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As of March 27, 2025, women’s health in Uganda stands at a crossroads of remarkable progress and persistent challenges. With a population of over 45 million, Uganda is a vibrant nation where women play a central role in families, communities, and the economy. Yet, their health outcomes reflect a complex interplay of cultural, systemic, and environmental factors. From maternal mortality to reproductive cancers, infectious diseases to mental well-being, the state of women’s health in Uganda tells a story of resilience amid adversity. Let’s explore the current landscape, the strides made, and the road ahead.

Maternal Health: A Beacon of Progress

One of the brightest spots in Uganda’s health narrative is the improvement in maternal health. Over the past decade, the country has slashed its maternal mortality ratio (MMR) from 336 deaths per 100,000 live births in 2016 to 189 in 2022 a staggering 44% decline. This achievement reflects concerted efforts by the government, international partners, and local organizations to prioritize maternal care. Investments in antenatal services, skilled birth attendance, and the integration of HIV and sexual reproductive health rights (SRHR) services have borne fruit.

However, the numbers still paint a sobering picture. At 189 deaths per 100,000 live births, Uganda’s MMR remains well above the global average of 152 (as of 2020). Every day, women face risks tied to childbirth, with an estimated 20 maternal deaths occurring daily in hospitals alone, often linked to inadequate facilities or delays in care. Rural areas, where access to healthcare is limited, bear the brunt of this burden. While 94% of women receive at least one antenatal visit, only 47% complete the recommended four, and just 42% of births are attended by skilled professionals. The disparity is stark: among the poorest 20% of the population, skilled attendance at birth drops to 29%, compared to 77% for the wealthiest 20%.

Reproductive Health: A Growing Concern

Beyond maternal care, reproductive health remains a critical issue. Uganda’s fertility rate, though declining from a high of 7.12 children per woman in the 1970s to 4.3 in 2019, still exceeds the global average of 2. This high fertility rate, coupled with limited access to contraception only 24% of women of childbearing age use modern methods contributes to health risks. Adolescent birth rates are particularly alarming, with 111.4 births per 1,000 girls aged 15-19 as of 2017, reflecting early marriages and inadequate SRHR education.

Reproductive cancers, such as cervical and breast cancer, are emerging as significant threats. Late-stage diagnosis is common, with 80% of breast cancer cases in Uganda detected when treatment is harder and outcomes poorer. This delay stems from weak referral systems and a lack of awareness among primary healthcare providers and women themselves. Cervical cancer, linked to low HPV vaccination uptake, further compounds the burden. A 2020 study highlighted that socioeconomic disadvantages and limited media exposure hinder vaccination efforts, leaving many girls unprotected.

Infectious Diseases and Beyond

HIV/AIDS remains a leading cause of death for women aged 15-44, with unsafe sex as a primary risk factor. While treatment outcomes have improved viral load suppression rates reached 96% in 2023 among those on antiretroviral therapy (ART) prevention lags. Over 60% of new HIV infections in this age group occur among women, driven by gender inequities and sexual violence. Sexually transmitted infections (STIs) are also prevalent, with a 2016 survey showing high rates among young women aged 15-24, particularly those with multiple partners or limited access to screening.

Malnutrition, though declining among children, affects women too, with 21% of girls aged 15-19 suffering from anemia in some regions. This condition, often tied to iron deficiency, increases risks during pregnancy and childbirth. Meanwhile, mental health a critical yet overlooked aspect receives little attention. Stress, domestic violence (reported by over 60% of ever-married women), and societal pressures weigh heavily on women’s well-being.

Systemic Challenges: The Health System Under Strain

Uganda’s health system, while improving, struggles to meet rising demand. With a doctor-to-patient ratio of 1:25,000 and a nurse-to-patient ratio of 1:11,000 far below WHO recommendations healthcare workers are stretched thin. Only 72% of public health facility positions are filled, and the health budget, at 8.9% of national spending, falls short of the 15% pledged in the 2001 Abuja Declaration. Critical infrastructure, like intensive care units (ICUs), is scarce, with just 1.3 ICU beds per million people, mostly concentrated in Kampala.

Rural women face additional barriers: long distances to facilities, lack of transportation, and cultural norms requiring male permission to seek care. These delays whether in deciding to seek help, reaching a facility, or receiving adequate treatment fuel preventable deaths. Even in urban Kampala, institutional maternal deaths highlight bottlenecks in referral processes and facility readiness.

Rays of Hope and Calls to Action

Despite these challenges, Uganda’s women’s health story is not without hope. Community health workers, empowered by initiatives like the Women’s Optimal Health Framework launched in 2024 with the First Lady’s support, are bridging gaps in rural areas. Programs integrating HIV and SRHR services show promise, while efforts to boost HPV vaccination and cancer screening are gaining traction. The decline in child malnutrition signals broader nutritional improvements that could benefit women too.

To build on this momentum, Uganda needs targeted action:

• Strengthen Health Infrastructure: Increase funding to recruit and train healthcare workers, equip facilities, and expand ICU access beyond urban centers.
• Boost Awareness and Education: Promote early cancer detection and SRHR through media campaigns and school programs, especially for adolescents.
• Enhance Access: Improve rural transportation and address cultural barriers to ensure timely care.
• Prioritize Prevention: Expand contraception access and HPV vaccination to reduce reproductive health risks.

Women’s health in Uganda is a tapestry of triumphs and trials. The progress in maternal mortality and HIV treatment reflects what’s possible with dedication and collaboration. Yet, the persistent gaps high fertility, late cancer diagnoses, and systemic weaknesses demand urgent attention. As Uganda navigates this pivotal moment, investing in women’s health is not just a moral imperative but a cornerstone of national development. Healthy women build healthy families, communities, and futures. The time to act is now.