By Davis Buyondo And Malik Fahad Jjingo
Ritah’s future was cut short after an attempt to terminate an unwanted pregnancy went wrong. The 14-year-old had arrived at Buwunga Health Centre III, in Masaka district, in deep pain and heavily bleeding.
By the time she was referred to Masaka Regional hospital for further attention, it was too late. The doctors say her condition had completely deteriorated beyond a point where they could save her, and she passed away later.
Her death is one of the many that occur in the country where thousands of women suffer complications from unsafe abortion every year. The teenager’s painful story raises a question that most health workers ask; ‘Where was the man responsible for the pregnancy at the time?’
For decades, the Uganda government has been trying to reduce maternal deaths and improve access to reproductive healthcare. However, unsafe abortion has largely remained a public health threat in the country with many girls and women suffering its consequences.
Due to the restrictive laws on abortion, many women who seek to end pregnancies find themselves doing it secretly while the majority use unsafe methods. The illegal pregnancy terminations are being done outside the formal health facilities and often handled, either, individually or non-professionals.
According to the Ministry of Health, Uganda records more than 300,000 abortions each year with the majority being unsafe. Still, unsafe abortion continues to contribute significantly to this public health problem: A 2010 report by the ministry estimated that 8% of maternal deaths were due to unsafe abortion.
However, during months of reporting in Masaka region, particularly in Masaka City, Masaka District, Lyantonde, Kalungu, Kyotera and Kalangala, this investigation established a recurring pattern from both survivors and health workers.
They say that while they were facing the harsh consequences of unwanted pregnancies and unsafe abortion, the men responsible were not present.
He Blocked Me, And disappeared
Katherine, 16, was an S.4 candidate when discovered she was pregnant. She says things fell apart as the boyfriend she expected to support her, disappeared the moment he found out.
“He denied responsibility, stopped answering my calls and later blocked me. He even shifted to an unknown location, leaving me stranded,” recounts.
Being out of options, Katherine sought help from her friends and relatives to end the pregnancy. This is the same experience many other young girls interviewed described as intentional abandonment.
Even so, experts warn that these individual accounts alone cannot be enough to prove a nationwide trend. They further wonder whether the systems that are designed to respond to unsafe abortion also adequately recognise men’s role.
Are Men Left Out By the system?
Many reproductive health programs or interventions focus primarily on women/girls because they directly experience physical consequences of pregnancy and abortion. However, researchers argue that this kind of approach undermine or leave out an important element in the prevention of unsafe abortion.
Policy planning and management experts explain that many unsafe abortions would be prevented if men accept and take up the responsibility of the pregnancies.
According to the Ministry of Health, men have an important role to play in any reproductive health and family planning matters. Different reproductive health and family planning initiatives involving men have been launched to prevent unwanted or unplanned pregnancies which can lead to unsafe abortion.
Some of these initiatives include the National Male Involvement Strategy and Guidelines which encourages men to take part in reproductive health (RH), family planning and maternal health. Through the Male Action Groups (MAGs), also supported by UNFPA, young men and boys are trained to teach their peers about the myths about contraceptives and further promote responsible sexual behavior that can prevent unintended teenage pregnancies and unsafe abortions.
In addition, the ministry, through the Community Dialogue and Sensitization Campaigns, also engages men directly on sexual and reproductive health (SRH). These engagements encourage positive attitudes to address harmful social-cultural norms, and discourage teenage pregnancies.
Another initiative is the Couple Counseling at Health Centers whereby the local health facilities and district hospitals offer couple counseling and family planning services that specifically encourage men to accompany their partners
What Health Workers See?
Mary Magdalene Nanyunja, a midwife at Buwunga Health Centre (HCIII), says they often receive young women in critical condition after attempted abortion going the wrong way. Nayunja further says that some patients report being abandoned by their partners leaving them helpless.
“Many wait until the condition runs out of hand and then they think of visiting a health centre for medical assistance. They fear being judged at the health facility or in their communities,” she explains.
Nanyunja adds that some men hire boda boda riders to take and abandon the women at the entrance of the health facility without accompanying them.
In recent months, the facility recorded dozens of girls and women seeking Post Abortion Care (PAC) services. “We received at least 30 women aged between 13 and 20 years since 2025 who were seeking PAC,” she reveals.
Following unsafe abortion complications, Kalangala HCIV enrolled 31 women for PACs between April and June 2025. Lyantonde registered at least 622 women for PAC services – 337 in 2024 and 285 in 2025. At Kalisizo hospital, more than 180 women were enrolled for PAC in 2025. In Kalungu HCIV, at least three women go for post-abortion care services every month.
According to Dr. Simon Peter Kayondo, an obstetrician-gynecologist, excessive bleeding is the commonest complication and the leading cause of death associated with unsafe abortion. Other short-term complications include infections and injuries to the internal organs.
However, Kayondo, also the Vice President of the Association of Obstetricians and Gynaecologists of Uganda (AOGU), warns that long-term effects that may emerge later (months or years) include infertility whereby the unsafe abortion survivors may struggle to conceive, the damaged uterus or cervix that can increase the risks of complications in future pregnancies, in addition to chronic pain, psychological distress among others.
Men’s responsibility and the Law
Uganda tightly criminalises access to safe abortion under the Penal Code Act but for exceptional circumstances. However, should a man, who contributes to the pregnancy, be involved in the conversation when difficult decisions about the pregnancy arise? According to legal experts, the question remains tricky.
According to Counsel Alex Lule, Uganda Law Society (ULS) Central Region representative, it’s the responsibility of both the couple (man and woman) to look after their child from conception and if a father disappears, the woman takes full responsibility, before the child is born.
“This is because there’s no evidence to prove paternity if the man denies being responsible for the pregnancy!” Lule explained. However, he added, if a lady went to court, the alleged perpetrator (man) can be compelled to take care of the pregnancy, until when the child is born to test for paternity.
He further argues that, under the law, the man’s participation in an abortion can only be established through his tangible actions such as sponsoring the abortion, providing the drugs or herbal concoctions, facilitating or transporting the woman to procure it, but not through intangible factors like persuasion or coercion to carry out an abortion.
Gendered responsibility
According to Gloria Namyaalo, a Social Worker in Masaka City, in many communities across Masaka region, the pregnancy responsibility is largely determined based on gender adding that most times women and girls are left to carry the burden with men bearing little responsibility. “This usually happens at different stages especially for an unwanted pregnancy,” she explains.
She further argues society usually expects women and young girls to take responsibility for using contraception to avoid unplanned or unwanted pregnancies while men are often taken to be optional participants when it comes to decisions on contraception uptake.
Namyaalo says parents and guardians should always create an environment where their children can be able to reveal a problem and seek assistance rather than reacting harshly in ways that may force them into making desperate and risky choices like unsafe abortion.
Why Most Men Disappear
To better understand the issue, the reporters spoke to men from different walks of life including university students and bodaboda riders. Many admitted withdrawing from their partners after learning they were.
“I personally fear arrest because impregnating a school girl is risky as it can land you in jail. Many parents are tough so denying responsibility or disappearing becomes the only option,” said Ivan Muwanguzi, a boda boda rider in Kyotera.
A senior Six (S.6) student, who preferred anonymity, explained that financial constraints and unemployment often push them in a tight spot where they cannot take care of the girl or woman or provide for the child hence facilitating her to terminate the pregnancy.
However, not all men disappear from their partners in case of an unplanned pregnancy. When 17-year-old Ryan Kimera discovered his S.2 girlfriend was pregnant, he immediately notified his uncle who advised them to keep the pregnancy.
Since they were both students, his uncle approached the girl’s family and discussed the matter and agreed to take care of the baby to allow them continue their studies. Experts argue that these positive examples highlight why male involvement and engagement matter a lot in an effort to prevent unsafe abortion.
Missing National Conversation
The government of Uganda has introduced different programs that encourage men’s participation in the prevention of HIV, accompanying women for antenatal care and child health. But the reproductive health experts still argue that deeper conversations about pregnancy prevention and discussions about abortion are often centred on women.
Police arrests
While thousands of abortions are conducted every year, very few are reported or recorded by police. According to the Annual Police Crime Report 2025, only 255 cases have been reported between 2022 and 2025. 59 cases were reported in 2022, 81 in 2023, 68 in 2024 and 47 in 2025.
However, the figures indicate a significant decline in reported cases since 2023.
Embedded code
The World Health Organisation (WHO) estimates around 73 million induced abortions take place globally each year. In Uganda, health workers and rights activists say the legal restrictions on safe abortion have further fueled the public health crisis, arguing that fewer girls and women would die if safe abortion were more widely permitted.
For Ritah’s family, the pain of losing a daughter remains apparent. Thousands of women and young girls across the country suffer in silence with the male individuals involved in their pregnancies absent or denying responsibility.
The question remains, in such difficult circumstances, what responsibility should male carry from conception and who should enforce it?
END
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