As Uganda joins the rest of the world to commemorate this year’s World Contraception Day, I join the government and its partners led by the United Nations Population Fund (UNFPA) in ongoing efforts to ensure that pregnancy is by choice, not by chance.
I am particularly in support of the Costed Implementation Plan (FP- CIP) 2015/2020) for scaling up family planning in Uganda from the current 26 per cent to 50 per cent and reducing the unmet need for contraception from 34 per cent to 10 per cent by 2020.
My support for the Costed Implementation Plan (FP- CIP) 2015/2020) is largely influenced by the fact that it has put;
“Increased age-appropriate information, access, and use of family planning among young people, ages 10–24 years” as its priority number one
Access to contraception by adolescents is key when it come to provision of youth-friendly reproductive health services. It is not only a deterrent to teenage or unwanted pregnancies; the use of methods like the male and female condoms is a key prevention measure against Sexually Transmitted Infections among young people.
Healthcare providers, therefore, have an important role in adolescent reproductive healthcare. Their long-term relationships with patients and families allow them to help promote healthy decision-making in regard to sexuality. They are expected to encourage abstinence among adolescents as a way to avoid the negative consequences associated with risky sexual behaviour.
As an advocate for the health and well-being of young people, I also believe that adolescents should postpone sexual activity until they are ready, because any sexual activity for which the adolescent is ill prepared leads to emotional, physical, and financial consequences. However, having worked and interacted with adolescents for the last three years, I have realised that some of them are already sexually active or will choose to become so.
I, therefore, have no choice but to encourage abstinence as well as the use of contraception, to reduce the risk of unintended pregnancies and to prevent STIs.
Contrary to fears by some Ugandans, providing information to young people about contraception does not result in increased rates of sexual activity, earlier age of first intercourse, or a greater number of sexual partners. According to a study by UBOS and Macro International Inc. 2011, one in four girls aged 15-19 years is already a mother or pregnant, and lack of access to youth-friendly reproductive health services is largely to blame. The primary reason that adolescents may hesitate or delay obtaining family planning or contraceptive services is lack of confidentiality. It is important for service providers to develop policies that ensure patient confidentiality.
For those adolescents whose parents or caretakers are unaware of their contraception use, it may be helpful to discuss with them how the contraception method will be consistently used.
Service providers can help adolescents identify their goals for safe and responsible sexual behaviour, including reinforcing and supporting abstinence. The promotion of healthy and responsible sexual decision-making is one of the goals of counselling adolescents about contraception. Successful counselling requires a supportive and nonjudgmental person who engages in effective dialogue, which includes skillful history taking, careful listening, and repetition of simple educational messages that contain essential information.
In most of the sexual reproductive health rights engagements, the issue of contraception for young people with chronic illness or disability is often forgotten. Contraception as well as sex education and counselling needs within this population should not be overlooked.
As we match on the streets of Pallisa town where the national event is being held, let us show support for young people with disabilities and their access to reproductive health services.