Although Uganda has made remarkable strides in improving the health of its populations, some of the key health issues especially regarding Adolescent sexual reproductive health remain wanting. For example, although most adolescents in Uganda have heard about many aspects of sexual and reproductive health, many have limited knowledge and accessibility to youth friendly and affordable ASRH services thus adolescents are not adequately utilizing SRH services. Furthermore, the ministry of health states that currently 25% of Ugandan teenagers become pregnant by the age of 19 and about 49% are married off before their 18th birthday. Prevalence of child marriages is highest in Northern Uganda, at 59%, followed by Western region (58%), Eastern region (52%), East central (52%), West Nile (50%), Central (41%), South west (37%), and lowest in Kampala (21%). (UNICEF Uganda, 2015)
Endreo Gladys, 16 years old who was schooling in Fuda primary school in primary five got married to a man of 20 years of age, living in Boroli, so when the school administration realizes, they immediately reported to AFOD who made a follow up with the parents. On inquiring why she got married, the parents explained that they can’t afford to pay the school requirements and they are unable to support her education. Due to AFOD’s continued pursuance of the case, the girl decided to give up her marriage and resume school.
Challenges still faced by girls in Adjumani District according to AFOD’s assessment:
According to a baseline assessment conducted by AFOD in April 2016 on availability and accessibility of ASRH services in Adjumani, results indicated; 100% of health managers reported no availability of ASRH planning tools, 83.6% reported no existence of ASRH friendly services, 100% said information on ASRH are not displayed and youth are not involved in planning, implementation and monitoring of ASRH services. The study found that the most pressing problems of the young people were:
Sexually transmitted infections, early pregnancy due to lack of information on sex education and access to reproductive health services, lack of sanitary towels (dignity kit) for the girl child and knowledge on menstrual hygiene management and high poverty levels among both the host communities and refugees in Adjumani district.
AFOD identified schools as a key entry point for delivering key messages to create immediate impact with full participation and involvement of the teachers, pupils and their parents. A report from the office of District Education Office, Adjumani indicates worryingly high teenage pregnancy/ early marriage leading to 5,729 adolescents dropping out of schools in the district. Findings from the baseline assessment conducted by AFOD and DHO in Mungula, Mireyi and host areas prior to the start of project also indicated high proportion of teenage pregnancy of 12.6%. AFOD has responded by training health workers to support ASRH services in health facilities and later trained teachers to support adolescents in schools followed by community meetings. AFOD conducted community dialogue meetings with participants totaling 2,151 refugees and 1,522 hosts respectively. All were adolescents who dropped out of schools. In schools, AFOD had 12 school health talk visits and interacted with 2,500 participants mostly in upper primary.
In the case of Gladys, AFOD involved the Local council leaders, community development officer and cultural leaders about the girl’s situation, both parents were met and they agreed that the girl should go back to school, some scholastic materials were bought for her and she resumed studies immediately. The 16 year old girl is back to school and AFOD keeps making follow up to assess her progress, this success is attributed to AFOD’s staffs, school administration especially senior woman teacher, local council leaders, community development officer and some community members who played a key role in ensuring that the girl gets back to school. In one of the follow up interaction with the girl after two months of schooling, she remarked “school is key to my future because I have seen many girls in life skills training and I hope to pursue the same“