allAfrica.com: Uganda: More Mothers Turn to Modern Birth Controls (Page 1 of 2)

Modern family planning methods can save Ugandan mothers from the excesses of motherhood, if only their husbands could cooperate, writes Bamuturaki Musinguzi

"We as a couple would go in for family planning because the nature of life and cost of living today requires that you count the costs that you go into," Sam Opolot cautions.

Seated by his wife, Alice who keeps nodding as a sign of agreement - at the Outpatient's Clinic at Kibuli Muslim Hospital in Kampala, where his she had come for her routine antenatal check-up, Opolot says: "If you are going to have children you have to think of how you will look after them."

He further adds: "Think of how having many children affects the health of your wife because giving birth alone takes its toll on her body. So you wouldn't want to expose her to so much risk."

The Opolots knowledge of family planning is an indication that this health system is becoming popular as evidenced by the 2006 Uganda Demographic and Health Survey (UDHS), which reveals that family planning in Uganda is highly influenced by education, wealth and introduction of modern methods like injectables as well as the urban - rural divide.

Ninety-seven percent of married women and 99 percent of married men know at least one method of family planning. Over 90 percent of both women and men know about pills, injectables, and condoms. "Fewer than one in five women, however, understand that a woman is most likely to conceive halfway between her two menstrual periods," the survey observes.

In the survey conducted by the Uganda Bureau of Statistics (Ubos), twenty-four percent of married women are using any method of contraception, and 18 percent are using a modern method. The most popular modern methods are injectables, used by 10 percent of married women and the pill, used by three percent of married women.

Use of modern family planning is more than twice as high in urban areas as rural areas (37 percent versus 15 percent). There is also substantial variation in modern contraceptive use by region, ranging from 8 percent in the north to 40 percent in Kampala. Contraceptive use differs significantly across educational categories.

Use of any contraceptive ranges from 13 percent among users with no education to 46 percent among those with secondary or higher levels of education. Use of modern methods among these groups increases substantially from 9 percent to 35 percent respectively. "Nevertheless, contraceptive use remains low, at only a quarter of married women."

The survey shows that use of contraceptives methods among currently married women in Uganda has increased notably from 15 percent in 1995 to 24 percent in 2006.

The increase is especially marked for modern methods which more than doubled in the 11 years between 1995 and 2006, from 8 percent to 19 percent when districts not surveyed in the 2000/01 UDHS are excluded from 1995 and 2006 data. This increase, the report says is mostly due to the rapid rise in the use of injectables from 3 percent in 1995 to 11 percent in 2006.

Over half of the women (52 percent) obtain their products from the private medical sector, while over one-third obtain them from the public sector, and 13 percent from other private sources. More than six in ten (65 percent) married women not using any contraception at the time of the survey say that they intend to use family planning in the future. Half of these prospective users (51 percent) favour injectables, and 14 percent cite the pill as their preferred method.

Men have been accused of being the biggest stumbling block in the access of family planning services as the senior nursing officer, Kibuli Muslim Hospital, Elizabeth Musoke says: "Men stop their wives from employing family planning out of ignorance because they have not been sensitised thinking that their women will fall sick or get hurt." Musoke adds that: "While others may agree with the wives as to the number of children they will have, some men have gone ahead to marry more women - upsetting the wives who in turn say: 'Why shouldn't I have more children because my husband is going to have children as well with the other wives?'"

Polygamy, the practice of having more than one wife, is relatively common in Uganda. Just over one-fourth of married women (28 percent) and 17 percent of married men are in polygamous unions.

The report notes that older women are more likely to be in a polygamous union than younger women. Polygamy is also slightly more common among rural women (29 percent) than urban women (23 percent).

The prevalence of polygamy is highest in West Nile (38 percent) and lowest in the southern area and Kampala (17 percent each). "Uneducated women and those in the poorest wealth quintile are slightly more likely to be in polygamous unions than other women."

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