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Sexual & Women’s Rights Country Overview: Uganda 2020

This series of country context overviews is founded in the Coalition of African Lesbians’ (CAL) work in different countries, specifically the Masakhane[1] project in Southern Africa. The project’s focus is on strengthening capabilities of CAL members and partners in different countries through learning in action, as the basis of facilitating effective growth in activism among the groups with which CAL works: lesbian women, women living with HIV and AIDS, sex-workers and young women[2]. As feminists and activists concerned with gender and sexual rights and justice, we understand that current social, political and economic structures, institutions, ideologies and practices undermine our rights and freedoms and restrict our autonomy. This understanding informs both CAL’s areas of focus in its work and the focus in this context overview; Sexual and Reproductive Health and Rights (SRHR), sexuality politics specifically expressed in issues of sexual orientation and gender identity, and gender discrimination and violence.

CAL’s approach to its work is also informed by the five factors identified in the “Report of the Study on the Situation of Women Human Rights Defenders in Africa” by the former Special Rapporteur on Human Rights Defenders in Africa of the African Commission on Human and Peoples’ Rights. CAL has modified these factors; patriarchy and heteronormativity, fundamentalisms, militarisation, war and conflict, neoliberal capitalism, crises in democracy and environmental exploitation.

This publication focuses on sexual and gender rights, specifically violence against women, sexual and reproductive health and rights and sexual orientation and gender identity. It is intended to support Civil Society Organisations, activists and government agencies and institutions in their work to address persisting SRHR issues, gender violence and sexual orientation and gender identity issues.


Background


Population: 45.7 million (United Nations Population Fund, 2020)
Women’s Literacy:  (UNESCO Institute for Statistics)
90% [15 – 24 years]
70.8% [15 – 64 years]
26.3% [65 years old and older]
Women’s Employment Rate: 67.1% (World Bank)
Maternal mortality: 342 per 100, 000 live births (World Health Organisation)
HIV prevalence:  7.1% [Women aged between 15 – 49 years old]
                                    2.8% [Young women] (UNAIDS)                               
GBV: 22% of women between the ages of 15 and 49 have experienced some form of sexual violence
at least once in their lifetime. (United Nations)
GDI: 0.863 (United Nations Development Programme)
GII: 0.535 (United Nations Development Programme)
COVID-19 Status: 38, 935 confirmed cases, 317 deaths (January 24, 2021) (World Health Organisation)
 

Sexual and Reproductive Health Rights

As concluded by the World Health Organisation (WHO)[3], Sexual Reproductive Health and Rights (SHRH) encompass efforts to eliminate preventable maternal and neonatal mortality and morbidity, to ensure quality sexual and reproductive health services, including contraceptive services, and to address sexually transmitted infections (STIs) and cervical cancer, violence against women and girls, and sexual and reproductive health needs of adolescents. Universal access to sexual and reproductive health is essential not only to achieve sustainable development but also to ensure that this new framework speaks to the needs and aspirations of people around the world and leads to realisation of their health and human rights.

Contraceptive Access and Use

According to the Uganda Demographic and Health Survey (2016), 27.3% of women of reproductive age have used some form of modern contraceptive (Mukiza, C. N. et al, 2019). The most popularly used methods of contraceptive include injections (14%), implants (5%), the male condom (3%), sterilization (2%), the pill (2%) and the IUD (1%). These figures indicate that the level of unmet need for contraceptives is high in Uganda, particularly amongst married women, and women living in rural areas. The reasons for the modest use of contraceptives vary from the women’s fear of side-effects, dissent from the women’s husband or partner, religious prohibition and/or a lack of access due to an inability to afford sexual reproductive health services (Khan, S. et al, 1995).

In 1957, Reproductive Health Uganda (RHU) was established to combat the various sexual and reproductive health concerns including the high prevalence of HIV/AIDS and the unmet need for contraceptives. The RHU currently provides sexual and reproductive health services across Uganda through 768 service points although it is estimated that 98% of its clients – sex workers, young women in conflict areas, internally displaced women and hawkers – are unable to enjoy the services due to their low economic standing, marginalisation and social exclusion (International Planned Parenthood Federation, 1957).

Maternal Mortality Rate

It is estimated that 1 in 49 women in Uganda die of a pregnancy and/or childbirth complication.[4] The reasons behind the high maternal mortality rate can be classified into three types of delays; a delay in seeking the requisite care, a delay in reaching care and lastly, a delay in receiving the suitable standard of care.[5] Collectively, these delays result in the loss of numerous women’s lives who often die of preventable maternal ailments such as haemorrhages, eclampsia and infections.

In a landmark judgement delivered on the 19th of August 2020, the Constitutional Court of Uganda held that the government needs to prioritise maternal health care within its budget (Petition 16 – Judgement (Maternal Health Case 2020). The ruling came after two women died during childbirth as a consequence of health centres lacking the essential and necessary facilities needed to support the pregnant women. In full support of sexual and reproductive health rights, the Court further went on to reiterate that an inability to provide women, particularly those who are pregnant, with quality healthcare services is a gross violation of their right to health and right to life. Additionally, the omission by healthcare facilities to provide such services is tantamount to degrading and inhuman treatment.

Abortion

The procurement of an abortion is illegal in Uganda except for an instance where a medical practitioner conducts a surgical abortion in order to save the woman’s life. This exception is as per Section 224 of the Penal Code and can be used as a defence against the offence of abortion provided the doctor acts in good faith, reasonable care and skill to preserve the life of a pregnant woman. Outside of this singular parameter, both the Constitution and Penal Code of Uganda prohibit abortions. Section 141 of the Penal Code, titled ‘Attempt to procure an abortion,’ criminalises any person who intends to induce a miscarriage by administering a noxious substance/poison or uses force or any other means to unlawfully terminate the pregnancy. This offence attracts a fourteen-year jail sentence. A woman – with the intent to terminate her own pregnancy – is liable to a prison sentence of seven years if she is found to have intentionally consumed noxious substances, poisons and/or used force or any other means of terminating her pregnancy, as per Section 142 of the Penal Code. Section 143 of the Penal Code additionally criminalises, with a prison term of three years, the act of intentionally providing a substance/drug to a person with the knowledge that said substances are to be used with the intent to terminate a pregnancy. The common feature across all the prohibitions is the intention – it needs to be established that there was an intention to terminate the pregnancy.

Although the Constitution of Uganda, as per Section 22(2), states that “no person has the right to terminate the life of an unborn child,” there are policies that appear to allow for abortions, despite the policies not being of a legally binding nature. Such policies include the National Policy Guidelines and Service Standards for Sexual and Reproductive Health and Rights (2012) and the Standards and Guidelines on Reducing Maternal Morbidity and Mortality from Unsafe Abortions in Uganda (2015) which both advocate for greater parameters under which abortions can be performed including when a woman has been raped and where the pregnancy is a consequence of defilement and/or incest and additionally call for universal access to contraceptives and the provision of abortion and post-abortion care services to all women in Uganda.

Unsafe abortions contribute significantly to the rate of maternal mortality in Uganda – up to 5%, according to the Annual Health Sector Performance Report 2018/2019.[6]

Discrimination and Violence against Women

It is estimated by UN Women that 50% of Ugandan young girls and women between the ages of 15 – 49 have experienced intimate partner violence of a physical and/or sexual nature at least once in their lives.[7] With the advent of social media and technology, women have begun to experience violence through cyber-bullying and revenge porn (Ssenkaaba, S, 2020).

In an attempt to curb the alarming levels of violence against women and girls, the Domestic Violence Act was adopted in 2009. The legislature defines ‘domestic violence’ as any act by a perpetrator which harms, endangers the life, well-being, and safety of a survivor. Under the Act, the scope of violence has been expanded to include economic, emotional/verbal/psychological abuse and harassment. Section 4 of the Act categorically states that a survivor’s consent cannot be deemed as a defence to the crime of domestic violence. Additionally, upon the conviction of a perpetrator, the survivor may be entitled to compensation. Despite the progressive provisions of the Act, research reveals implementation has been slow and many Ugandan women, particularly in the rural areas, are unfamiliar with the law. 

Women in Uganda face a disproportionate level of discrimination across the board. The discrimination against women is evident in various aspects such as land ownership, decision-making roles in their communities, access to health and education, among others.  Within the sphere of education, for example, a gender disparity is seen between the percentage of boys and girls who complete primary school – 53% and 42%, respectively (FIDH, 2009).

Similarly with land ownership, women only own 7% of agricultural land yet they perform a majority of the work on said land. Attempts have been made by various stakeholders to remedy the unfair situation pertaining to land ownership and have been successful to an extent – in 2006, the Constitutional Court declared that a provision from the Succession Act that barred women from inheriting property from their fathers was unconstitutional.

Sexual Orientation, Gender Identity & Expression

Sections 145 and 146 of Uganda’s Penal Code render same-sex relations illegal and unlawful referring to them as ‘carnal knowledge of any person against the order of nature.’ Should one be found ‘guilty’ of this offence, they are liable to life imprisonment. Contrary to this, the Constitution outlaws discrimination on a number of basis – sex and race, for example – but does not definitively speak to sexual orientation, gender identity or expression. Marriage between two persons of the same sex is strictly prohibited.

Late in 2009, the Anti-Homosexuality Bill was tabled before parliament. The legislature was formulated for purposes of protecting the “traditional family” through the prohibition of sexual relations between persons of the same sex and to prohibit the promotion/recognition of sexual relations between said persons. The bill was signed into law by President Museveni but later declared null and void in 2014. As a consequence of this bill, and previously held homophobic notions in Uganda, persons of the queer community face grave discrimination, stigma and ostracization from their communities, families and even in the workplace. Members of the queer community often face difficulties with accessing healthcare services that are otherwise readily availed to cisheterosexual people.[8]

Treaties Ratification Table[9]

Below are the sexual and reproductive health and women’s rights treaties to which Uganda is a party. By virtue of being a signatory to these instruments, Uganda is obligated to abide by the treaties and ensure that there is a harmony between its domestic laws and international law standards.

TreatySignedRatification, Accession (a), Succession (d)
Convention on the Elimination of All Forms of Discrimination against Women (CEDAW)30 July 198022 July 1985
Protocol to The African Charter on Human and Peoples’ Rights on the Rights of Women in Africa (Maputo Protocol)18 December 200322 July 2010*
*Note: While Uganda ratified the Maputo Protocol, it put in place a reservation to Article 14(2)(c) which speaks to the right to safe abortion under certain circumstances.

Organisations in Uganda Working on Women’s & Sexual Rights

  • Maternal Health Network
  • The Uganda Land Alliance (ULA)
  • Action for Development (ACFODE)
  • The Uganda Women’s Lawyers’ Association (FIDA-U)
  • The Ugandan Gender Resource Centre (UGRC)
  • National Association of Women in Uganda (NAWOU)
  • Centre for Domestic Violence and Prevention (CEDOVIP)
  • Sexual Minorities Uganda (SMUG)
  • Forum for African Women Uganda
  • Uganda Women’s Network (WOUGNET)

[1] Masakhane is a Nguni word which translates to ‘Let us build together’.

[2] CAL works on issues affecting all women on the continent, but works closely with these specific groups because they are further marginalised in society. 

[3] WHO (2014) Sexual and reproductive health and rights: a global development, health, and human rights priority, WHO. World Health Organization. Available at: http://www.who.int/reproductivehealth/publications/gender_rights/srh-rights-comment/en/

[4] ‘Ensuring Every Woman can Deliver with Dignity’ – Report by SOUL Foundation can be accessed at: https://www.souluganda.org/maternalhealth

[5] Supra.

[6] Annual Health Sector  Performance Report (Ministry of Health Uganda) can be accessed at:  http://library.health.go.ug/sites/default/files/resources/AHSPR%202018_19%20FY%20Final%20copy.pdf

[7] United Nations Women Country Profile (Uganda):   https://evaw-global-database.unwomen.org/es/countries/africa/uganda

[8] Uganda’s Policy and Information Note can be found here:  https://www.justice.gov/eoir/page/file/1150221/download.

[9] This table is focused on the treaties relevant to the focus of this context overview, for a more comprehensive database of treaties signed by Uganda, and their ratification status, visit the Office of the UN High Commissioner for Human Rights (OHCHR) website: https://tbinternet.ohchr.org/_layouts/15/TreatyBodyExternal/Treaty.aspx?CountryID=97&Lang=EN ,  the African Union (AU) website: https://au.int/en/treaties and the African Commission on Human and Peoples’ Rights (ACHPR) website: https://www.achpr.org/ratificationtable?id=49 .

References

Country Policy and Information Note Uganda: Sexual orientation and gender identity and expression (2019).
Available at: https://www.justice.gov/eoir/page/file/1150221/download
(Accessed: 19 August 2020).

FIDH (2009) Women’s Rights in Uganda: Gaps in between policy and practice. Kampala.
Available at: https://www.fidh.org/en/region/Africa/uganda/Women-s-rights-in-Uganda-gaps (Accessed: 7 September 2020).

Khan, S. et al. (1995) Unmet Need and the Demand for Family Planning in Uganda. Available at: www.ubos.org. (Accessed: 1 September 2020).

Mukiza, C. N. et al. (2019) Uganda Bureau of Statistics Management United Nations Population Fund GIS Expert List of Contributors to this report United Nations Population Fund UGANDA FAMILY PLANNING ATLAS.
Available at: https://www.ubos.org/wp-content/uploads/publications/12_2019Atlas_small-_30_12_2019.pdf. (Accessed: 20 October 2020)

Petition 16 – Judgement (Maternal Health Case) (2020) CEHURD. Available at: https://www.cehurd.org/publications/download-info/judgement-to-the-constitutional-petition-no-16-of-2011-maternal-health-case-decided-in-the-affirmative/  (Accessed: 2 November 2020).

Reproductive Health Uganda  (1957) International Planned Parenthood Federation .
Available at: https://www.ippf.org/about-us/member-associations/uganda  (Accessed: 1 October 2020).

Ssenkaaba, S. (2020) Uganda: Violence against women unabated despite laws and policies , Africa Renewal . Available at: https://www.un.org/africarenewal/news/uganda-violence-against-women-unabated-despite-laws-and-policies  (Accessed: 1 May 2020).

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