Pregnant Adolescents: Is Uganda Delivering On Promises Of Hope?

 

By Fred Ouma

 

In a banana field somewhere in the west, an adolescent wife is about to deliver her first baby. Another lonely teenage bar attendant at the border point infected with HIV by a passing truck driver is also in the same situation.

 

So, are terrified girls, abducted by the Lord’s Resistance Army in the north and street children in Kampala, addicted to drugs.

Every single hour, due to circumstances beyond their control or one careless moment’s exposure to risk, more than 1,600 Ugandan adolescents will give birth; many of them physically immature, with no exposure to antenatal care or access to delivery services or emergency obstetric care.

 

As a result, some will bear the scars of this trauma for life and give birth to children who, if they survive, will be caught in the same vicious trap.

 

Dr. Richard Nduhura

Dr. Stephen Mallinga

Dr. Ssentumbwe

Mugumya

Uganda has the highest teenage pregnancy rate in sub-Saharan Africa, with half of its girls giving birth before the age of 18. Some give birth to healthy children, but for many, pregnancy was unplanned, birth comes too early and the experience is one of fear and pain.

As the world observes the World Population Day today, countries like Uganda continue to have a huge unmet requirement for family planning services.
Many times girls marry and start their families before ending their own childhood.

 

The median age for women to marry is below the age of consent (17.8 years) as many experience their first sexual intercourse at 16.6 years, compared to 18.1 for men, according to the 2006 Demographic and Health Survey.

According to the World Health Organisation (WHO), adolescent girls face health risks during pregnancy and childbirth, accounting for 15% of the global burden of disease for maternal conditions and 13% of all maternal deaths.

In Uganda, adolescent mothers are twice as likely as older mothers to die during childbirth. Only 41% of births are attended by skilled personnel. For poor young mothers, aged 14 and under, the risk is highest because they have the lowest access to prenatal care, hence, more likely to deliver at home than in hospitals, experts say.

Ministry of Health data show also that fertility varies markedly with the education and economic status of the mother. Uneducated mothers have almost twice as many children as women with secondary or higher educations (7.7 children compared with 4.4).

Similarly, women in the poor households have more than twice as many children as women in the wealthy households (8 children versus 4.3 children).
“Pregnant adolescents are in a dark void of helplessness and hopelessness, waiting to be rescued,” says Dr. Olive Ssentumbwe Mugisa, the WHO advisor on family and population health.

“For some, their need dates back to their infancy, when their families were unable to give them access to education, nutrition and survival skills.”

Dr. Anthony Mbonye, the in-charge of reproductive health in the Ministry of Health, says for every young woman who dies in childbirth, on average 40 others are left with an injury (or incapacitated to fend for themselves).

“Young mothers are more likely to have low birth-weight babies, at the risk of malnourishment, poor development or death,” adds Mbonye.

“Infant and child mortality is highest among children of adolescent mothers. Girls who give birth miss school and opportunities for employment. There is a risk of the cycle repeating itself.”

Unwanted and early pregnancy, reflects a failure to provide a safe environment that supports girls to reach adulthood with education, prospects and hope.

In Uganda, many teenage pregnancies are not merely unplanned, but also unwanted, contributing significantly to an estimated 297,000 stealthy abortions annually. Because they are less likely to have access to legal and safe abortion, adolescents are estimated to account for over 14% of all unsafe abortions, per-

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