Despite growing awareness and national efforts to improve access to modern contraception, a surprising trend is emerging in Uganda: educated and economically empowered women are increasingly opting for traditional birth control methods.
The finding was revealed during the Performance Monitoring for Action (PMA) regional family planning dialogue and data utility meeting for KCCA and North Buganda held at Rider Hotel in Mukono District.
The meeting also highlighted a complex interplay of systemic shortcomings, cultural beliefs, and misinformation in Uganda’s reproductive health system.
A nationwide survey conducted in 2024 by Prof. Fredrick Makumbi and Simon Peter Kibira from the Makerere University School of Public Health showed that only 34 percent of Ugandan women aged 15 to 49 use modern contraceptives such as pills, injectables, implants, IUDs, or sterilization.
Meanwhile, 7percent continue to rely on traditional methods like the rhythm method, withdrawal, extended breastfeeding, and herbal remedies.
One of the most surprising revelations is that traditional methods are most popular among educated, urban, and wealthier women.
“It may seem counterintuitive,” said Prof. Makumbi, “but empowered women often have the autonomy to say no to sex or make their own fertility decisions—even if they opt for less effective methods.”
Fears about modern contraceptives, especially concerns about side effects such as infertility or cancer, are pushing women away from clinical methods. These fears are often fueled by myths and a lack of accurate information, the study noted.
Dr. Innocent Nkonwa, District Health Officer of Luwero, warned of the risks: “Traditional methods have a high failure rate.”
The consequences are evident. 40 percent of women who were pregnant or gave birth in the past five years said the pregnancy was unintended.
The rate of unintended pregnancies is especially high among rural, less educated, and economically disadvantaged women who lack access to information, services, or the ability to negotiate contraceptive use.
Resistance from religious communities has also been a longstanding hurdle.
Pastor Andrew Lugoloobi, Secretary General of the Born-Again Faith in Uganda and a board member of the Inter-Religious Council, said previous efforts failed due to lack of engagement with faith leaders.
However, recent collaboration has helped reframe the conversation. “We now call it ‘planning for your family’ instead of ‘family planning,’ and that has made a huge difference,” he noted.
Meanwhile, supply chain issues continue to plague public health facilities.
A recent Service Delivery Point Survey by UNFPA and the Ministry of Health found significant stockouts of male condoms, pills, implants, and injectables.
62 percent of public facilities reported not receiving their full orders, compared to 36percent of private ones.
Additionally, only 65percent of facilities offering IUDs had both the equipment and trained staff to administer them.
Rogers Kagimu, Monitoring and Evaluation Officer at the Ministry of Health, acknowledged the gaps but said efforts to improve supply consistency are ongoing, especially for implants, IUDs, and emergency contraceptives.
Experts stress that counseling and tailored care are critical. “A woman may want pills but only find injectables,” Prof. Makumbi said. “She’ll take what’s there—not what’s best for her.”
Integrating family planning into other health services like child vaccinations, along with increased male involvement, could improve uptake and effectiveness. “Men need counseling too,” said Prof. Makumbi. “They’re often left out and can unknowingly block access.”
As Uganda pushes forward with family planning reforms, the growing reliance on traditional contraceptives among its most educated citizens may be less a sign of choice than a silent signal of system failure.
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