By Dr. Peter Ibembe
Uganda, Kampala – Officially, the COVID-19 virus has infected almost 80,000 people in the country and more than 1,900 have lost their lives. However, the full extent of this catastrophe may be incalculably higher. Uganda’s community and health systems have been stretched to the limit. The economy has beenadversely affected. Vulnerable and underserved girls and Women have been disproportionately affected, and reproductive health services have been curtailed, withGender-Based Violence on the increase in Uganda.
Today, 11 July, 2021 the world marks World Population Day. This is a moment to raise awareness concerning the sexual and reproductive health needs of people around the world and in Uganda in particular. Reproductive Health Uganda (RHU), calls attention to the vulnerability and needs of women and girls amid the global Covid 19 pandemic, and highlights the efforts that are required to secure their sexual and reproductive health and human rights in Uganda.
But that is not all. According to the Uganda Bureau of Statistics (UBOS), Uganda’s population stands at 41.6 million people. It has one of the highest fertility rates in the world where each woman gives birth to no fewer than 5-6 children in her lifetime. In comparison, the global fertility rate stands at 2.3 births per woman.
“No individual, family, community, organization or district of Uganda can reduce the fertility rate alone,” Dr. Peter Ibembe, RHU Director of Programs, stressed in a presentation he made recently where he also
highlighted the increased reproductive health challenges vulnerable women face due to the pandemic.
Health workers, most of whom are women, some actively providing sexual and reproductive health rights services, also face a more direct risk of illness from COVID-19 as they are at the frontline, , .
But other women and girls outside the health sector also face serious risks, too. In refugee camps, in slums and other unplanned settlements; in other hard to reach areas. Communities that require sexual and reproductive health services may be anxious about exposure to the virus at health facilities, and some forgoreproductive health services entirely. Others have been unable to access care due to inter-district movement restrictions.
Several hospitals and health centres have reported a slump in the number of women and girls receiving critical sexual and reproductive health care, including maternal and childbirth services, family planning and counselling about reproductive health.
RHU and its partners estimate that as a result of three months of service disruption, 2.2 million women in different communities in Uganda will go without contraceptives; this will lead to an additional 20,000 unintended pregnancies. The number of maternal deaths is also expected to increase resulting from the curfew and travel restrictions that were instituted to combat Covid 19.
RHU and its partners are working to ensure continued access to reproductive health services and supplies.
For instance In the refugee camps, , where the pandemic has limited the number of women able to access health care, RHU is providing protective gear to health workers, improving community level communication through different community distribution mechanisms , and ensuring the continuation of reproductive health services including family planning and maternal health programmes in Uganda.
Anisha Filda, an expert working at RHU Gulu Health Centre, is relieved that she is able to continue providing maternal health care services while using protective measures including face masks and temperature guns.
“When the women come to the RHU facility, we make sure they wash their hands thoroughly with soap and water, sanitize and wear a mask. We also make hand sanitizers available for use at every stage or process while offering the SRHR services,” she said.
“The work we do here at RHU brings me so much joy. Seeing women and girls access family planning and SRHR services pleases me. This is who we are as sexual and reproductive health experts and this is what we do to save lives.”
But the challenge remains. Some health care providers in other private and public facilities do not have ready access. This increases the number of patients visiting RHU’s clinics as an alternative.
Circumstances are even more disturbing in humanitarian settings.
In Uganda, regular medical supplies and stocks have been necessary to strengthen the health system, which was already strained before the pandemic broke out in March 2020. Humanitarian support has beenessential for 18 -year-old Furaha Kamate, from Namiganda village in Kikuube district, who faced life-threatening pregnancy complications in the Kyangwali, refugee camp.
RHU and partners organized special and emergency services for her to deliver her fourth child. The entire process took a week of planning and another week for travel. Finally, Kamate, arrived at Rwenyawawa health Centre III in Kyangwali refugee camp, where she delivered a daughter through Caesarean section.
Though she is relieved to have had a safe delivery, she remains fearful about COVID-19 as well as conceiving another unplanned child.
“I am so worried about my baby during this COVID 19 lockdown, and I fear to get pregnant again. That is why I have enrolled on to the long-term family planning method, Jadelle,” she told RHU.
In other places in Uganda, during the COVID 19 lockdown, women are also reporting an increase inGender-Based Violence.
“During the curfew and lockdown period, I have I have interacted with women in the Albertine region, Busoga and West Nile, who have experienced violence at the hand of their husbands and partners,” Dr. Peter Ibembe says.
To make matters worse, access to anti GBV shelters and in-person counselling has been limited by reduced movement during the lockdown though RHU and her partners are striving to continue offering services for survivors wherever possible.
. New forms of violence may be increasing, including online digital communication violence. This is another area of violence that needs further assessment and investigation
“On social media, there is a lot of degrading communication, bullying and violence directed at women and girls in the light of the COVID 19 pandemic crisis,” Kamate, a young woman living in Kampala, intimated to RHU.
This is a new area of violence that needs further assessment and investigation.
The author of this story is the Director of Programmes at Reproductive Health Uganda (RHU). Dr. Peter Ibembe, is also a researcher in Education, Maternal and Reproductive health
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