I love burning the midnight oil. The tranquillity created by the night silence floods my mind with reflections, aspirations, ideologies, energy and excitements… Sexual and reproductive health and rights are timeless. As I sit here reflecting on the evolution, controversies, definitions, contexts and successes, I cannot fail to feel the struggle for recognition at the international arena. Sexual and reproductive health and rights cuts across health, population control, rights, laws and policies. Its progression cannot be written, read or discussed in isolation rather as sociocultural, religious, economic and political revolutions. The gaps in sexual and reproductive health and rights have exerted a toll on individuals, families and communities.
Sexual and Reproductive Health and Rights: Africanized Dilemma
Women and girls right to sexual and reproductive health has been a tool of war/conflict, sexual crimes, political milestones, controversial dialogues and reference to unrealised needs
There is a failure here and there, now and then, so often. Sub-Saharan Africa has continuously experienced poor sexual and reproductive health and rights. There are a number of factors contributing to this among them inconsiderate policies and laws, gender exclusion, weak economic capacity, the prevalence of sexually transmitted diseases, insufficient knowledge on human sexuality, retrogressive practices and failure to implement programmes to redress sexual and reproductive health and rights constraints. Food for the thought-how will Africa move forward on sexual and reproductive health and rights? Adopt to multi-sectroral approaches as stipulated by international and regional human rights bodies and governments such International Conference on Population and Development (ICPD) and Convention on the Elimination of All Forms of Discrimination Against Women(CEDAW). Before I proceed too far, you should know, rights to reproductive and sexual health is the right to life, liberty and security of the person, health care and information, non-discrimination in the allocation of resources to health services, their availability and accessibility.
Baby or no Baby ? Unmet Need and Demand for Family Planning in Uganda
Men and women have the right to be informed and access safe, effective, affordable and acceptable methods of family planning of their choice without coercion, discrimination and violence (IPPF).
Try to picture what it is to be the world’s most fertile woman. Yes, Miriam Natabanzi in her 40 years has given 44 children. You might be tempted to think she has been pregnant all her life. No. Miriam Nabatanzi’s journey to motherhood began in 1993 by then she was 13 years. Her first birth brought forth twins then triplets, quadruplets and a few single births. This is a rare condition known as hyper-ovulate. In her village, Miriam Natabanzi is nick-named Nalongo Muzala Bana (the twin mother that produces quadruplets). Miriam Nabatanzi regrets nothing about her many children; her only worry was his husband’s promiscuity, how he went missing for months and called to give names for his latest children in the family. Although life for Miriam has been a roller coaster, she has chosen not to scream but enjoy the ride. Putting food on the table has been the biggest challenge. They say a child is a child of everyone, that is how Miriam Nabatanzi has managed to bring up her 38 surviving children. Miriam Natabanzi’s suffers a rare genetic called cyst formation or in a lay man’s language enlarged ovaries whereby a single sperm can ovulate more than one embryos. Worse still the condition is also not compatible with contraceptives, a part from condoms.
Thought You Should Know..Family Planning is…
Unmet need for family planning is the percentage of women in the reproductive age brackets (15-49) either in marriage or a union whose desire is to stop or delay childbearing but are not currently using any method of contraception-United Nations.
The total number of women with unmet need for family planning fall in two categories: with unmet need for spacing and those with unmet need for limiting. Gone are the days when many children were a status symbol for wealth across traditional Sub-Saharan Africa. The contemporary times have created a cliché for family make-up of two, or at most three children; for many families, this is the decisive lead to the modern contraceptive method.
The major forms of contraceptives are: barriers methods of which the commonest are condoms or sheath, the contraceptive pill which contains the synthetic sex hormones that prevent ovulation in the female; intrauterine devices, such as the coil, which prevent the fertilized ovum from implanting in the uterus, and the male and female sterilization/vasectomy -(Center for Disease Control)
What modern contraceptive methods do is use technological advances to overcome biology. Such are intrauterine devices, implants, orals, condoms (male and female), sterilization, emergency contraceptives and diaphragms and cervical caps, hysterectomy and spermicidal agents. Unlike the non-modern methods of contraception such as coitus interrupts also known as withdrawal, lactational amenorrhea, rhythm, cervical mucus, calendrer methods and abstinence couples act on natural impulses and desires while the risk of pregnancy and sexually transmitted diseases (for condoms only) is negligible. Therefore, couples have the pleasure of sexual intercourse at any mutually desired-time
Contraceptives are the deliberate use of methods or other techniques to prevent pregnancy as a consequence of sexual intercourse.
Informed Consent: Plan for a Family or Just Have Kids?
Uganda has the highest rate of fertility in the world, teenage pregnancy prevalence, unsafe induced abortions, neonatal and maternal mortality. Family planning service and information enable couples/ individual’s make decision when or not to have a child. That is not a successful case in Uganda. The contraceptive prevalence rate is as low as 30% among married women and a high fertility rate of 6.2 per woman. This means the population growth is predicted to rise at more than 3.2% yearly. That’s not all; the rate at which unsafe abortions happen is alarming, not to forget the related complications among teenagers of 15-19 years. Just for the record, 2013 saw 57,000 teenage abortions in Uganda. The legal status of abortion according to the Ugandan Constitution states “abortion is illegal unless performed by a licensed medical doctor in a situation where the woman’s life is deemed to be at risk.”
Contraceptives /Family planning are proof for realisation of reproductive systems, functions and processes-safe and satisfying sex, the capacity to reproduce, the freedom to decide if, and when, and how often to do so (International Planned Parenthood Federation).
Family planning is the recommended interventions for lowering maternal and child morbidity and mortality rates. Family planning reduces the risks of high-risk pregnancies. Couples are also more peaceful and welcoming of pregnancies and childbirth when it was planned. There is more to family planning than just healthy timing, child spacing and limiting births to the desired family size. Family planning has ripple effects on families and communities because it improves the health of mothers and that of their children. Thus, communities and countries enjoy the outcomes of stronger, healthier and productive citizens who can cater for their need such as food, education, health, adequate housing and investments. This way, they are not a burden to one another or the government, while putting less strain on the natural resources and environment. Effective services and information translate to preventable maternal deaths and related complications.
No! What the Hell! I Am Pregnant.
Giving birth is a matter of death or life for mother or child especially among the poor in Sub-Saharan Africa. At least 200,000 mothers die as a result of complications during pregnancy and childbirth & 28 infant mortalities occur out of 1000 life births(World Health Organization).
The lives of newborns and children are dependent on family planning. According toUnited Nations International Child Emergency Fund (UNICEF), an estimation of one-third of all infants’ deaths happen because mothers had close frequent births or was too young. Babies who are born of underage mothers (18 years below) are most likely to be born preterm, suffer low birth weight or develop complications during birth with a probability of neonatal or maternal mortality. The world is globalised more than ever before. Teenagers and young girls are exposed to a pool of knowledge among them their sexualities. Instead of sweeping the dust under the carpet, family planning is important to delay pregnancies (I am not advocating for family planning among teenagers and adolescents, but if it the only solution, so be it ). That way their potential to realise better futures remain intact-no what the hell I am pregnant! No pregnancy shaming, no unsafe abortion, no coerced teenage pregnancies and no abusive relationships.
This post is a continuation of Sexual and Reproductive Health and Rights: Magnitude of the Challenge. It is going to highlight on Unmet Need for Modern Contraceptives in Uganda, Sexual Violence in South Africa, HIV/AIDS in Botswana, Maternal Mortality in Chad and Female Genital Mutilation in South Sudan and Breast Ironing in Cameroon.
Quote of the month
“There are three things that have to be done in quickness: burying the dead, opening the door for a stranger, and fixing your daughter’s wedding.” ~ Iranian Proverb