Almost 28% of maternal deaths in Uganda are attributed to young girls aged 15–24 years and 60% of premature deaths among adults are associated with behaviors or conditions that began or occurred during adolescence, reports indicate.
According to the 2016 Uganda Health Demographic Survey, Uganda continues to have one of the highest rates of teenage pregnancy in Sub-Saharan Africa, currently at 25%.
However, the responsible stakeholders like the Ministry of Health are positive that with the right sensitization and information dissemination to the teenagers and young adults, who are most vulnerable to the cause, these alarming rates can be contained and eliminated.
To fully understand what the Ministry of Health, together with its partners, are doing towards achieving better reproductive health, we caught up with Dr. Blandina Nakiganda, the Assistant Commissioner Adolescent and School Health Division at the Ministry of Health for a detailed insight.
The Ministry of Health, through its structures provides different services for the young people including disseminating the required information to groups and individuals, and provision of tangible essentials as Dr. Nakiganda explains.
What are these adolescent and youth friendly services?
“These entail facilities where adolescents can access services with a bit of confidentiality and trust with the health workers,” Dr. Diana Nakiganda said.
She confirmed that there is everything that they would require; including age appropriate information so that messages are not mixed up for those in different age categories.
“Information given to a 10 year old is not the same as that of a 20 year old for instance,” she added.
The health guides and staff ensure that the services offered are friendly by making scenarios in question relatable to the young people and being non-judgmental to any of those seeking help.
Dr. Nakiganda said that once the youth get out of these facilities at the end of the day, they will be confident to come again due to the good experiences shared with the staff.
Increasing Information Channels for the ever increasing number of adolescents
With the rapid growing population of the young people- adolescents, the services that the Ministry of Health availed at different centres in the past years are now rendered insufficient.
However, Dr. Nakiganda said that the Ministry is working on this issue through resorting to alternative structures to help the young people.
“We are getting more involved on various social media platforms; something which has not been there previously including twitter, Facebook, Instagram among others,” she said.
She explained that with the social media channels, adolescents may not go physically to health centres as most of them prefer to read and understand more about sexual and reproductive health from the comfort of their residences.
It should be noted that the government has made efforts to ensure availability of youth friendly services in various public health facilities. Efforts are being made to achieve integration at all heath facilities, so that the adolescents can be able to access holistic services they may require such as malaria treatment and other check-ups in one place.
The National Development Plan
Over 70% of the country’s population are young people. As such, the Ministry of Health seeks to create an economy of formally employed youth.
“The population of the youth is really bulging and with the right approaches to ‘growing up’, we can benefit from it when they have the skills. They can have better employment and at the end, there will be a better economy,” Nakiganda stressed.
The role of Reproductive, Maternal, Newborn, Child and Adolescent Health (RMCNAH)
The RMCNAH was put in place with an aim of improving the health of children and their mothers. This structure is backed by periodic RMNCAH youth summits in Uganda that seek to educate, sensitize and in turn, get responses on various issues from the youth.
This is a global perspective and in 2018, the national RMNCAH summit was held in Uganda. It was championed by the First lady, Janet Museveni as an accountability mechanism to various stakeholders and includes youths in various levels from different parts of the country.
This brought about support from various stakeholders like Civil Society Organisations to ensure gaps are closed among the young people and women, in attaining reproductive health services.
Covid -19 Positive Impact: Parent-child engagement
Dr. Nakiganda said that however much Covid-19 has disrupted normal life, it has given parents ample time to engage with their children.
Also, the National Programming Guideline by the Ministry of Gender has been giving guidance to parents on how to deeply relate with their children and through such a bond, she said, reproductive health issues can be addressed easily.
Naguru Teenage Centre – Teenage Pregnancies on the rise
Poverty has extremely contributed to teenage pregnancies as the young girls lack essential needs hence getting involved in undesired activities like prostitution just to earn a living, Dr. Nakiganda noted.
“In rural areas where there are many relatives living closely together, acts of rape and defilement are frequent. Now that the young people are home and there is limited information about sexuality and growing up for some, a lot of challenges are coming up,” she added.
“Just as the people living with HIV/AIDs are having challenges in attaining ARV drugs due to the hindrances in transport, so are the adolescents who need family planning services and counselling from health centres,” Nakiganda further explained.
Taking part in the struggle
Naguru Teenage Centre, in particular, is currently working at a stretched out rate to ensure better sexual and reproductive health among the young youth, especially during the lockdown when the rate of teenage pregnancies is shooting up.
Naguru Teenage Information and Health Care Centre provides youth-friendly, responsive Adolescent Sexual and Reproductive Health and Rights (ASRHR) services and information, primarily targeting young people of 10 to 24 years.
According to Mr. Joshua Thembo, an official at Naguru Teenage Centre, better sexual reproductive health is being achieved through provision of information about growing up, emergency contraceptives to young victims of sexual assault, counselling services in regard to copying with challenges such as rape and defilement and unintended pregnancies among others.
The centre also offers Antenatal Care Services (ANC) to young mothers up to the time of delivery when they are referred to delivery centres like Naguru China Friendship Hospital.
Postnatal Care Services including immunization, family planning methods and Post Abortion Care services are also provided at the centre and referrals are made where they cannot be managed from within the facility.
The Ministry of Health partners with various Civil Society Organisations to facilitate peer to peer mechanisms where adolescents are able to engage with their fellows at different levels.
According to the Ministry, the ideal set up for adolescent health care is multi-sectoral, as it requires combined efforts to achieve.
“It doesn’t only need the health sector to come in to achieve this. Even when it is referred to as the adolescent youth friendly services and health friendly facility, it is a multi-sectoral approach. Parents need to come in and understand the need of adolescents,” said Dr. Nakiganda.
“The schools need to come in and understand what the young people in schools are going through and devise means of teaching them to ensure that they are safe. Ministry of Finance has to come in to ensure funding as skilling a health facility for adolescent friendly services is quite a capital-intensive venture like the big screens, posters, training the health workers among others,” she stated.