Kabatoro who gave birth at 16 years believes that in the absence of self-care awareness many young women like her have gone on to have unwanted pregnancies and in the worst scenario contract sexually transmitted infections like HIV-Aids.
Adolescents and young mothers are
experiencing significant barriers, including stigma and discrimination to
accessing voluntary family planning and reproductive health (FP/RH) services at Kanara landing site, Ntoroko District.
Although self-care interventions have been
shown to reduce such social barriers to family planning and reproductive health
care little information is known about this intervention, particularly in low-resource
settings. With the district records showing teenage
pregnancies standing at a staggering 25% adolescents and young mothers now think
that if they are empowered to be in control of their health, such cases of
teenage and unwanted pregnancies can significantly reduce.
Self-care is a
significant initiative aimed at empowering individuals to take an active role
in their health management, ultimately alleviating the burden on healthcare
workers. Rehema Kabatoro a
resident of Kigungu village in Kanara Sub County says that many adolescents at Kanara landing site experience fear
and shame when purchasing contraceptive products and consequently avoid
healthcare facilities.
Kabatoro who gave birth at 16 years believes
that in the absence of self-care awareness many young women like her have gone on
to have unwanted pregnancies and in the worst scenario contract sexually
transmitted infections like HIV-Aids.
//Cue in: “Kumulorera egumire halinye…
Cue out: …naswara kujwa hairwaro.”//
Translation
“Am requesting awareness, so that individuals
can be able to make decisions on how they can manage their sexual life when
few self-care awareness training come here, they are conducted at the health
center III and most of the young girls fear to go there…”Rehama says Bob Kuguma. a youth in Kanara Town
Council notes that many young people are not equipped with skills and essential
items they can use to manage their health mentioning that the condom box
at the town council has not been refilled for the last year. For him and his peers, self-care is an
option for reducing discrimination and improving the user experience.
//Cue in: “Our main point…
Cue out: …they can inject them.”//
Sarah Sandra who gave
birth to twins at 16 years old recounts how she was lured into sex after being
convinced by her boyfriend that she was on her “safe day and wouldn’t get
pregnant. Both didn’t know how
the menstrual cycle works. She now wants self-care
awareness on family planning integrated into the routine health awareness
campaigns.
Swahili
byte...
//Cue in:
“Mimi natoka Kanara….
Cue out: …nazala mbiyo mbiyo.”//
Fred Kyotumu, the youth
chairperson for Kanara Town Council says that due to huge challenges faced by
families notably those that are staying in camps many young girls are
engaged in commercial sex without basic health information.
//Cue in: “Here we are…
Cue out: ...which is
very enough.”//
Jessica Bahat
Balikatura, a VHT at Stella Maris HCIII and a counselor at Ntoroko Hospital agrees that if young people are educated about self-care, it can reduce the
risk of costly non-communicable diseases. She says that from her
10 years of experience many sexually active youth fear seeking open medical
services from health services while the cultural setting bars such discussions
about family planning.
//Cue in: “Aban abato
kuba…
Cue out: …oba nka
group.”//
Translation
“But young people fear
to mix with the old at health facilities and such young people must be equipped with the knowledge on how they can be in control of their health, these can be self-care training in communities or schools…” she
says Bahati adds that it does not get women-controlled products like
the Caya diaphragm, the Woman’s Condom, and a
self-injectable contraceptive in such a setting with limited health service providers.
Due to lack of such
knowledge, she says the sub-county alone recorded more than 100 teenage
pregnancies during and after the Covid-19 lockdown.
//Cue in: “”Abakazi mu
Kanara…
Cue out: …ensoni
kugwayo.”//
Patrick Byaruhanga, the Ntoroko district
health educator agrees that the lack of self-administered
contraceptives among sexually active girls especially those not captured
by the national guidelines to access family planning has negative effects on
their lives and reduces their economic potential.
//Cue in: “Self-care is actually…
Cue out: …school going or what.”//
Byaruhanga however says that the district is
undertaking self-care awareness among adolescents and parents to improve
health literacy, promote autonomy, and
support women and girls to participate
directly in their health care. However, he decries limited funding and
partnerships that are affecting the outreach programs.
//Cue in: “If you bring...
Cue out: …of what To do.”//
Despite these gaps,
Uganda has initiated efforts to raise awareness about self-care practices to
reduce hospital visits and allow health workers to focus on patients with
serious health issues.
Fatia Kiyange, the Executive Director of the Center for Health, Human Rights, and Development
(CEHURD) says there must be programming around giving sexual reproductive health information so that young people can make informed decisions. She noted denying young people sexual education is denying them life-saving intervention.
//Cue in: “ Also self-care embraces...
Cue out: … the young people"//
Kiyange told URN that there is need to bring on front evidence regarding the impact of having no reproductive health information so that sexuality education can be socially accepted.
//Cue in: "Yes indeed the...
Cue out:...achieve immediately."//
Roseline Achola,
Technical Specialist for Sexual Reproductive Health and Self-Care at the
Ministry of Health mentions that self-care empowers individuals to make
informed decisions about their health management through the information
provided by health workers.
//Cue in: “And there are...
Cue out: …about in self-care.”//
But Dr. Olaro Charles,
the Director of Clinical Services at the Ministry of Health, argues that while
self-care is connected to the health system it should not include
self-medication. He agrees that there is a need to empower the community especially mothers to appreciate self-care.
//Cue in: “Self-care is
definitely…
Cue out: …not a stand-alone.”//
According to the World
Health Organization (WHO), there is an expected shortage of approximately 10
million health workers by 2030. WHO advocates for
self-care interventions as vital components in achieving universal health
coverage (UHC), promoting health, safeguarding the world, and serving
vulnerable populations.
In May this year, the Ministry of
Health in partnership with the Uganda Healthcare Federation established a
structure to steer and oversee efforts by the various stakeholders to promote
self-care in the public and private sectors.
