Opinion: Unsafe Abortions and Uganda’s Fight Against HIV, TB and Malaria

“I was already on HIV treatment. When I found out I was pregnant, I was terrified. I knew I could not continue with the pregnancy, but where could I go safely?” 

This is the story of Veronica (real name withheld), a 17-year-old teenager and a mother living with HIV whose immunity is compromised due to poor feeding and no meaningful source of income. Her only option was to terminate the pregnancy.

Stories like this are now becoming common in Uganda but never spoken about. They are whispered in hospital corridors and shared quietly among young women and teenagers. For many, the ending is tragic. Unsafe abortion remains one of the leading causes of maternal deaths resulting from severe complications such as sepsis and haemorrhage, among others.

Uganda records about 43 abortions for every 1,000 women of reproductive age, most of them unsafe. Behind that number are young girls afraid of being expelled from school, mothers already struggling to feed their children, and women living with HIV, TB who know that another pregnancy could compromise their immunity and livelihood.

The dangers are intensified when infectious diseases are part of the picture, because pregnancy weakens a prospective mother’s immune system, and the risk of opportunistic infections rises. And when unsafe abortions are carried out in unsterilized environments, one would be prone to imminent death. Other complications like severe bleeding or anemia further make malaria, one of Uganda’s deadliest illnesses even more dangerous for women.

Unsafe abortion ties into and is woven in the lives of young women in rural areas who pay the heaviest price considering that HIV infection rates are highest in this age category. The suffering is inescapable. Maybe access to safe and legal abortion could save countless lives like Veronica. It would keep women in HIV and TB care, reduce malaria risks, and ease the burden on hospitals that are currently overwhelmed by treating preventable complications.

Uganda has made significant progress in reducing maternal deaths, currently estimated at 189 per 100,000 live births (2022). However, this figure is still far above the SDG 3.1 target of 70 per 100,000 live births. To close this gap, government action is urgently needed to address the major causes of maternal mortality, including unsafe abortion. This requires clear provision of post-abortion care, and the expansion of the legal grounds under which abortion can be accessed.

We ought to remember that numbers tell only part of the story. Behind every number are hidden tragedies – the young woman who never makes it to the hospital in time, the mother whose children are left behind, and the girl forced to abandon her education. The spirit of the abortion law and how it is implemented has an important bearing on maternal health and teenage pregnancy and can influence reduction of the burden on healthcare system. It has the capacity to enable or disable access to safe abortion and body autonomy.

We should seek to expand grounds for safe abortion and access to SRH commodities as well as other related family planning services. The law ought to be a little clearer and unburden healthcare workers from being caught in the grey and retrogressive criminal justice system by allowing duty bearers to implement it in a manner that is tangible, accessible and fair.

Safe abortion is not just a medical service. It is dignity. It is survival. It should be part of our fight against HIV, TB, malaria, and overall preventable maternal deaths. Uganda cannot afford to lose more lives in silence and stigma. We owe our women better!

Compiled by Kitandwe Rhodine is a Health Rights champion and lawyer working with Center for Health, Human Rights and Development (CEHURD); kitandwe@cehurd.org

CEHURD Sues KCCA and NEMA Over Kiteezi Landfill Collapse; Statement

In response to the devastating collapse of the Kiteezi landfill on 10th August 2024, the Center for Health, Human Rights and Development (CEHURD), on 2nd May 2025, officially filed a lawsuit in the High Court of Uganda against the Kampala Capital City Authority (KCCA) and the National Environment Management Authority (NEMA).

The collapse, which claimed lives, destroyed homes, and contaminated the environment, was not a natural disaster but a direct consequence of institutional failure. Despite repeated warnings from the Kiteezi community about hazardous waste leakage, water pollution, and the dangers of unchecked garbage accumulation, the responsible authorities failed to take preventive action.

CEHURD’s case seeks accountability for these violations of constitutional rights to life, health, property, and a clean and safe environment. Specifically, we are calling for:

  • The immediate decommissioning of the Kiteezi landfill
  • Comprehensive environmental restoration of the affected area
  • The adoption of sustainable, science-based waste management systems that meet international best practices

This case represents a legal battle in the quest for justice, dignity, and the future of the Kiteezi community, whose cries for help went unheard for decades. CEHURD stands firm with the people of Kiteezi in demanding that no community in Uganda should ever again suffer such neglect.

The Uganda National Conference on Health, Human Rights and Development (UCHD) 2025; Building Bridges for Health Equity

The 2nd Biennial Uganda National Conference on Health, Human Rights and Development (UCHD) brought together leaders, policy makers, academics, civil society, and young advocates from across the continent under the theme: “The Right to Health: Bridging Gaps Across Other Sectors to Achieve Equitable Health for All.”

Convened by CEHURD in partnership with the Ministry of Health, the conference was officially opened by the Rt. Hon. Robinah Nabbanja, Prime Minister of the Republic of Uganda, who also launched CEHURD’s 10-Year Strategic Plan 2025-2034.

A Youth-led Start

UCHD 2025 began with a Youth Town Hall under the theme “Power in Conversation: Youth and Leaders at the Accountability Table.” Forty-six young delegates from across Uganda engaged directly with duty bearers from the Office of the Prime Minister, Ministry of Health, Ministry of Gender, Labour and Social Development, and other agencies. A Youth Declaration was developed and formally presented, amplifying priorities and commitments from the next generation of leaders.

A Gathering of Minds

Over 250 delegates attended the main conference, representing government ministries, development partners, academia, cultural and religious institutions, the media, civil society organizations, and international participants from Kenya, Tanzania, and South Africa. The keynote address was delivered by Prof. Ben K. Twinomugisha, who challenged participants to rethink health through a social justice lens.

Celebrating 15 Years of CEHURD

The conference also marked CEHURD at 15, with a Gala Dinner under the theme “Social Justice in Health: Honouring the Past 15 Years and Shaping the Future.” UNFPA’s Laura Lafuente was the Chief Guest, and partners were recognized through awards, alongside a documentary showcasing CEHURD’s journey.

Emerging Priorities

Discussions highlighted that equitable health cannot be achieved in isolation – every sector has a role to play. Key priorities included:

  • Recognizing social determinants of health as central to 80% of outcomes.
  • Strengthening disability inclusion and integrating health into all policies.
  • Addressing climate-responsive SRHR solutions for communities and refugees.
  • Tackling food fraud practices and supporting the Uganda National Nutrition Action Plan.
  • Embracing the One Health approach: people, plants, animals, and the environment.
  • Shifting to community mental health models and enhancing male involvement in health advocacy.
  • Creating sustainable health financing models in light of declining donor support.
  • Expanding youth platforms for engagement with leaders and policymakers.

Outcomes and the Road Ahead

What emerged from UCHD 2025 was a strong consensus: health equity is inseparable from broader development, governance, and economic justice. The conversations and commitments made at UCHD 2025 set the stage for stronger multisectoral collaboration, more youth-led accountability, and policies that place health at the center of Uganda’s development agenda.

Together, we birthed the Uganda Declaration on Social Determinants of Health, a shared commitment to advancing health equity in Uganda. The seeds of change were planted, now we carry the work forward into action.

Uganda’s Hidden Crisis: Unpacking Intimate Partner Violence

~ Compiled by Kitandwe Rhodine | Lawyer | CEHURD

Thousands of Ugandan women, and men, suffer silently from intimate partner violence (IPV). It‘s not just intimate; it is systemic, invisible, and inescapable.

In Uganda, Intimate Partner Violence (IPV) is hidden behind fake smiles, wedding rings, and Public Display of Affection (PDA). Behind closed doors, a crisis brews; affecting millions but rarely spoken about. Intimate Partner Violence is the most common form of gender-based violence cutting across every class, gender, and religion. Yet, it remains one of the most normalised and least addressed, particularly for women already pushed to the margins of society.

FACTS;

What is Intimate Partner Violence (IPV)? A recurring pattern of abuse by a current or former intimate partner aimed at gaining power and control. It includes:

· Physical abuse – Beatings with fists, belts, sticks and kicks are common.

· Sexual violence – Rape and coerced sex, though nearly never discussed openly.

· Emotional/psychological abuse – Verbal harassment, intimidation and control.

· Economic abuse – Controlling a partner’s access to money, resources or work

· Stalking – Unwanted contact that causes fear

· Reproductive coercion – Forcing pregnancy or abortion

· Spiritual & cyber abuse – Misusing religion or technology to harm

Did You Know? In Uganda, IPV is among the leading causes of illness and death for women of reproductive age.

Nationally, over 56 percent of ever-partnered Ugandan women have experienced some form of physical or sexual violence from a partner in their lifetime. Nearly, a quarter report having endured physical abuse, and one in four women has experienced sexual violence.

The 2024 Police Crime Report documented 14,073 domestic violence cases and 14,425 sex-related offenses. The majority of IPV incidents go unreported, especially among female sex workers, women with disabilities, and young people living with HIV.

Ms. Nakibuuka Noor Musisi, the Deputy Executive Director of the Center for Health, Human Rights and Development (CEHURD) says the crisis is deeper, systemic, invisible and inescapable. “Women are most vulnerable to IPV. They don’t have the power or the resources to leave violent relationships.”

Intimate Partner Violence isn’t just physical. It includes psychological torment, emotional degradation, sexual coercion, control over a partner’s movement, financial control, stalking, spiritual manipulation, reproductive coercion, and even technology-facilitated abuse.

It is not a single incident, but a deliberate pattern of behaviour rooted in power and control. The abuser, often a current or former intimate partner, isolates, intimidates, controls and undermines their victim and gags or removes all opportunities and spaces of speaking up.

The effects are devastating. Beyond broken bones and bruises, survivors live with deep emotional scars of depression, anxiety, post-traumatic stress, suicidal tendencies, overwhelming shame, broken homes, divorce and or death. IPV also exerts a heavy economic toll usually imissed wages, loss of employment, legal fees, and long-term poverty. For many women, IPV is a lifelong burden that denies them freedom, dignity, and opportunity. It can lead to unwanted pregnancies, miscarriage, disease, substance abuse, alcoholism, disability and economic insecurity. In Uganda, IPV is among the leading causes of mental illness and death among women of reproductive age yet, many still view it as a private issue. Yet, it is national emergency.

Among female sex workers, the danger is compounded by criminalisation, social stigma and discrimination. Public health data shows that nearly 59 percent of female sex workers experience moderate to severe IPV. Many are afraid to report abuse for fear of arrest or mockery. Their abusers range from clients turned boyfriends to cohabiting partners.

“For sex workers, the violence comes from all sides,” explains a Human Rights advocate who preferred anonymity in order to speak freely. “At home, they are abused by partners. On the streets, they are attacked by clients. When they resolve to eventually seek any possible support and legal redress, they are blamed or mocked.”

Women with disabilities suffer greater silence. The Uganda Demographic and Health Survey (2022) shows that 64 percent of married women with disabilities have experienced IPV. This number is much higher than the national average. Women with disabilities are more likely to be assaulted, coerced into sex, denied food, or emotionally degraded or forced to marry early or to men they do not want. Many are silenced, gagged or fear to report cases of violence. At least 24 percent of women with disabilities have reported suicidal thoughts compared to 17 percent of women without disabilities. With fewer options for income and movement, many of them are trapped in violent homes and violent relationships and; they have accepted their fate..

Young women living with HIV face a dual burden: the pain of violence and the weight of stigma. Uganda has one of the highest HIV rates among young women aged 15 to 24. Many HIV+ women report being abused by partners who restrict their access to medication, sabotage their treatment, or force abortion. A 2019 national survey found that 44 percent of HIV-positive women had experienced some form of IPV. “My partner used to hold my medication and say, ‘If you’re still with me, why do you need this?’” recalls one survivor whose identity was kept anonymous.

Men, too, are affected although their stories are rarely told. In 2024, a total 3,161 cases of IPV against men were officially recorded (Uganda Police Crime Report) But cultural expectations of masculinity, self-reliance, and silence often keep these male survivors from seeking help until it’s too late.

“These figures are not good at all,” says Maureen Atuhaire, Assistant Commissioner of Police. “We encourage people to sit down and resolve some of these issues -all we want is peace. You can get out of an abusive relationship; you don’t need to be there until death happens;

Men have a tendency of not sharing anything with their friends, their family members, or even counsellors. They think they can handle it on their own until it’s too late. In many cases, they either lose their lives or they take the lives of others. We encourage people to report and seek help because we live once, and it’s usually the dependents that are caught up in the middle.”

THE NUMBERS IN UGANDA:

· 56% of ever-partnered women report physical or sexual IPV

· 59% of female sex workers in relationships face moderate to severe IPV

· 64% of women with disabilities have experienced IPV

· 44% of Women living with HIV report IPV from a partner

· 24% of women with disabilities have reported suicidal thoughts from IVP

Despite the overwhelming evidence, Uganda’s legal system still struggles to effectively respond to this hidden crisis. The Domestic Violence Act (2010), the Gender Policy (2007), and the National Policy on Elimination of GBV (2016) offer strong legal frameworks on paper but their enforcement remains inconsistent, especially for marginalised populations.

The murder of a Ugandan female Olympian in Kenya, by her boyfriend serves as a chilling reminder of how violence escalates when warning signs are ignored. It reflects not only the danger of IPV but also the inadequacy of state response and social will to address the crisis.

Today, CEHURD is leading a nationwide campaign to bring these stories out of the shadows. It is championing survivor storytelling, community advocacy, public sensitisation through legal aid clinics, litigation and awareness raising. There is need to continue training police, health providers, judicial officers, the community and religious leaders to respond to IPV with compassion, accountability, and inclusivity. The goal is not just to change laws but our mindsets.

“Ending Intimate Partner Violence requires a cultural shift,” says Nakibuuka. “We must listen to survivors, document their stories, and reform the systems that failed them.”

Gender equality cannot be achieved if Intimate Partner Violence continues to harm millions in silence. It is everyone’s responsibility to invest in survivor support, or provide avenues and space for those experiencing it to come out and speak about it, share their stories, demand for reform of our justice systems, and change societal attitudes.

The Impacts of IPV:

· Health related problems: Injuries, miscarriage, HIV, disability, death

· Mental issues: PTSD, depression, anxiety, suicidal thoughts

· Economic burdens: Lost wages, poverty, legal costs, dependency

· Social effects: Isolation, shame, loss of dignity

For the survivors, speaking out is an act of courage. For the rest of us, listening and taking action is a responsibility we cannot ignore. No one regardless of disability, HIV status, identity, social and marital status or livelihood should be unsafe in their own home or or under anyone’s care. It’s time we shine a spotlight on this hidden crisis, rise up and speak up to end intimate partner violence.

A version of this article was first published in the Daily Monitor on 15th.July.2025

POSITIVE JUDGEMENT; Justice for a 15-year-old SGBV survivor

In 2021, CEHURD received and documented a complaint from Mr. Malinga Ronald of Buikwe District, whose 15-year-old daughter was defiled and impregnated by their landlord, Kyesswa Edward. The accused threatened and defiled the survivor twice while her parents were away, impregnating her. She gave birth, although the baby passed away just a week later.

The accused was arrested and charged with defilement under Section 129 of the Penal Code Act Cap 120 (as it then was). CEHURD watched brief in the matter (attended Court and provided legal representation to the client) while working closely with the State Attorney. After five years of litigation, the Chief Magistrates Court of Lugazi on Monday 5th May 2025 found the accused guilty of defilement. He was convicted and sentenced to five years imprisonment.

CEHURD has opened up a fund for survivors of sexual violence to access justice. The purpose of this legal aid fund is to support survivors of sexual violence with court attendances, and psychosocial support. We therefore, encourage the public to support this cause. Support can be extended through;
Bank Transfer
Account name:
Center for Health Human Rights and Development
Account number: 9030023415843,
Bank name: Stanbic, Branch: Garden city

Momo Pay
Dial 1653#, Merchant Code: 198080
For correspondence, please reach out to:
+256 200 – 956006 or info@cehurd.org

#CEHURDLegalAid

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