The Ministry of Health has raised alarm over a sharp increase in women seeking medical care for abortion-related complications, signaling a deepening reproductive health crisis in Uganda. While officials have withheld specific figures, Dr. Richard Mugahi, Commissioner for Reproductive and Child Health, expressed concern over the persistently high number of unintended pregnancies despite expanded access to contraceptives.

The troubling trend comes alongside newly released research from Makerere University School of Public Health, conducted in partnership with the Ministry of Health and Uganda Bureau of Statistics (UBOS). The Performance Monitoring for Action (PMA) survey, carried out between September and December 2024, reveals stagnant contraceptive uptake and widespread unintended pregnancies, painting a grim picture of Uganda’s sexual and reproductive health landscape.

The PMA findings indicate that four in ten women aged 15 to 49 reported their last birth or current pregnancy as unintended within the past five years. Among these, 12% explicitly stated they did not want more children but lacked proper information or held misconceptions about contraception. Dr. Simon Kibira, a senior lecturer at Makerere University and co-lead researcher, noted that comprehensive contraceptive counseling has not improved over the past two years, with young women being the least informed.

Alarmingly, the data shows that 24% of in-school adolescents and nearly half (49.6%) of out-of-school youth were sexually active in the month preceding the survey. Yet, a staggering 80% of women not currently using contraceptives said they had no plans to adopt any method in the next year. Only 19% expressed intent to use family planning—a statistic that underscores a critical gap in awareness and access.

Dr. Kibira attributes the low contraceptive uptake to inadequate counseling, misinformation, and cultural barriers. Many women, particularly adolescents, receive little to no guidance when seeking birth control, leading to improper use, discontinuation, or reliance on unsafe alternatives. This knowledge gap fuels unintended pregnancies and, consequently, unsafe abortions—a dangerous last resort for women with limited reproductive choices.

Peter Ddungu, Country Director of Marie Stopes Uganda, argues that the findings demand urgent action. He criticized the reluctance to provide contraceptives to sexually active adolescents, only for them to later seek emergency care after unsafe abortions. “Denying young women contraceptives doesn’t stop them from having sex—it only pushes them toward risky decisions,” he said.

Ddungu emphasized that poor family planning counseling leads to inconsistent contraceptive use, with many women abandoning methods due to side effects or lack of follow-up support. Without proper education and accessible services, Uganda’s cycle of unintended pregnancies and unsafe abortions will only worsen.

The Ministry of Health’s acknowledgment of rising abortion complications suggests a need for policy shifts, including expanded sexual education and youth-friendly contraceptive services. Experts argue that Uganda must move beyond mere contraceptive availability and address deep-rooted barriers—stigma, misinformation, and restrictive policies—that prevent women from making informed choices.

While abortion remains highly restricted in Uganda except to save a mother’s life, the reality is that women continue to seek the procedure clandestinely, often with deadly consequences. Health advocates urge the government to confront this issue head-on by improving contraceptive access, enhancing sex education in schools, and fostering open discussions about reproductive rights.

The latest data presents a clear challenge: Uganda’s efforts to reduce unintended pregnancies and unsafe abortions are falling short. Without stronger interventions, the health system will keep grappling with the fallout—overburdened facilities, maternal injuries, and preventable deaths.

Policymakers must prioritize comprehensive sexual education, destigmatize contraceptive use among youth, and ensure that women receive accurate, judgment-free counseling. As Dr. Mugahi and researchers have highlighted, the status quo is unsustainable. The time for action is now—before more women pay the price with their health and lives.

The surge in abortion complications is not just a medical issue but a societal one, demanding collective responsibility. Uganda must choose between perpetuating silence and suffering or embracing progressive reforms that safeguard women’s health and autonomy. The lives of thousands of women depend on that choice.