Dr.

Olive Sentumbwe-Mugisa, Family Health and Population Advisor,

Is a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity in all matters related to the Reproductive system , its functions and processes.

Safe motherhood Family Planning Unsafe abortion STIs including HIV/AIDS Adolescent Health Infertility Menopause and Andropause Cancers of the RH Organs( Cervix and breast, Prostate) Gender Issues (GBV,VVF, FGM)

1987
TFR
UNMET FP CPR
DELIVERIES( skilled)

1995
6.9
29% 15% 38%

2000
6.9
35% 23% 38%

2006
6.7
42% 24% 42%

7.3
33% 5% 37%

ADOL PREG. MMR IMR Neonatal

44%
527

43%
506

32%
505

24%
435

122
-

81
-

88
33/1000

77
29

Is a central aspect of human beings throughout the life cycle It encompasses sex, gender identities and roles, It addresses sexual orientation, eroticism, pleasure, intimacy As well as reproduction

 Is

a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity

Sexual behaviour, Attitudes Societal norms and standards, Beliefs and practices Biological risk and genetic predisposition

ADVOCACY

All human beings are born free and equal in dignity and rights (Universal Declaration of Human Rights) Human rights are universal, inalienable, indivisible, interconnected and interdependent. Everyone is entitled to all the rights and freedoms, without distinction of any kind, such as race, gender, religion, political opinion, etc. Prevention of and response to gender-based violence is directly linked to the protection of human rights.

The rights of all people to decide freely and responsibly on all aspects of their sexuality, includes protecting and promoting their sexual health, freedom from discrimination, coercion or violence in their sexual lives and in all sexual decisions

The right to attain the highest standard of sexual health, including access to sexual and reproductive health care services; seek, receive and impart information related to sexuality; sexuality education; respect for bodily integrity

choose a partner; decide to be sexually active or not; consensual sexual relations; consensual marriage; decide whether or not, and when, to have children; and pursue a satisfying, safe and pleasurable sexual life.

the rights of couples and individuals to decide freely and responsibly the number and spacing of their children, -- to have the information and education --attain the highest standards of sexual and reproductive health including access to health services -- make decisions about reproduction free of discrimination, coercion and violence

Right to scientific progress

YOUNG

PEOPLE

Adolescent 10-19 years constitute 23.3% of the population while young persons 10-24 years constitute 33.5% of the total population. Young people are prone to all kinds of accidents by virtue of their level of activity and willingness to take risks. Many of these will lead to physical infirmity and even death

The rapid development and growth in this age group points to a potential that can contribute positively to the socio economic development of the individual and the country. However, if not well directed it can lead to consequences that may be harmful to the current and future health status

Gonorrhea Syphilis HIV HPV Herpes etc

Early/unwanted pregnancy, unsafe abortion, STIs/HIV/AIDS, psycho-social problems such as substance abuse, delinquency, truancy, sexual abuse etc. The age at first sexual debut is estimated at about 16.7 .8 and 18.8 years for females and males respectively.

Uterus

Ovary

Vagina
Cervix

This is the uncontrolled growth of some cells on the cervix [the mouth of the womb]. Cells on the cervix begin to grow slowly and abnormally over several years.
These early (pre-cancerous) changes can grow into cancer if they are not identified [screening] and treated early.

Human papillomavirus (HPV) types 16 & 18. 99.7% of cervical cancer cases are associated with HPV

Progression from HPV infection to cancer usually takes about 15 years

Symptom free- Women are usually healthy looking and the condition is usually painless in early stages Irregular / intermenstrual or contact vaginal bleeding Foul vaginal discharge that never improves with treatment Pain (deep pelvic or back pain) In advanced cases; severe anaemia, renal failure, fistulae (rectal/vesico-vaginal), lymphoedema

Gender is broadly defined as the socially ascribed characteristics of men and women in society. Sex, on the other hand, refers to the physiological and biologically determined characteristics of men and women.
Gender refers to the socially determined or socially constructed differences between men and women. Sex is natural while gender is socially constructed. Sex is biological while gender is social. Gender is dynamic whereas sex is constant.

Any sexual act, attempt to obtain a sexual act, unwanted sexual comments or advances or acts to traffic, or otherwise directed against a persons sexuality using coercion, by any person regardless of their relationship to the victim or survivor In any setting including but not limited to home and work

Many women in Uganda lack access to basic sexual and reproductive health services and information, safe labour and delivery services, emergency obstetric care yet in danger of labour complications and unsafe abortion with an MMR of 435/100,000Lb Inadequate essential drugs and contraceptive supplies. Unmet need for FP rising to 40% Inadequate services for sexually transmitted infections with evidence of herpes simplex and syphilis existing in our country PMTCT coverage at only 30-32%

The evidence in Uganda through various studies done has shown that illness is both a cause and a result of poverty. Women are very poor due to patriarchal society that favours men in terms of property ownership, access and control this limits access to services

Women remain sick for longer, meaning that they will work less, feed the children less and produce less, perpetuating the vicious cycle of poverty. Good governance, transparency and accountability are crucial to running successful health provision schemes by any government. This is vital especially in Uganda where mismanagement of resources has manifested in various forms; poor procurement procedures, mistreatment of the poor by health providers and kickbacks for services provided remain rampant.

High maternal and newborn deaths and disabilities. Pressures from families and communities to have or not to have children, Violence and fear of violence especially sexual violence. Violation of womens wider rights that leave them unable to protect SRHR such as widow inheritance, lack of access to property inheritance and unequal employment opportunities. Inability to negotiate safer sex and fears and concerns around disclosure; Forced child marriages

Insufficient and poor quality maternal health services (ANC, EmOC, PNC and FP) Lack of access to: treatments for STIs and RIs; regular sexual health screening includingcancer cervix screening facilities,Prevention tools like female condoms;Services to support conception ( infertility),etc Judgmental attitudes of health care workers; Insufficient SRHR services for adolescents at all levels yet they are sexually active Insufficient programmes to target Mens SRH needs hence endangering womens health

Inadequate mobilisation of communities on sexual and reproductive health rights Unfriendly legal procedures in court hearings for rape and defilement

Maximise access to quality, non judgmental care, treatment and information related to SRHR issues for all women and men including people living with HIV; Scale up delivery of emergency obstetric care services and family planning as a matter of urgency and priority Support biomedical and scientific research on, birthing positions, HIV positive womens SRH health needs etc
Allocate more resources to Adolescent friendly services including school health

Advocate for and enhance meaningful participation of women living with female genital mutilation vesical vaginal fistula HIV and cancer of the cervix at all levels of policy and programme formulation around these areas of SRH. Build capacity of women living with female genital mutilation vesical vaginal fistula, HIV and cancer of the cervix in the area of Human Rights, SRH and Gender to be able to seek for care

Support research and documentation of human rights abuses of people living with HIV and AIDS; Engage Judiciary, Internal affairs and members of parliament to review laws and regulations governing and influencing service delivery for rape survivors including police forms Review the legal status of unsafe abortion and scope of practice for health workers within the existing laws

Empower women to have control over their SRH through awareness raising and training as well as change of behaviour; Empower men to change their mind set on promiscuity and health seeking behaviour for their SRH needs Advocate for access to equal employment opportunities and productive assets; Mainstream SRHR in Bonabagagawale/Microfinance projects Create supportive environments community based awareness campaigns to address gender inequalities and promote a womans right to control over what happens to her body; Involve men in SRH campaigns for improving womens health and their own health

Incorporate enforceable human rights and gender indicators in the national response to HIV and AIDS, adolescent health service delivery and safe motherhood programmes Create public awareness of the SRH rights of men, women and young people through media campaigns, workshops, etc. Support Ministry Gender to disseminate the gender policy and monitor implementation of agreed upon international plans of action as they relate to Cairo and Beijing

Provide comprehensive sexuality education especially to young people Provide education, training and support to professionals Develop and provide access to comprehensive sexual health care services Promote and sponsor research

Womens right to health, and reproductive health in particular, is essential to gender equality and female empowerment. In addition to saving lives and preventing infection and suffering, better reproductive health will lead to smaller families and slow population growth. These healthy families will be able to contribute meaningfully to the desired social-economic development of nations because households will have capacities to develop their skills.

All in all Government is accountable to uphold Sexual and Reproductive Health rights Parliamentarians and all politicians are urged to ensure that the constituencies they represent do not violate the sexual and Reproductive rights of the people they represent