FOR IMMEDIATE RELEASE
Tuesday 22nd March 2021
Kampala – Uganda. Center for Health, Human Rights and Development (CEHURD) will today file a report at the High Court [Civil Division], regarding Mulago National Referral Hospital’s progress on improving safety in handling babies delivered at the facility.
The report documents the steps Mulago hospital has taken, which include;
- Installation of security cameras in maternity wards to monitor the movement of babies
- Placing security guards at the entrance of the Hospital to register people entering and exiting the hospital
- Tagging newborn babies to their mothers for easy identification.
- Establishing a compassion ward where mothers who have lost the babies receive counselling services
On 24th January 2017, the Honourable Lady Justice Lydia Mugambe Ssali delivered a landmark judgment in High Court [Civil Division] Civil Suit No. 212 of 2013. In the suit,CEHURD, Micheal Mubangizi and Jennifer Musimenta sued the Executive Director of the Mulago National Referral Hospital and Attorney General, challenging the systemic gaps in the health care system, which resulted into the loss/ disappearance of Micheal Mubangiz and Jennifer Musimenta’s baby.
On 14th March 2012, Jennifer Musiimenta went to Mulago hospital with labour pains and delivered a set of twins on the same day. One of the babies mysteriously disappeared. The Hospital informed her and her husband that the second baby was born dead but could not produce the dead body. Eventually, on 17th March 2012, the Hospital gave the couple a dead body. The couple, however, rejected the body because it was of a baby who had just died.
Later, DNA examination confirmed that the body did not belong to their baby. The couple were aggrieved that their baby had disappeared in the hospital and they were denied information relating to their baby. The couple and CEHURD took Mulago hospital to Court for the unlawful disappearance of their baby, demanding that the hospital surrender their baby, dead or alive. In addition, they sought several declarations and orders from court.
The Court found that the failure of Mulago hospital to account for Micheal and Jennifer’s baby subjected them to psychological torture. Additionally, this was a violation of their right to be free from cruel, inhumane and degrading treatment, and the right to health. These rights are recognised under Objectives XX, XIV (b) and Articles 24, 44 and 45 of the 1995 Constitution of the Republic of Uganda and international human rights instruments.
Filing the report
In addition to these findings, the Court ordered that Mulago hospital award Michael and Jennifer compensatory damages, and CEHURD should file a report to the Court on the implementation of the Judgment. This is the report that CEHURD is filing today.
We applaud the hospital for complying with the orders of the Court after a series of engagements. We also call upon all healthcare facilities in Uganda to put in place reliable and credible systems that ensure the proper handling and movement of babies from the point a pregnant woman is admitted up to the point she is discharged from the health care facility.
We also call upon anyone who has suffered a maternal health rights violation to reach CEHURD on our toll free line 0800 300044 to pursue justice.
FOR IMMEDIATE RELEASE:
Friday 26th March 2021
Kampala, Uganda. Center for Health, Human Rights and Development (CEHURD) recognises the government’s efforts to ensure that pregnant girls sit for final examinations. However, we assert that this is not enough, especially in light of recently revised guidelines for the prevention and management of teenage pregnancy in school settings in Uganda.
In 2020 the Ministry of Education and Sports issued these guidelines, which stated that girls must undergo mandatory periodic pregnancy tests. The guidelines add that if found pregnant, the girl is forced to go on maternity leave when she is at least three months pregnant. The guidelines allow pregnant girls to sit for final examinations. However, on 16th March, 2021, Uganda National Examinations Board (UNEB) through their official Twitter handle noted that pregnant girls will be allowed to sit for the exams but warned that “the leeway may not continue after Covid era”. It went on to warn that UNEB does not condone teenage pregnancy and as such, learners should concentrate on studies before they think of babies. We find the warning by UNEB that the “leeway may not continue after covid” contrary to the guidelines issued by the Ministry.
On the revised guidelines, we are concerned about the provision requiring mandatory maternity leave in case of pregnancy. Allowing girls to sit exams while denying them an opportunity to attend class effectively amounts to violation of the right to education.
Teenage pregnancies indeed have grave consequences on the girl’s life and their future including the fact that she is more likely to die during pregnancy or childbirth. With an estimated 34% of school girls dropping out of school, Uganda will be raising a generation where women are locked out of education because of teenage pregnancy. We will be raising a generation where women significantly suffer long term effects such as limited skills essential for productivity and employability.
Call to Action
We ask that instead of taking action that punishes young girls, the government must take proactive measures that reduce teenage pregnancy while enabling pregnant teenagers to stay in school, prepare for and sit for their exams. We specifically ask that;
- Parliament uses its mandate to summon the Hon Minister of Education and Sports to update parliament on the progress of the National School Health Policy as it would address such issues.
- The government prioritizes management of school health programmes in times of health pandemics,
- The government promotes access to youth sexual and reproductive health and rights.
- That parliament in the exercise of its oversight mandate follows up on the implementation of the parliamentary resolutions to end teenage pregnancies of
- The relevant government line ministries give a status on the implementation of the parliamentary resolution of 2011 urging the government to institute measures to address maternal mortality and other matters considering that teenage pregnancies are one of the big contributors to maternal deaths.
- That the Ministry of Gender, Labour and Social Development fast tracks the effective implementation of the National Strategy on Ending Child Marriage and Teenage Pregnancies in Uganda of 2015.
Center for Health Human Rights and Development (CEHURD) is a non-profit, research and advocacy organisation pioneering the justifiability of the right to health in Uganda. Founded in 2010, CEHURD has moved from the margins to the center stage of advancing social justice and health rights in health systems including the rights of health workers in Uganda, East African Region, Pan-African and Globally.
For more information contact: email@example.com or call out toll free line 0800 300044.
CEHURD today shines the light on Tuberculosis (TB) as we commemorate the World Tuberculosis day under the theme “The clock is ticking”. This is a call to action towards commitments made by government to end TB especially in the face of the ongoing COVID 19 pandemic which puts these efforts at a risk. The World TB day is commemorated to raise public awareness about the devastating health, social and economic consequences of TB and to call on government to step up efforts to end the global TB epidemic. According to the World Health Organization (WHO), TB remains one of the deadliest infectious killer diseases and each day nearly 4,000 people lose their lives to TB and close to 28,000 people fall ill with this preventable and curable disease. A total of 1,400,000 people in the world died of TB in 2019 alone.
These glaring statistic do not get any better at home as Uganda is one of the 30 WHO designated countries with a high burden of TB and HIV. In 2019 the estimated incidence was 200 per 100,000 people with a mortality rate of 35 people per 100,000. It is indeed worrying that the cases of TB have even gone up given the little attention to the disease. According to WHO reports, in 2019 Uganda had 65,897 cases of TB notified which is an increase from 57,756 cases notified in 2018. There have also been reports of high drug resistance which poses a real challenge to the efforts towards controlling the infection. 87% drug resistance was reported in 2019 alone and this calls for more efforts towards research and investment for new medicines. There is however a lurking risk of patents on new medicines which may make these medicines expensive and thereby becoming a barrier to access for many TB patients.
It should be noted that most TB patients in Africa suffer catastrophic treatment costs making access to quality TB treatment impossible despite the disease being curable. In Uganda it is reported that 53% of TB patients suffer catastrophic costs of treatment as indicated in the WHO factsheets on the TB situation in Uganda. Although government has made some efforts toward the control and management of TB through commitments made under the National Tuberculosis and Leprosy Control Program 2016-2020 which aligns with the WHO End TB strategy, more is needed to ensure equitable access to quality treatment for TB patients.
It is disheartening to see that Uganda’s TB financing indicates very little of Government’s political will to end TB as committed under the Control Program and WHO End TB strategy. In 2019 the national budget for TB control and management was USD 37,000, 0000 of which government only contributed 5% while 56% of the financing was by international partners and 39% of the budget was unfunded. The second health sector development plan 2015/2016-2019/2020 is designed to support government’s commitment to achieving Sustainable Development Goals which among others seeks to “Achieve universal health coverage including financial risk protection, access to quality essential health care services and access to safe , effective quality and affordable essential medicine and vaccination for all by 2030”.
This is to therefore call upon government on this world TB day to fulfil its commitment towards the END TB strategy by;
- Increasing domestic funding towards TB management and control to ensure equitable access to TB quality treatment
- Investing in research and development for new and effective medicines to find lasting solutions to drug resistance
- To utilize the flexibilities in the Trade Related Aspects of Intellectual Property Rights to ensure that Intellectual Property Rights do not pose barriers to accessing the new and more effective medicines
By Doris Kwesiga
How can we expect girls to aspire to greatness when they are dealing with teenage pregnancies?
Uganda has a predominantly young population, with 53 per cent projected to be under the age of 18 years in 2020 according to the Uganda Bureau of Statistics’ 2020 Statistical Abstract. The country also has a high number of teenage pregnancies, for example among girls aged 15-19 years, 25 per cent have started childbearing, with higher rates in the rural areas according to the Uganda Demographic and Health Survey 2016 report. These rates are worsened by the COVID-19 pandemic lockdown and closure of schools. Different studies and media reports show an increased rate of defilement, pregnancies and early marriages. For instance in 2020, the Daily Monitor newspaper reported that there were 3,430 teenage pregnancies in Kitgum, 1,014 in Kabale, 200 among school girls in Kibuku and 130 underage girls in Lwengo were married, among others. These are the reported cases. Several others remain unreported.
Many of these pregnancies are as a result of defilement. Some are due to engagement in early sexual relationships, sometimes with peers, without accurate information on how to avoid pregnancy, beliefs in ineffective myths, fear of seeking Sexual and Reproductive Health (SRH) services or denial of access when they do.
The immediate consequences of teenage pregnancies are several but the high mortality rate during birth for teenage mothers, plus frequently conducting unsafe abortions are a serious issue. Other effects, some long term, are the interruption in the girls’ education. Many girls will not return to school, a few may later join vocational education and even fewer will return to the formal education structures they were part of. Other possible effects include contracting HIV, in addition to unemployment and thus lower income. These limit their ability to provide good nutrition and care for their children, thus negative trickle-down effects.
I would like to commend the Government of Uganda for its recent directive allowing pregnant girls to sit for their final exams that are currently underway, giving them extra time, as well as making provisions for those breastfeeding. This is a positive step in trying to ensure girls are educated and acquire the necessary qualifications.
However, what next for the girls who then go home to look after their babies? As we continue reflecting on this year’s International Women’s Day theme,“Women in leadership: Achieving an equal future in a COVID-19 world”, we need to reflect on the path to leadership for girls. One of the fundamental boosters to getting into leadership, especially at a national, regional or global level, is education. Although we do have leaders within communities and beyond who may not have gone far with their education and are doing amazing things, to go to higher levels one needs more skills picked up along the education pathway. It also helps with building networks and increasing exposure, among others.
How then can we get girls to aspire to greater things when many of them have had their dreams suddenly brought to a standstill by pregnancy at an early age? While it is good to address the visible issues like ensuring they sit exams, are these not majorly outcomes of policies, approaches and cultures that are detrimental to the lives of teenagers, their babies, families and communities? I believe we need to understand the root causes of the problems and be bold in addressing them.
One of our focus areas should be on increasing access to SRH information and services among adolescents. For instance, with adequate information about SRH, pregnancy and its negativities among younger women, they would know how to protect themselves and avoid pregnancy in the first place or other diseases like HIV/AIDS, where possible. More so, actually ensuring availability of services to those who make informed decisions to use them, would be helpful. However, this goes hand in hand with passing national policies that are progressive to this end.
Additionally, the issues of Sexual and Gender Based Violence (SGBV) are key and should not be avoided. Part of this could involve engaging boys and men as partners in fighting SGBV, alongside provision of safe reporting avenues for victims, and ensuring access to justice. Indeed, another challenge to adolescents realizing their SRH rights is our cultures and beliefs. However, changing cultures is not an overnight process, but one step at a time could make a difference, starting with sensitising communities that SRH services are not necessarily promoting immorality but also saving lives.
Ms Kwesiga is a Research Fellow at Center for Health, Human Rights and Development (CEHURD).