UYDEL and Sexual and Reproductive Health in Uganda

One of first site visits on the trip was to the Ugandan Youth Development Link’s (UYDEL) facility in Masooli, an organization that is celebrating its 25th year. The facility acts as the headquarters for their work and is the residence for children requiring more help and/or without a place to go. The kids in Masooli are offered treatment from social workers for PTSD, substance abuse disorder, depression, and anxiety. Their problems stem from abuse, sexual abuse, and alcohol and/or drug problems; ultimately, the root of the problems stems from poverty in general. The social workers took immense pride in their aerobics and sports programs, emphasizing the importance of exercise combined with therapies to create lasting change. Pharmaceuticals are not regularly used for treatment of the students. It was abundantly clear that the social workers at UYDEL are fulfilled and energized by their work. I’m in awe of them for spending their days (and nights, as they also live at the facility) with troubled youth and for trying to make a difference. They estimate they’ve helped 6,000 youth, which doesn’t include secondary and tertiary network impacts on parenting, behaviors, and job skills.

After a brief introduction to the organization’s mission and staff, we toured the educational facilities. Rather than focusing on academic education like one might assume, they focus on instilling vocational skills that can translate to gainful employment after graduation. The favorite vocational skill, by far, is hair braiding as they can be self-employed and work out of any venue. Other vocational options include sewing, catering, plumbing, welding, masonry, and electronics repair. Each room had “school rules” with strict boundaries set for the kids as well as several motivational posters. It appears that repetition and intense scheduling are very beneficial for their rehabilitation.

During the tour, we were able to peek into the clinic and talk with the nurse who works and lives in UYDEL. As someone interested in sexual and reproductive health, I inquired about the sexual education curriculum and availability of contraceptives. The nurse indicated that long acting reversible contraception is available through the clinic in town, though not regularly used. The youth are primarily taught an abstinence model, though condom usage is also taught. With the average woman having an estimated eight children in her lifetime, it seems that contraception usage is contrary to the Ugandan dream of a large family. In fact, in 2016 the Ministry of Gender decided to remove sexual education from secondary school, stating that it was against Ugandan values. While we have been here, the Ministry of Education released a new Sexual Education Framework outlining the new curriculum. It would be interesting to measure and understand the implications of how a two-year gap in sexual education could affect STI and pregnancy rates.

This complex relationship with contraception is particularly challenging when taking into account the background of the youth housed within UYDEL. Many students there reported engaging in survival sex. Instead of the transactional prostitution more common in other countries where cash is exchanged for acts, many of the girls had men covering certain expenses in their life (i.e., one man covers housing expenses, another hair braiding costs, etc.). Combining survival sex with a climate that discourages sexual agency could create unfortunate consequences. Overall, the attitudes for SRH are very different that what I’m familiar with. I’m hesitant to make sweeping generalization about what may or may not be best practice, but the attitudes and standards here to appear to depart from U.N. Population Fund standards in other countries.


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