala office in the Partners for Population and Development (PPD).

The project will be implemented in nine countries in sub-Saharan Africa and South Asia by a consortium of core partners, including the Johns Hopkins Bloomberg School of Public Health; Partners in Population and Development (PPD), an inter-governmental agency of 26 countries representing the voices for population and family planning from the South; the African Women's Development Fund based in Ghana; and the Future's Group International. The consortium will collaborate closely with USAID, other bilateral donors, international and local non-governmental organizations, and the private sector in advocating for increased political commitment and resources. Additionally, the project will work closely with USAID?s Repositioning Family Planning Initiative to draw on lessons learned and to potentially replicate and scale up successful initiatives.

"President Obama has demonstrated his support for family planning and reproductive health (FP/RH) by proposing the largest budget for FP/RH in USAID's history. He has also established family planning as a priority under the new Global Health Initiative which seeks to build strong partnerships at the country and international levels, said Dr. Scott Radloff, Director of the Office of Population and Reproductive Health. "This consortium is an excellent example of just such a partnership."

The project will also help establish a sustainable African Women for Reproductive Health Network to harness the energy, talents, and needs of women at the community level. In past decades, women have become change agents at the national and global levels.

"The women in the Network, like this consortium, understand that if we do not address the unmet need for family planning, the other global health goals of improving maternal, infant, and child deaths and combating infectious disease will be difficult to achieve by 2015," concluded Professor Duff Gillespie at Johns Hopkins Bloomberg School of Public Health.

Source: http://allafrica.com/stories/200911200826.html

 

News Article: US funding revamps African contraceptive drive

US funding revamps African contraceptive drive
By Ben Simon (AFP) – Nov 18, 2020

KAMPALA — A new 12 million dollar family planning drive launched here Wednesday highlights how Obama administration funding has revamped a contraception drive in Africa and developing states, UN officials said, noting a sharp turnaround from the Bush era.

The change in US policy was praised at a three-day conference on family planning in Kampala which launched the project to improve access to contraceptives for women in six African nations as well as Indonesia and Pakistan.

UN health workers said the drive spearheaded by the US Agency for International Development (USAID) and several partners might not have been possible under former US president George W.Bush.

In 2001, Bush re-activated the Mexico City Policy, which precluded the US from funding any international organisation that provides abortion services or counselling, including the United Nations Population Fund (UNFPA), a key player in promoting family planning in Africa.

In January, just days after he was sworn in, US President Barack Obama rescinded the policy.

Obama publicly distanced himself from Bush's approach in a January 23 speech that said the previous policy "undermined efforts to promote safe and effective voluntary family planning in the developing world".

"Certainly politics played its affect in development aid, but I think that what we can see now is the new administration going forward in an integrated way," said Janet Jackson of UNFPA, one of more than 1,000 health workers from 59 countries at the conference.

Uganda, Ethiopia, Nigeria, Senegal, Tanzania and Kenya will share in the 12-million dollar funding, but international organisations still have to persuade certain African governments that it is in their interest to curb population growth.

Public health experts said some, notably Rwanda and Malawi, have embraced the message, but the nation hosting the conference continues to provide mixed messages about fertility rates.

Ugandan women have 6.7 children each and the population is growing 3.2 percent per year, one of the highest rates in the world according to the Population Reference Bureau (PRB).

"This rapid population growth is contributing to the degradation of Uganda?s natural resources, the backbone of Uganda?s economy and household livelihoods," the PRB said in research released in June.

Some government officials, including the health and ethics ministers, have called on Ugandans to only produce the number of children they can afford, but President Yoweri Museveni has repeatedly urged Ugandans to have large families.

"I think other governments and other countries do look to the US for leadership in this area," said Scott Radloff, USAID's population and reproductive health director, adding that renewed American focus on the issue might help shape events across the continent.

Copyright © 2009 AFP. All rights reserved.

Source: http://www.google.com/hostednews/afp/article/ALeqM5iUUDgNP0hqKdi9eF3IcAklg4oVKw

 

News Article: Family Planning - Country Walks a Wobbly Path

Family Planning - Country Walks a Wobbly Path
New Vision (Uganda)
By Joel Ogwang
15 November 2020

Kampala — THAT Uganda loses 16 mothers to pregnancy and childbirth everyday is as strange as it is true. To put facts into perspective, this is an equivalent of losing a commuter taxi full of expectant mothers everyday.

"People will make 'noise' when a taxi kills the (expectant) women than when they die while delivering," says Charles Zirarema, the acting Population Secretariat director.

The daily loss translates to 6,000 women dying during or after delivery in Uganda annually. This is a maternal mortality ratio of 435 deaths per 100,000 live births.

According to Hassan Mohtashami, the United Nations Population Fund (UNFPA) deputy country representative, pregnancy is the most joyful time for a mother, the family and the community.

"But it is also very painful when the mother dies during delivery," he says.

Most of the heroines lose the 'battle' and succumb to death in ways that could be avoided if sexual and reproductive health information and services were universally available.

Sylvia Ssinabulya, the Woman MP for Mityana district, says it is the poorest couples that have least access to these amenities. Hence, about 41% of married women who want to postpone or delay child bearing cannot do so.

"This is because they have no access to Family Planning services."

This results from lack of sensitisation and inadequate supply of reproductive health commodities like contraceptives and condoms.

Ssinabulya says promotion of family planning would avert the 35% of all maternal deaths and 10% of childhood deaths in Uganda.

Formation of FPAU


To address the need of the time, the Family Planning Association of Uganda (FPAU) was born 51 years ago.

"But we needed to look at a human being in totality," says Elly Mugumya, the executive director of Reproductive Health Uganda (RHU).

However, with the rising cases of HIV/AIDS, gender, post and ante-natal issues, that were also related to reproductive health, FPAU was re-branded. This gave rise to the formation of RHU.

While family planning was misinterpreted as a 'woman- only' business, limited to child spacing, reproductive health cuts across all ages and sex.

The common global family planning methods include female sterilisation, contraceptive pills, injectable contraceptives, barrier methods like condoms and cervical caps, vasectomy, implants, intrauterine devices and contraceptive jells.

In Uganda, injectables, pills and condoms are widely used because they are relatively cheap, accessible and easy to use.

Reproductive health has increased access to reproductive services and safe sex practices as young people access condoms and other birth control services.

As a result, teenage pregnancy has dropped from 43% in 1995 to 25% in 2005. Voluntary HIV/AIDS counselling and testing has also increased.

Challenge of reducing maternal mortality

During the UN Millennium Summit in September 2000, 147 heads of state and governments met and drew Millennium Development Goals (MDGs) actions and targets contained in the Millennium Declaration adopted by 189 nations.

The MDGs are eight goals to be achieved by 2015, responding to the world's main development challenges.

These include:
Goal 1: Eradicate extreme poverty and hunger
Goal 2: Achieve universal primary education
Goal 3: Promote gender equality and empower women
Goal 4: Reduce child mortality
Goal 5: Improve maternal health
Goal 6: Combat HIV/AIDS, malaria and other diseases
Goal 7: Ensure environmental sustainability
Goal 8: Develop a global partnership for development.

In line with reducing Goals 4 and 5 of reducing by two thirds the mortality rate among children under five and reduce by three quarters the maternal mortality ratio, Uganda still faces hurdles that threaten to cripple its ambition by 2015.

According to Rukia Chekamondo, the finance state minister in charge of privatisation, the country is still below the targets and may not achieve the MDGs.

This is in spite of the tremendous efforts made on achieving Goal 2.

Chekamondo notes that results showed increase in new HIV infections with the burden of treatment and care in most developing countries, including Uganda.

"Young people remain vulnerable to sexual and reproductive health conditions, including teenage pregnancy," she says.

UNFPA's Mohtashami called for the prevention of pregnancy before 18 years and after 35 years as this increases incidences of maternal mortality.

"There should be a minimum of three years between two pregnancies," he says.

"The less the number of pregnancies a woman has, the less the risk of dying in childbirth."

Dr. Jotham Musinguzi, the former Pop-sec director, says Uganda and indeed other African states' failure to achieve Goals 4 and 5 stem from underfunding of reproductive health.

For example, under the Abuja Declaration, 2001, African states set a target of allocating at least 15% of the total national annual budgets to the health sector to achieve universal coverage of reproductive health services by 2015.

Musinguzi, now the regional director of Partners in Population and Development Africa regional office, says this largely remains a paper work.

"African governments need to follow up their pledges with financial commitments," he says.

Currently, Tanzania has the highest budgetary funding (11%) towards the health sector in East Africa, followed by Uganda (10.8%) and Kenya (9%). The other challenge to Uganda in achieving the MDGs is the high population growth rate.

Demographic figures


At a 3.2% growth rate and a fertility rate of seven children per woman, Uganda has one of the world's fastest population growth rates. The population has increased from 23.5m in 2000 to 27.6m in 2005 and is expected to reach 32.9m in 2010. It is estimated that the population increases by 1.2m annually.

By 2020, Uganda's population is projected to rise to 46.6m and to hit 54.8m come 2025. Currently, the population is estimated at about 31 million people.

It is also estimated that a quarter of Uganda's female teenagers have already had children, leading to early marriage, school drop-out and high maternal mortality.

Experts have expressed concern over Uganda's increasing population, warning that this will stunt gains of economic growth and development.

"We have to ensure that the population grows at a rate equal to the available resources," says Zirarema.

Unmet family planning need

A woman has unmet need for family planning if she says she prefers to avoid a pregnancy, wanting to either wait for at least two years before having another child, or stop child bearing altogether, but is not using any contraceptive method.

Unmet need for family planning in Uganda accounts for 41%, costing the country a whooping $101m annually, according to the UNFPA.

This is a drop from 52% in 1989. While the figure reduced to 29% in 1995; it rose to 35% in 2001 and 41% in 2006.

The percentage of women using family planning rose from 23% in 1995 to 24% 2006.

While 41% of married women don't want to have more children, 35% want to wait for two or more years before the next birth and about 16% want to have children in two years.

Janet Jackson, the country representative of UNFPA, says investing in reproductive health commodities not only promotes the health of mothers and babies, but also saves money and ensures healthy men, she says.

This would benefit the poorest women and regions in shrinking the health gap between the rich and poor, while fast-tracking the MDG targets.

"For every dollar spent on a family planning commodity, it saves nearly about $3 on maternal and newborn care," she says.

Therefore, while thinking about the future, Jackson says, there is an urgent need that must be catered for to curtail maternal mortality and meet the MDGs.

It is worth noting that Goals 4 and 5 are key to achieving all the MDGs since a health birth reduces and eliminates unnecessary expenses on medication and ensures continuity of education which is a key component in fighting poverty.

Source: http://allafrica.com/stories/200911161265.html

 

News Article: Uganda to host family planning conference

Uganda to host family planning conference
Health& Living, The Observer (Uganda)
Written by Simon Musasizi  
Wednesday, 11 November 2020 18:22

Over 1500 health professionals and policy makers from all over the world are expected in Kampala for a four day International Conference on Family Planning starting November 15 to November 18, at Speke Resort  Munyonyo.

The conference organised by the Gates Institute at the Johns Hopkins School of Public Health and Makerere University’s School of Public Health alongside Partners in Population and Development (PPD) Africa Regional Office, will provide platform to different players to share their best research and practices, which will be transformed into action to expand access to family planning services, an explicit target of the Millennium Development Goal 5 (Improve Maternal Health).

“We believe this conference will provide a lot of social capital for the advocacy of family planning, safe motherhood, child survival as well as increasing government commitment and funding to activities that will bring about the changes that we desire to see in policy and programmes,” said Dr. Jotham Musinguzi, the Director PPD.

Musinguzi told journalists at a one day briefing session at the Population Secretariat (PopSec) on Statistics House that the conference in Kampala is a follow up on 1994 International Conference on Population and Development Programme of Action (ICPD PoA) in Cairo, Egypt where 179 nations committed themselves to among others to reduce maternal mortality and to ensure universal access to reproductive health care including family planning, assisted childbirth and prevention of sexually transmitted infections by the year 2015.

All these goals were later included in the targets and indicators of the Millennium Development Goals (MDGs), mainly MDG 5, which is to improve maternal health. It is 15 years since the ICPD programme action was developed, which will subsequently be followed by the 10th anniversary of the MDGs in 2010.

Approximately 204 million women worldwide have an unmet need for family planning services, contraceptive prevalence rates are low in many developing countries and access to male and even more so to female condoms is difficult and often unaffordable.

In Uganda for example, the unmet need for family planning has over the years grown from 34% to 41%. This has had great impact on the country’s population growth, which is now ranked third among the world’s highest growing populations -with a growth rate of 3.2%.

According to statistics by Population Secretariat, Uganda’s population as of June 2009 is estimated to be 31 million people, 6.6 million people higher than 24.4 million people that the country had in 2002.
Much of this population growth is in the rural areas where over 80% of the population lives with 68% engaged in subsistence farming and some times producing what is not enough for consumption.

“We have a population of poor people. People who cannot afford Shs 1,000 everyday,” said Hannington Burunde, the Head of Communication and Information at PopSec.

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Source: http://www.observer.ug/index.php?option=com_content&view=article&id=5920:uganda-to-host-family-planning-conference&catid=58:health-living&Itemid=8

 

News Article: Mallinga Urges Commitment and Support in the Health Sector

 

News Article: Minister Mallinga Wants Health Funding Increase By Five Per Cent

Uganda: Minister Mallinga Wants Health Funding Increase By Five Per Cent
22 September 2020
Monitor (Uganda)
By Evelyn Lirri

Health Minister Stephen Mallinga has urged Members of Parliament to push for an increase in the health budget to meet the 15 per cent target that Uganda agreed to in Abuja in 2001. Currently Uganda spends only 10 per cent (Shs784 billion) of its total national budget on health.

Speaking at a regional meeting for parliamentary committees on health, drawn from east and southern Africa in Kampala yesterday, Dr Mallinga said having the budget increased to 15 per cent will address challenges facing the health sector like frequent stock out of essential medicines in hospitals. "We have increased the health budget to 10 per cent. We are appealing to MPs to increase it to 15 per cent to enable us meet most of our obligations to the population in health service provision," Dr Mallinga said.

The Abuja Declaration of 2001 commits African countries to allocate at least 15 per cent of their national budgets excluding donor contributions to the health sector. According to Dr Mallinga, legislators can use their role of appropriating budgets to change the policy environment and improve reproductive health.

"Parliamentarians are key stakeholders who can, through their roles, remove legal and administrative barriers to access high quality health services by influencing resource allocation and ensuring clear budget lines and expenditures on health," he added.

Dr Jotham Musinguzi, the regional director for Partners in Population and Development, said of all African countries, only Malawi has reached the 15 per cent target on health spending.

Source: http://allafrica.com/stories/200909220251.html

 

News Article: Uganda fails to meet health targets

Uganda fails to meet health targets
Monday, 21st September, 2009
New Vision (Uganda)
By Joyce Namutebi

UGANDA and other sub-Saharan African countries, except Malawi, have not yet reached the agreed target of devoting at least 15% of their national budgets to health, the health minister has said.

Steven Mallinga appealed to Parliament to increase the health budget to 15% to enable the ministry meet its obligations.

His appeal was backed by Dr. Jotham Musinguzi, the regional director of Partners in Population and Development Africa Region Office (PPD ARO).

Mallinga and Musinguzi told the regional meeting of parliamentary committees on Health in Eastern and Southern Africa at the Commonwealth Resort Munyonyo yesterday that African leaders must fulfil their commitments.

“Our Heads of State and health ministers in the Abuja Declaration in 2001 pledged to devote at least 15% of the national budgets to health, a pledge, which has remained a major challenge,” Musinguzi noted.

“Our countries have good and clear policy frameworks, but the overriding problem is lack of political will and commitment to support the implementation of these good policies.”

Musinguzi explained that Uganda was allocating only 10% to health, Kenya 9% and Tanzania 11%.

Source: http://www.newvision.co.ug/D/8/13/695361

 

News Article: Over sh222b lost to poor family planning

Over sh222b lost to poor family planning
Wednesday, 2nd September, 2009
The New Vision (Uganda)
By Joel Ogwang

UGANDA loses over sh222.2b annually due to people who do not receive family planning services, Janet Jackson, the United Nations Population Fund Country representative, has revealed.

Currently, the number of people who do not receive family planning services stands at 41%.

She said investing in reproductive health and family planning not only promotes the health of mothers and babies but it also saves money and ensures healthy people.

Jackson said this would benefit the poorest women and regions in reducing the gap in health status between the rich and poor.

She added that it would also fast-track the realisation of the Millennium Development Goals targets.

'Every dollar spent on family planning saves nearly about $3 on maternal and newborn care. Therefore, while thinking about the future, there is also the immediate need that must be catered for,' she said.

Jackson was speaking during the Eastern Africa Reproductive Health Network meeting on reproductive health commodity security at the Golf Course Hotel in Kampala on Friday.

The summit was a follow-up to review and evaluate the commitments made in 2008 in Kampala.

Rosemary Sseninde, the parliamentary social services chief, said Uganda loses about 6, 000 annually due to pregnancy related complications resulting from lack of family planning services.

'Many more women become pregnant with pregnancies they didn't want or plan and which contraceptives could have prevented,' she said in a speech read by Sylvia Ssenabulya, an MP.

Jotham Musinguzi, the Partners in Population and Development (PPD) Africa regional director, noted that Africa's population had increased from 215 million in 1950 to one billion in 2009 and would rise to over two billions by 2050.

This subsequently represents an increase in global population share from 9% to 15% and 22%, respectively over 100years.

'In spite of this rapid population increase, many African states have invested adequate funds to meet the growth. Few countries that are signatory to Abuja declaration meet the 15% national budgetary declaration in the health sector,' he said.

Apparently, Tanzania leads investment in the east African region with 11%, followed by Uganda (10.8%) while that of Kenya dropped from 9% to 5% in the health sectors, respectively.

Musinguzi said Uganda's population had increased from 23.5million in 2000 to 27.6m in 2005 and expected to reach 32.9m in 2010.

Source: http://www.newvision.co.ug/D/8/13/693192

 

News Article: Kenya reports shortage of contraceptives

Kenya reports shortage of contraceptives
By Catherine Karong’o
Kapital News, Kenya
4 August 2020

NAIROBI, Kenya, Aug 3 - Kenya is faced with a shortage of contraceptives due to over reliance on donors, according to Family Health Options, the government agency that deals with family planning.

Director of Programs Muraguri Muchira said on Monday that injectables which were the most common method of contraception in Kenya were currently not readily available and said this was part of a major stock-out in the country.

“We don’t have enough of them in the government supplies or even the Non Governmental Organisations. In our (Family Health Options) case, we are sometimes forced to buy from the private sector which is very expensive and we can’t afford to buy enough quantities to meet the demands,” Mr Muchira said.

He added that this constant commodity insecurity where the family planning methods are not readily available had led to 25 percent of Kenyan women lacking the service.

“The biggest challenge we have as a country is the sourcing of contraceptives. Kenya depends highly on development partners and each one of them brings their supplies in their own different channels. So it’s very difficult to know how much is being brought in the country at any one time. And as far as I know nobody has come up with a solution,” he said.

Mr Muchira said that Family Health Options got over 90 percent of its contraceptives from the Kenya Medical Supplies Agency (KEMSA) and revealed that a series of meetings had been ongoing to solve the problem.

Kenya mainly gets its contraceptives from the United Nations Population Fund (UNFPA), UK’s Department for International Development (DFID) and the German government.

“There isn’t one coordinating committee or agency or unit. So it’s very difficult to know how much is being brought into the country at any one time. We do not want to have a huge supply of condoms for example when we don’t have other contraceptives like the pills,” he said.

Medical Services Minister Professor Anyang' Nyong'o said that the contraceptive insecurity was to blame for the increased use of herbal alternatives that were harmful to health.

“If our women don’t have access to contraceptives, then they will result to these herbalists who then give them what seems to be cheap but what in the final analysis is very expensive to their health,” Professor Nyong’o said.

“This is a health disaster. What it tells us is not to just deal with those herbalists but to take a much more preventive measure to make the contraceptives available to the women,” he added.

He said the government had appealed for more support on reproductive health from donor partners.

“But also let us not forget that a lot of it has to do with awareness and education to intensify reproductive health education from primary schools,” he said.

Partners in Population and Development Executive Director Harry Jooseery noted that in the last ten years, investment in family planning in most developing countries had fallen from 55 percent to about seven percent.

“Family planning has lost focus amidst shifts in international health and development priorities. It is estimated that 137 million women who want to avoid a pregnancy are not using any Family Planning Methods,” he said.

In Kenya 45 percent of women have unwanted pregnancies annually.

Source: http://www.capitalfm.co.ke/news/Local/Kenya-reports-shortage-of-contraceptives-5372.html

 

News Article: Shortage of contraceptives looms

Shortage of contraceptives looms
By Mike Mwaniki
Daily Nation Kenya
Posted Monday, August 3 2009 at 22:30

A warning was sounded on Monday over a looming shortage of family planning medicines for women.

Speaking in Nairobi, health practitioner Muraguri Muchira blamed the shortage on low budgetary allocation from the Treasury and poor sourcing by the Kenya Medical Supplies Agency.

Following the shortage, Mr Muchira, who is the Family Health Options Kenya director of programmes, said the number of women with an unmet need for family planning had risen.

Partners in Population and Development executive director Harry Jooseery said lack of family planning devices aggravates the situation in sub-Saharan Africa, which has the highest fertility rate in the world with five to six births for each woman.

Modern methods
“Only 18 per cent of married women in sub-Saharan Africa are using modern family planning methods with 35 million women in the region having an unmet need for family planning.

“The percentage of unintended pregnancies in Kenya stands at 45 compared to Lesotho with 50, Uganda 46, Ghana 40 while one in every three births is unintended in Congo, Ethiopia, Senegal and Zimbabwe,” Mr Jooseery said.

The official said about five million abortions were procured in the region annually, 98 per cent of which are illegal, clandestine and unsafe.

The policy dialogue meeting on reproductive health and HIV and Aids issues was opened by Medical Services minister Anyang’ Nyong’o at Hilton Hotel.

Maternal mortality
The three-day meeting assembles Afro-Arab parliamentarians from Benin, the Gambia, Ghana, Kenya, Mali, Morocco, Senegal, South Africa, Tanzania, Tunisia, Uganda, Yemen and Zimbabwe.

Prof Nyong’o said Kenya faced a major challenge, especially regarding the reduction of maternal mortality. The minister was pessimistic that Kenya would meet most of the Millennium Development Goals by 2015.

Source: http://www.nation.co.ke/News/-/1056/634380/-/ulkh5n/-/

 

News Article: Experts laud China's family planning policy

www.chinaview.cn 2020-11-26 20:16:13 Print
by Ronald Ssekandi

KAMPALA, Nov. 26 (Xinhua) -- Population experts have lauded China's module on family planning to reduce the burden the population growth is exerting on the global resources and better development of human beings.

The experts from over 20 countries are attending a two-day international forum early this week to review the progress and prospects of the action plan adopted at the International Conference on Population and Development held in Egypt, in 1994.

Harry Jooseery, executive director of Partners in Population and Development (PPD), an intergovernmental organization that brings together 23 developing countries, told Xinhua that developing countries, especially the ones in sub-Saharan Africa, need to adopt the Chinese module while putting into consideration of their own environment and conditions.

Jooseery said that some African countries like Rwanda are already planning to adopt the Chinese module as population growth is negatively affecting the quality of life of their citizens.

Sara Seims, chair of the Development Committee of the Population Association of America and a member of UNESCO's Global Advisory Group on HIV and Sex Education, also urged developing countries to adopt deliberate family planning polices as China did if they are to reduce the effects of rapid population growth.

"The rapid population growth is going to worsen the food crisis. The more mouths you have to feed the harder it is to feed them," she said.

Prof. Haryono Suyono, Indonesia's former minister for population and minister for people welfare, said that because Indonesia adopted a similar policy, it has had less negative effects of rapid population growth.

China's family planning policy, which promotes most couples having only one child, was introduced by the Chinese government in 1979 to alleviate social, economic, and environmental pressure on the Asian country.

"After over 30 years' endeavor, China has created two wonders, rapid economic development and holistic human development, and a uniquely Chinese path of addressing population issues with comprehensive approaches," said Li Bin, China's minister of National Population and Family Planning Commission and the current chair of the PPD.

Li said that population issues were never closely related to the development as such under the context of current global financial crisis and slowdown of world economic growth, along with energy, environmental and food crises.

"As the most populous country in the world, China's proper handling of its population development is a remarkable contribution to the stability of global population," she said.

Over years, China has reduced total fertility rate from 5.8 in 1970 to around 1.8 currently, transforming its population reproduction pattern, while average life expectancy has reached 73 among many other improved indicators. Studies have shown that China, Thailand, Singapore and Indonesia, which had each of its economy take off within just few decades, benefited from checking their population growth which led to good health services, better education and consequently a much more productive workforce.

"Development economists now say that up to 40 percent of the economic growth experienced by China and Korea came through reducing the rate of population growth," Seims revealed.

China, however, still faces severe challenges ahead with its population rising at a speed of 8 to 10 million people per year within the next decade accompanied with notable birth defect rate, gender gap and an aging population, posing a grave outlook on the population development. Though facing tough tasks, China is always ready for extensive and in-depth cooperation with PPD member countries in population, family planning and reproductive health on the basis of equality and mutual benefit, the Chinese minister assured the member countries.

Editor: Zheng E

Source: http://news.xinhuanet.com/english/2008-11/26/content_10416899.htm

 

News Article: Interview: Expert says population explosion fueling brunt of global crises on developing countries

www.chinaview.cn 2020-11-26 01:46:58 Print
Special Report: Global Financial Crisis

KAMPALA, Nov. 25 (Xinhua) -- Developing countries risk suffering more from the effects of the current global financial crises because of the rapid population growth they are experiencing, an expert here has warned.

Sara Seims, chair of the Development Committee of the Population Association of America and a member of UNESCO's Global Advisory Group on HIV and Sex Education, told Xinhua in an interview on Tuesday that governments need to urgently address the rapid population growth.

"The rapid population growth is going to worsen the food crisis. The more mouths you have to feed the harder it is to feed them," she said while attending a two-day international forum on population and development that opened here on Monday.

The forum was organized by the Partners in Population and Development, an inter-governmental organization, which brought together 23 developing countries.

Seims cited the case of Ethiopia where the government provides food to 3 million people who face starvation as 2 to 3 million Ethiopia babies are born annually, which makes it hard to break the starvation cycle.

She further warned that whereas Africa is not the major emitter of greenhouse gases, it will suffer most from the effects of climate change.

"If you have a very rapidly growing population and you are experiencing the effects of climate change, it is going to be harder for you to ensure the health of your citizens, enough food and enough education for them," she said.

Seims also dismissed advocacy by some African leaders who have called for rapid population growth to provide the continent with a huge market.

Studies have shown that China, Thailand, Singapore and Indonesia are able to economically develop because they check their population growth which has led to good health services, better education and a much more productive workforce, according to her.

Seims called on developing countries to adopt deliberate family planning polices if they are to reduce the effects of population explosion.

Editor: Sun

Source: http://news.xinhuanet.com/english/2008-11/26/content_10412412.htm

 

News Brief: Mrs. Museveni meets population experts

The New Vision (Kampala)

Wednesday, 26th November, 2008


Mrs. Janet Museveni (left) confers with Dr. Nafis Sadik and Prof. Haryono, who were given awards for promoting population awareness by the Partners in Population Development International. This was at a dinner in Imperial Royale Hotel in Kampala on Monday.

 

Opinion Article: Population legislation vital for development

Population legislation vital for development

Publication date: Monday, 24th November, 2008

The New Vision (Uganda)

By Jotham Musinguzi

The year 2009 marks the 15th anniversary of the International Conference on Population and Development (ICPD). While very few people know the acronym, much less the goals and outcomes of this United Nations conference held in Cairo, Egypt in 1994, most people, particularly those in developing countries, have benefitted from the agreement of 179 countries (including Uganda) to the ICPD programme of action.

The ICPD programme of action has been an essential scale for countries’ population legislation and policy and has proved critical to the global improvement of sexual and reproductive health and rights and gender equality.

The population conference was groundbreaking in its introduction of a new human rights-based approach to population and development — the links between women’s status, reproductive health, environmental destruction, poverty, and social and economic development were first recognised by the global community at the ICPD. The principal goal of the ICPD — universal access to reproductive health services by 2015 — is reinforced in the Maputo Plan of Action, which agreed that poor sexual and reproductive health is a leading killer in Africa. The Maputo Plan was later ratified by African heads of state.

In Uganda, infant mortality fell from 122 deaths per 1,000 live births in 1989 to the current rate of 76 deaths per 1,000 live births. In 1995, the use of modern contraceptive methods among married women in Uganda was 7.8%, this has now increased to 17.9%. And due to the strong partnership between the Government, civil society and international organisations, more people have access to reproductive health information and services to help them fulfill their decisions on the number and spacing of their children and to protect themselves from sexually transmitted infections such as HIV/AIDS.

We should congratulate ourselves on these changes while recognising that Uganda, like most developing countries, requires much more progress on these sexual and reproductive health and rights indicators. Global progress has, in part, been hampered by underfunding and the effects of the HIV/AIDS epidemic.

Despite progress on many of the Millennium Development Goals (MDGs), less than a 10th of the distance to be covered to meet the MDG 5 of reducing maternal mortality globally has been met.

This MDG on maternal health is unlikely to be met, particularly in sub-Saharan Africa, without concerted efforts. A woman’s lifetime risk of dying from pregnancy or childbirth in sub-Saharan Africa is one in 16 while the risk in developed countries is only about one in 3,800. Maternal health is, therefore, an issue of great concern.

In Uganda alone, approximately 6,000 women die every year due to pregnancy complications. Women bleed to death, they do not have access to antibiotics to prevent simple infections; they often do not have the option of a caesarean section when it is necessary. It is a tragedy that women continue to die when maternal deaths and injuries are preventable when women have access to prenatal care, skilled attendance at births, and emergency obstetric care.

This means that Africans, must not only acknowledge our accomplishments in reproductive health, but we must take responsibility and work to address areas of greatest need. We can do this by sharing our experiences and good practices through South-South cooperation and learning from the successes of our brothers and sisters in other developing countries.

We need to look at example from countries like Malaysia, Thailand, South Africa and Sri Lanka, who have successfully lowered their rates of maternal ill-health through sustained financial and political commitment. Sri Lanka’s long-term commitment to safe motherhood services has, over four decades, decreased maternal mortality more than twenty-fold, from 486 maternal deaths per 100,000 livebirths to 24 per 100,000.

This shows that with effort and resources, large-scale improvements in public health are achievable, a lesson that we need to take seriously. South-South collaboration is a workable model for developing countries to partner and learn from each other as we all strive towards the attainment of the common ICPD goals and MDGs.

Reproductive health and rights play an essential role in the development of our countries. Yet, these critical development issues have not received the importance and priority they deserve, despite their centrality to poverty eradication.

Enhancing individual reproductive health and rights enables governments to achieve their population goals—such as preventing unplanned pregnancies and slowing population growth—and provides the necessary conditions for economic and social development. Improving the overall well-being of populations also improves the development prospects of our countries.

As representatives from 25 developing countries gather this week in Kampala at the International Forum on “ICPD @ 15: Progress and Prospects,” hosted by Partners in Population and Development, to review progress and agree to an agenda for how to move the ICPD programme of action forward.

As we come to the 15th anniversary of the conference in 2009, we must remain focused on the most vulnerable and overlooked populations and issues to ensure that a just, equitable, and sustainable development is the one we bring about. Ensuring sexual and reproductive health and rights is not only a moral imperative, it is economically sound. Economic and social development can only happen with a healthy and educated population.

We need donors and our governments to allocate sufficient resources, financial and otherwise, to support sexual and reproductive health and rights to fight poverty in our countries.

We must activate civil society to hold donors and governments accountable for the promises they have made. We must remain committed and vigilant, and demand that policies are in place and funds are allocated and expended in line with the commitments our leaders have made.

We must not relent on these efforts until women and their families in developing countries no longer fear marriage and pregnancy because of the high likelihood of death, illness and disability for themselves and their children.

We want to watch our sisters, wives and daughters experience the birth of their children as sources of joy, not as the cause of suffering and untimely death.

The writer is the Regional Director, Partners in Population and Development Africa Regional Office

This article can be found on-line at:http://www.newvision.co.ug/D/8/459/661115


 

News Article Prioritize maternal healthcare, First Lady tells policy makers

Prioritise maternal healthcare, First Lady tells policy makers

Publication date: Monday, 24th November, 2008

The New Vision (Uganda)

By Anthony Bugembe

LEADERS and policy makers from developing countries should address the high maternal and infant mortality rates.

This, according to the First Lady, Janet Museveni, will help to achieve sustainable development as the causes of the mortality are largely preventable.

“We cannot just sit back and watch as our women continue to die during pregnancy and child birth,” said the First Lady.

Mrs. Museveni was yesterday opening an international forum on population and development at the Imperial Royale Hotel that attracted political leaders and experts from 24 developing countries.

The health minister, Dr. Stephen Mallinga, decried Uganda’s poor progress on most health and social indicators.

“We still have a low contraceptive prevalence rate at 24%, low supervised deliveries at only 39%, high infant and maternal mortality at 76 and 435 respectively.”

“Although we have considerably reduced HIV prevalence to 6.4%, HIV/AIDS remains an epidemic in our country,” he said.

Mrs. Museveni said that Ugandan women continue to face risks during pregnancy and child birth.

“Uganda loses 6,000 women per year during pregnancy and child birth. These poor and powerless women continue to die, year in year out, most of them in remote villages.”

“For every woman who dies in pregnancy and child birth, six others survive but with chronic debilitating injuries and ill-health,” she said.

Mallinga noted: “As countries of the south, we need to realise that we have somewhat similar backgrounds. We should act in concert to promote a common health agenda.”

The theme for the conference is, ‘ICPD@15: Progress and prospects’. It is reviewing the progress of the International Conference on Population and Development (ICPD) held in 1994 in Cairo, Egypt.

“While we need to find new champions for family planning and promote greater resource mobilisation for reproductive health programmes, we need perhaps more importantly to re-inforce political commiments and promote good governance,” said Harry Jooseery, executive director, Partners in Population and Development (PPD).

Besides Reproductive health, the conference will address new concerns like food crisis and human security, climate change and environmental degradation and review the south-to-south cooperation as a modality of change.

Jotham Musinguzi, the PPD chief for Africa, said governments pledged at the 2000 Abuja declarationto commit 15% of national budgets towards health.

This article can be found on-line at:http://www.newvision.co.ug/D/8/13/661183

 

News Article: Uganda Government News: Uganda to host population and development conference

First published: 20081122 7:11:32 AM EST
Uganda news...
Ultimate Media

The government of Uganda has been urged to ensure it has a quality population other than focusing on having more numbers of people.

Harry Joseery, the Director of Partners in Population and Development says the quality of the population is more important than the numbers, if Ugandan is to ensure a healthy and prosperous life for its people.

President Museveni has been insisting that Uganda needs a big population in order to have more labour and market. But Joseery says the country should focus on having a population that provides quality labour, and a population that has the capacity to purchase goods and services. He says this means that you have a trained and relevantly skilled population that is also wealthy.

Joseery was speaking in Kampala to announce an international conference on population and development which will be hosted by Uganda in Kampala.

He says the conference will attract public servants and development practitioners from different countries to chart ways of ensuring better life for their citizens.

Joseery says the conference in aimed at teaching governments how to ensure they have a healthy and prosperous population. He says the conference will also focus on ways of making reproductive health a reality for all Ugandan women and children.

Source: http://www.ugpulse.com

 

News Article: Uganda-Population-Forum

Agence de Presse Africaine - Article, 26-11-2020

Ugandan leader reiterates commitment to promote commercial agriculture

APA-Kampala (Uganda) Ugandan President President Museveni on Tuesday told a delegation of ministers of Partners in Population and Development led by their chairperson Dr. Li Bin who paid a courtesy call on him on Tuesday evening at State House in Kampala that his government was committed to promoting commercial agriculture in order to liberate the people of Uganda from poverty.

According to a from State House press release on Wednesday, Partners in Population and Development, that has just concluded a three day international forum in Kampala, was initiated to expand and strengthen the South-South collaboration between the developing countries in the area of reproductive health, population and development.

President Museveni further informed the delegation that the government introduced universal primary and secondary education in a bid to build the human resource that is employable.

The leader of the delegation, Dr. Li who is also the minister of National Population and Family Planning Commission in China commended President Museveni for the stability and security now prevailing in Uganda.

Members of the delegation were particularly impressed with the economic growth of the country saying Uganda has a high tourism potential.

They further hailed President Museveni for spearheading the fight against HIV/AIDS.

JM/daj/APA
26-11-2020

Source: http://www.apanews.net/apa.php?article81537

 

News Article: Mrs Museveni wants LDC to share experiences

Posted on Monday 24 November 2020 - 15:29

Uganda’s first lady Mrs. Janet Museveni is calling on leaders from developing countries to form networks that will allow their people to share evidence-based information, experiences as well as good practices.

Mrs. Museveni was today opening the International Conference on Population and Development at Imperial Royale Hotel in Kampala, Uganda’s capital city.

The conference has drawn participants from several countries world wide.

Mrs. Janet Museveni noted that countries of the south have renewed their efforts to ensure that expertise and skills are not always flowing from the north to the South but are shared in order to enrich their experiences through the South-South cooperation.

She further pointed out that leaders have a responsibility to ensure that women do not continue to die from preventable conditions whose remedies are available to them. She pledged to work tirelessly and take up the challenge of safe motherhood. Mrs. Museveni added that the tragedy of maternal deaths should be jointly handled to save the women in society.

Uganda’s Minister of Health Dr. Stephen Malinga urged the developing world to address a common goal in the area of reproductive health, population and development.

Other speakers at the official opening ceremony included the chairperson of the PPD board Dr. Li Bin who saluted Uganda’s government for its commitment to the health of the people saying this illustrates the emphasis the government of Uganda places on population and development.

Source: http://www.africanews.com/site/Mrs_Museveni_wants_LDC_to_share

 

News Article: MPs Want More Investment in Maternal Health

MPs Want More Investment in Maternal Health 
The Monitor (Kampala) 
NEWS
24 September 2008 
Posted to the web 24 September 2020

By Evelyn Lirri

When members of parliament from 13 countries across east and southern Africa gathered in Kampala last week to deliberate on health issues affecting the continent, one thing that came out forcefully was the health of mothers and children.

The MPs who were drawn from parliamentary committees of health and social services from the countries of Uganda, Kenya, Tanzania, Botswana, Zimbabwe, Zambia, Angola, Namibia and Swaziland others discussed the challenges affecting the health sector in their various countries, urging for more investment, particularly in maternal health and equity in health. 

Dr Jotham Musinguzi, the African regional Director for Partners in Population and Development (PPD), an intergovernmental alliance of 22 developing countries that hosted the meeting painted a bleak picture of the health status in sub Saharan Africa.

He said that while 25 percent of the global disease burden is in the region, only one percent is spent on health. As a result, he said, the region is characterised by poor reproductive health indices, high HIV/Aids and food insecurity among other problems.

Mothers die of preventable illnesses 
Maternal mortality indices across the African continent are still high and countries could fail to meet MDG targets related to health unless issues of reproductive health security are addressed.

PPD Executive Director, Mr Harry Jooseery said reproductive health and population issues have been neglected.

"Until we deal with the population problem, stabilise and produce a quality population, we are not going to resolve any of our problems.

The well being of a nation is how much a country has invested in health and education," he said.

Health Minister Dr Stephen Mallinga said that one of the greatest challenges facing developing countries was poor health particularly for women and children.

He said that reproductive health issues have in recent years not received the importance and priority they deserve yet it is central to poverty eradication.

"A woman's lifetime risk of dying during pregnancy or childbirth in sub Saharan Africa is one in 16 while the risk in developed countries is one in 3,800," Dr Mallinga said.

According to the health minister, the rate at which mothers die from haemorrhage, infection due to lack of antibiotics and complications was absurd. He added that cases that necessitates a caesarean can significantly be reduced through access to prenatal care, skilled attendance at births and emergency obstetric care.

Free bleeding medication 
Dr Mallinga said one of the things the ministry was doing was to the introduction of a drug called misoprostol, which can help in preventing women from bleeding after birth, which he said is the leading cause of maternal mortality in Uganda.

Misoprostol tablet, which Dr Mallinga said is already available in health centres will be given free of charge to women who experience bleeding after birth.

Bleeding after birth remains a great health risk for women not only in Uganda but the African continent.

Uganda's maternal mortality rate, according to the 2006 demographic and health survey stands at 435 for every 100,000 live births.

Besides the misoprostol tablet, the government is also in the process of launching a new roadmap to accelerate the reduction of maternal mortality.

The Parliamentary Social Services Committee in August 2008 presented to parliament a report, among others recommending that maternal/reproductive health be prioritised and resources mobilised to address funding gaps.

________________________________________

Copyright © 2008 The Monitor. All rights reserved. Distributed by AllAfrica Global Media (allAfrica.com).

 

News Article: Poor Reproductive Health Hurts Growth

New Vision (Kampala)
NEWS
18 March 2021
Posted to the web 19 March 2021
By Flavia Nakagwa
Kampala

Uganda has to meet her reproductive health needs and promote population development to address poverty, a health official has said.

According to Dr. Jotham Musinguzi, the regional director of Partners in Population and Development, poor reproductive health conditions and high birth rates greatly affect the development of a country.

"Unless women are able to achieve full control of their reproduction, it will be nearly impossible to meet millennium development goals like reducing child mortality, improving maternal health and poverty."

Opening the Eastern Africa Reproductive Health Network (EARHN) workshop at Protea Hotel in Kampala, Musinguzi said countries in the region had highlighted a strategic plan to boost reproductive health matters. EARHN is an initiative of government ministries addressing population, reproductive health and development in Burundi, Ethiopia, Kenya Rwanda, Tanzania and Uganda.

Musinguzi said abject poverty had affected many people and little was being done to avert the situation.

"Maternal mortality rate is high in Uganda. It is important for political leaders to be engaged in enlisting their commitment to sexual and reproductive health and rights," he said.

He decried the health workers' bad attitude towards expectant mothers.

"We need to work together as a community. Our health system is still very weak and there is great need for equipment and supplies in medical centres."

Dr. Betty Kyaddondo, the head of the Population Secretariat, said it was important to promote good sexual reproductive health policies and programmes in East Africa.

"We want to see a region free of reproductive health burdens."

Copyright © 2008 New Vision. All rights reserved. Distributed by AllAfrica Global Media (allAfrica.com).

Source: http://allafrica.com/stories/printable/200803190067.html

 

News Article: Births of a nation

By Sam Knight, Photographs by Andrew McConnell

The Financial Times (London)

Published: February 29 2008 21:06 | Last updated: March 1 2008 01:01

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Dr Jotham Musinguzi, Uganda’s leading population adviser, has the serenity of a man who can do no more. A former gynaecologist and obstetrician with a methodical, gentle voice, Musinguzi is the director of Uganda’s Population Secretariat, which advises the government on population policy. And for 10 years he has been asking the same question: “Are we ready?”

The answer has always been no. Recovering from civil war and an HIV prevalence rate that peaked at 30 per cent in the 1990s, Uganda now has one of the world’s fastest-growing populations. There are twice as many Ugandans today as there were 20 years ago, and there will be twice as many again – about 60 million – by 2030. By 2050, Uganda is expected to have 103 million citizens: a shade more, if current trends continue, than Russia. But it is not so much the size of the population as its structure that has Musinguzi concerned: Uganda is also the world’s youngest country, with more than half of its population – 56 per cent – under the age of 18.

Youth pervades Kampala, the country’s dusty, traffic-mad capital. The habits and ambitions of young Ugandans are visible everywhere: in the internet cafes, the brand new universities, the mobile-phone stalls selling credit in 200-shilling (6p) denominations – enough for a few text messages, not even a call. But their needs are evident, too: in the half-built schools, the throngs of teenage boys that gather outside carpentry shops and butchers, looking for odd jobs to do, the ceaseless tumble of children in the slums. “In Africa we don’t see children as things to be counted,” explained one Ugandan youth worker. “A child is a child.”

Coping with, and celebrating, an explosion of young people places Uganda at the leading edge of the demographic challenge that is confronting most countries at the beginning of the 21st century. Not the familiar European and east Asian unease about ageing baby boomers and low fertility rates, but the opposite: the larger question of how to feed, employ and generally satisfy the biggest generation of young people in human history. There are 1.5 billion people between the ages of 12 and 24 in the world, and 87 per cent of them are growing up in developing countries. “I have turned down several jobs elsewhere because the challenge is here,” Musinguzi told me recently, over coffee in Kampala. “Is our population going to be a positive resource or the thing that undoes all our progress? This is the question I will keep asking.”

His uncertainty, despite abundant statistics, is genuine. To some extent, Uganda’s population is following a path already travelled, and one that has generally led to prosperity. In the coming decades, Uganda and other countries across Africa, the Middle East and south-east Asia will go through the steepest phases of the “demographic transition” that other societies went through when they industrialised in the 19th and 20th centuries. The demographic transition describes the swing from the high birth and death rates of pre-industrial, uneducated, unhealthy populations to the low birth and death rates of their richer, healthier and more cautious descendants. The process involves rapid population growth because the death rate – eroded by improvements in public health – falls before the birth rate does, leaving one, or two, or three much larger generations that can double or triple the population when they themselves reproduce, even if they do not have as many children as their parents and grandparents. With development, the fertility rate then tends to fall, leaving countries in the advantageous situation of having a labour force that is much larger than both its dependent young and old: a 30- or 40-year opportunity to generate wealth, save it and invest.

The rewards of this “demographic window”, while hard to calculate precisely, can be enormous. Europe and the US made the best of their demographic bonus in the second half of the 20th century. China, whose birth rate fell dramatically because of the one-child policy, is in the pink right now. India, whose growth rate peaked in the 1970s, is about to come good. Economists have attributed as much as 40 per cent of east Asia’s per-capita income growth between 1965 and 1990 to its beneficial population structure. By contrast, Latin America, through inept military dictatorships and economic instability, has largely fluffed its demographic opportunity.

All of which can feel a long way from Kampala. In part, that is because if Uganda is on the same demographic path as the richest countries in the world, it is only at the very beginning. With a life expectancy of 47, and with 56 per cent of people younger than 18, Ugandans in 2008 are demographically not dissimilar to the English of 1821, when 51 per cent of the population was 19 or younger and people could expect to die at 40. Uganda’s fertility rate is yet to fall noticeably from seven children per woman. Population dynamics suggest that Uganda, along with the rest of the world’s youngest countries, will not benefit from any demographic bonus until 2045 at the earliest.

But another possibility is that Uganda – like much of the rest of sub-Saharan Africa and other outliers such as Afghanistan, Yemen and Iraq – might not be following any familiar demographic path at all. First, there are the numbers. Developing countries, above all in Africa and the Middle East, are experiencing rates of growth, youth and change that have never been seen before. Through all the turbulence of empire and the industrial revolution, Britain’s population never expanded at more than 1.5 per cent per year. America’s century-changing baby boom, meanwhile, peaked at a growth rate of 2.05 in 1950. By contrast, Musinguzi expects Uganda’s population to grow by 3.6 per cent in 2008, and in recent years both Kenya and Yemen have broken the 4 per cent mark. A population growing at 3 per cent doubles every 23 years. To be as rich (or merely just as poor) as their parents, these children will require an economy twice as large.

But what raises the most questions – and fears – is where these demographic changes are taking place, and who they are happening to. The youth wave of the early 21st century is breaking over societies that appear least equipped to receive it. Demographic success stories in the past have relied on strong economies. Youth unemployment in the US actually fell during the 1960s, despite the flood of jobseekers in the enormous postwar generation. Likewise, from 1993 to 2003, GDP growth rates across Asia managed to outstrip the growth in the labour force, in China comfortably so. By contrast, average GDP growth in sub-Saharan Africa in the same period was 2.9 per cent, all but cancelled out by a growth in the labour force of 2.8 per cent. Simultaneously, across the Middle East, demographic pressures have been at least partly blamed for youth unemployment rates of 30 per cent or more.

The prospect of record-breaking generations of young people coming to maturity in fragile economies directed by brittle, corrupt governments has prompted plenty of dire predictions, known in the trade as “security demographics”. A German anthropologist, Gunnar Heinsohn, for instance, has enjoyed cult success in Europe and invitations to international security conferences on the back of his theory of the “youth bulge”.

According to Heinsohn, who uses historical analysis to come to his conclusions, once a country’s proportion of males between the ages of 15 and 29 reaches 30 per cent, it is more likely to dissolve into civil war or start a conflict with its neighbours. “I would be careful not to argue that the youth bulge explains every huge atrocity there has ever been,” he said. “But it explains quite a few developments in human history.” After the rioting in Kenya in January, Heinsohn e-mailed me to point out that the Kenyan population had grown by a factor of 13 since 1928, and that 15- to 29-year-old males now represented almost exactly 30 per cent of the population.

Ask Liliane Katusiime about Uganda’s population and she will reply “Ensi Yaleta”. It’s the name of a Ugandan pop song that means “the world has brought” – as in stuff, people, chaos – and young people in Kampala use it to describe their crowded lives. Liliane is 16, and one of 20 relatives who live together in Kalerwe, Kampala’s western slum. I met her outside the hairdressers where her mother works. There was the fluff of hair extensions in the dust and small radios everywhere played the hectic commentary of a Uganda versus Kenya football match.

“Every time you are walking around, you are seeing so many people my age,” said Liliane. “I think there is going to be a struggle for space. Where I come from, people are living very many in a house. Then, when you go to school, you compete for a desk, for a class, for a teacher and so on.”

Liliane wants to be a journalist but has had to give up school; stretched family finances are being concentrated on her older sister, Maureen, who is going to Makerere University, Uganda’s best, to study computing. Liliane described her large family as, simultaneously, a source of support – “without them you get trampled” – and a place where everything, including opportunities, had to be shared. “I grew up in a family of seven. Life becomes expensive when you have seven young kids. Living is a crowded thing. When I get rich, I’m not going to bother with so many kids.”

She took me to meet her brothers and sisters in the family house in a district called Mulago after Kampala’s biggest hospital, which sits on the top of the hill. There was an evangelical prayer book on the one table and around it sat her sisters, including Maureen, an amplified version of the precocious Liliane. I asked Maureen if she felt optimistic about finding a job in IT and she looked at me as if I were a very simple person indeed. “In Uganda you can’t just get a job anyhow,” she said. “Didn’t you search the internet before you came?”

Then I noticed a small boy sitting on my left. It was Liliane’s younger brother, Ronald Agaba, who wants to be an accountant. He had been out playing football. Ronald was born on May 11 1993, making him the median age for a Ugandan man – between 14 years and 8 months and 15 years and two months, depending on which international statistics you use. When I told Ronald this – that half the Ugandan male population was younger than him – and that the equivalent age in the UK was 39, in Japan 43, he looked worried and said: “My age is too young. I want to continue my studies.”

It is the Ronalds that occupy Dr Musinguzi, who is 58, and the alliance of demographers, statisticians and opposition MPs that is trying to bring down Uganda’s birth rate. Andrew Mukulu, the director of population in the Ugandan Bureau of Statistics, has an eight-year-old son. “He is one of the people who makes me think so much about the population,” he said. Mukulu’s other great worry, shared by the World Bank, is Uganda’s dependency ratio – the size of its labour force compared with those too young or old to work. In Europe, Italy’s dependency ratio of slightly over 50 per cent (two workers to each dependent) is causing concern. Uganda’s dependency ratio, the world’s largest, stands at just over 110 per cent (nine workers to every 10 dependents). Even that might be bearable if Uganda’s labour force was fully employed, or paying taxes, or working mainly in the formal, salaried sector, but it is none of these things. Seventy per cent of adult Ugandans describe subsistence agriculture as their main economic activity. According to Mukulu, that leaves just 10 per cent of the population generating a surplus that can pay for Uganda’s public services. “They can pay for all this healthcare and education?” He asked. “To me, that burden is big.”

Increasing formal employment in countries with young populations is also a demographic priority, because it can bring down the birth rate. Few family-planning campaigns have rivalled the contraceptive power of modern, urban, wage-earning life. I learned this from another elder of the Ugandan population scene, John Ssekamatte, who teaches the country’s only demography course at Makerere University. I saw Ssekamatte the evening before I met Musinguzi and the professor was the first person to tell me about another great challenge for demographers in Uganda: that most people, including President Yoweri Kaguta Museveni, who has ruled the country for the past 22 years, do not think the country has a population problem at all.

Ssekamatte told me a story about the adviser who stood up to present the results of Uganda’s last census to the president in 2002. For the first time, statisticians predicted that the population, even allowing for a fall in the fertility rate, would pass 100 million in 2050. According to Ssekamatte, the adviser told Museveni that such a high rate of population growth would cause Uganda serious problems. The president responded that a population of 100 million in 2050 should be a target, rather than something to worry about. “That is what I want,” he said.

“Of course we teased the man who was standing there,” said Ssekamatte. “We said, ‘You got a real slap in the face there’.”

The man was Jotham Musinguzi.

That was when we realised we had a president who was hooked on a large population,” Musinguzi told me the following day. And the president is not the only one. Every morning Kampala wakes up to Kalisoliso (“the sharp-eyed”), a radio show that commands seven million listeners across southern Uganda. Kalisoliso began 10 years ago as a sports segment but has become a hectoring, song-laden blast of news, gossip and social commentary that can set the tone of national debate.

On the Friday before Christmas, Abbey Mukiibi, one of the presenters, a big-voiced man who fondles his belly before telling a joke, was preparing to go on air. That meant checking his mobile phone for any last-minute messages; he and his co-host, Kato Lubwama, read out as many as 20 rowdy congratulations for new parents every day, even though their show is only 15 minutes long. “It’s still a big deal here, giving birth,” said Mukiibi. The radio presenter is aware of Musinguzi and the work of the Population Secretariat. “We have had a lot of clashes with Pop Sec and the UNFPA [United Nations Population Fund] because we urge people to have lots of children,” he said. “But we want to have a large market base to make us a strong nation. That is what we believe.”

The Kalisoliso doctrine – “We believe that population is power. We believe that population is production,” said Lubwama – is the other side of the Ugandan youth debate, and it reaches to the top of politics and business. It blends traditional African pride at having a large family, the economic argument for a large domestic market and alarm at what is happening to Europe and Asia’s ageing societies.

Bitamazire Namirembe, the country’s veteran education minister, a long-time ally of President Museveni, believes it. And she is in charge of a system that will have to educate twice as many children in 15 years’ time, but even now has only one teacher for every 54 pupils – of whom just 4.5 per cent complete secondary school. “It is like a flood coming,” she said. “But what can we do?” Even James Kinobe, Uganda’s youth minister, who talks openly about the need to reduce the country’s fertility rate, was careful to moderate his concerns: “We will not be another Japan, where they don’t recognise they need their own children.”

At the end of our interview, Kinobe waited for one of Musinguzi’s colleagues from the Population Secretariat to leave the room before turning to me: “You need to have positive thinking. That’s the problem with these population people. They look at the population as a bad thing, but there is nothing we can do.”

The result, after listening to both sides, is the ambivalence of Charles Mbire, a businessman who runs the Ugandan arm of MTN, the mobile-phone network. Mbire, a powerful, pragmatic man in his 40s, does not know what to think about Uganda’s record generation. Primarily, he wants customers, and young ones. “I am a businessman. I am happy. My market is growing,” he said. Since the first day of business in 1999, MTN has grown from 7,000 customers to 2.5 million and seen the average age of its mobile phone users fall from 24 to 17. It is now the largest taxpayer to the Ugandan government. But Mbire is also an avid watcher of the History Channel – “all my spare time” – and he does not want Uganda to make avoidable mistakes. “Uncontrolled population growth will bring an unsatisfied population and that will bring revolutions, so you are back to square one,” he said. “So there should be an orange light beaming, saying, ‘Gentleman, we have a problem’.”

But Mbire cannot suppress his commercial instinct that Uganda’s population growth is also providing it with a young labour force that other countries do not have and that some of the richest among them are going desperately to need. When we met he was excited about reports that Ugandan security guards in Iraq had sent home more than $4m in remittances. “Resources are moveable,” he said. “The world is a global village and right now human labour is a very important resource if properly used.” Mbire suggested that the Ugandan government set up a ministry for emigration, subsidise air fares and offer practical teaching specifically for those going abroad. “That is what is wrong with us,” he said. “Everybody says, ‘Train.’ Train. Train. Train. Everyone wants to be a graduate. A graduate of what? Of philosophy? In Uganda?” He looked exasperated. “If we had technical schools for taxi drivers, nannies and bellboys – that would be practical! Every hotel in Europe needs bellboys.”

Increased migration must be one logical consequence of the youth wave in places such as Uganda. If 87 per cent of the world’s young people are in developing countries, there must be places where they are not. According to the Ifo Institute, a leading German economic think-tank, the traditional 15 countries of the EU will need 190 million working-age immigrants by 2035 to maintain their present dependency ratios – and that figure assumes that the immigrants themselves will not age. But it is not just manpower that Uganda can provide. According to Mbire, his young mobile-phone users are a different, globalised breed. “This generation is productive. They are not a sit-back generation. They are very exposed. They wear shoes. They eat sausages. They have fashion,” he said. “They are like a new tribe.”

And that is the heady, truly unknown variable in arguments about the teenagers of the 21st century: whether the IT revolution, freer movement and new technologies will make the demographic transitions of the future as radical and optimistic as those that came before. Jo Boyden, who runs Young Lives, which collects data on 12,000 young individuals in the developing world for a project funded by the Department of International Development, cannot quite give in to the pessimists. “It just troubles me that we base so many conclusions on stereotypic assumptions about ourselves and [our] own past,” she said. “In any discussion about youth bulges, the context is as important as the demography. And the context is no longer Uganda, or Ethiopia, or West Africa, or Vietnam, or India. It’s that plus the world. That is what is socialising these young people, and in a way that has really never happened before.”

On my last morning in Uganda I went with Musinguzi up the hill from Liliane’s house to the maternity wards of the Mulago Hospital, where Musinguzi worked until the early 1990s. “This is where we churn them out,” he said, as we walked through the blood-swiped labour ward to the bright, postnatal dormitories where new mothers rested with their babies. When Musinguzi left, just over 15 years ago, between 25 and 30 babies were born each day at the Mulago. Today, the same staff, in the same rooms, accommodate between 50 and 80 deliveries every 24 hours. “It is too much,” said Clemensia Nakabiite, the senior obstetrician. Musinguzi walked along with his former colleague, past the mothers in labour, sitting on the hospital floor, and I thought of what he had said once when I asked him how he imagined the future of Uganda.

“I travel a lot,” he had replied. “And when I go to the main streets in London, when I go to Euston Station, or when I am in New York, on 42nd Street, near the UN, I see the hustle and the tussle of human beings. I see the world moving and I think, this is good. This world has energy, this is growth.

“But when I see Uganda with 55 million people, will Kampala be like London, with everyone healthy and well-dressed, charging to the Underground? Or will I see people just begging in the streets, still two worlds apart? This is not what I want to see, but if I do, I will tell the story of how it came to be this way.”