SEXUAL REPRODUCTIVE HEALTH AND RIGHTS

DESCRIPTION OF THE PROBLEM

In Uganda, young people form a large proportion of the population i.e. 68.9% is below 25 years according to the 1995 Uganda Demographic and Health survey (UDHS 1995) those aged 20-24 years are estimated to make up 33% of the population.
The findings also revealed that reproductive Health is so poor to most especially the Adolescents. According to the same survey, by 20 years, almost 67% of women in Uganda have had children. Contraceptive use (all methods) was 7.5% among 15-19 years old compared to the National average of 13.4%. The female condoms are un heard of.
Amongst married women, the contraceptive prevalence rate was 9.9% among 15.9 years olds compared to 20.9% in the 30-34 years age group.
Teenage pregnancies and births often led to school dropouts and unsafe abortions for girls. Records from the main national referral hospital, Mulago Hospital, reveal that 50% of the unsafe abortion cases are among Adolescents and as a consequence, there is high maternal mortality and morbidity rate in this age group.
By age 15, 30% of women have had sexual intercourse and by 18 years, 72% have had sexual intercourse. 56% are married by the age of 18. It is no wonder then that about half the number of people infected with HIV/AIDS are young people aged between 15-24 years.
The male to female ratio stands at 1:3 young people compared to 1:1 for Adults. This implies that there are more infections among females than their male counterparts.
Factors contributing to the poor reproductive Health situation include among others, unfavorable cultural norms and traditions; peer and social pressure; inadequate access to services; long distances to service provision points; poor quality services and unfriendly service providers. These often lead to failure of Adolescents to access correct information and guidance as well as service.
A number of recent adolescent studies in Uganda reveal that adolescent sexual activity is relatively high with a corresponding exposure to the risk of STD’s/ HIV/AIDS Agyei, et al. (1994).  Parents’ school authorities, Government through MOH and other NGOs have expressed concern about the levels of adolescent’s sexuality because of reproductive health problems and needs of this sub population.  Such concern has stimulated interest in the sexual behaviors of adolescent’s men and women and has resulted in further research in both small scale and national surveys.
Most of these surveys generally suggest that the proportional of sexually active adolescents who have general knowledge on reproductive health is very high.  However, the same survey shows that levels of behavioral change are very low among adolescents (Ntozi, et. al. 1997).
In addition to this, majority of parents and guardians have not played the guidance role due to lack of adequate knowledge and information about sexual and reproductive health issues. Life skills, sex education and the appropriate skills on how to help their children develop decision-making skills, have not been adequately disseminated. Unfortunately, life skills for young people have not yet received the due emphasis in curricula and programmes for in and out–of school youth. Parents and guardians are expected to play crucial role accessing information to their children, which would empower them with the ability to make meaningful decisions and act responsibly in order to protect themselves against STI’s including HIV and unwanted pregnancies. Since most of the youth especially those out of school miss the opportunity of acquiring knowledge about sexuality and sexual and reproductive health, ability of majority of youth to make meaningful informed decisions that can protect them against sex related problems is limited.
The status of sexual and reproductive Health status in Kassanda sub-county, services are unaffordable and are neither comprehensive, nor integrated, and decline in drug supplies in government units especially Kassanda Health centre IV has grossly affected the quality and level of sexual reproductive health service delivery. Huge gaps exist between demand and supply of quality, integrated sexual reproductive health services.
There is need to empower Adolescents with knowledge on sexual and reproductive health. This will enable them understand how their bodies function and perceive the risks of STD/STI’s including HIV teenage pregnancies and unsafe abortion.
Sex education can help delay first sexual intercourse for youth who are sexually active as well as promote safe and responsible sexual behavior among the sexually active youth.  There is great need to empower the Peoples’ Medical Centre, (The Partner member of KCF) with supplies, personnel training and volunteer staff.

Educating the Adolescents and women on their sexuality, sexual and reproductive health and life skills through Drama, Educative Games and sports, peer education, counseling, clinic and referral services, Nonetheless, there is need to strengthen  the existing capacity further to be able to provide a wide range of services to women and the Adolescents, that are designed to provide reliable and sustainable source of information. This will facilitate the women and Adolescents to protect themselves against STD’s/STI’s including HIV and teenage pregnancies. The is need to build capacity and promote awareness of KCF, in conjunction with Kassanda Health Centre, The people’s Health Centre, for Women and Adolescents seeking sexual and reproductive health services that they may have been seeking from else where in the project area but in vain

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