USAID/Uganda Family Planning Activity Celebrates World Contraception Day 2024
As we approach World Contraception Day 2024, Uganda faces a stark reality that mirrors many countries in sub-Saharan Africa: nearly one in four girls aged 15-19 is either pregnant or already a mother. This alarming statistic underscores a fundamental truth—when people cannot exercise the basic human right of deciding freely about their own sexual relations and fertility, they don’t have control over their own lives.
The scale of this issue is staggering in sub-Saharan Africa—in 2021, adolescents 15-19 years gave birth more than 6 million times. Unintended pregnancies in the region occur at about three times the global average, heightening women’s risk of unsafe abortion, maternal death, mental illness, and malnutrition.
In Uganda, the situation remains critical. While we’ve made good progress in reducing the maternal mortality rate—from 336 deaths per 100,000 live births in 2016 to 189 deaths per 100,000 live births in 2022—only 38.5% of reproductive-age women use modern contraception. This gap between need and access puts young women at grave risk of dying from pregnancy- and birth-related complications.
To avert these preventable deaths, achieve the 2030 Sustainable Development Goals, and reach Uganda’s Vision 2040, we must employ solutions that create pathways for widespread access to contraception. Pathfinder International, in partnership with Uganda Protestant Medical Bureau, Samasha Medical Foundation, and Uganda Youth and Adolescent Health Forum, through the USAID/Uganda Family Planning Activity (FPA), has been leading the charge since 2020.
Working with the Ministries of Gender, Labor, and Social Development, the National Population Council, and the National Planning Authority across 11 districts with high unmet need for contraception—Buliisa, Kiryandongo, Kibaale, Kyankwanzi, Kyegegwa, Kyenjojo, Ntoroko, Bundibugyo, Butambala, Gomba, and Rakai—FPA has applied Pathfinder’s community-led approach to strengthen health systems. FPA has worked through existing structures to enhance access to and delivery of high-quality services. The impact has been significant and multifaceted:
- Policy and Funding: FPA provided technical assistance in developing crucial national strategies, working with the Ministry of Health and other partners to develop and disseminate strategic family planning (FP) documents that guide programming. These include Uganda’s FP2030 commitments, the National Total Market Approach Strategy (2020-2025), the Second National FP Costed Implementation Plan (2020-2025), and the National FP Advocacy Strategy Costed Implementation Plan (2020-2025). Through SMART advocacy approaches, FPA has trained 252 local champions and facilitated the formation of 12 political caucuses at district and national levels. This has led to increased budget allocations, with 10 out of 11 focus districts allocating over 100 million Ugandan Shillings to FP interventions in their 2022-2024 budgets.
- Health System Strengthening: FPA improved service quality at 167 health facilities, focusing on postpartum family planning. Pathfinder’s Beyond Bias approach has addressed provider biases in 146 health facilities, ensuring youth-friendly services. FPA has also integrated FP into maternal, child health, and HIV care services.
- Supply Chain Modernization: FPA conducted 446 visits to enhance supply chain management, implemented electronic ordering systems in 116 health facilities and 16 district stores through the Automated Delivery System, and established continuous stock monitoring. These efforts ensure a consistent supply of contraceptives, even in remote areas.
- Data Management: FPA strengthened the Health Management Information System, training health workers in FP data quality management and reporting. This has ensured FP services are informed by accurate, timely, and actionable data.
- Community Engagement: To create demand and increase access to FP services, particularly in hard-to-reach areas, FPA has worked with community health workers to reach those with least access to FP services. FPA trained 1,263 community health workers in FP mobilization, reaching 500,932 people through interpersonal communication that addressed harmful social and gender norms and dispelled myths and misconceptions that hinder uptake of FP services.
While these achievements are commendable, they are not enough. We must scale up these efforts to reach every corner of Uganda. The technology and knowledge exist—what’s needed now is the political will and resources to implement them nationwide.
As we commemorate World Contraception Day under the theme “Your Choice, Your Future,” we must recognize that access to contraception is key to transforming the lives of women, families, communities, and countries. It is a development “best buy” and crucial for accelerating progress toward the Sustainable Development Goals.
Looking ahead: continuing the journey
As FPA prepares to conclude in March 2025, we call on all stakeholders to join us in ensuring that the gains we’ve made are not just sustained but expanded.
- Government officials must prioritize FP and reproductive health in national health budgets and policies.
- Health systems must integrate strengthened contraceptive services into primary care, with a focus on adolescents and youth.
- Health providers must enhance the quality and accessibility of FP services, eliminating biases that hinder access.
- Community leaders and media must actively work to dispel myths and misconceptions surrounding contraception and reproductive health.
- In our changing world, it’s also crucial to incorporate reproductive health into climate-adaptation and disaster-mitigation strategies, recognizing the interconnectedness of these global challenges.
We must seize the opportunity to close the gap and build a healthier future for all Ugandans. Together, we can make “Your Choice, Your Future” a reality, with individuals making informed choices about their reproductive health and building stronger families, communities, and ultimately, a stronger nation.
