by Sonia Mulumba
Being a woman comes with its fair share of challenges. Being a woman in Uganda comes with more than its fair share. Women and girls in Uganda face a number of challenges that negatively impact on their sexual health mostly attributable to limited access to information and services regarding their sexual and reproductive health rights (SRHR). They are at high risk of unwanted pregnancy, violence, high HIV infection rates as a result of forced intercourse, rape, etc., and other sexually transmitted infections. Young people in Uganda are experiencing a pushback and backlash regarding their sexual and reproductive health rights (SRHR), particularly in regards to sexual education, contraception and gender equality.
Sexual health, as defined by the World Health Organization, is “a state of physical, mental and social well-being in relation to sexuality.” Sexual health is fundamental to the overall health and well-being of individuals, couples and families. In the same vein, it is essential to the social and economic development of communities and countries. Sexual health therefore requires a positive and respectful approach to sexuality and sexual relationships as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence.
Approximately 54.7% of Uganda’s population are below 18 years of age with female youth twice as likely not to go to school as their male counterparts. The median age of female sexual debut is 16.9 years with 25% of adolescent girls pregnant before the age of 20 years. Uganda as such has one of the highest teen pregnancy rates in sub-Saharan Africa. This is attributed to high unmet contraceptive needs amongst women of reproductive age. Additionally, data from the Guttmacher Institute shows serious gaps in sexual and reproductive health services for adolescent women in Uganda. For example, and estimated 648,000 women aged 15-19 in Uganda are sexually active and do not want a child in the next two years. However, among this group, more than 60% have an unmet need for modern contraception, meaning that they either use no contraceptive method or use a traditional method of contraception.
It is therefore important to ensure that young people have access to age-appropriate, comprehensive sexual education as well as high-quality sexual and reproductive health services. They must also be empowered to make informed sexual and reproductive health decisions in order to achieve their full potential.
Women and girls are also at risk of sexual coercion, which is defined as an “act of forcing (or attempting to force) another individual through violence, threats, verbal insistence, deception, cultural expectations or economic circumstances to engage in sexual behavior against his or her will”. This issue has been recently brought to light through social media channels like twitter under various hashtags. #MeToo also known as the Me Too Movement is a movement against sexual harassment and sexual assault of women. In the recent past, Ugandan women gained the courage to out their abusers through twitter under the hashtag #MeTooUg and most recently sharing their stories under the hashtag #whyididn’tcomeout. Spaces like these have enabled women take back their power and stand up for their rights. Despite this positive step in tackling sexual abuse and harassment, it is important to note that such avenues are available to only a limited number of Uganda women leaving a bigger percentage of under privileged women in the bondage of such situations.
This has been magnified especially during the lockdown enforced as a result of the COVID19 pandemic. In most cases, it escalates into gender based violence leaving women trapped in unsafe homes and environments with no recourse to help. Gender based violence is highly attributable to the inequality that continues to exist in households.
Under international human rights law, States have a duty to respect, protect, and fulfill all human rights, including the right to accessibility of reproductive rights. Though states are allowed to exercise progressive realization as regards the right to health, there are circumstances where states must meet a minimum core set of obligations, including in the context of sexual and reproductive rights. Uganda therefore has an obligation to respect, protect and fulfill women’s SRHR. This can be done through increased provision of SRHR education and information. Comprehensive sexuality education (CSE) and information is fundamental to empowering all women and girls regarding their SRHR.
Budgetary allocations and financing strategies need to be recognized as playing a critical role in creating the enabling environment to achieve good health outcomes, universal health coverage and cost effectiveness of service delivery. The government of Uganda therefore ought to prioritize provision of sexual health services while drawing up its annual budgets.
Policies and procedures are also needed to ensure that women can safely report rights violations, such as discrimination, violations of informed consent, violations of medical confidentiality and denial of health services.
The UN Special Rapporteur on the Right to Health has further elaborated that states must take immediate steps to remove legal restrictions on accessing reproductive health services, as removing these does not entail resource constraints and thus doesn’t require progressive realization. As such, high incidence of maternal mortality or morbidity or unmet need for contraceptives are indications that states have not fulfilled this duty.
This leads me to reiterate my opening statement. Women, especially those living in Uganda face their fair share of challenges and there is need to advocate for provision of high quality sexual health services as well as disseminating age-appropriate information concerning SRHR. InPact Uganda has done this through its Girls to Girls initiative which is working with communities to diffuse gender transformative actions aimed at addressing gender inequalities and enabling women to take back their power. Promoting equity between male and their female counterparts is crucial so as to eliminate the power gaps in various households that in most cases result into GBV. Positive change is therefore achievable if women are mobilized in power groups which encourage them to speak up for their rights. This is therefore a call for action to support the Girls to Girls initiative so as to empower girls and ensure women stand up for their sexual and reproductive health rights. As Kofi Annan rightly stated, “there is no tool for development more effective than the empowerment of women”.
For more information regarding the Girls to Girls Initiative and more kindly click here.