Namayingo: The Ministry of Health, in partnership with nonprofit organizations, has unveiled the “Bold Campaign” aimed at adapting and enhancing Social and Behavioral Change (SBC) interventions to tackle adolescent health challenges in Uganda.
Launched on Monday, November 4, 2024, at Banda Secondary School in Banda Town Council, Namayingo District, the national adolescent health initiative uses a human-centered design approach to combat the growing challenge of teenage pregnancy and other related issues affecting young people.
The project is designed to equip adolescents with the knowledge and life skills to reduce the risks of pregnancy, HIV/AIDS, school dropout, drug abuse, and mental health challenges. Key objectives of the initiative include challenging negative social and cultural norms that put adolescents at risk and empowering parents, teachers, and health workers to provide quality support and guidance to young people.
“Today marks a significant step towards creating a supportive environment for our adolescents and youth. This campaign aims to strengthen community engagement, enhance advocacy for adolescent health programs, and raise awareness about the services and information available to our youth,” said Dr. Diana Atwine, the Health Ministry Permanent Secretary, who was represented by Dr. Charles Olaro, Director of Curative Services.
Dr. Olaro emphasized that community engagement is at the heart of this campaign, stressing the need for collective action to create an environment where adolescents feel supported and valued. He highlighted the importance of involving parents, teachers, community leaders, and adolescents themselves in the efforts.
“By doing so, we can ensure that the voices of young people are heard and their needs are met. We need to act with urgency to improve the well-being of our young people,” he said.
The Busoga region holds the highest teenage pregnancy rate nationwide at 34%, with Namayingo District leading the region, recording a rate of 23.4%. According to reports, as of June 2024, teenage pregnancies make up 27% of all antenatal care (ANC) attendances in Namayingo District. However, this figure represents only a fraction of the actual teenage pregnancies in the area, as many young mothers do not access formal health facilities.
Of those who do deliver, only 27% choose to do so in health facilities, with the majority relying on community-based assistance from traditional birth attendants.
“Statistics underscore this need: 349% of all young females are married off prematurely, and nearly a quarter of them have begun childbearing by the age of 19. This jeopardizes their health and contributes to the country’s overall maternal mortality ratio of 189 deaths per 100,000 live births,” Dr. Olaro said.
He added that early pregnancies also hinder educational aspirations and limit socio-economic potential, noting that “We must enhance multi-sectoral collaboration.”
Recently, the Ministry of Health laid the groundwork for a united front against teenage pregnancy by bringing on board key stakeholders, including accounting officers from the Ministries of Education and Gender, Labour and Social Development.
According to Dr. Olaro, the country should build on this multi-sector partnership by integrating efforts across all levels of government. The health sector has established an accountability platform for Teenage Pregnancy Surveillance and Response, which discusses “Ending Teenage Pregnancy” at the district level. Namayingo is one of the districts that has shown progress in addressing teenage pregnancy.
Third Deputy Prime Minister Hajjati Lukia Isanga Nakadama, who also serves as the Mayuge District Woman Legislator, underscored the need to strengthen advocacy for programs that support adolescent health.
In her message, delivered by Mr. Tomas Matende, the Mayuge Resident District Commissioner (RDC), Nakadama said, “We need to ensure that policies and programs are in place to address the unique challenges faced by our adolescents.”
“Raising awareness about the available health services and information is essential. Adolescents should know where to go for help and feel confident in accessing these services,” she emphasized.
The USAID Social and Behavior Change Activity (SBCA), World Vision, United Nations Population Fund (UNFPA), and Busoga Health Forum are at the forefront of implementing this campaign. Other partners include the Adolescent and School Health Division and the Health Promotion Education and Communication Department (HPEC).
Ms. Juliana Lunguzi, UNFPA’s team leader for Sexual and Reproductive Health (SRH), said adolescents between 10 and 19 years are at risk of early sexual debut, teenage pregnancy, and school dropout. Many lack comprehensive knowledge of body changes and safe sex negotiation.
“Parents struggle to guide on SRH due to limited knowledge and cultural or religious biases. They are often judgmental towards adolescents and may transfer their frustrations or life challenges onto their children. Many come from broken homes, face livelihood challenges, and have limited access to reliable mass media information,” Ms. Lunguzi explained.
She also pointed out that structural barriers hinder health workers’ ability to provide quality adolescent services. Personal and cultural biases may lead them to assume adolescents already know about SRH, creating an uncomfortable service environment.
Located in Eastern Uganda, Namayingo District is largely surrounded by the waters of Lake Victoria and enjoys vibrant cross-district and regional interactions that shape its social and economic dynamics. The district borders Kenya and Tanzania and is home to a multilingual community, including the Samia, Basoga, Japadhola, Bagishu, Baganda, Jaluo, Bakenye, Bagwere, and Iteso people.
Mr. Abudallah Twaha Kawuta, the Vice Chairperson of Namayingo District Local Government, explained the complexity of health services in the district and noted that parents significantly contribute to teenage pregnancies due to poor upbringing.
“We have a new practice of ‘Matanga,’ which our locals have copied from Kenya. When a family loses a member, instead of mourning, they celebrate and fundraise. During these events, a young girl is instructed to choose a man to dance with. It is customary for the man to either dance with the young girl or pay money. We don’t know what happens when an older man dances with a young girl at night, but of course, that leads to pregnancy,” Mr. Kawuta said.
Throughout the 2023/24 financial year, Namayingo has experienced a troubling rise in cases of adolescent abortion, injuries from gender-based violence (GBV), sexually transmitted infections (STIs), and mental health disorders. GBV cases escalated from 22% in 2023 to a peak of 39%, with a modest reduction to 34%, a rate that remains alarmingly high.
Contributing factors include the fear of judgment, financial insecurity, limited safe spaces for adolescents to discuss their challenges, and unsafe environments where youth struggle to voice their concerns and make informed decisions.
Hon. Magrete Makoha, Namayingo District Woman MP, urged school-going children to respect the Bold Campaign, encouraging them to say “NO” to teenage relationships.
BOLD is an acronym for Building in your dreams, Owning your choices, Living with purpose, and Dedication to your destiny.
