KAMPALA – When Mary Nabuzale, 13 got her first period, her mother told her to start avoiding sex in a bid to avoid teenage pregnancy.
But Nabuzale, who was armed with information on reproductive health and sexuality education from school, asked her about what she is expected to do and her mother told her never to discuss issues concerning sexuality in life.
She said her rural mother urged her to stop flirting around with boys and never to talk about menstruation to anybody saying it is a taboo in their tradition.
And because of this Nabuzale and other girls in this community are growing up regarding sexuality Education and reproductive issues as taboos in their community.
She explained that at Busiita Primary school in Sironko district where she attends lessons when a topic related to sexuality and reproductive Education is brought for discussion, discomfort, giggling and laughter erupt from participants in class forcing the teacher to change the topic.
She said because of the taboo associated with sexuality education and reproductive health, rural adolescents are uncomfortable discussing topics related to sexuality like family planning, use of contraceptives, etc.
“And they have nobody to talk to about these, It is more evident when teachers begin to explain common occurrences during adolescent puberty, like when a boy experiences ‘wet dreams’ or when a girl begins menstruation,” said Nabuzale.
She said given parents’ traditional ties and hesitation to discuss topics related to sexuality, many adolescents between the ages of 12 to 16, are lacking the knowledge to deal with – and prepare for – their first menstruation.
It is clear that there is a culture of silence amongst rural traditional folk, the older generation does not talk about the grave matters for adolescents, such as sex or domestic violence, in order to preserve cultural survival and continuity.
She added that this explains why adolescents, especially girls and young women in Sironko have limited knowledge and understanding about sexuality and reproductive health.
This comes at the backdrop of reports from government officials in the Ministry of Education and experts that have shown concern at the rising cases of teenage pregnancies in Uganda indicating that the country is facing an ‘epidemic’ of teenage pregnancy during the Covid 19 pandemic.
Educationists claim that during the COVID-related restrictions, over 90,000 girls under 18 have got pregnant during this period when they were not going to school.
Ms Agatha Nafuna, a retired midwife explains that many adolescents especially girls/young women in this society have also adopted a culture of silence with their parents which has killed sexuality Education needed most during those crucial transitioning stages in their [adolescents] lives.
“And when their curiosity is enticed and adolescents begin to develop sexual desires, they don’t even think of raising the subject with parents because they never speak nor make it approachable, so it becomes an uncomfortable subject to talk about, this explains why many teenagers are getting pregnant,” said Ms Nafuna.
She added that the feeling of embarrassment to talk about sexuality is only worsened by the tradition that bars adolescents/young women from talking about sexuality with many incidents reported where girls are teased and mocked if they are seen with bloodstains on their clothes and skin, without notice.
“Teenage pregnancy is common because girl-child does not have knowledge of sexuality education and reproductive health, they go into sex ignorantly without skills, guidance and information,” added Ms Nafuna.
More typically, however, most adolescents and young women in rural areas of Uganda go through this kind of silence and remain uninformed about sexuality Education and reproductive health, this explains why many have gotten pregnant during Covid 19 movement restrictions.
According to the Ministry of Health, 25 percent of Ugandan teenagers become pregnant by the age of 19 and that close to half is married before their 18th birthday and continue having babies until their mid-40.
According to Mr Muhammad Kasule, Technical Assistant at Ministry of Education and Sports, Under School Health/HIV Unit at the critical stage in the lives of adolescents: they require empowerment to skills, guidance and information about their bodily changes.
He said the ministry supports the development of policies, strategies and programmes to secure the health, development and human rights of all adolescents and youth and that they are promoting digitalisation of sexuality Education.
The discussants at the UNFPA E-meet described mobile phones as the most popular way to get to digitalisation because they reach all adolescents with information.
“And given the fact that the country is today introducing people to the internet in unprecedented numbers and this could have profound implications for girls/women empowerment from entrepreneurship opportunities to affordable healthcare and peer learning platforms,” said Mr. Kasule.
Ms Anne Sizomu, Programme Specialist, Adolescent & Youth Sexual and Reproductive Health UNFPA encourages digitalization of information about reproductive health and sexuality education in order for adolescents to access it on smartPhones.
She revealed that the SAUTIplus app helps youths get access to accurate and reliable information about their Sexual and Reproductive Health.
Although Nabuzale in Sironko is an extreme case in rural areas of Eastern Uganda, Becky [also an adolescent] from Mbarara says when she got introduced to the SAUTIplus app, everything changed because it helped her do away with the fear of speaking up.
“When I applied the SAUTIplus app, I found the part of the Sauti Senga where I could ask anything about reproductive health and sexuality education and get answers immediately,” said Becky.
She said with the many myths and misconceptions about family planning and HIV that I knew, I was greatly helped to know what is true and what is not. For example, now I know that I can use any contraceptive method without the worry of getting cancer.
“I also found out that the referral part on the app is very useful especially because it doesn’t matter where I am whether in Mbarara or another district the app shows me all the health centers that are in my area and in other districts,” added Becky.
She revealed that one time she didn’t want to go to certain health because one of her parents was known to the health workers and that she used the app to find another health facility in her area where she was comfortable accessing the sexual reproductive health services
She disclosed that UNFPA has also helped to create peer-to-peer networks to improve access to health services among young people in and out of school.
Ms Sizomu says that at UNFPA, they have realized that disparities in sexual health education are prominent and mainly affect young women and that the current sexual health education technologies for adolescents helps fill the gaps in knowledge.
“As a result, the use of technology to reach these marginalized populations could potentially invoke change and it is crucial to determine the viability of technology as a mechanism to bridge the knowledge gap regarding sexual health for adolescents that are most at risk of teenage pregnancy and unwanted pregnancies,” said Ms Sizomu.
Ms Sizomu said lack of knowledge and a combination of anxiety and shame has led to a high number of girls who skip class during their monthly menstruation.
Ms Anne Sizomu, while presenting a paper titled; UNFPA’s response to increasing access to Sexual and Reproductive Health and Rights for adolescents amid COVID-19 at the Adolescent & Youth Sexual and Reproductive Health at Post Day of the Girl Media E-Chat Media E-Chat 16 October, said with the onset of adolescence, young people are exposed to heightened vulnerability to sexual and reproductive (SRH) ill-health, as well as to negative social practices that jeopardize their right to a healthy, successful transition into adulthood.
She said despite evidence that Uganda, like other developing countries, is paying greater attention to youth through public policy initiatives, young people still confront many obstacles that prevent them from having a safe transition into adulthood.
She explained that in partnership with young people, the government and other stakeholders, UNFPA supports the development of policies, strategies and programmes to secure the health, development and human rights of all adolescents and youth.
“UNFPA’s programming is focused on reaching the most vulnerable adolescents and youth first, with particular attention given to adolescent girls, young people with disabilities and refugees,” said Ms Sizomu
She disclosed that UNFPA working with the government of Uganda, the Ministry of Health has also created Safe spaces, (formal or informal place where women and girls feel physically and emotionally safe) , skilling and livelihood clubs for vulnerable adolescent girls and youth, including in humanitarian settings.
Ms Sizomu said UNFPA is working with the Ministry of Health and other key partners like Jumia, to bring the services to young people through the Jumia e-shop, where young people are able to order contraceptive services using their smartphones and they are delivered to their doorsteps.
“We also have GetInApp, Safe Pal App, Sauti Helpline and UNFPA also supports the Ministry of Gender, Labour and Social Development to strengthen the SAUTI helpline which improves reporting cases of sexual and gender-based violence for young people across the country,” said Ms Sizomu.
She said the Youth corners are a new innovation in health facilities to help youth attain services to improve their sexuality choices away from the prying eyes of adults.
She explained that critical investments should be made to protect young people’s rights, improve their health, including sexual and reproductive health, and provide skills and knowledge to build their capabilities and agency.
“Despite evidence that Uganda, like other developing countries is paying greater attention to youth through public policy initiatives, young people still confront many obstacles that prevent them from having a safe transition into adulthood,” said Ms Sizomu.
Ms Olgha Daphynne Namukuza, a sexual Health Activist said the ministry of Health needs to prioritize the implementation of policies, strategies, plans and programs that promote the sexual and reproductive health of adolescents and youth, including training of public health providers in the provision of adolescent and youth-friendly services to ensure no adolescent is turned away from hospital for seeking contraceptive services and information.
She added that all stakeholders, especially the health and education ministries have a critical role in ensuring facilitation of comprehensive sexuality education for adolescents in and out of school to equip them with knowledge and capacity to make informed choices.
“And in this digital age, embracing new innovations like toll-free hotlines, social media and apps that address related issues is essential to ensure access to timely, factual and quality sexual and reproductive health information for adolescents and young people is key,” said Ms Namukuza.
She urged adolescents to make use of ‘The Stage’ a platform for young people to express themselves through telling their stories, sharing experiences, sharing ideas and deriving inspiration from peers to address social issues in their communities.
About the Apps
Android application Sauti Plus Peer Educator developed by ThinVoid is listed under the category Productivity. According to Google Play Sauti Plus Peer Educator achieved more than 200 installs. Sauti Plus Peer Educator currently has 9 ratings with an average rating value of 4.1
From healthy living to family planning and other sexual-related issues; they seek to demystify commonly held notions and ensure that youth get affordable access to sexual reproductive health care services through partner health institutions across the country.
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