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What does Contraception Have to Do with Education? Everything

By UN Foundation

September 23^rd, 2016

Worldwide, 62 million girls between the ages 6 and 15 are not in school, and girls continue to fall significantly behind boys in completing secondary school.

There are numerous reasons for these disparities – cost, distance, safety, lack of sanitary supplies, gender discrimination, early marriage, and more. There are also a number of solutions to help get more girls in school, including expanding access to reproductive health information and services.

The United Nations Foundation’s Universal Access Project recently returned from a trip to Uganda, a country where nearly a quarter of girls are pregnant or have a child by age 19, and comprehensive sex education is not taught in many schools. There, we met over a dozen girls, women, and young men about their lives, challenges, and dreams.

A recurring theme surfaced in almost every interview: Adolescent girls were getting pregnant, dropping out of school, and often getting married. We also heard of women unable to plan their families who ended up having more children than they wanted and could not afford to send their children to school.

Research finds that family planning can help girls stay in school and achieve their educational and employment goals. We can help to break the cycle of school dropouts by empowering girls with information about their bodies and access to proven solutions to prevent unintended pregnancy and transmission of sexually transmitted infections, including HIV.

Sharon never completed high school. She wants two kids and is seeking family planning at a pop-up Marie Stopes clinic in Kampala.

USAID supports reproductive health services for young people in Uganda, a country with 75% of its population under age 30.

50-60 people come each day to this clinic for primary care and family planning. Sometimes they go three months without birth control pills.

Annette distributes contraceptive commodities from UNFPA to her community from her garage, where she also runs a small sewing business.

Betty, with her first baby, came to the health center to get a long-term contraceptive. She dropped out of school and wants to go back.

Below are stories from a few of the Ugandan girls and women we met who have seen in their own lives and communities how poor access to reproductive health hurts educational outcomes.

Margaret Nakanjakko: “I started learning about contraception, and I thought, ‘oh, I wish I had known about this.’”

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What does Contraception Have to Do with Education? Everything

Margaret was born in small village near the mouth of the Nile River in a tiny home with no electricity or running water. Her mother had 22 pregnancies and 16 children. Life was difficult according to Margaret, “You can see how big my family was. So my father was always struggling. I know what it means to sleep hungry. I know what it means to go naked. I know what it means to go without a blanket … Maybe someone would give us an old blanket, but it would be full of holes. We would cover up, but we could feel the coldness coming through. … It was too hard.”
Margaret started working at an early age to support herself and her family. She would walk six miles every morning to work on a farm before school, and then run to school, often missing classes. Despite these many challenges, Margaret was one of the best students in her village.
At 18, just as she was about to graduate from the Ugandan equivalent of high school, Margaret became pregnant. It was the first time she ever had sex, and having never received any sex education, Margaret knew nothing about her body. “It did not occur to me that I was going to get pregnant,” she said.
When Margaret’s parents found out she was pregnant, they kicked her out of the house and she dropped out of school. “The first time I gave in, I got pregnant. I was hurt so much. In my village, people respected me, because most girls failed to reach Senior 4. … Most of them got pregnant and dropped out. … Now I was pregnant. My family felt humiliated. My mother cried,” said Margaret.

Shortly after the baby was born, Margaret’s father took the baby away and give him to the parents of the baby’s father. Margaret would not see her son again for ten years. In the meantime, she secured a job as a janitor at Reproductive Health Uganda, the oldest reproductive health organization in Uganda, and a recipient of significant USAID and UNFPA support. It was there Margaret first learned about reproductive health. “I started learning about reproductive health and my rights. I started learning about contraception, and I thought, ‘Oh, I wish I had known about this,’” she explained.
Today, Margaret is a community health worker who specializes in reaching out to young people about their health and rights, explaining she doesn’t want them to be in the dark as she was: “If I had known about at least condoms, or the pill, I wouldn’t have gotten pregnant ….Because I didn’t want that.” She was also reunited with her son and says they are now “the best of friends” and he “tells her everything in life.”
Margaret’s message to U.S. policymakers: “The people down here, they are capable of being anyone … but they need help. Ignorance is the worst disease.”

Eunice: “What inspired me to use family planning is I see so many other girls in this village who get pregnant … and when they get pregnant they can’t continue with school.”

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Seventeen-year-old Eunice lives in Buyodi, a small village in Uganda on the border with Kenya. Every day, she cleans the house, collects fire wood, does the dishes, and collects water in a large container that she balances on her head, a task that requires a two hour round-trip walk and often hurts her neck.
Eunice also walks an hour each way to school where she is currently in the equivalent of 9th grade. Asked what her greatest fear is, she replied, “I really fear getting pregnant, because I see how other girls who got pregnant suffer.” Eunice is currently using Sayana Press, a three-month contraceptive injection. “What inspired me to use family planning is I see so many other girls in this village who get pregnant … and when they get pregnant they can‘t continue with school,” she said, explaining her motivation to use contraception in order to stay in school.

Eunice learned about reproductive health from her mother, Jackqueline, a community health volunteer trained by FHI360, a key USAID-funded service delivery organization. Jackqueline goes door to door providing contraceptive information and services to the approximately 1,000 people in her village.
Eunice shared her determination to follow a different path than that of so many other girls in her village and to chart a new course for future generations, saying, “For me, I‘ve always wanted to complete school and come back to the village and discuss [reproductive health] with other girls.”

Immaculate: “Nowadays we are more aware. We take our daughters for family planning services, that way they can stay in school.”

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Immaculate lives just a short walk from Eunice and Jackqueline, but as her story reveals, she did not grow up with the same access to reproductive health information as Eunice.
Immaculate grew up with seven siblings, and when she got pregnant at 15, her father, a small-scale fish trader, stopped paying school fees for Immaculate and her sisters, instead investing in the education of his sons. “My father had very many children, so he could not afford to take care of all of us …. I felt bad about it. I was really angry …. I loved to study and wanted to be a nurse,” said Immaculate.
Unable to finish school and pursue her dream, Immaculate followed in her mother’s footsteps and began making a local brew she sells for a small fee. Still, she and her husband, who works as a farmer, struggle to afford school for their five children. “Right now my biggest challenge is having my children educated. I am worried about my capability to pay for school fees,” she said.

Immaculate shared that she does not want to have any more children and is grateful to her neighbor Jackqueline, who comes to her home every three months to provide her with Depo Provera, a three-month contraceptive injection. Before she began receiving services from Jackqueline, Immaculate faced challenges accessing contraception. “Sometimes you would go [to the clinic] and there were many people, and you would have to wait … once I went and there were no commodities,” she explained. “I honestly would have at least 15 children by now if I didn’t use family planning.”
She stressed that she wants her children’s lives to be different from hers, saying, “I would love to have my children go to school and become educated, as compared to how I was. … Nowadays we are more aware. We take our daughters for family planning services so they can stay in school.”

Learn More and Take Action

The U.S. provides almost $14 million for family planning in Uganda, the backbone of its reproductive health budget, and U.S. and United Nations funds support most of the programs providing services to the girls and women with whom we spoke.

Despite these critical investments, demand for reproductive health is still outstripping supply in Uganda, where 1 in 3 women have an unmet need for family planning, three-quarters of the population is under 30, and nearly a quarter of girls aged 15 to 19 have had a baby or are pregnant. Developing nations like Uganda have long relied on donor countries to cover the cost of contraceptives. But today the world is facing a contraceptive crisis, with a funding gap of at least $847 million.

The international community, with the U.S. in the lead, should increase its support for international reproductive health programs in Uganda and other high-need countries, not only to improve health, but also to help keep girls in school and empower them to live healthy, productive lives. Only through such strategic investments will we achieve the Sustainable Development Goals.

Read more stories from girls, women, and young people from around the world on the Universal Access Project’s Global Voices for Family Planning. To learn more about the global contraceptive crisis and find out how you can take action, visit the Reproductive Health Supplies Coalition.
Robyn Russell is the Deputy Director of the Universal Access Project at the United Nations Foundation, a program dedicated to strengthening U.S. leadership on international family planning and reproductive health for girls and women around the globe.

Footnotes

Cover photo by Jonathan Torgovnik/Reportage by Getty Images. Full Release. All other photos by Robyn Russell, Universal Access Project, United Nations Foundation.

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FootNotes

Cover photo by Jonathan Torgovnik/Reportage by Getty Images. Full Release. All other photos by Robyn Russell, Universal Access Project, United Nations Foundation.

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