“What we are seeing is not adequate, but we think we are seeing very good positive movement, and we want to build on that,” said Jotham Musinguzi, director of the African regional office for Partners in Population and Development (PPD) in Kampala, Uganda. Musinguzi is a public health physician by training who previously advised the government of Uganda on population and reproductive health issues. “We think that [the government] is now on a firm foundation to continue investing properly in family planning,” he said.
Family Planning for Development
Uganda’s high population growth rate (the country has a total fertility rate of 6.4 children per woman, according to the UN) presents a number of challenges, said Musinguzi, exerting pressure on education and health systems, as well as on basic infrastructure, particularly for housing and transportation. Additionally, high levels of poverty and unemployment can become a source of instability.
Policymakers in Uganda are beginning to recognize the urgency of the issue, however, particularly in regards to young people, said Musinguzi. “They don’t have access to jobs, they don’t have the skills, and therefore the challenges of poverty eradication become even more important.”
Nonetheless, the country’s contraceptive prevalence rate is low, at 24 percent, with 41 percent of married women expressing an unmet need for family planning services, according to the 2006 Demographic and Health Survey (DHS) for Uganda. Low levels of investment and lack of government involvement remain the primary obstacles, according to Musinguzi, in addition to socio-cultural and religious barriers.
Uganda historically depended primarily on donor finance, rather than government funding, to support family planning and reproductive health services, Musinguzi said. However, over the past two years, the Ugandan government has increased investment due to concerted efforts by PPD, as well as USAID, the UN Population Fund, and civil society groups. “Our point was that if the government does not fund family planning, then they are going to find that achievement of the Millennium Development Goals…is going to be very challenging,” he said.
“I think the low investment in family planning in Uganda is a thing of the past, and we are now looking forward to really better investment in this field,” Musinguzi said. “I am sure we are going to witness quite a big change [in the 2011 DHS] in terms of access as a result of the proper social investment that the government is trying to do now.”
“I have a keen and strong interest in South-South collaboration in the field of reproductive health, family planning, population, and development,” Musinguzi said. Countries in the South have experience linking programming on population and development, and may face similar challenges, he said. For instance, Bangladesh and Vietnam had successful family planning programs that helped blunt rapid population growth rates.
“Countries, like Uganda, and others which haven’t gotten there yet, could learn from these other countries,” said Musinguzi, by sharing best practices and lesson learned, and replicating applicable solutions.
PPD also has a regional project reaching out to policymakers to increase commitment and accountability for family planning and reproductive health services. For instance, parliamentarians may not realize that they can play a significant role, but they have a unique function in providing government and budget oversight, Musinguzi said. Furthermore, they can create legal and administrative frameworks that prioritize family planning programs.
“We continue to make the case for more investment in family planning and reproductive health, but also making sure we hold leaders accountable, to show more commitment, and make sure they improve on the welfare of the people that they represent,” Musinguzi concluded.