By Joshua Mirondo, youth writer for Transition Earth.

The novel coronavirus, also known as COVID-19, is altering lives around the world.  Below is a closer look at how it is impacting Uganda, and peoples’ access to reproductive health.

Uganda registered its first COVID-19 case on March 22^nd, when a Ugandan citizen returned with the virus after having been in the United Arab Emirates, a country that was considered to have a low number of infections. This came at a time when Uganda’s president, H.E Yoweri Kaguta Museveni, had stopped public gatherings; however, some non-crowded institutions were still running. Confirmation of the new cases made the government revise its initial measures put in place, which included a stoppage on public transport followed by a lockdown, where only essential workers were left operating. At this point, COVID-19 cases were rising and all these steps suppressed the issue.

The quarantine was a major step in curbing the pandemic, but it negatively affected people’s livelihoods. A great number of Ugandans only work for their daily sustenance, and the absence of vendors from streets meant a severe lack of food and other basic needs. The government responded to this problem after some weeks by promising to provide food to those in the most affected areas.

President Museveni also passed a directive that those who wished to go to the hospital could contact the Residential District Commissioners (RDC), who are the President`s representative at the district level. This meant that districts with over 2 million people had to converge at the RDCs premises to make sure they could get clearance to use cars when in need of getting health care. Those who could not had to walk to health facilities, many of which are quite far from areas of residence. Because of this, a woman had to give birth on the roadside. Luckily, she was assisted by passers-by and had a successful delivery; yet she should have had access to proper care.

Figure 1: Activist Moses Nsubuga joins community members to save a woman who was giving birth by the road side during a ban on public transport.

​In another example of hardship, women who were scheduled to go to the doctor for a mandatory antenatal checkup couldn’t because of the quarantine measures. This was later changed when the president said that pregnant women do not need any documents to use vehicles.

Access to contraceptives also became difficult during this period, as some facilities closed because of the lockdown. The ones that remained open weren’t easy to access, especially by young people, given that many had to travel long distances. The negative perception of sexual and reproductive health (SRHR) also stopped youth from getting SRHR services for fear of being judged by the public since everyone’s moves can easily be monitored. This will likely result in numerous unintended pregnancies that will bring a drastic increase in Uganda’s already rapidly growing population.

Charles Owekmeno, the national coordinator of SRHR Alliance Uganda, said that as much as we want people to be safe from all other aspects, social reproductive concerns are at their peak too. “Uganda is headed for a big number of the baby boom and unwanted pregnancies since family planning and sexual reproductive health is limited,” he added.

Figure 2: Charles Owekmeno of SRHR Alliance Uganda on local TV

Health centers also suspended all HIV related activities as a measure of safeguarding people from getting COVID-19. A number of people living with HIV missed critical Anti-Retroviral Treatments (ART), due to social distancing measures and health centers that could not handle crowds. All of a sudden people could not visit health facilities for their review – crucial for their health – and neither could those who wanted to be tested for HIV.

The Ministry of Health, therefore, advised people on their first ART to get a six-month supply of drugs from nearby facilities in order to maintain their treatment. Those on second and third ART were advised to get drugs for at least a month because of the uncertainty of the lockdown length. However, there are people who access treatment from distant places because of stigma, and these people were greatly impacted by the ban on public transport. A group of young people from the Uganda Network of Young People Living With HIV (UNYPA) took it upon themselves to ride bikes and deliver drugs to those far from health facilities. This helped to bridge the gap between homes and health centers. However, this is only happening in some parts of the country, leaving many to find it challenging to access treatment.

Figure 3: Some young people from UNYPA delivering drugs

​​The ​Uganda Police force is also seeing high rates of Gender Based Violence (GBV) during this lockdown period. The situation has intensified gender inequalities, and already marginalized women and girls are in a worse situation. This is because the victims are now spending more time with their abusers, as schools and work places have been closed.

Of course GBV already existed before COVID-19, but the recent measures put in place have escalated its occurrence. Before the virus, one could easily walk to the neighbor, police or any authority to seek refuge after being tormented, but this cannot happen anymore because of the limitation in movement. It is also quite hard to report perpetrators. Making a phone call is difficult, as the victims are being watched by their abusers all the time. These cases may worsen as the lockdown continues, putting victims at great risk of mental and physical harm.

For the sake of human health and rights, authorities need to consider taking measures to curb the growing challenges that have been brought by COVID-19 so as to prevent adverse effects that might end up being very costly to manage. ​

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