After the devastating loss of her husband, Akello Sarah, a 40-year-old mother of six, found herself in a difficult situation with her new partner. He was unemployed and showed no interest in supporting their family, leaving Akello as the sole provider for her children.
Determined to create a better future for her family, Akello made the difficult decision to prioritize her existing children's well-being over having more. She visited Ibuje Health Centre III in Apac District and received the Sayana Press injection, a self-administered contraceptive.
“I got myself the Sayana Press injection last month and from the support of the midwives at the hospital, I am not worried about pregnancy any more. I am now focused on seeing that children have a bright future,” she affirmed.
“With the support of the midwives and the peace of mind that came with family planning, I was able to focus on my livelihood and provide for my children. My income also increased, allowing me to improve my children's nutrition and overall quality of life,” she says.
Akello's newfound financial stability also enabled her to plan for her children's future. She joined a local savings scheme to ensure that she could provide for their educational needs and other long-term goals.
In Abim district, following the birth of her first child, 17-year-old Brenda Akech faced a different challenge in accessing family planning. She had to travel a long distance to reach Orwamuge Health Centre III in Abim District. However, she was relieved to learn about Sayana Press, which she could self-administer at home, saving her time and money on transportation.
“I reached the health facility very exhausted. But I was so relieved to learn that there was family planning I could take and administer by myself at home. This made me happy because I was also saving on transport costs,” she said.
In addition to Sayana Press bearing a positive financial implication to Akech, she also admits that learning how to use the method was a mind-opening experience.
“I was taught why it is important to maintain hygiene while using this method, the importance of checking the expiry date and the recommended areas on the body to administer Sayana press,” she revealed.
Akech says she experienced no side effects and was grateful for the peace of mind that came with being able to control her fertility.
Meeting the unmet need
The testimonies of Brenda Aketch show how family planning can empower women and girls with the freedom to make choices about their bodies, lives and futures, unlocking economic opportunities and fostering autonomy.
In 2024, through the Uganda Private Midwives Association (UPMA), UNFPA Supplies Partnerships supported interventions in Acholi and Karamoja sub-regions to ensure every woman who wished to delay childbearing had access to contraception.
The statistics paint a stark picture: while 44% of pregnancies in Uganda are unplanned, this figure rises to 50.7% of women and girls aged 15-49 in the Acholi sub-region. Karamoja faces an even greater challenge, with the highest total fertility rate (TFR) in Uganda, an average of eight children per women, significantly higher than the national average of five.
For UNFPA, addressing the unmet need for family planning remains a key priority. The post-family planning (FP) 2020 era has renewed both international and Ugandan government commitments to improving health, reducing inequities and promoting human rights, acknowledge the underlying poor health indicators on family planning uptake.
Midwives during a counselling session on use of Sayan Press at Ubuje HC III in Apac district.
This includes supporting the Government of Uganda in fulfilling its goal to accelerate the uptake of modern contraceptives through strengthening the health system and addressing gaps in quality and access to family planning information and services, especially for young people and hard-to-reach communities, promoting human rights, leaving no one behind and reaching the furthest behind first.
The appreciation of Sayana Press among other FP methods by women in the Northern and Karamoja regions of Uganda is a key step towards bridging the gap towards achieving the goal of increasing Modern Contraceptive Prevalence Rate (MCPR) for all women, from 30.4% in 2020 to 39.6% by 2025, and reducing unmet need from 17% to 15% within the same timeframe.
The positive experiences of women like Akello and Akech demonstrate the role that methods like Sayana Press can play in empowering women, improving their well-being, and enabling them to plan their families and futures.
