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
Makerere-Incubated Safe Bangle Technologies Wins Prestigious World Summit Award for Innovation Against GBV
By Joseph Odoi
In a groundbreaking achievement, SafeBangle Technologies, an innovation incubated at Makerere University, has won the prestigious World Summit Award 2025 for its groundbreaking contribution to the fight against gender-based violence (GBV) in Africa. This remarkable honor comes in recognition of the development and implementation of a real-time domestic violence reporting bracelet.
The award was presented to the SafeBangle team that was represented by Saul Kabali, Messach Luminsa, and Janet Christine Nabaloga from SafeBangle Technologies at the WSA Global Congress in Hyderabad, India, where Uganda’s innovation potential was proudly showcased on a global stage.
The award was conferred in the Inclusion & Empowerment category for Safe Bangle’s cutting-edge solution; a wearable safety bracelet designed to address the pressing challenge of gender-based violence (GBV) across Africa.
The SafeBangle is a smartwatch-like, real-time domestic violence reporting bracelet that allows users to send SMS alerts via a single button press. Its core mission is to create a safer, more secure environment for women and children in Africa through innovative, affordable tech solutions.
According to Saul Kabali and Messach Luminsa, the innovators behind SafeBangle from SafeBangle Technologies, hosted at the Resilient African Network Lab. This award is very timely and a recognition that cements the importance of community rooted technology.
The team further stated that ‘’This award is a powerful affirmation of our mission and refuels our commitment to empowering Ugandan women and girls through innovation and technology. It influences our next steps by opening doors to new partnerships, increasing our credibility, and accelerating efforts to scale the SafeBangle nationally. We’re now more equipped to positively impact the daily lives of Ugandan women and girls through our SafeBangle bracelet.
To further the innovation, the team has called upon government to support the Safe Bangle Innovation
‘’Governments can support us by providing funding, facilitating policy support, and creating collaborative platforms for innovation. NGOs can help with grassroots outreach, and connect us to potential donors and funders interested in solving Sexual and Gender Based Violence amongst vulnerable communities; and tech partners can enhance scalability through infrastructure, data insights, and capacity building.
Moving forward, the team emphasized the importance of uniting innovation, partnership, and purpose to scale impact. “As we empower communities, invest in local solutions, and promote collaboration, we can transform how technology protects and uplifts women and girls across Uganda,” added the award-winning team.
The Story Behind the Safe Bangle Bracelet Innovation
According to the Safe Bangle innovators Saul Kabali and Messach Luminsa , ‘’The inspiration behind SafeBangle came from a deeply personal place. ‘’We heard countless stories of women who couldn’t call for help during moments of danger. We were deeply affected by the story of Aisha, a young woman in a rural village who was attacked while walking home alone at night. With no way to call for help, she felt helpless and vulnerable. This incident made us realize the critical need for immediate reporting alert tools, accessible to women like Aisha. We knew technology could play a crucial role and this incident awakened a strong desire in us to create a solution’’
To Makerere University School of Public Health’s Dr. Juliet Kiguli, who collaborated closely with the team during the rollout of the bracelet, this award is a vote of confidence in the work of Makerere University, whose core function focuses on teaching, learning, community engagement, research, and innovation, all contributing to the university’s efforts in addressing domestic violence.
‘’The award-winning innovation stems from the findings of a longitudinal study led by the Makerere University School of Public Health.
While carrying out a study after the Covid-19 Pandemic, we identified gaps when it comes to reporting and response to Gender Based Violence (GBV) among women in informal settlements. Therefore, we used to incorporate the SafeBangle intervention to solve the problem of lack of affordable and immediate reporting mechanisms for violence using a bracelet that reports violence in real time
We’re excited about the progress so far, and with this recognition, we hope that more like-minded partners will join us to scale this initiative and ultimately help make the world a safer place for all.” Added Dr Kiguli of the Safe Bangle innovation potential
The research team, comprising Dr. Juliet Kiguli (Principal Investigator), Dr. Roy Mayega (Deputy Chief of Party, RAN), and Dr. Agnes Nyabigambo (Study Coordinator), piloted the bracelet under the PEER (Partnerships for Enhanced Engagement in Research) program with support from USAID and the National Academies of Sciences.
A consortium of partners, including SafeBangle Technologies, Makerere School of Public Health/RAN , the Medical College of Wisconsin, and Somero Uganda, implemented the rollout of the Domestic Violence Real-Time Reporting Bracelet. The initiative was supported by USAID and the National Academy of Sciences in Washington, DC. Key contributors to the project included Dr Juliet Kiguli Roy Mayega from Makerere University School of Public Health, Dr. Kelly Robbins, Dr. Lina Stankute-Alexander, Dr. Brent Wells, Dr. Melissa Trimble, and Uganda’s Dr. Gloria Kasozi at USAID. Wisconsin Madison Medical University’s Prof. Julia Dickson-Gomez was also a collaborator.
In terms of the acceptability of the SafeBangle innovation as a solution to GBV, the team has piloted the technology with more than 1,000 users, resulting in a 63% reduction in response times
During the event, SafeBangle Team participated in the “Equity by Design” panel, sharing insights on inclusive technology development with global experts including Dorothy Gordon, Abhishek Singh from India’s Ministry of Electronics and IT, Baroness Beeban Kidron, and representatives from UNESCO and WE Hub.
About SafeBangle Technologies
SafeBangle Technologies is a Ugandan social enterprise hosted at Resilient African Network Lab focused on addressing gender-based violence through innovative safety solutions. The company combines wearable technology with an interactive web platform to provide real-time reporting of violence and physical assaults, even in areas without internet connectivity. Founded in 2018, SafeBangle operates with a mission to make safety accessible and affordable for vulnerable populations, especially women and children.
Health
A Humble Petition from the Marabou Storks of Kampala to His Excellency, President Yoweri Kaguta Museveni
Your Excellency,
We send you warm greetings from the skies above Kampala — from your old, bald-headed friends, the Marabou Storks, or as we are fondly called, the Kalooli. We are not the prettiest of birds, with our wrinkled faces, hunched shoulders, and sharp beaks, but we carry an important duty. Where others see waste and decay, we see purpose. We are nature’s cleaners, recycling what would otherwise rot and cause harm.
Some count us among Africa’s “Ugly Five,” alongside hyenas, vultures, wildebeests, and warthogs, but we take no offense. Beauty was never the Creator’s mission for our mission, but service was. We glide quietly between life and death, keeping the balance, cleaning the mess, and doing the work that must be done.
Today, we come to you not with complaints, but with a plea for partnership, to protect our shared home and ensure a cleaner, healthier Uganda for all. We still remember the day in 2008, Mr. President, when you gave the Uganda Wildlife Authority and the Kampala Capital City Authority instructions to “kindly relocate us” from the esteemed grounds of State House, Nakasero. We don’t harbor angry feelings. Truly. We realized back then, as we do now, that not everyone finds our odd looks or the noble scent that naturally results from a lifetime of cleaning your lovely nation appealing.
Your Excellency, we are modest. And forgiving. We maintained our composure even when we were discussed in Parliament in 2020, when honorable members referred to us as “health threats” and asked that we leave the Parliament gardens. We birds, after all, literally have thicker skin!
We are better citizens now. Thanks to Makerere University‘s kind hospitality, we have discovered a new haven. We express our deep thanks to Vice Chancellor Professor Barnabas Nawangwe for preserving the ancient trees, the very canopies that now provide us with protection, generation after generation. Students here lovingly refer to us as “the real professors of Makerere,” observing us as we keep a watchful eye on campus life with our sage, steady gaze. Some people think it’s a blessing to see a Kalooli before an exam. We take selfies with other people. We have kind of turned into little celebrities, sir. We appreciate the tranquility, love and peace you provided, with your comrade freedom fighters. They bring uhuru to these trees, and our kids pray for you every day for more life.
However, we come before you today not just to reminisce, but to raise important concerns not for ourselves alone, but for the survival of Uganda’s fragile ecosystem.
We are concerned about the growing crisis in waste, plastics, and environmental decay.
Your Excellency, you are a man who loves numbers. Allow us to present some:
- 768 metric tons — that is the amount of food waste produced DAILY in Kampala alone.
- 65% to 79% of solid waste in Kampala landfills consists of food waste.
- The dairy industry in Uganda loses $23 million annually from waste alone, according to the Food Rights Alliance.
- 135,804 tons of plastic waste generated in the Kampala Metropolitan Area recently.
- 42% of that waste remains uncollected, leading to clogged drains, flood risks, pollution of wetlands, and of course, diseases.
- Shockingly, 10% of this waste ends up in Uganda’s precious water systems!
Your Excellency,
It might surprise you but it’s true. Between 2018 and 2021, Uganda produced 12,330 tons of recycled polyethylene (rPET). And that’s not all conservative estimates predict a 91% increase in production between 2022 and 2025, should imports stay the same.
Mr. President, we Marabou Storks have served loyally as your unpaid, unsung environmental officers. While your citizens discard waste carelessly, we fly across the city, scavenging, sorting, and managing organic decay. We are your frontline solid waste managers, yet without uniforms, pensions, or even a simple “thank you.”
We join you in mourning the tragic loss of life that occurred at Kiteezi Landfill. We experienced devastation because the birds that live there consider that place their territory. We directly observed your people’s struggle to survive while they navigated hazardous unstable waste piles. Our deepest condolences go out to the families who lost loved ones and to every Ugandan citizen. The disaster served as a harsh reminder that waste mismanagement impacts people directly beyond just environmental concerns. Working together as environmental custodians we ask you to take action to prevent more deaths from occurring beneath waste mountain piles.
Just for context, Mr. President, since you fondly like science, here is the scientific truth about us
You may recall Dr. Derek Pomeroy and Mr. Michael Kibuule, distinguished researchers at Makerere University, who in 2021 published the history of our kind in Uganda. They noted:
- Over 1,200 nesting pairs once graced Kampala city alone.
- Over 800 Marabous nested at Makerere University.
- Uganda likely hosts the largest urban colony of Marabou Storks in the world.
Dr. Pomeroy and Kibuule should receive Katonga medals because we recognize their devotion to us. They have loved us. Dr. Pomeroy first came to Uganda in 1969 to work in Makerere University‘s Department of Zoology. He developed deep affection for us and demonstrated excellent understanding. He has written affectionately about us. He knows we are innocent. Dr. Pomeroy maintains his affiliation to Makerere University while conducting independent research as both a Zoologist and an ecologist.
Mr. President, in the beginning, our existence was in the untamed savanna. We transitioned to urban areas alongside human development to assist with cleanup duties rather than to create any disturbance. We came to clean up the areas where you discarded bones and waste. Ronald Norman Magill stated that despite being part of Africa’s “Ugly Five,” we remain crucial to ecosystems because our simple and gritty nature is what makes us indispensable. Our role includes feeding on dead animals and decomposing matter to prevent diseases and sustain soil health through silent and selfless recycling of life.
Your Excellency, here are our humble pleas to you, Our President
- Please urge your people to plant trees.
Our homes are disappearing completely. Sky scrapers are popping up everywhere we used to patch. Your Excellency, we merely ask that you recognize our role and protect our habitats; we are not opposed to development. In order to locate nesting sites, we now have to travel a considerable distance between Kiteezi, Lubigi, and the University. For all creatures, feathery, four-legged, and two-legged—healthy trees translate into richer soils, cleaner air, better rainfall, and cooler cities. - Please strengthen plastic waste management.
Your laws Mr. President, the 10-Year Restoration Plan, the National Environment Act 2019, and the Extended Producer Responsibility rules are all positive steps, but laws that do nothing are just as useful as wings on a tortoise. Please advocate for implementation, particularly in the areas of public education on responsible dumping and enforcement. We implore you to encourage your people to stop illegal dumping, sort their waste, recycle, and treat the environment as a gift rather than a trash can. - Please invest boldly in waste infrastructure.
Your Excellency, - If Parliament can enjoy a small patriotic “thank you” of the legendary “100 silver coins” for safeguarding peace, surely a few crumbs can reach us, the Marabou Storks; Kampala’s tireless, unpaid sanitation workers, as a token of national gratitude. Imagine what a few billion shillings for KCCA, for trucks, bins, and civic education could achieve. A cleaner Kampala would mean less wandering for us and less embarrassment for you when tourists meet our noble, bald-headed selves. At least then, we would feast in dignity, not after cross-country marathons over scattered rubbish.
- Support Community Environmental Heroes.
Students, youth, schools, churches, and communities are already doing cleanup drives. Support them with grants, incentives, recognition, and encouragement. Empower a new generation of eco-warriors.
Mr. President, we, Marabou Storks are no longer the nuisance you once sought to relocate.
We are living proof that resilience, adaptation, and hard work can co-exist even in a changing, urbanized world.
All we ask now is for you and your government to join wings with us, birds and humans alike to clean up Kampala, to green Uganda, and to create a legacy that future generations will bless you for.
Let us work together, so that Uganda shines not under mounds of waste, but under canopies of trees, rivers flowing freely, and skies where even the humble Kalooli can soar proudly.
Yours sincerely,
The Marabou Storks of Kampala
The writer is a science and health communicator
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