Ntoroko Youth: ‘Self-Care’ only hope to curb unwanted, early pregnancies

Ntoroko, Uganda | THE INDEPENDENT | 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.

“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.

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.

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.

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.

“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.

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.

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.

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.

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.

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.

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.

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.

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