In Summary
  • Faith and contraception. Religious beliefs and principles are powerful influences on behaviour when it comes to sex, marriage, family and child bearing. Some individuals even consider these clergy men as counsellors. Gillian Nantume answers the question of how religious leaders are tackling the unmet contraception need.

Life is much better for Clare Ongom, a project manager with a non-governmental organisation. Her husband has a good job and both of them are able to take care of their four children.

A few years ago, though, their marriage almost broke down because of their divergent views on the number of children they should have. While Ongom had always wanted two children, her husband was against the idea of family planning.

“When I had our second child, my husband had been unemployed for over a year. Money was scarce, but surprisingly, he insisted that using contraceptives is a mortal sin, against the laws of God. We are Born Again Christians.”

Because the couple could not reach a compromise, Ongom took to denying her husband his conjugal rights. “It worked for a while but when the marriage became strained, I gave in. Within a short time, I was pregnant with our third child yet I was the sole breadwinner in the home. When I became pregnant for the fourth time, I decided I had to do something about our situation.”
Ongom secretly visited a hospital and requested for tubal ligation - a permanent method of family planning where the fallopian tubes are cut and sealed. She has no regrets, and to this day – seven years after her surgical procedure – her husband is none the wiser.

There is one thread that runs through all shades of religion – children are a blessing. The theme on which most faith-based organisations (FBOs) are anchored is self-preservation of the human race. Sex is for procreation. Period.
This is what drove Pastor Girado Olukol, the leader of Pentecostal Outreach Ministries in Tororo District, to call out couples who use family planning as murderers.

“You people who are involved in family planning habits, you are killers, you are murdering, you are murderers. God has planned for you. Stop destroying your children, produce and fill the earth as He commanded. Family planning has far reaching consequences on the users,” Pastor Olukol was quoted by Daily Monitor as telling his congregation.
A number of the worshipers, however, quietly disagreed with their ‘spiritual father’ saying family planning has helped them to have manageable families.

The role of FBOs in family planning
Pastor Olukol’s sermon brings to light the powerful position that faith-based organisations have on developmental issues such as population growth, quality of family life, and the sexual reproductive health.
Uganda has an annual population growth rate of 3.3 per cent, and with limited resources, the strain of unplanned pregnancies has an immediate effect on household income.

According to the findings of the annual Performance Monitoring and Accountability (PMA 2020) survey, carried out by Makerere School of Public Health, approximately 46 per cent of women of childbearing age in Uganda say their last pregnancy was unintended. The survey was conducted in 78 districts between April and May 2018.

Religious beliefs and principles are powerful influences on individual behaviour when it comes to when sex is permissible, marriage, families, and child bearing. This influence is strengthened by the fact that FBOs do a substantial amount of health related work. For instances, Uganda Catholic Medical Bureau (UCMB) has 32 hospitals and 263 health centres affiliated to it. None of these facilities offers modern contraceptive commodities such as, condoms, pills, injectaplan (depo provera) or intra uterine devices (IUDs).

Janet Komagum Opota, the Natural Plan Project coordinator in UCMB, says this policy is in keeping with the position of the Church on contraception.
“The Church believes that the primary purpose for sex is procreation and love. You cannot say you love someone youo not want to have a child with him. Those hormonal methods (modern contraceptives) put a stop on the purpose of sex yet sex is supposed to be open to life. If you wear a condom you have stopped life.”

After many years on a total blackout on family planning services, UCMB’s health facilities have softened their stance and are now offering information on natural family planning methods where a woman is taught how to be aware of her fertility by listening to her body.
“These methods are recognised by World Health Organisation. Women who do not want to have children should utilise the infertile periods of their menstrual cycle. On fertile days, they should abstain,” Opota says.

The fertility awareness methods include, lactation amenorrhea method (LAM) which relies on exclusive breast feeding for six months, the two-day method involves a women checking the consistency of her varginal discharge as an indicator of fertility, and the cycle beads which can only be used by women who have regular menstrual cycles.

“Our health workers are empowered to give information on all methods of family planning. If one chooses the hormonal methods, we shall not ridicule them. Instead we counsel them about the advantage of using natural methods,” Opota says.
Opota, who has used natural family planning methods for 13 years, adds that with correct use, there is a 95 per cent success rate.

Other FBOs hold slightly different views, although they roundly condemn use of contraception in certain circumstances. Pastor John Chemonges of Deliverance Church Entebbe says all human life is sacred and God-given.
“Life begins with fertilisation. We do not believe that it is wrong to prevent fertilisation, but we disagree with any method of contraception that acts after fertilisation to end human life. We encourage believers to seek God for guidance on which method to use, and where possible, seek medical advice.”

He adds that during premarital counselling, family planning are discussed. “We usually discourage couples from conceiving during their early days (together) because they are still adjusting to each other and getting a third person immediately can complicate the adjustment process.”
The Anglican Church, on the other hand, offers modern contraceptive methods and commodities to everyone, without discrimination, in the 11 health facilities that are affiliated to it.

Controlling families from the pulpit
In many communities, priests and other religious leaders are seen as counsellors. People run to them when they are in distress, especially when the quality of life in their homes is not good.
Dr Ruth Obaikol, the director of the Directorate of Health, at the Provincial Secretariat Office of Church of Uganda (CoU), says the Church encourages planning for families.

“We respect family planning among the married couples only. Our emphasis is not on pumping out contraceptive information, but on planning properly for one’s family. However, we do not specify the number of children one should have. The priests give out this information from the pulpit, publically.”

CoU has developed guidelines on the kind of sexual reproductive health (SRH) information that its priests can share and who should consume that information. The priests also refer congregants to health centres for access to modern contraceptive methods.
Other FBOs, however, leave the issue of SRH and use of contraceptives to women’s groups in their churches. The only problem with this set up is only one half of the couple has access to family planning information.

Ongom had heard about the use of contraceptives from her prayer partners. “After praying, we normally talk about our families. While I got advice on how to control the number of children I can have, my husband did not receive the same kind of information. That is why my contraceptive method is a secret.”
There is a need to remove the conversation of contraceptives and family planning out of specific groupings and bring it out in the open. If the Church is to encourage contraceptive use among married couples, then this information should not be restricted to the married women alone.

Marginalising youths and singles
In most FBOs, adolescents and single people are expected to abstain from sex until they get married. The reality, though, is different.
The national teenage pregnancy rate is at 25 per cent. This implies that one of every four teenage girls is pregnant.

According to the PMA 2020 survey, while 67.7 per cent of the women surveyed have a demand for contraceptives, only 53.6 per cent of that demand is satisfied by modern contraceptive methods.
Also, among unmarried but sexually active women, the use of emergency pills is growing, and this has led to a fear of an increase in new HIV infections.

Stephen Angala, the programme officer in-charge of SRH/HIV in COU’s Directorate of Health, says the church does not have the same standards as the secular world.
“We only give information about family planning. Do single people have families to plan for? We tell them to abstain until the right time for them to enjoy sex comes. This is a more helpful message than giving them information about condoms.”

On whether this attitude is not akin to an ostrich burying its head in the sand and wish trouble away, Angala says, “The Church is aware that youths are using condoms but its major focus is on morals. The Church is the authority from God to control morals in society and it will not advise youths to use condoms. If out of 100 youths, 40 can be morally upright and abstain, that is good.”

Including FBOs in contraceptive use
Overall, Uganda’s the contraceptive prevalence rate is at 41.8 per cent, falling short of the desired 50 per cent. With the rising teenage pregnancy rates, FBOs have a big role to play.
A study on the incidence of induced abortion and post abortion care among adolescents in Uganda carried out by Makerere University School of Public Health and the Guttmacher Institute found that the 2.3 million women who got pregnant in Uganda in 2013, 386,000 were adolescents aged between 15-19 years. An estimated 57,000 of these adolescent pregnancies were aborted.

To incorporate the role of FBOs in SRH and family planning, Faith to Action Network and Christian Connections for International Health have organised a faith pre-conference on November 11, 2018 on the side-lines of the International Conference of Family Planning to take place in Kigali, Rwanda.
The event will promote knowledge sharing among leaders of FBOs and religious leaders and acts as a catalyst for their action in support of family planning and advocating for advancing policies, funding and institutional commitment for family planning.

PREGNANCY NUMBERS
A study on the incidence of induced abortion care among adoloscents in Uganda carried out by Makerere University School of Publiic Health and the Guttmacher Institute found that the 2.3 million women who got pregnant in Uganda in 2013, 386,000 were adoloscents aged between 15 to 199 years, an estimated 57,000 of these adolescent pregnancies were aborted.

Should the church address family planning issues?

Elizabeth Namakula, manager
I cannot consult the church to help me address such isssues.

Moses Tobiah Musoke, Businessman
It is good for the church to sensitise people about family planning because the biggest percentage of our population is still adamant on the benefits of family planning.

Sylvia Ssentongo, cashier
I would support my church to address issues of family planning so as to help tackle the issue of women giving birth to many children.

Enock Nsubuga, Student
I think the modern church should do much more than just wining souls rather than only shaping the destiny of its congregation.