Though abortions are illegal in Uganda except when pregnancy endangers a woman’s life, an estimated 297,000—54 for every 1,000 women of fertile age—occur each year, according to two recent surveys of health facilities and health professionals knowledgeable about conditions of abortion provision in Uganda.
Because women seeking abortions rely primarily on untrained personnel using unsafe methods, 85,000 women are treated for abortion-related health complications each year, and unsafe abortion is the country’s leading cause of maternal death. At current rates, half of all Ugandan women will require treatment for complications related to abortion in their lifetime.
Half of all pregnancies in Uganda are unintended. According to the researchers, this high proportion reflects the fact that half of married Ugandan women do not have access to the full range of contraceptive services they need to prevent unwanted pregnancies and plan their families. While contraceptive use increased slightly between 1995 and 2000, the gap between the number of children a woman wants and the number she has rose slightly over the same time period. On average, Ugandan women have two more children than they plan.
Increased access to contraceptive services is needed for all women, the study authors conclude. "Helping women obtain contraceptives will reduce the number of abortions in Uganda. Health care providers, advocates, professional associations, government and communities all have a role to play in ensuring women’s access to the contraceptive services they need," said study co-author Dr. Florence Mirembe, Professor of Obstetrics and Gynecology at Makerere University in Kampala.
The analysis "The Incidence of Abortion in Uganda," by Susheela Singh and Elena Prada of the Guttmacher Institute, New York, NY and Florence Mirembe and Charles Kiggundu of Makerere University, Kampala, Uganda, appears in the December 2005 issue of International Family Planning Perspectives. Also in this issue:
"Promoting Informed Choice: Evaluating a Decision-Making Tool for Family Planning Clients and Providers in Mexico," by Young Mi Kim of Johns Hopkins University, Baltimore, MD, et al.
"Pregnancy Intentions Among Salvadoran Fathers: Results from the 2003 National Male Reproductive Health Survey," by Marion Carter of the Centers for Disease Control and Prevention, Atlanta, GA, and Ilene S. Speizer of the University of North Carolina, Chapel Hill, NC.
Crisis in Northern Uganda
The abortion rate in Uganda is particularly high in the North, where 70 abortions are performed for every 1,000 women, compared with a national abortion rate of 54 per 1,000. This number reflects in part the increased difficulties faced by women seeking health care because of the civil unrest and violent conflict that have plagued this region since 1980. Security issues have forced health facilities to close and created gaps in delivery of contraceptive supplies. In addition to these hardships, women in areas of conflict are often widowed, may have to resort to commercial sex work to support their children, and face an increased risk of rape and physical abuse—all situations in which they may seek abortions if they become pregnant.
"Gender and Relationship Differences in Condom Use Among 15–24-Year-Olds in Angola," by Ndola Prata of the University of California, Berkeley, CA, et al.
"Pharmacists’ Knowledge and Perceptions of Emergency Contraceptive Pills in Soweto and the Johannesburg Central Business District, South Africa," by Kelly Blanchard of Ibis Reproductive Health, et al.