A lthough HIV/AIDS is probably Uganda’s gravest public health issue, unintended pregnancy and unsafe abortion also rank high among serious health problems facing the country. Unplanned births are common and represent a growing proportion of all births— almost 40% in 2000, compared with 29% in 1995. With such high levels of unplanned childbearing, it is likely that abortion is becoming increasingly common in Uganda, even though national law permits abortion only to save a woman’s life.1 Evidence from small-scale studies suggests that abortion to end unwanted pregnancies is widespread, that it is usually performed clandestinely in unsafe conditions and that unsafe abortion is a leading cause of maternal death in Uganda.2
Report
Reducing Unintended Pregnancy and Unsafe Abortion in Uganda
Reproductive rights are under attack. Will you help us fight back with facts?
1. Uganda Penal Code Act (Cap 106), rev. ed., 1964. 2. Mirembe F and Okong P, Risk factors associated with maternal mortality in three Kampala hospitals, unpublished report, Kampala, Uganda: Makerere Medical School and Nsambya Hospital, 1995; Mirembe F, A situation analysis of induced abortions in Uganda, African Journal of Fertility, Sexuality and Reproductive Health, 1996, 1(1):79–80; and Kinoti S et al., Monograph on Complications of Unsafe Abortion in Africa, Arusha, Tanzania: Commonwealth Regional Health Community Secretariat for East, Central and Southern Africa, 1995. 3. Population Reference Bureau (PRB), 2004 World Population Data Sheet, Washington, DC: PRB, 2004. 4. U.S. Department of State, Bureau of African Affairs, Background note: Uganda, Dec. 2003, , accessed Feb. 17, 2004. 5. United Nations Development Programme (UNDP), Human Development Report 2003, New York: Oxford University Press, 2003, pp. 239 & 252. 6. Uganda Bureau of Statistics and ORC Macro, Uganda Demographic and Health Survey 2000–2001, Calverton, MD, USA: Uganda Bureau of Statistics and ORC Macro, 2001. 7. Singh S, Darroch JE and Bankole A, A, B and C in Uganda: the roles of abstinence, monogamy and condom use in HIV decline, Occasional Report, New York: The Alan Guttmacher Institute (AGI), 2003, No. 9. 8. U.S. Department of State, 2003, op. cit. (see reference 4). 9. UNDP, 2003, op. cit. (see reference 5), pp. 239–240. 10. UNDP, About Uganda,, accessed Apr. 9, 2004. 11. AGI, unpublished tabulations from the 1995 and 2000 Uganda Demographic and Health Surveys (DHS). 12. AGI, unpublished tabulations from the 1988, 1995 and 2000 Uganda DHS. 13. Ibid. 14. United Nations Population Fund, 10th Anniversary of the International Conference on Population and Development, Background, Nov. 2004, , accessed Nov. 26, 2004. 15. AGI, unpublished tabulations from the 2000 Uganda DHS. 16. Kiragu K et al., Promoting reproductive health in Uganda: evaluation of a national IEC program, IEC Field Report, Baltimore, MD, USA: Center for Communication Programs, The Johns Hopkins School of Public Health, 1996, No. 7, Table 6.2, p. 65. 17. Kinoti S et al., 1995, op. cit. (see reference 2), Table 9, p. 65. 18. Mirembe F and Okong P, 1995, op. cit. (see reference 2); and Mirembe F, 1996, op. cit. (see reference 2). 19. Kinoti S et al., 1995, op. cit. (see reference 2), Table 12, p. 69. 20. Ibid. 21. Kasolo J, Abortion in Uganda, Initiatives in Reproductive Health Policy, 2000, 3(2):9–10; and Kinoti S et al., 1995, op. cit. (see reference 2), Table 15, p. 71. 22. Kinoti S et al., 1995, op. cit. (see reference 2), p. 71. 23. Uganda Government Policy Database, , accessed Feb. 17, 2004; PRB, Reproductive Health in Policy and Practice: Case Studies from Brazil, India, Morocco, and Uganda, Washington, DC: PRB, 2000; and PRB, Reproductive Health in Policy and Practice: Uganda, Washington, DC: PRB, 1998. 24. Inter-Parliamentary Union, Women in national parliaments, , accessed Feb. 18, 2004. 25. Uganda Government Policy Database, 2004, op. cit. (see reference 23); PRB, 2000, op. cit. (see reference 23); and PRB, 1998, op. cit. (see reference 23). 26. Ibid. 27. Ibid. 28. International Labour Organization, National guidelines in Uganda, Dec. 2003, , accessed Apr. 9, 2004. 29. PRB, 1998, op. cit. (see reference 23). 30. Lutalo T et al., Trends and determinants of contraceptive use in Rakai District, Uganda, 1995–98, Studies in Family Planning, 2000, 31(3):217–227. 31. PRB, 1998, op. cit. (see reference 23). 32. Wolff B, Blanc A and Ssekamatte-Ssebuliba J, The role of couple negotiation in unmet need for contraception and the decision to stop childbearing in Uganda, Studies in Family Planning, 2000, 31(2):124–137. 33. PRB, 1998, op. cit. (see reference 23). 34. Okwero M et al., The realities of unmet need in Uganda, Planned Parenthood Challenges, 1994, 1:17–19. 35. Kiragu K et al., 1996, op. cit. (see reference 16), Table 4.10, p. 40. 36. Blanc AK et al., Negotiating Reproductive Outcomes in Uganda, Calverton, MD, USA, and Kampala, Uganda: Macro International and Institute of Statistics and Applied Economics, Makerere University, 1996. 37. PRB, 1998, op. cit. (see reference 23). 38. Ibid. 39. Ibid. 40. Uganda Bureau of Statistics and ORC Macro, 2001, op. cit. (see reference 6). 41. Bankole A and Singh S, Couples’ fertility and contraceptive decision-making in developing countries: hearing the man’s voice, International Family Planning Perspectives, 1998, 24(1):15–24. Credits This report was written by Fatima H. Ahmed, Elena Prada, Akinrinola Bankole, Susheela Singh and Deirdre Wulf. The authors thank Florence Mirembe, Mulago Hospital/Makerere University, Uganda; Stephen Kisambira, Population Division, United Nations; and Frederick Mugisha, African Population and Health Research Center, Kenya, for having provided insightful comments on an earlier draft. They also acknowledge the guidance provided by colleagues at The Alan Guttmacher Institute (AGI): Beth Fredrick, Jennifer Nadeau, Melanie CroceGalis, Ann E. Biddlecom and Ann Moore. Susan London, an independent consultant, and Dore Hollander edited the report. This report is part of a larger project on unsafe abortion that is being implemented jointly by AGI and project partners in Uganda led by Dr. Florence Mirembe, Mulago Hospital at Makerere University. The project is supported by the Netherlands Ministry for Development Cooperation, the United Kingdom’s Department for International Development and the World Bank. Suggested citation: Ahmed FH et al., Reducing unintended pregnancy and unsafe abortion in Uganda, Research in Brief, New York: The Alan Guttmacher Institute, 2005 (No. 1).