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.”
Health experts from across Africa have called for stronger use of routine health data in planning, supervision and service delivery, noting that although countries are generating large amounts of health information, much of it is still not being used.
The call came during a webinar hosted by the Makerere University School of Public Health (MakSPH) in partnership with The Global Fund under the theme “From National Dashboards to District Action: Strengthening Subnational Data Use for Planning, Supervision and Service Delivery.”
The webinar brought together health information specialists, policymakers and practitioners from Uganda, Kenya, Zimbabwe and Ethiopia to share experiences and lessons on using subnational data for evidence based decision making.
Kenya’s journey from data collection to action
In her keynote address, Dr Helen Kiarie, Head of the Monitoring and Evaluation Division at Kenya’s Ministry of Health, urged health practitioners and policymakers to move beyond routine reporting and use data to improve health outcomes.
“The bottleneck is no longer collecting data. It is turning routine data into decisions and decisions into action,” Dr Kiarie said.
Drawing on Kenya’s experience, she pointed to the country’s shift from paper based reporting systems to digital platforms, noting that more than 95% of public health facilities have been digitised.
According to Dr Kiarie, Kenya has developed National Data Analytics Guidelines to support evidence based decision making across the health system. The guidelines set out a structured approach to data analysis, interpretation and dissemination so that the information generated can be used.
She said building a culture of data use requires leadership that asks for evidence, regular performance reviews, public dashboards, mentorship programmes, and the integration of data into planning and budgeting.
Community data improving maternal health
Dr Kiarie gave practical examples of how data can shape health outcomes.
In Kwale County, community health promoters used household level data to identify and follow up pregnant women, encouraging them to attend antenatal care services and deliver at health facilities.
As a result, skilled birth attendance increased from 50 per cent in 2022 to 85 per cent, while reported home deliveries fell from 808 to 248.
She also pointed to Kenya’s efforts to link digital health data with health financing systems, saying better documentation and data quality have strengthened accountability and increased reimbursements to health facilities.
She added that real time maternal and perinatal death surveillance systems are helping health authorities identify gaps in care, assign responsibility and take corrective action to prevent avoidable deaths.
“Data has moved beyond documenting losses to becoming an instrument for preventing the next avoidable death,” Dr Kiarie said.
Addressing data quality challenges
Despite major investments in digital health systems, Dr Kiarie acknowledged that data quality challenges remain.
She cited system downtimes, the parallel use of paper and digital records, limited access to some digital platforms, and resistance to change among some health workers as barriers to data quality and use.
Still, she said Kenya’s data quality has improved considerably through digitisation and continued investment in governance, analytics capacity and quality assurance.
Regional experiences and lessons
The webinar also included a panel discussion with experts from Uganda, Zimbabwe and Ethiopia, who shared experiences on strengthening data use at district and facility level.
The discussion pointed to the importance of strong leadership, timely information, digital infrastructure and feedback mechanisms that help health workers and managers make informed decisions with the data available.
Participants agreed that health information systems should do more than serve as reporting tools. They should also support decision making where services are delivered.
Moving from information to impact
Speaking during the webinar, Prof. Rhoda Wanyenze, Dean of Makerere University School of Public Health (MAKSPH), commended countries for progress in strengthening health information systems and encouraging data use.
She urged practitioners and researchers to go beyond documenting challenges and start capturing examples of how data informed decisions are improving programmes and health outcomes.
“It would be really good for us to dig deeper in terms of what decisions we have actually made and what we would not have known or done differently if we did not have the data,” she said.
In his closing remarks, Dr Wodimu Ayele of The Global Fund said the value of data lies in its ability to improve service delivery, inform decision making and strengthen accountability.
He called on countries to keep investing in data quality, analytics capacity and health information systems, while making sure evidence generated at all levels leads to measurable improvements in health outcomes.
Uganda has released the preliminary findings of the 2025 Uganda Population-Based HIV Impact Assessment (UPHIA 2025), a national household survey that provides a current picture of the country’s HIV response and selected non-communicable disease indicators.
At the Uganda Media Centre today, 1 October 2026, the Minister of Health, Hon. Dr Chris Baryomunsi, released the preliminary results and said the evidence would guide policy, resource allocation and service improvement, with particular attention to people and communities with the greatest gaps. He urged Ugandans to know their HIV status, use prevention services and, when diagnosed, start treatment promptly and adhere to it.
Among adults aged 15 years and above, HIV prevalence was 5.9 percent, including 7.3 percent among women and 4.1 percent among men. Among adults aged 15–64, prevalence was also 5.9 percent, unchanged from 2020/21. Across the country, prevalence ranged from 1.3 percent in Karamoja to 8.0 percent in the South Western region. Of adults living with HIV, 85.3 percent knew their status; 99.1 percent of those aware were on treatment; and 96.5 percent of those on treatment had achieved viral load suppression. HIV-status awareness remains the central gap in the 95-95-95 cascade.
The survey also measured selected non-communicable disease indicators for the first time. Elevated blood pressure affected 15.5 percent of adults, while 24.8 percent had overweight or obesity and 0.9 percent had raised blood glucose.
Conducted from July to September 2025, UPHIA 2025 was the first population-based HIV impact assessment to be fully country-led. The Ministry of Health provided overall leadership, while Makerere University School of Public Health served as the prime implementing organisation, working with UVRI, UBOS, regional referral hospitals and local governments. PEPFAR funded the survey through the U.S. CDC.
Watch the UPHIA 2025 preliminary results launch:
https://www.youtube.com/live/QfHFBaJ-L-w
Read the UPHIA 2025 summary results:
https://drive.google.com/file/d/1nElGNwgcAcZyAo9CLCQKRpO2jJgyxjSc/view?usp=drive_link
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