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.”
A major milestone in Uganda’s efforts to reduce newborn mortality was marked on June 17, 2026, when Makerere University College of Health Sciences graduated the first cohort of fellows from the Perinatal and Neonatal Medicine Fellowship Programme.
The pioneering cohort of five specialists completed the two-year sub-specialty fellowship designed to equip pediatricians with advanced competencies in newborn care, leadership, research, advocacy, and neonatal intensive care. The programme is accredited by the Uganda Medical and Dental Practitioners Council and is implemented through a partnership involving Makerere University, Mulago Specialised Women and Neonatal Hospital, Kawempe National Referral Hospital, St. Francis Hospital Nsambya, Seed Global Health and Elma Philanthropies.
Speaking at the graduation ceremony, the Principal of the College of Health Sciences, Prof. Bruce Kirenga, described the occasion as a significant achievement for Makerere University and Uganda’s health sector.
“Today is a very important occasion for the College of Health Sciences, and indeed the health sector in Uganda,” he said, noting that the fellowship was established to develop highly skilled specialists capable of responding to increasingly complex healthcare needs.
Prof. Kirenga emphasized that Uganda’s changing disease patterns, increasing life expectancy, and growing demand for specialized healthcare services have created an urgent need for super-specialized training programmes. He challenged the graduates to use their newly acquired knowledge and skills to improve newborn health outcomes and save lives.
Addressing Uganda’s Neonatal Health Burden
Presenting an overview of the fellowship programme, the Head of the Department of Paediatrics and Child Health, Prof. Victor Musiime, highlighted the urgent need for specialists in neonatal care.
He noted that neonatal deaths, those occurring within the first 28 days of life, remain one of the leading contributors to child mortality in Uganda. The country continues to face a shortage of professionals with advanced skills in neonatal care, research, leadership, and advocacy.
“The demand for neonatologists remains extremely high,” Prof. Musiime explained, adding that the Ministry of Health envisions deploying neonatologists to regional referral hospitals and other health facilities across the country.
The fellowship programme was established to build a critical mass of neonatologists, strengthen care for high-risk newborns, develop expertise in advanced neonatal procedures, and produce leaders and advocates for newborn health.
A unique feature of the programme is its strong clinical apprenticeship model, complemented by international placements at leading institutions, including Yashoda Hospital in India and Aga Khan University Hospital in Nairobi, Kenya.
Ministry Commits to Expanding Neonatal Services
Representing the Ministry of Health, Commissioner for Maternal and Child Health, Dr. Richard Mugahi, congratulated the graduates and commended Makerere University and its partners for establishing the fellowship programme.
Dr. Mugahi revealed that the five graduates join another five neonatologists already serving in Uganda, bringing the country’s total number of neonatologists to ten. He described the locally trained fellows as a critical addition to Uganda’s healthcare workforce.
“The Ministry’s vision is to have a neonatologist at every Regional Referral Hospital,” he said, adding that Uganda aims to have at least 14 neonatologists by 2030.
He further outlined government plans to strengthen newborn care through the establishment of specialized neonatal care units at different levels of the health system, ranging from Health Centre IVs to Regional Referral Hospitals and super-specialized facilities such as Mulago Specialised Women and Neonatal Hospital.
Dr. Mugahi assured the graduates that the Ministry of Health is investing in equipment and infrastructure to support advanced neonatal services and pledged to advocate for improved career progression pathways for super-specialized health professionals.
Makerere’s Commitment to Advanced Medical Training
Representing the Vice Chancellor, the Deputy Vice Chancellor (Finance and Administration), Prof. Henry Alinaitwe, congratulated the fellows and their families on the achievement.
He praised the College of Health Sciences for its contribution to national development and noted that programmes such as the Perinatal and Neonatal Medicine Fellowship enhance Makerere University‘s position as a leader in knowledge generation and societal transformation.
Prof. Alinaitwe paid tribute to the graduates’ families, particularly their spouses and children, for supporting them through the demanding years of specialist training.
“The work you do is truly priceless,” he told the fellows. “The contribution you make to humanity is immeasurable.”
Graduates Hailed as Future Leaders in Newborn Health
In attendance were the director of Mulago Specialized Women and Neonatal Hospital, Dr. Sam Ononge, Deputy Director Mulago Referral Hospital, Dr. John Sekabira, Dr. Mary Nyanzi from Kawempe Referral Hospital, Sr. Dr. Assumpta Nabawanuka, the Director of St. Francis Hospital Nsambya, Dr. Irene Atuhaire from Seed Global Health Uganda and Ms. Ritah Akankwasa from ELMA Philanthropies Services, who partnered with the college in training the fellows.
The training partners described the graduates as pioneers who had demonstrated exceptional resilience and commitment throughout the rigorous training programme.
They applauded their contributions to patient care, teaching, mentorship, and supportive supervision, noting that their work had already contributed to improvements in maternal and newborn health services in Kampala and other regions of Uganda.
“As Kawempe National Referral Hospital, we have been privileged to witness your growth, not only as clinicians but also as leaders and advocates for newborn health,” Dr. Nyanzi said.
The graduates
- Dr. Tumwebaze Anita Kiiza Muhumuza
- Dr. Ediamu Tom Didimus
- Dr. Kezia Kibedi
- Dr. Hellen Kyokutamba
- Dr. Gerald Ojambo
For most people, the thought of death evokes grief, fear, or loss. But at Makerere University‘s College of Health Sciences, death became a lesson in gratitude, service, and humanity as students, faculty, and health professionals gathered to honour a unique group of teachers, individuals who continued to educate future doctors long after their passing.
At the Second Cadaver Commemoration Ceremony, on June 11, 2026, organized by the Makerere Students’ Anatomy Society, candles flickered softly as students paid tribute to what they fondly call their “silent teachers”, the human bodies that make it possible for medical students to learn anatomy and develop the skills that will one day save lives.
Standing before fellow students and guests, Chairperson of the Makerere Students’ Anatomy Society, Joseph Mwera, reminded the audience that the ceremony was not about mourning the dead.
“Today, we gather not only to remember those whose bodies have contributed to medical education but also to celebrate their lives,” he said. “Their legacy continues to inspire and serve humanity even after death.”
For many medical students, the anatomy laboratory is where they first encounter the reality of the profession they have chosen. Behind every lesson on muscles, nerves, blood vessels, and organs is a person who once lived, loved, worked, and contributed to society.
That reality was brought to life by the keynote speaker, Rev. Prof. Dr. Samuel Luboga, a surgeon, anatomist, and priest who spent nearly four decades teaching anatomy at Makerere University.
Reflecting on his own days as a medical student, Prof. Luboga recalled spending long hours in the anatomy laboratory after his classmates had gone home, studying human anatomy in detail.
Many people wondered whether he was afraid to spend so much time among cadavers.
His answer was simple.
“These men and women had lived productive lives. They had raised families, served their communities, and contributed to Uganda’s development. Even in death, they continued to teach us the science and art of medicine. They had earned my admiration, my respect, and my gratitude.”
His remarks resonated deeply with the students in attendance.
In a society where discussions about death and body donation remain sensitive, Prof. Luboga challenged participants to view the individuals in anatomy laboratories not as lifeless remains but as people who continue to contribute to humanity through education.
“The silent teachers before us today made learning possible,” he said. “The impact of their contribution is reflected in the doctors you have become and those you are yet to become. It is reflected in the countless patients you will treat and the innumerable lives you will save.”
Legal framework to guide body donation
The ceremony also sparked important conversations about the future of anatomical education in Uganda.
Head of the Department of Anatomy, Prof. Elisa Mwaka, highlighted the need for a national legal framework to guide body donation and anatomical research. While anatomy training in Uganda has traditionally relied on unclaimed bodies obtained through hospitals, he noted that many countries are increasingly embracing voluntary body donation programmes.
According to Prof. Mwaka, building public trust will be essential if Uganda is to establish a sustainable body donation programme.
“We must help the public understand how human bodies contribute to medical education, how they are treated with dignity, and how appropriate legal safeguards can protect donors and their families,” he said.
He revealed that discussions are already underway to develop an Anatomy Act that would provide a modern legal and ethical framework for the use of human remains in medical education and research.
Representing the Deputy Vice Chancellor (Academic Affairs), Prof. Julius Kikooma described the ceremony as much more than an academic event.
“Behind every competent healthcare professional stands an invaluable source of learning that often remains unseen and unheard,” he said. “These individuals taught us without speaking a single word. Though they are no longer able to communicate, their contribution continues to educate, inspire, and shape future generations of healthcare professionals.”
He commended the medical students for organizing what remains the only cadaver commemoration ceremony of its kind in Uganda, noting that the initiative reflects the values of compassion, professionalism, and respect for human dignity that are at the heart of medicine.
The event concluded with recognition of past and present leaders of the Department of Anatomy whose contributions have shaped anatomical education at Makerere University over the decades. Students also honoured exceptional educators who have inspired generations of future health professionals.
Yet the most powerful tribute of the day was reserved for those who could not be present to receive awards or applause.
The silent teachers
Individuals whose names may never appear in textbooks, whose stories may never be fully known, but whose gift continues to echo through hospital wards, operating theatres, and communities across Uganda.
Every doctor trained, every surgery performed, and every life saved carries a small part of their legacy.
And for one day at Makerere University, students paused to say the words that are rarely spoken aloud: Thank you.
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