The Church of Uganda has tremendously evolved from some of its core principals to finally accommodate Christian faithfuls using modern family planning methods.
Previously, the Church stamped a zero tolerance tag on the use of modern contraceptives in favour of the view that the practice is a sacrilegious sin against God. But since 2012, this rigid position has changed over the years and priests can now preach family planning from the pulpits. Through its medical arm, the Uganda Protestant Medical Bureau (UPMB), the Church is encouraging the faithful to embrace modern family planning services.
Through different donor-funded projects, the bureau has implemented over the years, modern contraceptives services in at least 22 Church-owned health care facilities out of the network of more than 300 it operates.
Irene Nakiriggya, the reproductive health officer at Mengo based UPMB says the Church has found no biblical condemnation of family planning anywhere in the Bible. She says rather than condemn it, the Bible actually encourages people to plan for their families in many verses including Genesis 1:28.
"We’ve have seen that family planning for the family really starts in the Bible. God himself was a planner, he had his son Jesus, one son…likewise, when God talks living life in abundance that's in John 10:10 that you can have life and live life in abundance, you can only have this life in abundance when you plan," said Nakiriggya.
"The communities previously weren’t aware that the Church can offer family planning services, so they were reluctant to come to the facilities. But with the number of different units that have been implemented because I have talked of four facilities, that is one project, but there are also other projects that had about 18 facilities across the country and the uptake is good because we also involve the community VHTs [village health teams] to offer the short term methods like the moon beads, the cycle beads, the pills and the injectables…They have been part of the team." Nakiriggya added.
Ever since the Church lifted the veil on the use of modern contraceptives, uptake of family planning services has been significantly shot up among communities. 28 per cent of Ugandan have an unmet need for family planning, a decline from 34 per cent in 2011.
Government hopes to reduce this figure to 10 per cent in the run up to 2020 when the country is expected to attain middle-income status. Nakiriggya says religious leaders have been trained as family planning champions spearheading the introduction of some of the 12 methods of family planning available in the country. She says the champions comprise of priests, lay readers, Fathers’ and Mothers’ unions, the youth and village health teams.
"As Uganda Protestant Medical Bureau we offer a mix of family planning services and our services are integrated within the facilities and the community. We work together with the Church. The Church creates demand for the family planning services. The Church has been trained, we have four churches that own health facilities that is in Mityana…and also in Busoga diocese. So the Church leaders within the Church that is; Mothers Union chairperson, the Fathers Union, the youth and the parish priests themselves we have taken them on training in family planning advocacy at community level." added Nakiriggya.
There are 12 family planning methods available in Uganda including condoms, lactational amenorrhea method, pills, injectables, implants and the moon beads. The others are the intrauterine device (UID), tubal ligation, vasectomy and the emergency contraceptive pills.
Nakiriggya says, before when the services were stationed in the 22 health facilities, the family planning champions concentrated on referring mothers to government facilities which were offering the services but now, the family planning champions are to also educate and sensitize Christian families on the misconceptions and myths of family planning services from the biblical stand points.
Among the biblical verses the Church is using to popularize healthy timing and spacing of pregnancies are Genesis 1:28; 1 Timothy 5:8 in which God instructs Christian believers to take good care of their families. The verses say believers who can’t plan and provide for their families are worse than non-believers.
Among the family planning champions, family planning is known as “Healthy Timing and Spacing of Pregnancies (HTSP) and often preached during baptism ceremonies, Sunday services and other church meetings. It is during this meeting that Christian families are encouraged to send girl children to school in order to delay child bearing to at least 18 years.
Reverend Moses Ssemugooma, the health coordinator in Mityana Diocese is one of the many family planning champions, he says family planning is not a sacrilegious sin that should be shunned by the Church.
"We developed what we called the three access model where we are connecting the community, the Church and the health facility. So using that approach, we are able to see that religious leaders have the opportunity to reach out to the community and also refer the community to the health facility such that they are able to get the quality healthcare…Actually when you talk about family planning as religious leaders, some people think you’re growing mad, but it is right as religious leaders to talk about family planning because it goes back to us as religious leaders when our people are poor. But if we can work together to solve such issues within our reach then we are able to have a growing population that can sustain itself." he said.
According to the State of the 2019 World Population Report, 16 women die giving birth in Uganda every day, with more than 850,000 unplanned pregnancies every year while the annual population growth rate is 3.3 per cent.
This is motivating some family planning champions to integrate the education on family planning services with messages on HIV beyond pregnant mothers - to include the youth, who are seen as a group vulnerable to unwanted pregnancies and even HIV.
The United Nations Population Fund UNFPA says it is time issues of maternal health under which family planning is a critical component be integrated in the socio-cultural and legislative planning processes.
Dr Olive Sentumbwe Mugisha, the World Health Organization (WHO) focal point person for reproductive health, gender and human rights in Uganda says girl child education is critical in eliminating teenage pregnancies and its associated challenges. She says when girls are educated, they make informed choices on when to get pregnant and how many children to have.
"There is a realisation now that we must do more, we must be more innovative and I'm glad that all sectors have opened up to this and we need to mainstream it in all our daily walks of life. In terms of the sexual education framework in schools, the health policy, the ministry of health, sexual reproductive health policy - all trying to propose strategies in communities in which parents come back to a real discussion in terms of the sexuality education framework in schools with their growing children. I think this is an encouraging move and they are encouraging all types of religion and cultural institutions to also have programmes." Dr Sentumbwe said.
Over the years, the Uganda Protestant Medical Bureaus has worked with partners such as the Christian Connections for International Health and the Packard Foundation to promote proper family planning in and out of the inner circles of the Church.