Sexual and Reproductive Health Rights (SRHR) and HIV/AIDS:

Despite the existing legal and policy frameworks in Uganda, there are still high levels of child sexual violence and abuse. For instance, Child Marriage (CM) continues to rob millions of girls around the world of their childhood. It forces them out of education and into a life of poor prospects, with increased risk of violence, abuse, ill health or early death. Police statistics in Uganda show that 21 children are (sexually) abused every day.

According to UNICEF's 2015 report, "State of the World's Children ̈, national statistics show that 40% of women in Uganda were below the age of 18 at the time of marriage. One in every four girls between 15 and 19 is already a mother or pregnant with her first child in Uganda (UNFPA report). The situation is worse for children under difficult circumstances like refugees, children on the move and those living on the streets and/or in extreme poverty. There is evidence that child marriage and other forms of sexual exploitation and abuse are linked to the social norms and inequalities as drivers.

Currently, there is a significant unmet need for sexual and reproductive health services in Uganda across all age groups. Demand for HIV and SRHR services is growing as a result of the age structure of the population. 49% of Uganda’s population is under 15 years of age. In the coming years a growing proportion of the population will be sexually active and of reproductive age, unless urgent action is taken, this will further increase the gap between the demand for SRHR services and the supply. HIV remains the most significant public health problem facing Uganda and in recent years the epidemic has witnessed a reversal in its decline with prevalence rising to 7.3% among the adult population. HIV prevalence is higher in women (8.3%) as compared to men (6.1%). Three percent of adolescent girls aged 15-19 live with HIV and this figure doubles by the time they reach 24.

HIV prevalence rates are much higher among Key Populations (KPs) than the general population; 13% for men who have sex with men (MSM) and 35% for sex workers (SWs). HIV-related mortality is declining, largely due to increased enrolment in ART. The Contraceptive Prevalence Rate (CPR) for modern family planning (FP) methods among all women of reproductive age in Uganda is low at 30% and the unmet need for FP remains high at 34%. Given the low CPR it is not surprising that Uganda has one of the highest fertility rates in the world at 6.2 children per every woman of reproductive age. Women and girls are unable to delay motherhood and to plan their family size. A number of factors account for this including women’s limited access to information, education and counseling. Supply side factors that contribute to the low levels of uptake of modern FP methods include poor FP commodity security; staff availability and skills, social and cultural factors.