U.S. abortion politics felt globally: The chase of the global gag rule

On January 23rd, 2017, U.S president Donald Trump issued Presidential Memorandum reinstating the Mexico City Policy popularly referred to as the Global Gag Rule within Civil Society Organizations due to its restrictive nature on health services and advocacy particularly on Sexual Reproductive Rights for women and marginalized groups in societies that receive U.S. funding. Trump`s administration renamed the policy as Protecting life in Global Health Assistance; as the name suggests, the policy now applies to all U.S. global health assistance amounting to nearly USD $9 billion and includes funding for HIV/AIDS, tuberculosis, malaria, maternal and child health, family planning and reproductive health, nutrition, global health security, zika virus, and WASH at household and community levels. Non- U.S. NGOS who receive any global funding have 2 choices; Accept U.S. global health assistance and restrict their activities on abortion or refuse U.S. global health assistance and find other funding.

This policy has instilled fear on NGOS and caused them to self – censor and not ask questions about the policy because they are afraid of potentially losing U.S. funding. This has led to them over restricting their activities to be sure they are in compliance with the policy. Other NGOs have discontinued partnerships, stopped participating in coalitions, and no longer apply for some grants and unnecessarily stopped certain activities, which causes irreparable damage to their beneficiaries and civil society partnerships. President Trump’s policy masquerades under the guise of preserving life, but it endangers life. Restricting abortion information and access threatens and endangers women’s lives and families at large socially and economically.

Impacts of the Global Gag Rule have resulted into shut down in clinics, reduced access to contraceptives and HIV services, limited rural communities` access to health care, disrupted referral networks, and weakened civil society partnerships, coalitions, advocacy efforts around unsafe abortion. These impacts will worsen over time as more NGOs lose funding and are forced to restrict activities. Trump’s policy does not protect life. Women’s sexual reproductive health rights and health rights of marginalized persons are important and should matter.

Together we can make a difference by standing tall against the GGR and rising above its inhuman nature. It is important to monitor, document and report changes in relationships with sub-grantees and organizations affected by declining the funds or refusing to comply to continue mitigating or countering the impact of GGR to feed into data to push for the repealing of the unjust policy targeted at dehumanizing marginalized groups in society globally. This should be a wakeup call for the Ugandan government to prioritize Heath funding in the national budgets rather than largely depend on foreign aid that often comes with strings attached to the disadvantage of its citizens.

 

By Amuron Dorothy

Concerns and experiences: Improving Family Planning services in Uganda

Family planning services and contraceptives are critical in the prevention of unintended pregnancies, miscarriages, unsafe abortions and maternal deaths. Henceforth, improving the health of women and the overall well-being of families. There has been laudable effort from Government of Uganda, with support from development partners and civil society actors to ensure access to family planning goods and services.

However, in spite of these efforts, contraceptive access and use in Uganda remains a major challenge. To understand the major challenges, CEHURD, in partnership with Center for Reproductive Rights undertook a fact-finding exercise to collect experiences from women, men, service providers, policy makers and other relevant stakeholders with provision, access and utilization of contraceptives. The report summarized the key findings and identified the gaps highlighting what communities go through while accessing and using contraceptives as indicated below;

To amplify the findings as share the community findings, CEHURD held dissemination workshop involving various stake holders including; policy makers, development partners, civil society organisations, Justice Law and Order Sector, Ministry of Health, Local Governments and the communities. This also marked the launch of the Contraceptive access and use in uganda. The event had an aspect of experience sharing from the communities, learning from the experts who shared experiences as service providers, the policy makers who clarified on the budgeting process and parliaments commitiment on the issues of health and the Ministry of Health technocrats who responded on issues of policy and guidelines.

Key highlights from the event

  • Parliament is progressively though at a slow pace committing itself to the Abuja deceleration 2015 in increasing the health budget. The health budget has increased from 7.5 in 2018 percent to 8 percent allocation in 2019, with the current overall budget of 2 trillion where 16 billion has been allocated for reproductive health services and commodities.
  • MoH has come up with the human rights approach and developed guidelines to help them implement their work without violating people rights.
  • Challenge within the law that does not cater for the minors and clearly indicates the consent age as 18 years where health workers are not allowed to give services to people who have not consented.
  • Unmet need of married women is at 28 percent and 32 percent for sexually active unmarried women while the contraceptive prevalence rate is at 38 percent for married women and 51 percent for sexually active unmarried women, with 52 percent of un planned pregnancy in Uganda which has led to 1 in 4 girls having a child or pregnant with first child at 19 years.
  • Contraceptive use and accessibility is determined by working hours yet the peak hours are during public holidays, evenings, night hours and weekends as most of the public facilities are always closed yet it’s when the clients need the services most.

The report was jointly launched by the Executive Director CEHURD, Hon Members of Parliament, Ministry of Health, Center for Reproductive Health Rights country representatives and Uganda Medical Association President. The report was handed to the Ministry of Health for referencing and also respond to the recommendations.

 

By Angella and Chris

Commemoration World cancer day 2019 – CEHURD

CEHURD has today 4th February 2019 joined the rest of the World to Commemorate World cancer day for the year 2019. As an institution devoted to advancing the right health, we call upon all stake holders to join hands as we make healthy lifestyle choices and avoid using tobacco and related products and educate ourselves and others to support the Tobacco Control cause through complying with the public health/tobacco control laws in place.

Background:
Each year on the 4th of February different people, organizations and Ministries come together to commemorate the World Cancer Day and support, raise a collective voice, take personal action, raise awareness on cancer, and urge their governments to do more in curbing cancer and related diseases. The theme for this year is “I am and I will, your story and your commitment”. The Center for Health Human Rights and Development (CEHURD) joins the rest of the World to commemorate this day, highlighting our story and commitment in using the law to curb Cancer and related illnesses. For this year, we specifically want to highlight the harm caused by tobacco as a major cause of cancer and how the use of legal tools is key in curbing this public health crisis.
Facts about Tobacco and Cancer:

Tobacco use remains a significant public health challenge, danger and burden in Uganda and a leading cause of Cancer and Non communicable diseases. The 2011 World Health Organization (WHO) Global status report on NCD’s states that exposure to tobacco smoke remains one of the four main behavioral risk factors that contribute to NCD’s. It’s important to note that Tobacco alone accounts for 6 million deaths each year and this toll comes up to 13,000 people losing their lives daily from tobacco related illnesses and diseases. These are preventable deaths we all can commit to end if only we raise awareness on tobacco control and adhere to public health policies.
Dr Noleb Mugisha, the Principal Medical Officer and Head of Comprehensive Community Cancer Program at the Uganda Cancer Institute notes that there are various diseases related to tobacco use and these have been scientifically proven like Cancer, Cardiovascular diseases, Respiratory disease, Reproductive complications, Postoperative complications, Diabetes and others.

The 2004 Surgeon General’s Report shows that Tobacco use is a major risk factor for the development of many forms of cancer and evidence is sufficient to infer a causal relationship between smoking and cancers of the lung, larynx, esophagus, pancreas, bladder, kidney, cervix and stomach. Results from the 2011 Global Youth Tobacco Survey indicate that 19.3% of young men and 15.8% of young women use tobacco. Raising awareness and education on Tobacco control in order to take action against Cancer is therefore key.
Strategies for curbing this public health crisis:

We need to create public awareness on tobacco control, adhere to and comply with the public health and tobacco control laws, and help reduce the morbidity and mortality of cancers caused by tobacco smoke through monitoring tobacco use and prevention policies, protecting people from tobacco smoke, offering help to those who want to quit smoking, warning people about the dangers of tobacco and promoting a smoke free environment.

Uganda ratified the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) in 2007 developed in response to the globalization of the tobacco epidemic. In a bid to curb the tobacco epidemic, Uganda also enacted and passed the Tobacco Control Act 2015 aimed at controlling the demand and supply for production and consumption of tobacco products to the people. It also aims at promoting the health of persons and reducing tobacco related illnesses and deaths.

The Constitution under Article 39 guarantees the citizens right to a clean and healthy environment. It is therefore important to protect the environment from the effects of tobacco consumption and exposure to tobacco smoke.

The Public Health Act Cap 281 mandates every local authority to take all lawful, necessary, and reasonably practicable measures for preventing the occurrence of any outbreak or prevalence of infectious, communicable or preventable diseases to safeguard and promote the public health of individuals.

The Penal Code Act Cap 120 under Section 228 (f) makes it an offence for a person to dispense, supply, sell or give away any poisonous/dangerous matter in a manner so rash and negligent. The Tobacco Control Regulations will also soon be finalized and passed by Ministry of Health.

Conclusion:
As such, let us all join hands to make healthy lifestyle choices and avoid using tobacco and related products and educate ourselves and others to support the Tobacco Control cause through complying with the public health/tobacco control laws in place.

LET US JOIN HANDS AND KICK CANCER OUT OF UGANDA!!!.

Understanding culpability for sexual harassment in Uganda.

Sexual harassment is understood differently by different people. However ignoratia non excusant must be the answer for the harassers, be women or men. The use of law may be a powerful tool in both prevention and response to sexual harassment in all context and equality between women and men must be seen as a struggle of humanity, a struggle for both men and women. In the face of sexual violence and discrimination, everyone is concerned and everyone needs to act. Find FULL ARTICLE HERE

Fading cultural norms and practices and their impact on health.

It is that time of the year when everyone gets excited about the holidays. The Christmas bells have started ringing (the jingle bells). Around time senior four and six students are writing their final exams. While primary seven students are already on holiday. Institutions are planning closure dates, finalizing project reports and proposal writing in search for funds. It sounds a busy time of the year, right? Everyone seems to get to a vacation mood. Chritsmas is around the corner.

This season comes with challenges. The preparations for holidays come different in various homes. Vacists have planned to watch movies, play, get to driving schools, roam around Kampala, swim, visit friends, read novels, join computer schools etc. Others have arrangements to visit and stay with relatives.

In the previous years, such a time of the year came with cultural norms and practices. Young girls would be sent to their aunties and boys to uncles. At these places, boys and girls engaged in learning, re-learning and un learning various practices. Girls were taught how to peel, cook, wash, cleanliness and prepared to become women. It was a taboo for a girl to get pregnant while at home and girls were nurtured towards keeping their virginity until marriage. There movements to trading centers during their first menstrual periods was limited- this was meant to help them learn how to keep clean but also never to engage in sex during the time. On the other hand, boys were taught fatherly roles in the home, how to work, and ride bicycles among other activities.

The whole set of comprehensive sexuality education was given to these holiday makers. Christmas season was such a joy. The girls and boys could gather in the evenings around a fire place and tell stories. The stories again passed on information to them, some of which allowed them as men and women to make informed SEXUAL REPRODUCTIVE HEALTH decisions. During the day, girls went into knitting sessions. It was hard to find a girl of the time who didn’t know how to knit either mats, baskets, or the like.

Today, such cultural norms and practices have faded. Of course the world has developed. This development has come with implications to the realization of the right to health. While such times exposed girls and boys to things that made them busy but also to people that had accurate information on SRHR, and allow tem make informed decisions, today, the story is different. TV, Play centers, radios, video games, social media and the internet are the order of the day. Girls and boys as young as you can imagine know much correct and much wrong SRHR information gathered from various sources. These prefer to listen and learn from their peers as much as possible- perhaps because the roles uncles and aunties played are no longer possible? Or is it because parents are too busy to guide them into making informed SRHR decisions?

While this is the case, and as long as the country continues this way, the right o health will continuously be affected. Uganda will continue reporting high rates of teenage pregnancies and school dropout rates.
Perhaps as a country we need to rethink the implications of such fading norms and practices to health. We may not have to copy the very same way they used to happen but learning something from that and comparing the times to today.