By Joshua Mirondo, youth writer for Transition Earth.

Community health worker in Uganda.

[Editor’s note:  Uganda has a rapidly growing population and people there – like all over the world – need to have services that support health and well-being.  We believe it’s important to share the view of youth in particular, who have to deal with the many issues rampant growth brings up.]

Uganda faces a wide range of challenging demographic features which stress the importance of Sexual Reproductive Health & Rights (SRHR) policy and programmes. For instance, we have one of the highest fertility rates in the world, high rates of teenage pregnancies and rising HIV/AIDS infection rates amongst adolescents. These are coupled with high rates of sexual and gender-based violence (SGBV), and the situation has worsened during the wake of COVID-19. The limited movement due to measures to curb the pandemic, like the lockdown, deterred people from accessing services and information. Recovery from the adverse effects of the COVID-19 pandemic may not be drastic but efforts should be made immediately.

Uganda’s Ministry of Health, in partnership with UNFPA, organized a two day National e-conference this past February on strengthening systems for the Integration of Sexual Reproductive Health, HIV and Gender-Based Violence.  The program was officially opened by the Minister of State for Primary Health Care, the Hon. Dr. Joyce Moriku. She was joined by the UN resident coordinator Rosa Malango and Daniel Johansson Arnhem, acounselor for the Swedish Embassy in Uganda.

The conference was held under the theme of “Integrating SRH, HIV and GBV services for Universal Health Coverage. My Role.” It was partly physical and virtual and was attended by SRHR practitioners from the government, development partners, academia, and civil society organizations in Uganda.

In her opening remarks, the UN Resident Coordinator addressed how COVID-19 has devastated communities and economies, yet it also provided an opportunity to address the urgent need for universal health coverage in Uganda. “If achieved, there will be affordable, high-quality services leading to better health for everyone, including children and women. Ugandans will be more educated and productive to the economy and families will be protected from poverty-causing health costs.”

Young people presented a paper that was developed from the pre-conference which recommended a meaningful engagement of youth at all levels in decision-making so that they are empowered to make informed choices regarding their SRHR and play a vital role in determining their destiny and making a meaningful contribution within their expertise.

“Prioritize innovative approaches for delivery of services and reaching young people as we are diverse with diverse needs. Young people both in and out of school need to be reached with accurate and age-appropriate sexuality education information and this requires different approaches. Integrated outreaches are proving to be great though there is need to scale up and address the issue of how in school young people can also benefit.” – James Ocen, Participant

The connection between sexual & reproductive health and GBV is mainly through intimate relations that are influenced by socio-cultural factors, including gender power imbalances. Socio-cultural factors, such as the unfavorable economic position of women, child marriages, female genital mutilation (FGM) and the inability to insist on condom use make most Ugandan women unable to negotiate the timing of sex and the conditions under which it occurs. Thus, they are rendered powerless to protect themselves against HIV infection and other sexually transmitted infections, and unwanted pregnancies.

As part of the experience sharing during the conference, several SRHR practitioners presented abstracts and posters of the unique interventions, especially during the COVID-19 period. This was aimed at presenting evidence of solutions or attempted solutions that could result in a shift from what is being done to what needs to be done.

Her Excellency, Karin Boven, the Ambassador from the Kingdom of Netherlands to Uganda, gave closing remarks in which she commended the Ugandan government for the progress and achievements made to address SRHR/HIV and SGBV. She also acknowledged the need to do more so as to secure sexual and reproductive health for all, and to ensure women and girls are able to live a life free of violence. “This means we need to step up our efforts, be critical about our strategies, and collaborate to have the highest impact on the lives of girls and boys, women and men.”

The UNFPA Representative, Mr. Alain Sibenaler, gave his remarks on the closing day, which were centered around showing accountability to the communities served, the government, and development partners, amidst the COVID-19 pandemic. “The issue of safeguarding the reproductive rights of our young people who have experienced sexual violence during the period when we have schools closed as a measure to prevent the spread of COVID. Ladies and gentlemen, teenage pregnancies are a gross violation of human rights and a form of gender-based violence.”

Youth, civil society organizations, development partners, and the Ministry of Health all committed to working together in each of their capacities to reckon a force that will foster the integration of SRHR, GBV, and HIV in fulfillment of the SRH rights of young people.  This is central in the development and will enable Uganda to achieve ICPD+25 commitments and SDGs especially goals number 3 (Ensure healthy lives and promote well-being for all at all ages) and number 5 (Achieve gender equality and empower all women and girls).

Summing it all up was the Hon. Dr. Moriku of the Minister of Health for Primary Health Care. She stated that going forward, the Ministry of Health will focus on improving access to high quality sexual and reproductive health services for all ages. This will therefore strengthen coordination mechanisms for quality delivery of integrated health services at all levels. Dr. Moriku concluded by urging everyone to ensure that there is a collective responsibility to succeed in the integration of SRH services to make a difference for positive change for all Ugandans.

Joshua Mirondo is a digital marketer, blogger, photographer and volunteer at Reproductive Health Uganda.