We continue to resound that health workers must operate in a safe environment without fear of being arrested, intimidated or harassed as they provide Sexual and Reproductive Health Rights services. In turn, women should be able to seek care knowing that they will not suffer stigma or be denied service.

CEHURD

On 1st February 2022, the Chief Magistrate of Lugazi Court dismissed the case of Uganda vs Fredrick K (Criminal Case No.56 of 2020) for want of prosecution. 

Mr Fredrick K, a senior clinical officer from Buikwe District was arrested after saving a life – providing a post abortion care service. Two years later, CEHURD, and the Legal Support Network have worked to ensure that he is freed. 
We continue to resound that health workers must operate in a safe environment without fear of being arrested, intimidated or harassed as they provide SRHR services. In turn, women should be able to seek care knowing that they will not suffer stigma or be denied service.
Restricted environment and the misinterpretation of abortion laws restrains health workers from providing post abortion care services for fear of arrest which in turn has led to the inability of women to access the services.
With unsafe abortions contributing to the high maternal mortality rate in Uganda (according to the UDHS 2016), there is need to address the underlying factors that drive these deaths ie the restrictive legal and policy environment, misinterpretation of the law due to inadequate knowledge among others.

Story;
In November 2019, Mr Fredrick K, a senior clinical officer at Mukisa Medical Clinic was approached by a patient who had carried out an abortion in Buikwe District. She was in critical condition. Mr Fredrick K was able to provide Post-Abortion Care to her and thereafter referred her to Lugazi Referral Hospital for an abdominal scan. A few days later, the patient returned to his facility for further therapy. On finding that she had not had the scan as he had recommended, Mr Fredrick referred her back to the hospital.
On April 6, 2020, police officers from Lugazi Central Police Station arrested Mr Fredrick on accusations of having carried out an abortion on the teenager girl, which is a criminal offence under sections 141 and 143 of the Penal Code Act. The Ugandan Constitution does not explicitly prohibit abortion. 
On May 11, 2020, the Legal Support Network applied for bail for Mr Fredrick, basing on the standards and guidelines by the Ministry of Health that permit health workers to provide Post-Abortion Care.

A CEHURD compilation.

PRESS STATEMENT

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 16^th 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.

About CEHURD

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: info@cehurd.org or call out toll free line 0800 300044.

MINISTRY OF EDUCATION AND SPORTS

P. O. BOX 7063 Kampala, Uganda
Tel: 256-414-234451/4
Fax: 256-414-234920
Email: pro@education.go.ug

FAX +256-414234920

Greetings,

In Uganda, the first case of COVID-19 was reported on March 21^st 2020 from a traveler returning home from Dubai. He was intercepted at Entebbe International Airport. Since then, the confirmed cases have risen to 657, with 118 recoveries and no deaths as of 9th June 2020.  Most of these cases are “imported” as they are from returning travelers or their contacts. However, there have been a few identified from the community, confirming that there is community transmission in Uganda.

Several measures intended to flatten the pandemic curve in Uganda were adopted, including the closure of schools due to the fact that social distancing was not practically possible in our school setting. These measures have been effective and we applaud His Excellency the President of Uganda for the leadership as well as the COVID-19 task force at the Ministry of Health. The Uganda education system has over 15 million learners with an additional 600,000 attending schools in refugee settlements. In your maiden address to the nation since the closure of schools, you highlighted April 27^th 2020 as the tentative date for the reopening of schools and higher institutions of learning.

However, the increasing number of cases of COVID-19 in the country resulted in the extension of the lockdown by 21 days. This prompted your second address in which you noted that schools would not reopen as initially communicated. In the same address, you emphasized the need for continuation of learning despite the delayed re-opening of schools and issued various strategies to facilitate this process including; radio, television, and self-directed learning materials that would be disseminated in the national newspapers.

“On the continuity of learning, I informed you that this happens beyond the four walls of a classroom but reinforced by effective implementation of the whole curriculum. In the present circumstances of total lockdown, the greatest contributors to learning are the parents and immediate family” – Hon. Janet Kataaha Museveni, Minister of Education and Sports.

In his 15^th National address on COVID19, the president noted that schools re-opening will only be considered after a month from the 28^th May 2020 with only learners in candidate classes being allowed to resume school.    Civil Society Organizations advancing the sexual and reproductive health and wellbeing of individuals across Ugandan communities, recognize the timely and monumental strides made by the Ministry of Education and Sports under your leadership to ensure continuity of learning despite the lock down.  As these innovative strategies are being adopted across communities, other issues that could potentially impede the successful learning of young people remain partially unaddressed.

 The inequalities and inequities further exacerbate the already existing inhibitions to learning as indicated below;

• The proposed methodologies of learning prioritize traditional subjects. However, sexual and reproductive health needs of young people have not been prioritized, including access to correct, age-appropriate, and culturally sensitive information which facilitates informed decision making regarding their health and lives. 
• The disruption in the school syllabus could result in work assignment overload for learners in a bid to make up for lost time, which could cause stress and compromise the mental health and wellbeing of both learners and teachers. This may push some children to lose interest in learning due to the pressure, teachers failing to complete the syllabus yet exams can be set from anywhere, leading to low grades, and eventually school dropout.          
• Learners from hard to reach areas and those with special needs may experience difficulties in accessing learning materials as disseminated on the various platforms and channels.
• The learners living in child-headed and economically deprived homes are likely to benefit less from the proposed strategies of learning as their priorities are divided between meeting their basic needs and dedicating time to learning- yet accessing the learning materials is close to impossible for most of them.
• The capacity of parents is not strengthened enough to bridge the sexual and reproductive health information gaps and ably support learners during this period to appreciate sexuality education which also includes information on growth, puberty, fertility, dangers of early sex, and pregnancy among others.

Recommendations

Developing and establishing  robust crisis response strategies  for the learners in candidate classes   that have so far been directed by the president to resume school  in a months’ time and those still in the  during the lockdown and   to ensure their overall health and wellbeing. Therefore, the Civil Society Organizations propose that the Ministry of Education and Sports;

• Expedites the passing and implementation of the National School Health Policy to guide and rejuvenate the school health programmes post the COVID-19 pandemic.
• Operationalizes the National Sexuality Education Framework as per the presidential commitment at the ICPD+25 conference in Nairobi, See
•  Establish mechanisms of protecting learners and teachers as schools re-open, ensuring that they have masks, hand washing facilities, temperature guns, among others to minimize the spread of the virus.
• That the Ministry revises the school calendar and supports the school administrators to adjust to the revised calendars to avoid panic in schools in a bid to complete the syllabus.
• That the Ministry ensures that all schools have psychosocial support to meet the mental health and sexual reproductive needs of learners and teachers. Train senior women and male  teachers on how to provide counselling and deal with the different health needs of young people, including implementation of the Girl child School Re-entry and Retention Strategy to give any girls who may report to school with pregnancies, an opportunity to continue with their studies
• Ensure liaison of schools with nearby health centers and that the test kits for the COVID19 are available and accessible in the various healthcare centres at any time for access by schools.
• Address the unique health challenges of adolescents like sexual and gender based violence, teenage pregnancies, menstrual health and HIV, among others within the learning medium and materials shared for learners.
• That the Ministry of Education and Sports establishes the Operational Standard Procedures and guidelines to direct learning institutions operate amid COVID19 and establish  a feasible and  coordinated plan to ensure that the public health preventive measures of COVID19 such as installing hand washing facilities , social distancing, and  wearing of masks, among others are in place.
• That Ministry of Education and Sports works with operators of the institutions of learning to devise practical measures for school fees payment and  opportunities to educate their children amid the financial constraints that the response to COVID-19 has created, as many people have stopped working. Post COVID-19, this will prevent learners from dropping out of school as a result of defaulting on school fees.

We will appreciate your timely response and action.

Sincerely,

1. Center for Education, Graduate Entrepreneurship and Empowerment
2. Center for Health, Human Rights and Development
3. Joy For Children Uganda
4. Naguru Teenage Center
5. Partners in Community Transformation
6. Philomera Hope Foundation
7. Public Health Ambassadors Uganda
8. Reach A hand Uganda
9. Reproductive Health Uganda
10. Sexual and  Reproductive Health Alliance Uganda
11. Teach for Uganda
12. Uganda Health Marketing Group
13. We talk series Uganda
14. White Ribbon Alliance Uganda
15. Youth Equality Center

A version of this article was originally published in the Daily Monitor on Friday 19th June 2020.

We were honored to present Recommendations for the National Health Insurance Bill to the Parliamentary Committee on Health which is currently compiling a report from stakeholder consultations.
The recommendations were derived from a Right to Health analysis made in regards to this Bill.