WHY GYNAECOLOGISTS AND OBSTETRICIANS BECAME SRHR ADVOCATES

 By Dr. Simon Peter Kayondo

Dr. Simon Kayondo

Under normal circumstances, gynecologists (doctors who specialize in female reproductive health) should be attending to mothers and prospective mothers with pregnancy or child birth complications in maternity wards; but as fate would have it, members of the Association of Obstetricians and Gynaecologists in Uganda (AOGU) have also joined the Sexual, Reproductive Health and Rights (SRHR) advocacy movement for obvious reasons.

As a member of AOGU, I think this move was long overdue given the not so impressive maternal and child health statistics in our country. For a long time for instance, the teenage pregnancy rate has stagnated at a high of 25% with some regions and districts way above this national average. The situation became worse at the peak of the COVID-19 pandemic.

We continue to have a high rate of maternal mortality due to preventable causes like unsafe abortion, child marriage, teenage pregnancy and poor access to SRHR services.

The unwanted pregnancy rate is still very high, meaning that the uptake of contraception is still low.

I will never get over an experience of a colleague who had to remove the uterus of “Carla” a 15-year-old girl who had procured an unsafe abortion from quacks. Whatever they gave her to use had terribly injured her uterus and the only way to save her life was to remove it. This implies that much as Carla’s life was saved, she will never bear children.

Like Carla, there are many other girls who for some reason are sexually active and end up with unintended pregnancies simply because they are denied access to key contraception information and services.

Young and desperate, they also procure unsafe abortions and unlike Carla, we lose some of them, especially those who don’t access post abortion care in time.

Therefore, one of the critical areas that we and others stakeholders including the government need to address currently is access of adolescent friendly sexual reproductive health information and services.

It is upon this back ground that we decided to take off gloves and join hands with government and partners to improve maternal and child health indicators in Uganda through advocacy.

Our involvement in the famous Petition 16 also energized our resolve to do advocacy in addition to our ward rounds.

With our input, the constitutional court judgement issued on August 19, 2020 directed government to take urgent action on a number of issues raised by the petitioners including the following directive;

“In order to meet the constitutional obligation of the state to uphold the right of women and fulfil their reproductive rights, the government should in the next financial year prioritise and provide sufficient funds in the national budget for maternal health care”.

We are therefore not in advocacy by coincidence but we are on a mission to address a serious and well known problem.

We want to add our voice to those who are advocating for increased access to Sexual Reproductive Health services without stigma or discrimination. And also to ensure that there is a good policy environment that supports appropriate access and uptake of these services.

Considering that AOGU is a membership organisation of Gynaecologists and Obstetricians, this is really our area of interest.

We have a number of ongoing SRHR advocacy projects; one is about reducing maternal mortality and morbidity due to unsafe abortions funded by the International Federation of Gynecology and Obstetrics (FIGO). This one has been ongoing for the last four years and the outcomes are impressive.

We also have a project funded by SAAF under which we are equipping health workers with skills in provision of post abortion care, family planning but also assisting them to understand the law and the policy environment in regard to different SRHR services.

On top of the fact that young people under the age of 24 year constitute the biggest chunk of our population, they continue to be a neglected group of people, especially when it comes to access to accurate information and services on contraception. Many health workers do not understand how to effectively serve them. This coupled with the rampant stigma directed at adolescents who choose to seek information or services from health facilities especially on contraception and post abortion care is a serious problem that needs joint efforts to address.

We therefore don’t want to be left behind especially on issues that are directly connected to our profession.

For God and our country

The writer is a Gynecologist and the Treasurer of AOGU. He also Coordinates one of the organization’s SRHR advocacy projects.