Health
New study: 46% of Women in Uganda say they had unintended pregnancies in 2021
Women in Uganda continue to report high levels of unintended pregnancies. Results from Phase 2 cross-sectional survey of the Performance Monitoring for Action -PMA Uganda project at Makerere University School of Public Health (MakSPH) show that 46 percent of pregnancies in 2021 were unintended.
Of the 2,159 women of ages 15-49 from across the 141 enumeration areas (villages) in 15 sub regions of Uganda interviewed by the study team, at least 54% said their current/ recent pregnancy was intended.
The women were asked whether they were pregnant by intention of their most recent birth or current pregnancy. 33% said they wanted a pregnancy later while a total of 13% said they wanted no more children but ended up getting pregnant.
The proportion of those who had unintended pregnancy varied from the those that were in urban and rural areas. For instance, a whopping 48.5% of those who had unintended pregnancies were rural based women while 35.9% were in urban areas.
Also, results show that more than 50% of women who said they never wanted to be pregnant or wished to delay child birth were aged 35 and above. A higher proportion (more than 60%) of women who experienced unintended pregnancy in 2021 were teenagers aged between 15 and 19.
The enumeration areas are sampled by the Uganda Bureau of statistics (UBOS). The survey was conducted together with the Ministry of Health, supported by Jhpiego, a Johns Hopkins University Affiliate, MakSPH and the Uganda Bureau of Statistics – UBOS and the overall technical guidance from the Bill & Melinda Gates Institute for Population and Reproductive Health at the Johns Hopkins Bloomberg School of Public Health.
At MakSPH, PMA Uganda project is led by Principal Investigator Dr. Fredrick Makumbi and Co-Principal Investigator Dr. Simon Peter Kibira. The results were released on February 15, during a stakeholder breakfast engagement meeting at Golden Tulip in Kampala.
For trends in use of contraceptives among married women, the prevalence stands at 50.2%. “It is the first time we are hitting this indicator and the modern method of family planning standing at 43%. So, we are rising though not first enough given the Covid-19 implications for the last 1-3 years. But it is amazing that we have had some adoption from the Ministry of Health and the implementing partners and the results show that at least, there is progress,” says Dr. Simon Peter Kibira, the PMA Uganda Co-Principal Investigator.
Dr. Kibira cites that among a few challenges Uganda has faced is the struggle with the quality of services provided. For instance, data shows that only 43% of women were told about the side effects of a modern contraceptive method they were using, how to cope up with them, and the availability of other alternative methods.
“This is not a good indicator and we still have a long way to go around that,” he says.
The survey interrogated service delivery points offering Family Planning services in 255 public health facilities and 118 private facilities that included 46 hospitals, 58 Health Center 4s and 96 Health Center IIIs and 55 Health Center 2s.
There was a general drop in stock outs for family planning services. For instance, Oral contraceptive pills in public health facilities stood at 48% in 2021 down from 68% in 2020.
According to the Principal Investigator Dr. Fredrick Makumbi the study team assessed availability of family planning services largely in public health facilities because they are many and can give stable statistics.
“Implant stockouts were very common compared to the IUDs which had lower use. What about Oral contraceptive pills stockouts, I daresay nearly half of the facilities were stocked out either at the time of the survey or in the past three months,” Dr. Makumbi.
The reasons advanced for stock out of FP commodities in Public Service Delivery Points, a higher percentage (46%) of the facilities said they had ordered but not received shipment. At least 20% said they had ordered but not received right quantities while 9% said there was unexpected increased consumption and just 2.8% said they lacked stock due to COVID-19 disruption.
“For as long as Family Planning partners, Ministry of Health and the rest as mobilizing and creating awareness, people are coming and using the methods and particularly in this study 9% said they did not have enough pills,” Dr. Makumbi says.
In terms of education background, the study noticed a difference in women of primary and secondary levels of education in terms of contraceptive use.
“The highly educated have a significantly high proportion of use of modern planning methods implying that education is key, factor and we need to make sure that women, men and couples using family planning are educated,” says Dr. Kibira.
The Uganda Family Planning Costed Implementation Plan, 2015–2020, launched by the government in November 2014 sought to increase the modern contraceptive prevalence rate among married women to 50 percent by 2020. This target was however not met.
According to Dr. Kibira, we have not yet reached it even in 2022 currently at 47.7%. “We are still struggling a little bit and if we work on that we, shall make sure that we hit on the target of 50%, and that’s for 2020. Much as we set a conservative target, there are adaptations we have seen otherwise we wouldn’t see any usage of family planning methods during Covid-19,” he said.
He adds that what has contributed to the high prevalence rate for contraceptives has been the use of modern methods and therefore the adaptations by the Ministry of Health and other implementing partners worked citing that if they did not work, Uganda would have seen worse indicators.
“Regardless of the effects of Covid-19, I am glad we had good indicators. I think this Covid-19 situation could have been a speed jump because couples stayed at home hence exposed to having more sex and that would lead them to take on the modern family planning method. And sometimes you have the challenges and the same challenge propel you to better indicators,” he noted.
In each of the 141 numeration areas the research team interviewed all eligible women aged 15 and 49 years in 35 households.
“We interview and we ask them issues about sex, and if there is any form of pregnancy control method being used. If someone says condom, implants or any other method, we don’t go ahead to interrogate why they are using that method. We are actually interested in asking, if you are not using, then why are you not using,” says Dr. Kibira.
There are various family planning methods and women / couples should be at liberty to choose with full information at the facility where you are receiving the method, for example among the pills, injectables, IUDs.
Notably Dr. Kibira asserts that implants and IUDs are long acting reversible methods and they are the most active compared to the short-term methods that are recommendable for people who want longer time delays for example space for 5 years.
He adds that; “The beauty with long term methods is that they are cheaper, effective and offer long years of protection and it should be ideal that people use what is ideal to their needs either short term and long term and it’s a choice.”
Dr. Makumbi says each development partner has a role to play in ensuring access to family planning services to Ugandans. “I think everyone of us has an opportunity to play their role, we generate evidence, we work with Ministry of Health, implementing partners, Population Council and everybody so that we can have evidence-informed decisions and that can make a significant difference and I am glad to see members of parliament who can help us support when all this information comes to parliament.”
Dr. Charles Ayume the Chair of the Committee on Health in Parliament of Uganda said they (committee) were extremely happy to engaging in a dissemination of PMA results citing that it sharpens the way they tackle issues on the floor of parliament.
“We really want a parliament that articulates issues based on evidence and very strong data. We do not only represent our constituencies, we are also dutybound to represent the views of health workers on the floor of parliament and good enough we have health workers on the committee,” said Dr. Ayume.
Adding that; “this is where data is produced. But then fortunately or unfortunately the policies are made on the floor of parliament. So if you don’t arm us well, then we do a poor job on the floor. We pledge total support.”
The two-day 2nd Artificial Intelligence (AI) in Health Africa Conference that kicked off today in the Main Hall, Makerere University has been described as not being about technology but about people – the vulnerable communities bearing the burden of infectious diseases and other health challenges – and the promise AI holds as a panacea. Officially opened by Hon. Dr. Monica Musenero, Minister of Science, Technology and Innovation the conference will be held under the theme “Setting AI for Sustainable and Inclusive Health Systems in Africa”.
Africa Must Enter the ‘Evil Forest’
In her now characteristic style of speaking from the heart, Hon. Dr. Musenero observed that Africa has from the first industrial revolution to the current fourth and impending fifth industrial revolutions experienced emotions ranging from non-recognition, rejection and skepticism to the current consumption with awe. This current emotion, though receptive unlike previous ones, continues to position Africa at a disadvantage economically, she noted.
“We are positioning ourselves to disadvantage in skill; we have positioned ourselves at the consumption end and we’ve stood in awe of this technology,” she observed, using the example of the amount of admiration a user who whips out the latest iPhone 17 attracts from those around them. “We respect you for your iPhone 17, but I would be happier if you were able to design and manufacture iPhone 5” intimated Hon. Dr. Musenero.
The Minister urged fellow scientists to wake up to the realization that the future of Africa lies in their hands. “We can no longer be passive participants, we can no longer reside on the shallow end of science; we must be willing, as I said when I was here last week, to enter the ‘evil forest’”.
The ‘evil forest’ is Hon. Dr. Musenero’s analogy of Africa’s perception of current technology ecosystem drawing parallels with scenes often dramatized by Nigerian Movies. She notes that though depicted in these movies as scary and potentially dangerous, the ‘evil forest’ is loaded with hidden treasures, necessitating resilience and wisdom for one to navigate the pitfalls until they discover the treasure trove. Upon discovery, the value of this treasure has the potential to turn around the fortunes of the family, community or entire kingdom. Entering the ‘evil forest’ therefore, is her way of encouraging scientists to go beyond adapting imported technology for local use to understanding how it works enough to develop homegrown solutions.
Building AI Capacity through Synergy
Representing the Vice Chancellor, Prof. Barnabas Nawangwe, the Academic Registrar, Prof. Buyinza Mukadasi concurred with Hon. Dr. Musenero that Uganda needs to accelerate investment capacity in AI, if it is to be used as tool to manage health challenges. He nevertheless underlined the steps Makerere has undertaken to close the gaps by hosting units such as the Infectious Diseases Institute (IDI), AI and Health Lab, Innovation Pod, while working with various partners.
“We want to renew our commitment that we shall continue to translate our research findings into service delivery and products that improve the livelihoods of our people,” pledged Prof. Buyinza, who also noted that this will be undertaken within institutional ethical guidelines and policies, bolstered by good practices and recommendations arising from the conference.
Taking cognizance of contributions of various partners to strides made so far, the Permanent Secretary Ministry of ICT and National Guidance, Dr. Aminah Zawedde who was represented by Mr. Ambrose Ruyooka, the Ministry’s Head of Department of Research and Development, thanked the Makerere University AI Health Lab, IDI, Health AI for All Network, the Research and Innovation Fund, the African Population and Health Research Centre, and the Mastercard Foundation for convening the second edition of the conference.
“This year’s theme aligns perfectly with Uganda’s digital transformation vision. It reminds us that while innovation is powerful, true progress lies in ensuring it is equitable, ethical, locally relevant, and accessible to all” read Dr. Zawedde’s remarks.
She noted that when used responsibly, AI empowers healthcare workers to do more with greater precision and efficiency while extending services to under-served communities, essentially amplifying their impact whilst preserving the essential human touch that defines care. Dr. Zawedde reiterated the Government of Uganda’s commitment to positioning AI as a catalyst for national development and improved service delivery through the national AI governance framework. “By the end of 2025, we expect to reach a decision on whether to adopt a comprehensive AI policy or a flexible, sector-led regulatory approach.”
Referring to projects already underway at the College of Computing and Information Sciences (CoCIS), the Principal, Prof. Tonny Oyana underscored the great promise AI holds for not only improving affordability but also diagnosis of disease. He nevertheless called for targeted investment in data centres so as to build the required capacity to process the large amount of data that AI thrives on.
The Executive Director IDI and conference Co-Chair, Dr. Andrew Kambugu described the conference timing as “impeccable”. Citing a recently convened conference on Communicable and Non-Communicable Diseases that discussed Universal Health Coverage, he shared “there are people in this country who are one step away from disaster because of health.”
He therefore paid tribute to his conference Co-Chair, Dr. Rose Nakasi, whose AI-automation work with the light microscope, one of game-changing inventions in human medicine to-date, has improved precision, accuracy and efficiency in diagnosis of malaria, tuberculosis and cancer in healthcare facilities. Dr. Kambugu therefore urged his audience to always be eager to learn about the capabilities game changing tools such as AlphaFold.
“Our African Centre of Excellence in Bioinformatics & Data Intensive Science (ACE) in collaboration with CoCIS has been one of the first trainers of AlphaFold in Africa” remarked Dr. Kambugu. He added that the to ensure inclusive training ACE has attracted funding to support the She Data Science (SHEDS) project, an initiative that offers MSc and PhD fellowships to Ugandan women in the fields of data science and bioinformatics, with a strong emphasis on health data.
How Ocular is shaping healthcare
Conference Co-Chair and Principal Investigator of Ocular, Dr. Rose Nakasi noted that their project that aims at empowering healthcare professionals with AI-powered microscopy was motivated by the fact that wrong diagnoses have a cascading effect on prescription, treatment, recommendation and surveillance services. “Where health practitioners have been taking 30 minutes or more to diagnose malaria, and days to diagnose cancers, we are slashing down that time to literally 5 seconds to diagnose and make a recommendation.” She added.
Dr. Nakasi added that beyond diagnosis, the Ocular project is supporting the Ministry of Health with more precise surveillance and monitoring of diseases by quicker augmentation of information for faster roll-out of interventions as opposed to current weekly or monthly reporting period required by the Digital Health Information System (DHIS 2).
“The beauty about AI is that it has the capability not to just learn with one dataset but also provide insights on different pieces of data – for diseases such as malaria where climate has an effect, we want to integrate climate datasets and seasonality aspects so that interventions by Government are timely and targeted to specific locations.”
Beyond the plenary sessions, the 2nd AI in Health Africa Conference will feature abstract presentations, a Makerere AI Health Lab Showcase, Breakout Sessions, Workshops, Masterclasses and a hackathon for prototypes developed during the conference. Please see downloads for a detailed concept and programme.
The Ministry of Health (MoH), Makerere University School of Public Health (MakSPH), Makerere University College of Health Science (MakCHS) and other partners are jointly hosting the National Annual Communicable and Non-Communicable Diseases (NACNDC) and 19th Joint Annual Scientific Health (JASH) Conference 2025, running from 3rd to 7th November. Ahead of the official opening on Wednesday, 5th November, a Mental Health Pre-Conference Symposium was held under the theme “Breaking the Silence: Advancing Mental Health Awareness and Resilience,” with a sub-theme on “Advancing Mental Health in Schools and Universities — Research and Policy Perspectives.” The session, held at Victoria Hall, Speke Resort Munyonyo, brought together mental-health experts, policymakers, researchers and education stakeholders to explore how learning institutions can strengthen emotional well-being, resilience and support systems for young people across Uganda.
Speaking as Guest of Honour, Justice Duncan Gaswaga of the African Court on Human and Peoples’ Rights urged stakeholders to recognise the deep connection between mental health and human rights, noting that mental well-being cannot be separated from the social and economic realities in which people live. He commended the theme on “breaking the silence,” arguing that open conversations and early prevention offer the most cost-effective path to protecting communities, especially learners. Drawing from his judicial experience, he shared first-hand accounts of emotional trauma faced by judges who regularly encounter distressing evidence in court, including cases from the LRA conflict, and observed that legal professionals, like health workers and teachers, are not immune to psychological strain. Justice Gaswaga raised concern over rising mental-health challenges in schools and universities, citing data showing increased depression, substance use, and emotional distress among students, particularly girls. He attributed these trends to pressures such as long study hours, parental absence, peer influence, online risks, poverty, and untreated trauma. He called for stronger government funding, implementation of school mental-health policies, closer parental involvement, and coordinated action across sectors, adding that legal reforms, including debate on decriminalising attempted suicide, may be necessary to ensure individuals can seek help without fear of punishment.
The Deputy Inspector General of Government (IGG), Mrs. Anne Twinomugisha Muhairwe emphasised the urgent need to prioritise mental health across all sectors, noting that society often treats the subject as taboo despite its profound impact on productivity, ethics and service delivery. She argued that mental well-being is not only a personal concern but a governance issue, pointing out that health workers, who shoulder enormous responsibility, also require structured support systems to safeguard their psychological welfare. Citing recent incidents, including a case in Masaka where a patient reportedly died after a medical worker allegedly refused treatment over a payment dispute, she warned that unresolved mental-health challenges can influence behaviour and decision-making in critical service spaces. The IGG further highlighted a link between mental health and corruption, suggesting that addressing emotional strain and psychological pressures among public servants could contribute to ethical conduct and better public service outcomes. She encouraged continued engagement on the topic, calling for mental-health considerations to be integrated into anti-corruption strategies and institutional reforms, and expressed readiness to contribute more deeply to future discussions.
Delivering the keynote at the Mental Health Pre-Conference Symposium, Dr Racheal Nuwagaba of Makerere University urged stakeholders to confront mental health as it is today and abandon siloed approaches, calling for full integration of services into primary health care and evidence-led policy. She said nearly two decades of clinical practice and teaching have shown her that young people carry mounting pressures, highlighting Uganda’s youthful demographics and pointing to drivers such as sleep deprivation, academic strain, abuse and neglect. Citing recent trends, she warned against sensational statistics and urged clear differentiation between mild, moderate and severe symptoms, noting post-COVID rises in depression, higher burdens among refugees and significant risks for girls and senior students. Dr Nuwagaba stressed the frequent co-occurrence of mental illness with addictions and physical conditions, explaining that untreated disorders worsen over time and can impair brain function, while treatment and adherence improve outcomes. She encouraged mindfulness and presence in classrooms and clinics, and pressed institutions to use research to guide decisions, reduce stigma, and design culturally grounded, community-based responses. Concluding, she appealed for sustained collaboration across sectors and for the deliberate hiring and fair remuneration of professional mental-health providers to safeguard learners’ emotional, social and academic well-being.
The symposium also featured a panel discussion on Mental Health in Schools and Universities, chaired by Dr Kenneth Kalani from the Ministry of Health, and bringing together experts including Dr Harriet Abbe, Prof Ane-Marthe Solheim of the Norwegian Institute of Public Health, and Ms Rebecca Namakula from the Ministry of Education and Sports. Panelists underscored the urgency of addressing mental-health challenges among learners, with insights highlighting early substance use among children as young as six, the need for teacher training in mental-health literacy, and the critical role of schools as early-detection points. They emphasised stronger linkages between health facilities and learning institutions, investment in prevention and early intervention, and the importance of equipping teachers, parents and school leaders with the skills to identify and respond to distress. The panel agreed that mental-health support must extend across the entire school community and be backed by policy enforcement, coordinated services and sustained collaboration across sectors.
In her closing remarks, Dr Hafsa Lukwata, Assistant Commissioner for Mental Health and Control of Substance Abuse at the Ministry of Health, urged Ugandans to break the silence around mental well-being and be intentional about seeking help and supporting one another. She noted that mental-health challenges are widespread across schools, homes and workplaces, and emphasised that silence only deepens the burden. Dr Lukwata encouraged institutions to appoint mental-health focal persons and called for sustained dialogue, continued collaboration and proactive efforts to build resilience in communities. She reminded participants that improving mental health begins with individual awareness and collective action, urging them to treat the day’s engagement as a starting point for strengthening support systems across the country.
On 24th October 2025, the 3rd cohort (65 professionals) of the ‘Science of Designing Adaptation and Implementation of Evidence–Based Parenting Interventions’ graduated at a ceremony held at Africana Hotel, Kampala, Uganda. The professionals were advised to be good ambassadors and share the knowledge from the training.
The training is a collaboration between Child Health Development Centre (CHDC) at Makerere University College of Health Sciences (MakCHS) and Ministry of Gender Labour and Social Development (MoGLSD) through their Parenting Agenda Initiative.
The graduation brings the total of those trained to 130 since cohort 1, and marks a significant milestone in the journey of standardising parenting interventions in Uganda and testament of the nation’s commitment to strengthening families and communities.
In his remarks at the graduation, Dr. Godfrey Siu – Senior Lecturer at CHDC, Programme and Course Lead congratulated the participants for successfully completing the intensive parenting course. He said, ‘I am filled with an immense sense of pride and hope, not just for what we have accomplished during the training but the ripple effect this will have across Uganda’.
Dr. Siu highlighted that the course was not conceived in isolation, but is a vital pillar in the ambitious and crucial efforts by the Government of Uganda (GoU) through MoGLSD with an aim to strengthen and standardise parenting interventions in the country.
‘We extend our appreciation to GoU and MoGLSD in particular for the unwavering commitment and steadfast support. The vision for stronger families is a collective one, and leadership by government is its cornerstone. Let us go and build a future where every child in Uganda can thrive in a nurturing, supportive, and loving family’, Dr. Siu said.
Dr. Siu thanked the various partners who supported the training including the ELMA Foundation, Global Parenting Initiative and Uganda Muslim Supreme Council (UMSC); facilitators of the programme, drawn from a diverse spectrum of expertise. He advised the graduands to be champions, as standard-bearers for a new-era of parenting in Uganda.
He also called for support from development partners, donors and GoU in funding the next phase of the critical work noting that investment in parenting is an investment in the health, stability, and prosperity of the nation.
Dr. Herbert Muyinda, Director-CHDC noted the multi-dimensional benefits of the course including standardisation. He said, ‘all researchers dream about their work making impact and influence policy which Dr. Siu has achieved with this training programme’.
The Director-CHDC thanked all partners, MakCHS and CHDC administration for ensuring the success of the training. He commended the participants for the commitment and resilience during the training and expressed hope that they will use the knowledge when they return to their communities and organisations.
Professor Richard Idro, Deputy Principal-MakCHS represented the College administration at the graduation. In his speech he congratulated the participants on the milestone, thanked MoGLSD for entrusting the University with this work and also thanked CHDC for undertaking the programme not only for research but also as a contribution to the nation.
Professor Idro noted that parenting today is so different from what many of us experienced, highlighting that many parents work away from home also spending less time with their children.
He said, ‘teachers and carers spend more time with children therefore standardisation from initiatives like this are welcome’.
Highlighting the new strategy of taking the University to communities and solving societal challenges, Professor Idro commended the CHDC for the work which is well aligned to the aforementioned strategy. He called on the graduands to cascade the initiative learned to the lowest level of local governments for the benefit of the whole population.
He expressed hope that for sustainability, funding of the programme would be included in the government budget cycle to ensure continuity. He thanked the UMSC for the support recognising time that Sheikh Ali Waiswa had spent at the event as a sign of commitment to improved parenting in Uganda.
‘Our children are vulnerable, I hope this training takes us back to the basics of parenting. I encourage everyone to start with their family and share with all those around them’, said Dr. Angela Nakafeero – Commissioner for Women and Gender Affairs who represented the Permanent Secretary-MoGLSD, Mr. Aggrey Kibenge.
She thanked partners, MoGLSD departments, and various government institutions that have contributed to work accomplished to-date. She reiterated the message of the previous speakers to the graduands not to keep what they had learned to themselves but share with others. ‘Don’t keep information acquired, share it, make better parents and raise better families’, she said.
‘The ministry remains committed to the parenting agenda. As a nation we have always stressed the importance of cultural and religious appropriateness; the University is on-board to offer technical knowledge and this partnership will continue to deliver results’, Dr. Nakafeero added.
She invited the Chief Guest, Sheikh Ali Waiswa – Deputy Mufti, UMSC who represented the Mufti to address the congregation.
Sheikh Waiswa reminded those present that holy books including the Quran and Bible prescribed the family as the cornerstone of society giving guidance on how to raise good families.
He warned against the increased violence against children present in our communities. Quoting statistics, he expressed disappointment that children endure acts of violence in places meant to be safe havens like homes and schools with acts committed by people meant to be trusted. ‘Nearly 6 out of 10 girls and 7 out of 10 boys have experienced physical violence, while 35% of girls are affected by sexual violence’, he said.
The Deputy Mufti commended the training course for bridging the gap between research and practice, saying it would revolutionise parenting, strengthen families and in-turn society. ‘Don’t underestimate the power of the work you are doing, as we celebrate, let us remember our blue print is this initiative and training’, he said.
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