The Center for Health, Human Rights, and Development (CEHURD) with funding from the European Union through the Office of the Prime Minister under the Development Initiative for Northern Uganda (DINU) wishes to hire consultants in relation to the Legal Empowerment and Social Accountability (LESA) project.
CEHURD in partnership with Partners in Community Transformation (PICOT) has been implementing the LESA action since January 2020 in the districts of Koboko and Maracha. The LESA action is an empowerment and advocacy project titled “Integrating Legal Empowerment and Social Accountability for improved local government performance and governance in the districts of Koboko, and Maracha’’.
The consultants will work on the following assignments;
Conduct the Endline Evaluation of the Legal Empowerment and Social Accountability (LESA) project. Apply Here
Document the Legal Empowerment and Social Accountability (LESA) methodology an advocacy tool to improve social services. Apply Here
Adolescents have the highest rate of unintended pregnancies and their unmet need for contraception is much higher. In developing countries, roughly half of the pregnancies among adolescents aged 15-19 are unintended, and half of these result in abortions, the majority of which are unsafe.
BY RODNEY KITANDWE
Sustainable development requires ensuring healthy lives and promoting well-being at all ages. To achieve the Sustainable Development Goals of excellent health and well-being, the world must harness the full potential of all generations.
As a young person, I constantly come across contradictory and perplexing messages about gender and sexuality. With the help of a comprehensive and high-quality curriculum-based sexuality education program, I believe that all children and young people can navigate these messages and develop healthy norms about themselves and relationships that can help them become responsible citizens from an informed point of view. Although most governments have some sort of sexuality education program in place, these programs are frequently ineffective or poorly implemented. The emergence of new resources for putting these approaches into practice, as well as newly emerging research findings about effective approaches to sexual and reproductive health and rights, make this a very advantageous time to advance this fundamental human right.
As we commemorate the international youth day 2022 under the theme Inter-Generational Solidarity: In Preventing Teenage Pregnancies and Child marriages, we must promote access to comprehensive contraceptive care and contraceptive methods as an essential component of women’s health care by enacting policies and taking actions that ensure the availability of affordable and accessible services. There is a need to underpin all advocacy and programming work that ensures sexual and reproductive health and rights for all without discrimination. Fulfilling these rights and empowering adolescents and youths to make timely, informed decisions about their own bodies and their place in the world will yield long-term benefits.
Efforts should be made to increase access to emergency contraception, including the removal of the age restriction for contraception products, and to create over-the-counter access to oral contraceptives with full insurance coverage or cost assistance. Adolescents have the highest rate of unintended pregnancies and their unmet need for contraception is much higher. In developing countries, roughly half of the pregnancies among adolescents aged 15-19 are unintended, and half of these result in abortions, the majority of which are unsafe.
When designing programs for young people, it is critical to consider their reasons for not using contraception despite the fact that they do not want a pregnancy. Infrequent sex, concerns about contraceptive side effects, breastfeeding, or opposition to contraception, believing that its use conflicts with their traditions and religious directives are examples of such reasons. In this context, contraception information and education are required, as are efforts to understand and address myths and misconceptions. The revised International Technical Guidance on Sexuality Education establishes key concepts and learning objectives for use in school and community-based sexuality education that are scientifically accurate, comprehensive, age and developmentally appropriate, and based on human rights and gender equality.
The writer is an intern in the Strategic Litigation programme at the Center for Health, Human Rights and Development (CEHURD.
Center for Health, Human Rights and Development (CEHURD) invites different universities with schools/faculties of law in Uganda to participate in the 9th Annual National Inter-University Constitutional Law Moot Court Competition. The moot is scheduled to take place on 3rd – 4th November 2022.
The 9th Annual National Inter-University Constitutional Law Moot Court Competition is taking place under the theme, “Gender Discrimination: The Plight of Pregnant Girls in School”. Uganda has experienced an ever-growing number of teenage pregnancies exacerbated by the outbreak of COVID-19 and the lockdown that ensued. Many teenagers have been forced out of school while others have dropped out due to the stigma and discrimination they have faced. Their freedom from non-discrimination, as much as their right to education has therefore been violated. The moot has been designed to enable students to analyse the revised guidelines developed by the Ministry of Education and Sports for the prevention and management of teenage pregnancy in school settings in Uganda, and assess their legal impact on the right to Education through the use of a hypothetical moot problem that students shall use to participate in the moot.
The main objective of the Moot is to train students in practical aspects of litigating health and human rights within Uganda’s Courts of Law. This kind of arrangement helps bring out lawyers that understand key constitutional and health issues beyond what they are taught in class. The Moot specifically aspires to train students in legal writing, arguing cases in Court, professional conduct and demeanor while arguing cases and preparation of Court pleadings.
We call upon universities that are interested in participating to fill this form as an expression of interest to participate by Friday, 19th August, 2022 at 5:00 pm.
By Peter Eceru – Programme Coordinator, Advocacy – CEHURD
Currently, the East African Legislative Assembly is undertaking regional consultations on the Sexual and Reproductive Health Bill, 2021 in the all-members states. The Bill is premised on Article 118 of the treaty for the establishment of the East African Community which provides for cooperation in health and promotes the management of health delivery systems and better planning mechanisms to enhance the efficiency of health care services. The East African Community treaty also seeks to harmonise national health policies and regulations in order to achieve quality health care in partner states. The treaty also looks at cooperation in the development of specialised health training, health research, reproductive health, pharmaceutical products and preventive medicines.
The Bill further seeks to strengthen the mechanism that facilitates attainment by the Community of the goal to ensure universal access to sexual and reproductive health care services by 2030. These services include family planning, information and education, and the integration of reproductive health into national strategies and programmes. This goal is enshrined in the EAC Integrated Reproductive Maternal, New-born Child and Adolescent Health Policy Guidelines 2016-2030, and the EAC Sexual and Reproductive Health Rights Strategic Plan.
The Bill recognises the obligation of Partner States under several international, continental and Community frameworks, to respect, protect and fulfil the right to health. They do this by facilitating, providing, and promoting the highest attainable standard of health and providing measures toward the full realisation of the right to health. Bill will strengthen the mechanism to facilitate the attainment of the Community goal of ensuring universal access to sexual and reproductive health care services, including family planning, information and education.
The Reproductive, Maternal, Newborn, Child and Adolescent Health indicators in the East African Community member states are worse than the average in the rest of Africa. High maternal and mortality rates for children under five, high unmet need for contraceptives and adolescent fertility rates demonstrate a need for collective action across the community to respond to the sexual and reproductive health challenges. In 2020, 39,000 children in East Africa were born with HIV infections that could have been easily prevented. During the same period, 62,000 mothers died from childbirth complications that could have been easily addressed. Two hundred million girls and women are estimated to have undergone genital mutilation. Additionally, cervical cancer remains a leading cause of cancer-related deaths in African women, where the estimated rate of deaths is 94 women per 100,000. Currently, 19 million women in East Africa cannot access modern contraception and a further 2.5 million are at risk of death due to complications from unsafe abortions. The Covid-19 pandemic led to a very big increase in violence against women and girls all over the East African Community putting the future of millions of women and children in jeopardy.
Indicators across the different countries in the region vary in terms of severity. For example, South Sudan has the highest maternal mortality rate within the Community with 1,150 deaths per 100,000 women who give birth, while Rwanda has the lowest at 248 deaths per 100,000 women giving birth. These variations demonstrate the need for collaborative health systems planning and how this would benefit the region in dealing with high mortality rates within the East African Community Member states. Various countries have over time developed best practices that can be shared across the Community. In Uganda, a weekly maternal death surveillance enables the ministry to follow up on maternal deaths and investigate the causes. This enables timely response.
To strengthen regional Health Information Management Systems, it is critical to have a regional framework to guide this. The collection of data on for example contraceptive use, sexual and reproductive health and the wider reproductive, adolescent maternal newborn remains uncoordinated across the Community. In Uganda, this information is collected through the Uganda Demographic Health Survey and the Health Information Management Systems. In the case of partner states, different information is collected among partner states and this information is collected along different time periods. This makes it difficult to utilise the information for the purpose of regional planning and collective decision-making. Sound and reliable data is the foundation for decision-making across all health system building blocks and is essential for health system policy formulation and implementation, governance and regulation, health research, human resource development, service delivery and financing.
The consultations on this Bill are therefore a very important process in strengthening regional integration and specific emphasis on the promotion of sexual and reproductive health in the EAC partner states.
A total of 63 Health Centre (HC) IVs conducted cesarean sections without blood transfusion services and 38 HC IVs did not provide any emergency obstetric care services in FY 2019/20 because of the inability to access blood or absence of requisite staff.
By Grace Awilli
It is likely that the National Budget Speech will be read today. Incidentally, today also happens to be World Blood Donor Day. The day was first commemorated in 2005 by a joint initiative of the World Health Organization (WHO) and the International Federation of Red Cross and Red Cross societies to raise awareness of the need for safe blood and blood products as well as thank the donors for their voluntary, life-saving gift of blood. It is one of the eleven global public health campaigns marked by WHO as well as the civil society organisations around the world.
Usually, blood and blood products are essential for the management of injuries, medical illnesses, and childbirth. However, chronic shortages in blood supply in the country perpetuate the high levels of morbidity and mortality from injuries, maternal loss of blood and treatable diseases. Therefore, a safe and adequate blood supply is crucial in ensuring patients in both emergency and non-emergency situations get access to safe blood to save their lives. According to WHO’s global database on blood safety, a country should be able to collect blood equivalent to one per cent of its population and Uganda with an estimated population of about 48 million collects far below the required amount which in turn leads to a wide shortage of blood in the country and thus loss of lives. In 2021, Uganda Red Cross Society mobilised 152,891 units of blood which were still insufficient in relation to the population of the country.
In Uganda, haemorrhage continues to be the leading cause of maternal death, contributing 42 per cent of all deaths reviewed, with postpartum haemorrhage contributing up to 90 per cent of all haemorrhage cases reported. Thirty-six per cent of maternal deaths occurred among young mothers under 24 years who should have been in school, contributing up to 10 percent of all maternal deaths. It should be noted that a total of 63 Health Centre (HC) IVs conducted Cesarean sections without blood transfusion services and 38 HC IVs did not provide any emergency obstetric care services in FY 2019/20 because of the inability to access blood or absence of requisite staff. It is estimated that 8,400 mothers are being unnecessarily referred to regional referral hospitals because the HC IVs lack the capacity to perform obstetric care due to the lack of blood supplies. Installation of blood fridges at HC IVs would allow these patients to receive on-site care and reduce unnecessary referrals, saving time and effort of the specialised medical staff at the regional hospitals, and reducing transportation costs. The Budget Committee of parliament noted that UBTS collects about 300,000 Units of blood annually yet the actual estimated need stands at about 420,000 Units. This leaves a blood deficit of 120,000 Units annually. In order to meet this gap, UBTS needs to expand its capacity to mobilise, collect and screen enough blood requirements.
It should be noted that low-and middle-income countries frequently have insufficient blood supplies necessary to meet the demand and as a result, patients in low and middle-income countries are frequently unable to access blood units necessary for the transfusion in a timely manner. At times, shortages of blood at hospitals in Uganda, especially in rural areas last for several days and according to statistics from various hospitals, so many people die due to these shortages. Much as Uganda has a national blood transfusion service, there has been a noticeable lack of a steady blood supply available for patients at the different health facilities. The reluctance by the community members to donate blood is attributed to a number of factors including superstition, fear of knowing their HIV status and interruptions in the supply of donor kits and testing reagents.
Therefore, the WHO recommends voluntary, non-remunerated blood donation and has set a standard of 10 blood donations/ 1000 population as a baseline value for all countries to meet. While on average, high-income counties have 32.1 donations/1,000 population, low-Income countries have only 4.6 donations/1000 population which is really low to meet the high demand for the blood needed by patients. It is estimated that blood donation by only one per cent of a country’s population is needed to meet the basic demand for blood and to achieve this, there is a lot that should be done by Ugandans in order to meet the blood donation standards by WHO and this can only be done by mobilising and encouraging the public to voluntarily donate blood so as to fill the national blood demand. Uganda also needs to improve existing structures for blood collection and enhance allocation to Uganda Blood Transfusion to cater for blood collection and processing.
It is therefore our hope that today’s budget speech will indicate increased funding for blood collection and management in order to save lives.
The writer is a Lawyer and volunteer in the Campaigns, Partnerships and Networks programme at the Center for Health, Human Rights and Development (CEHURD).
