Source: The Observer
More than 50 per cent of women are scared of discussing family planning issues with their husbands, according to a study by Reproductive Health Uganda (RHU).

RHU Projects Officer Nathan Tumuhamye says they found that most of the men do not want their women to use family planning methods, blaming misconceptions such as overbleeding.

Consequently, many men are more comfortable discussing family planning issues with their male peers.

“Some men feel that their wives will bounce [back] to them [reproductive] issues discussed. So, if one is not well versed with reproductive health issues, he will resort to freely speaking to a peer who will not ask as many questions as the wife,” Tumuhamye explained.

The findings are part of a study carried out in Hoima, titled Male involvement in sexual and reproductive health and rights (SRHR). The study, carried out in conjunction with Sonke Gender Justice, a South Africa-based organisation, also benefited from the input of Uganda Bureau of Statistics (Ubos) and ministry of Health.

Tumuhamye explains that the findings came about during a review of health information systems, which had reflected an increase in HIV/Aids infections and low uptake of sexually-transmitted infections (STIs) management services.

The statistics, mostly from Ubos, show that most men don’t discuss family planning issues, which they regard as women’s concerns.

“The reproductive health policy is so weak; men use it as an avenue to escape responsibility,” Tumuhamye said.

Reflecting on the findings, the minister of state for Health, Sarah Achieng Opendi, defended the policy, saying vigorous reproductive health campaigns had been carried out across the country with positive results.

“This policy is strong but some men have an attitude that [these] are women’s issues and have no time for them,” Opendi said.

“We need consistent sensitisation for men, which is not easy in case one has a negative attitude towards reproductive health.”

Opendi added that there was enough family planning gear at no cost but people didn’t utilise them.

“They think free government products are not durable,” she lamented.

Unwanted babies

Dr Yovani Moses Lubaale, a senior lecturer at the school of Statistics and Applied Economics, Makerere University, led the team that carried out the survey in seven sub-counties in Hoima district.

He said they had asked 164 men aged between 18 and 54 whether they would use a condom. Lubaale said only 7.3 per cent were willing to use a condom.

“This means that many men are severely exposed to the risk of disease because they lack knowledge about reproductive health,” he said.

“Even those who have some knowledge don’t want to share it with their wives,” Lubaale added.

The survey figures bear out this situation, with 30 per cent of the women in Hoima getting unintended pregnancies. Compared to Ubos figures, Uganda had a total fertility rate (TFR) of 6.2 children in 2011. In addition, two million women get pregnant each year, with about 755,000 of these (37 per cent) being unintended pregnancies.

About 297,000 have unsafe abortions while 85,000 suffer from reproductive-health-related complications each year. Tumuhamye says the study has helped in designing a programme to involve more males in reproductive health issues as equal partners, clients and agents.

The researchers propose that more men be engaged and educated about their own sexual and reproductive health to prevent the spread of STIs, including HIV, unwanted pregnancies and reduce the burden on women.

One of the achievements Tumuhamye referred to was the RHU clinic in Hoima, which has tested 4,740 men for HIV since January this year, compared to 1,005 in 2011 and 1,717 in 2012.

“This was a great number received, not only men testing [for HIV], but they also leave after being sensitised about the rewards of sexual and reproductive health issues,” Tumuhamye said.

To address the apparent challenges, Opendi says her ministry plans to review the village health team (VHT) system and increase manpower at health centres to enable them pay more attention to family-planning-related issues. 

 

• Uganda