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We Are No Longer Worried about an Unwanted Pregnancy!

A Ugandan couple discusses their family planning journey.

Najjingo Madde (age 42) and her husband, Suleiman Ssali, are a happy couple living in Ngondati Village, Masaka District, in central Uganda, 37 km from the equator. As they begin narrating their story, one can only marvel at their fortitude over the course of their marriage. They have nine surviving children; the eldest is aged 26 years old, and the baby is now 5. Two additional children died at early ages. The family depends on subsistence farming, which means that the growing yields of staple crops like tomatoes and beans may be too small to sustain such a large family. Najjingo explains that her family now includes grandchildren, too: Their eldest son is married with two children. With a family this size, Najjingo and her husband spend long hours every day working their plot, as well as working at a small farm nearby: “It is not easy to put food on the table every day for such a big family. We have to work very hard to ensure that they do not starve.”

Najjingo began using family planning methods more than a decade ago—when she still had “few children”—and decided to use oral contraceptives. However, refilling her stock of pills was difficult, since the only government health facility that provided free family planning methods was over 10 km away. “Many times, I would spend a number of days without swallowing any pills.” As a result, Najjingo had three unplanned pregnancies.

Six months ago, while Najjingo was doing her daily chores at home, a village health worker visited her home and told her about a team of health care workers coming to a nearby health facility called Bukoto Health Centre III. She talked that night with her husband, who agreed that she should visit the health center to get more information about reliable family planning methods. Bukoto Health Centre is one of many mobile outreach service sites supported by EngenderHealth, with funding from the Bill & Melinda Gates Foundation. After being counseled on a wide range of available methods, Najjingo accepted a hormonal implant. She reports that she has not experienced any major side effects as a result of using an implant. Najjingo noted that she missed her menstrual periods for the first three months, but the provider had mentioned this as a possibility before she accepted the method, so she was not scared.

Najjingo and her husband are thrilled: “We are no longer worried about having an unwanted pregnancy,” Suleiman says. “We hope to give our children better schooling, food, and clothing.” Like Najjingo, thousands of other women in Uganda wish to space their births or stop bearing children altogether, and 34% of women have an unmet need for family planning. Efforts are building across the country to improve access to information, services, and supplies to meet the need for family planning, to improve the lives of women and families.

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