The sudden upsurge of interest in birth control (family planning) in Uganda has coincided with the rising anti-immigration mood in the developed western world. When family planning began after World War II, there was fear that population in developing countries was growing faster than Europeans’. The main fear was that there would be competition for scarce resources and consumers in developed countries would be forced to scale down their lifestyles. They were not prepared for that. To avert this threat, developing countries had to reduce their population growth through contraception. To avoid controversy, the proponents of birth control came up with a ‘sugar-coated’ idea that contraception would ease the suffering of women who produce too many children in rapid succession. They also replaced the unpopular birth control terminology with family planning to disguise the fact that in the end population at couple and national levels would decline with adverse national security and economic development implications.
The impressive results of the Green Revolution in developing countries resulted in global total food availability in excess of total global demand which diffused the urgency to reduce the number of mouths to feed in the developing world. At the same time, birth control programs that had begun in the 1960s did not fare well for four main reasons. First, because it was promoted by European experts, birth control was interpreted as a European attempt to reduce population in developing countries in order to re-colonize them. Second, birth control practices were confined to married women without the knowledge of their spouses who became very suspicious. Third, the side effects were so severe that many women withdrew from the program. And fourth, Third World leaders and experts believed that development was the best contraception.
As noted above, the recent upsurge in the anti-immigration mood in the developed western world has resurrected the idea of birth control as a matter of urgency which has changed the conclusion of the 1994 Cairo Conference on Population and Development that focused on reproductive health and rights and on persons, not numbers.
The sponsors are now looking for a country where the government will allow experiments in birth control using contraception. They have chosen to focus on Uganda because the leadership cooperated on structural adjustment program with stiff conditionality after it had run into trouble in Ghana. Birth control like structural adjustment needs a strong and bold leadership that will not tolerate opposition once it becomes a national policy. And Uganda has potential for that kind of leadership. Second, sponsors have come up with exaggerated figures about Uganda’s natural rapid population growth without discounting the massive immigrants and the children they produce when in Uganda. Third, they do not tell Ugandans that fertility has already begun to decline albeit slower than the sponsors of birth control want. Fourth, the sponsors of birth control have failed to emphasize that poverty, early drop out of school in part for lack of school lunches as agreed to by NEPAD, women’s lack of empowerment to manage their reproduction, and subsistence economy, high mortality rate and dependence on children in old age – all common in Uganda – contribute to high fertility. It should be made clear that in the absence of improvements in the standard of living of all Ugandans contraception alone even with well staffed and supplied birth control clinics within five kilometers of each other will not solve the problem. Fifth, the sponsors do not tell us that the ethnic, tribal, religious and political configuration of Uganda call for a cautious approach to birth control practices. Sixth and finally, the use of foreign experts has been avoided. Instead, Ugandans from all walks of life most with limited knowledge of a complex subject as family planning have come forward with half-baked stories urging the government to take aggressive steps and curb fertility in Uganda. They forget that having children is a basic human right which cannot be violated with impunity. And targeting one particular group – ethnic or religious – can invoke many accusations.
To avoid controversy and unnecessary accusations, it would be wise for sponsors of family planning to have a comprehensive short, medium and long term development program on migration into Uganda, education of girls beyond primary level, empowerment of women, reduction of poverty and child mortality and provision of birth control facilities for those who volunteer to use them. Forceful application of birth control will be counterproductive.
The public should be given an opportunity to read and hear from both sides. So far the media has been inundated with stories from those who favor government to immediately launch aggressive measures to reduce fertility in the shortest possible time. Examples from Asia do not favor that approach. Ugandans are rational human beings. All they need is to be assisted to take informed decisions at the appropriate time.