By Humphrey Nabimanya, Founder & Team Leader, Reach A Hand Uganda

COVID-19 remains one of the fastest-growing public health concerns across the globe. Ever since the virus was declared a pandemic by the World Health organisation, it has disrupted the status quo of governance systems and access to family planning information and services has not been spared.

While governments across the globe, including Uganda’s, are taking all required measures aimed at restricting the spread of the pandemic, family planning (FP) experts continue to identify gaps and suggest more recommendations on how to deal with challenges and prepare for the aftermath of the pandemic.

Let’s not forget that Uganda was dealing with several family planning challenges before the pandemic, and these include high teenage pregnancy rates that persist as among the highest in Sub-Saharan Africa and low access to contraception despite increased government efforts. Still, the country has made considerable progress - developing a Costed Implementation Plan, increasing the Modern Contraceptive Prevalence Rate, and more.

But now, COVID-19 presents an unprecedented threat to this progress.

Speaking at the first-ever e-Conference on Family Planning Planning In Uganda, Alain Sibenaler, the UNFPA Uganda Country Representative, mentioned that COVID-19 is already causing disruptions in family planning services as clinical staff are called to work on COVID-19 response. In addition, the lack of personal protective equipment to provide services safely is concerning, and nationwide lockdowns have disrupted access to many health services, including family planning. At the beginning of the nationwide lockdown, health facilities in many Ugandan villages were closed, subsequently limiting the services available, and women refrained from visiting health facilities due to fears about COVID-19 exposure.

But with these challenges lie great opportunities to promote innovations during the pandemic. Dr. Dorothy Balaba, the PSI Uganda Country Representative speaking at the e-Conference, said digital technology has become more crucial than ever when a physical connection is difficult or impossible. PSI Uganda, for example, has partnered with several technology companies, including Airtel, to set up a number (161) that Ugandans can call to access information about COVID-19 as well as family planning. PSI Uganda has also set up digital product locators to help clients efficiently find health products and services they need, thus limiting the time they need to be away from home.

Reach A Hand Uganda (RAHU), a youth-led organization and FP2020 commitment maker, has introduced a USSD Code platform (*284*15#) that young people can dial and be referred to health centres to get information on family planning information and services even while using feature phones. A week after the e-Conference, RAHU launched SAUTIplus TV, an online streaming service with edutainment shows that focus on contraceptives and Sexual Reproductive Health and Rights accessible via web, Android and iOS.

Ensuring the success of these initiatives, however, also requires prioritizing engaging men. Jackson Chekweko, the Executive Director of Reproductive Health Uganda observed that lockdowns should have promoted spousal harmony but instead, gender-based violence (GBV) cases have become a ‘pandemic within a pandemic.’

"This is the time where putting men at the forefront of family planning and access to other SRH services becomes very important. You all know that men influence most decisions about family planning in the African setting and often perpetrate gender-based violence if they find out women made a decision without their permission," Jackson further mentioned. 

The media and police in Uganda have reported an increase in the number of cases of GBV in the country due to the COVID-19 lockdown. For instance, The Independent, a local magazine of 16th April 2020 reported that police had far recorded 328 cases of domestic violence since the COVID-19 lockdown.

It’s clear the COVID-19 pandemic has threatened Uganda’s progress in family planning access, but the pandemic has also given us all an impetus to innovate and find new ways to work together to overcome these barriers.