Health workers and civil society organizations in Mbale city, eastern Uganda have decried the increasing numbers of unreported deaths resulting from unsafe abortion among adolescent girls in rural community and blames it to the limited knowledge and information on available Sexual Reproductive Health Services (SRH) and a lack of clear information by both health workers and public on the Law’s permissibility on abortion.
The Uganda Demographic Health Survey 2016 states that the maternal mortality ratio is still high at 336 per 100,000 live births, and maternal deaths are estimated at 16-18 per day with 4-6 deaths attributed to unsafe abortion. Unsafe abortion continues to be a leading cause of maternal death.
“We receive frequent reports from the community about young girls who attempt to carry out unsafe abort and unfortunately the majority of them die while a few lucky ones are rushed to the health facility for Post Abortion Care(PAC) when situations worsen”
“It is saddening that many of these pregnancies result from rape and incest but in the end, the adolescent girl innocently pays the price just because they are driven by fear due to lack of knowledge on SRHR and specific constitutional provisions on safe abortion”
“Even many of us the health workers are not properly informed and knowledgeable on under what circumstances is an abortion is permissible in the law”
This was revealed during a community engagement organized by UYAHF Adolescent Health (ADH) Clinic in Mbale on International safe abortion day to raise awareness of the increased mortality rates among adolescent girls due to unsafe abortions held on 28th September 2022.
International Safe Abortion Day commemorated every 28 September is a global feminist campaign for access to safe and legal abortion. This year’s theme is ‘uncertain times call for diverse, collective action on many fronts. It calls upon those who support women’s rights and gender justice to speak up as accountable allies.
The community engagement was held under the objectives; To sensitize the community on different contraceptive methods to enable women to choose the best methods for themselves, To expand and improve the quality of affordable post-abortion care services at the facility, and To create awareness on the dangers of unsafe abortions in our community.
It was attended by over 30 participants from several suburbs of Mbale city including young mothers, adolescent girls and boys, CSO representatives, teenage mothers, health workers, VHTs, and youth champions among others.
Speaking at the opening of the engagement, Dr. Namonyo Franco, the in-charge UYAHF ADH clinic noted that the only way to prevent teenage pregnancy and its related consequences that involve unsafe abortion is by embracing the use of contraceptives.
“I am very sure that those who go for unsafe abortion do it because they don’t want the pregnancies. But then I also ask myself, why don’t you practice safe sex by using contraceptives to avoid all these problems” he wondered.
He revealed that the UYAHF ADH clinic has been put in place mostly to solve the long-existing challenge of limited access to Sexual reproductive health services and information to young people due to stigma, fear, and a lack of confidentiality.
“The clinic is here for you people, we have ample space for you to come and relax, interact with our health official privately without any judgment, open up to them, and ask any questions in regards to your health and they will happily help you so that you don’t end up in situations that will cost your life” he noted.
While sharing experiences on incidences of unsafe abortions, Jessica Tumusiime, a social worker working with Women With a Mission (WWA), a female-centered local community-based organization revealed that from her interaction with many young people over time, she has been told that they use concentrated tea leaves, jik, and sometimes dangerous objects like razorblades, hunger metals, stick which with the help of friends they insert in their uterus.
“When you hear these narrations from these girls you feel like you are passing out, these young people do extremely dangerous things that you can’t imagine” she added
She noted despite the fact that we keep talking to young people about not attempting unsafe abortion, it has not stopped them from doing the dangerous procedure. Jessica encouraged them to open up about complications that might have resulted from unsafe abortion.
“All in all, we may not be able to know what is happening where and at what time but all I encourage you is to at least seek for help or encourage your friend who might have attempted an unsafe abortion to go to a health facility for what we call post abortal care to save them from further complications that may result to death” she said.
Dr. Ayeku from reproductive health Uganda who joined the engagement virtually took the participants on the legal aspects of abortion in Uganda and the provisions under which abortion is permissible under the law.
“The only situations in which an abortion is permissible in Uganda include; in the cases of rape or defilement and when the baby may cause harm to the mother if kept, and cases where the baby has life-threatening anomalies” Dr. Ayeku explained.
“So you realize that this leaves a big gap for the rest of you women and adolescent girls who get unintended pregnancies which predispose you to unsafe abortions that highly puts your life at risk” he warned
He however emphasized that the procedure “must” only be induced by a professional and qualified health practitioner in a health facility where proper care and monitoring can be done to ensure safety and proper post-abortion care services.
At the close of the engagement, young people acknowledged the receipt of a wealth of knowledge on matters concerning unsafe abortion, the legalities and contraceptive use.
They committed to start taking up contraceptive services as a way to prevent unwanted pregnancy and becoming champions in their communities in demystifying the myths and misconceptions around contraceptive use. They further pledged to teach their colleagues on the dangers of unsafe abortion and discourage them from indulging in unsafe sex practices.