How mothers are grappling with myth and misconceptions to embrace family planning.

Kibaale.

How mothers are grappling with myth and misconceptions to embrace family planning.

By: Akugizibwe Victor

Supported by CHEHURD

Women in rural communities of Kibaale district in western Uganda are struggling to cut through a plethora of myth and misconceptions to embrace family planning. The slow uptake of family planning services is according to experts contributed to rapid population growth something that is exerting immense pressure on available resources.

Margret Nalubega a resident of Busesa Kasaraba in Matale Sub County says she has failed to embrace family planning because of bad things she has been hearing about it from other women.

‘‘I always hear women talking about family planning and they scare me from using it. I heard that some family planning methods cause fibroids in the uterus while others cause lack of sexual appetite fear losing my husband and my family because of failure to have sexual appetite. I want to first study how family planning works before I can start spacing my children’’ Nalubega says.

Joyce Tumushabemukama a mother of five in Nyamihindo village in Bwamiramira sub county, Kibaale district says she enrolled for family planning services for three years without informing her husband. She left it after fearing that her husband would turn against her.

‘‘I after getting three children, I started using family planning for three years but I developed fear that my husband would get to know about it and turn against me. I left it and started getting pregnancies rapidly. I one time got pregnant while having a one year-old baby and I suffered from an infection in my breast. I suffered alone until I was forced to go back for family planning ’’ Tushabemukama says.

However, Tushabemukama says that she had never experienced any complications with family planning apart from simple pain the lower abdomen.

‘‘I have never been disturbed apart from simple pain in the lower abdomen. I can’t tell my husband because he has always discouraged me from using contraceptives. I however see no problem in family planning and I will continue to use’’ Tushabemukama adds.

Julie Tusiime of Rukindo village, Kibaale town says she has been using an Intra Uterine Devise for the last two years. She was first sensitized by health workers at a health facility to dispel her fears.

‘‘I urge my fellow mothers to desist from listening to rumors and other falsehoods about family planning. Others say a lot of things like failing to conceive again, immense pain, lack of sexual appetite and other believe that they are supposed to give birth to as many as possible children’’ Tusiime says.

Josephine Nalongo says she left family planning because of lack of sexual appetite and over bleeding during her menstrual periods.

‘‘After visiting a health facility, I was given pills but I started feeling headache. I changed to an implant in the arm and I got more problems like lack of sexual appetite and over bleeding during menstrual periods. I decided to leave it completely because I was suffering’’ Nalongo says.

Rev Samuel Kwesiga the programmes coordinator of USAID Pathfinder family planning activity says there is low uptake and embracement of family planning in rural communities because of lack of access to information and services.

‘‘In 2021 we found that family planning uptake was very low. However, we are using a system where we penetrate rural areas in order to reach out to the local people. Currently we have scored about 27 percent of family planning outreaches.Forexample, at one of health centers, people seeking for family planning services have increased from 10 to at least 34 people. The numbers are increasing because of our ground sensitization before we advise people to go to health centers. I believe people will embrace family planning with time and Kibaale will be a model district’’ Kwesiga says.

Kwesiga admits to having faced a challenge of myth and misconceptions among people like some men who complain of being injured by the Intra Uterine Devise (IUDs) during sexual intercourse.

‘‘I have a wife and our child we are supposed to be adding on is about eight years and my wife uses the Intra Uterine Devise and has never got any problem. There is myth and misconceptions about birth control methods which are factually not correct. Uncontrolled birth has affected economic productivity of homes. A woman can’t be having a one year-old baby and pregnant at the same time it means she will always be weak’’ Kwesiga adds.

Pastor Mugisha precious attached to Karuguza Seventh Day Adventist church says that family planning is a make-up of God for betterment of families.

‘‘To me, family planning is a good plan of God in fact it’s the creation of God right from the beginning of the world. It is meant for one to have good family and that is why the bible says that of one cannot provide for his family, he is worth unbeliever’’ Mugisha says.

He adds that as the church, they are sensitizing people by dispelling off the misconceptions they have about family planning.

‘‘As the seventh day Adventist church, we have a service dedicated for the family and whenever we are preaching, we usually get a dialogue where we sometimes invite health workers to sensitize our people on family planning. We are ready and we support all family planning methods depending on the wish of  a Christian’’ Mugisha adds

What health workers say

Dr Richard Lubega the director of Busesa health Center in Matale sub county, Kibaale district says mothers should not just enroll on family planning methods before a critical assessment by qualified personnel. He reveals that in most cases, mothers go to health facilities with a predetermined mind on the family planning method she wants different from what would be the advice of a health personnel.

‘‘It was the responsibility of a health worker to advise a mother or couple on the method to be used. The functionality of our bodies is different. Like we don’t advise a mother with high blood pressure to use hormonal methods like injections, pills and implants which may increase blood pressure as we monitor their progress’’ Lubega says.

Lubega admits that there are some side effects that come with some hormonal family planning methods.

‘‘Some side effects like bleeding during menstrual periods, failure to menstruate, pain in the lower abdomen and lack of sexual appetite among others may happen to people using family planning for the first time.However,we always advise people who get such side effects to consult their service providers for further attention’’ Lubega adds.

He says there has been a reported increase in numbers of people seeking for family planning since the outbreak of covid-19 pandemic.

‘‘People are continuing to seek for family planning more especially after the covid-19 pandemic. We have also sensitized people through outreaches in rural communities. Like at our health center, we get between 60 and 80 people who visit us for family planning services. The biggest challenge is ignorance of people and self management on family planning’’ Lubega says.

Sister Josephine Tibenderana a midwife at Kibaale health center four says the family planning challenges are being escalated by lack of mutual agreement in couples.

‘‘There are many misconception and other false based briefs but there is a need for mutual understanding between a man and his wife. We are currently getting about 300 people coming to seek for family planning services as a result of sensitization through outreaches in rural communities’’ Tibenderana says.

According to the Ugandan Government Family Planning 2030 Commitments, the Government of Uganda recognizes the role family planning will play in achievement of Uganda Vision 2040 target to reduce population growth rate from 3.2% to 2.4% that will result into reaping the demographic dividend.

Population experts worried

Jacob Bombo the Kibaale district planner says the district population growth rate currently stand at 5.9 and the fertility rate standards at 7 which is a high number for the district to hold in terms of resource provision. He says low family planning uptake has also factored the population growth.

 ‘‘If the population continues to grow at this rate, we are likely to face challenges in provision of services like education because we have limited resources. Health service provision will also be strained because of high numbers of people and the environment will be at stake as people may start destroying environment for survival’’ Bombo says.

He adds that uncontrolled population growth is likely to plunge people into unemployment and domestic violence because of limited survival resources like land. He says there is need for sensitization of local people on embracing family planning as one of the major ways of controlling population growth.

‘‘Family planning is one of the ways of controlling population growth rate and this will be possible if we advocate for uptake of family planning among communities’’ Bombo adds.

Family planning (FP) is defined by the World Health Organization (WHO) as a voluntary and informed decision by an individual or couple on the number of children to have and when to have them.

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