Supporting Family Planning in Uganda: A Couple Accesses Contraceptives to Prevent Unwanted Pregnancies
Thirty-year-old Miriam Makeba and her husband, Mujulizi Dan, struggle to provide for their two daughters, aged six and two years. Living in the Kyenjojo district of Uganda, Makeba is a stay-at-home mother and her husband is a boda-boda motorcycle taxi driver. Dan works from dusk till dawn to bring home the little money he makes throughout the day.
Many days, however, he comes home without a shilling in his pocket and the family has to go without supper.
"Even though our family is small, we struggle to put food on the table or raise money for school fees for the children," said Makeba. "I don’t have formal employment. I try to supplement my husband's income by selling some few items that I grow in the garden. But still, that too is not enough for the family."
Makeba and her husband decided against having more children to avoid adding to their burden. But they needed to decide on a family planning method.
Luckily, a village health team (VHT) supported by the US Agency for International Development (USAID)-funded STRIDES for Family Health project, led by Management Sciences for Health (MSH), had set up an information center on maternal health and family planning in the main trading area in Kyakapekye village where Makeba lives.
The VHT also facilitated motorcycle transport for women who needed to visit a health facility.
The VHT referred me to Kisojjo Health Center III where I started on the three-year [contraceptive] implants. I have not looked back since.
Although most Ugandan women are aware of family planning, the contraceptive prevalence rate is only about 30 percent, according to Uganda's 2011 Demographic and Health Survey (PDF). An absence of accurate information, poor access to quality services, spousal disapproval, and lack of funds often prevent women from seeking contraceptives. Other complications include contraceptive stock-outs, and conflicting social, cultural, and religious norms, as well as myths and misconceptions.
VHTs trained and supported through STRIDES for Family Health have helped women overcome some of these barriers in communities such as Kyakapekye.
Makeba said both she and her husband are happy to be able to plan for their family:
We do not have to worry about what could happen if I conceived. It could have been worse had we got another child. We can at least manage the size of the family now.