Abortion is illegal in Uganda. Girls who get pregnant resort to deadly backstreet abortion providers. However, it is also criminal to provide safe abortion services. Credit: Wambi Michael/IPS
By Wambi Michael
KAMPALA, Aug 18 2025 – Sarah Namukisa nearly missed her final year exams earlier this year. She was subjected to a mandatory pregnancy test—the 25-year-old student at the Medical Laboratory Training School in Jinja was then expelled because she was pregnant.
While Namukisa’s case sparked public criticism, activists say it was by no means an isolated incident.
Across Uganda and other East African countries, pregnant students continue to face expulsion, forced school dropout, and stigma in both public and private educational institutions.
Labila Sumaya Musoke, from the Initiative for Social and Economic Rights (ISER), told IPS that the widespread practice reflects deep-seated systemic discrimination and patriarchal control over young women’s bodies and futures
She said the expulsion mirrors systemic and institutional discrimination that international and regional human rights bodies have explicitly deemed unlawful and incompatible with human rights standards.
Namukisa was lucky that her case attracted the attention of the civil society and Uganda’s Equal Opportunities Commission. The commission ordered her school to rescind the expulsion. Many young women resort to deadly “backstreet” abortions in an effort to find ways to return to school or higher learning institutes. Abortion is still outlawed in Uganda and its neighbors—Kenya and Tanzania.
The most recent Demographic and Health Survey (DHS) datasets of the 12 East African countries found that the overall prevalence of adolescent pregnancy in East Africa was 54.6 percent. The survey concluded that it is vital to design public health interventions targeting higher-risk adolescent girls, particularly those from the poorest households, by enhancing maternal education and empowerment to reduce adolescent pregnancy and its complications.
Teenage pregnancy and motherhood rate in Kenya stands at 18 percent. This implies that about one in every five teenage girls between the ages of 15-19 years has either had a live birth or is pregnant with their first child.
The rate of teenage pregnancy has stagnated for over a decade in Uganda; it stood at 25 percent in 2006, at 24 percent in 2011 and now shows trends of rising at 25 percent. Teenage pregnancy in Tanzania is a significant public health issue, with 22 percent of women aged 15-19 having been pregnant, according to a 2022 Tanzania Demographic and Health Survey.
Rosemary Kirui, the Legal Advisor at the Center for Reproductive Rights—which works in seven countries, including Uganda—said the enjoyment of the Sexual Reproductive Health rights has been limited by barriers related to the legal and policy framework.
“We have a legal environment that has restrictive laws that criminalize some SHRH services. Most of the laws were adopted or inherited from the colonialists. And most of the countries have not changed the laws. So you will find that the penal code is similar, giving a blanket criminalization of abortion. So you will find this is being interpreted narrowly in many African countries,” said Kirui.
She told IPS that the other aspect of restrictive laws is the age of consent, where there is a mandatory third-party requirement for adolescents seeking information and sexual reproduction health services.
Primer Kwagala, a Ugandan Lawyer whose organization, Women Pro Bono Initiative (WPI), has been litigating for access to SHR services, told IPS that the country maintains restrictions on abortion.
“We are saying that 16 women are dying each day due to lack of services in public health facilities. And there are those who are dying in communities due to unsafe abortion. We have on our law books outdated colonial policies preventing health workers from providing life-saving services.”
Uganda’s constitution says that no one can take the life of an unborn child except in exceptional circumstances.
“For many women to exercise autonomy over their bodies and to say, ‘I cannot carry this pregnancy; I need an abortion,’ they cannot go ahead and have that discussion. The first thing the health worker will say is, ‘I don’t want to go to prison,’” said Kwagala.
The Ministry of Health in Uganda has issued guidelines allowing safe abortions in cases of defilement, rape, and incest. But the guidelines, according to Kwagala, are more on paper than in practice.
In 2020, a ruling by the African Committee of Experts on the Rights and Welfare of the Child (ACERWC) against the Republic of Tanzania found that Tanzania’s policy of expelling pregnant schoolgirls constituted a violation of the African Charter on the Rights and Welfare of the Child, particularly the rights to education, health, dignity, and non-discrimination.
Six girls who were pregnant were expelled from the school. The committee urged Tanzania to reform its education policies.
Dr. Godfrey Kangaude, an expert on Sexual Reproductive Health and Rights based in Malawi, said there is a tussle between the gatekeepers who think the SHR issues are for the civil society to handle.
“But I think this is closest to us. Sex and reproduction are relevant to everyone,” said Kangaude while speaking to the East Africa Law Society on litigating for sexual health rights.
He said sexual and reproductive justice is closely interrelated with finance and labor justice and generally the overall well-being of humans.
Kagaunde explained that in Malawi and other countries in the region, there are anomalies when it comes to the age of consent.
“In Malawi, the law says an adult cannot have sex with a child. Okay, we want to protect children. Isn’t it? But the line has been so rigid that an 18-year-old boy can’t have sex with a 17-year-old girl, because a 17-year-old is a minor and an 18-year-old is an adult. We understand that we want to protect people from harmful sexual conduct, especially children, but the law shouldn’t just be arbitrary. It should take into account that the 17-year-old and 18-year-old are peers.”
Criminalization of Consensual Sex
Kangaunde and others argue that rights-based reform is needed. Laws should be gender-neutral, orientation-neutral, and distinguish exploitative adult–child sex from non-exploitative peer sex. Kangaude points to alternatives like multi-stage consent and close-in-age (“Romeo & Juliet”) exemptions.
Kangaunde and others have been criticized over their stance on the age of consent to sex and access for individuals younger than 18 to access contraceptives and safe abortion services.
“But look, there is a 19-year-old boy who is being charged with the offense of having sex with a girlfriend of 17. I mean, for him, life just went crazy. He is at school, and he had to stop schooling,” said Kangaude, the director at Nyale Institute. His institute provides legal support and engages in strategic litigation to protect and promote sexual and reproductive health rights.
Activists have since 2017 been pushing for a regional Sexual Reproductive Health Rights law. They contend that across East Africa, sexual and reproductive health rights have been narrowly defined as standalone rights.
If enacted, it would require the EAC member states to harmonize provisions on sexual and reproductive health services and information.
The bill has, however, faced significant resistance based especially on social and cultural barriers. The resistance has focused on aspects of comprehensive sex education for teenagers and provisions regarding legal abortion.
Dr. Tom Mulisa, a human rights and constitutional law researcher based at the University of Rwanda, told IPS that sexual and reproductive health rights are broad.
“Constitutions have those rights, and national health laws and policies have those rights, we are talking about the right to health, which most constitutions have, and we are talking about the right to privacy, the right to information, and sexual and reproductive health rights,” he said.
The partner states have ratified the Maputo protocol, which allows for the termination of pregnancy. The protocol is the main regional instrument that advances women’s rights especially sexual and reproductive health rights. The protocol also provides for elimination of discrimination and prohibition of harmful practices, such as female genital cutting.
Within the region, some countries have ratified the protocol, others have not and others have ratified it with reservations. Enforcement of the protocol has been split, making it difficult for all to enjoy the broader rights therein.
Kenya made reservations about Article (14), which provides for safe and legal abortion. Kenya’s constitution, on the other hand, provides for a right to legal and safe abortion when the life of the mother or fetus is at threat.
Learning From Advances in Rwanda
Rwanda has made significant progress in improving the sexual and reproductive health (SRH) of its population, especially young individuals. Like many countries in the region, it had post-colonial laws. It embarked on reform since 2009. The reforms laid the groundwork for what many describe as a flexible system.
Earlier this month, Rwanda’s Parliament passed a new law granting adolescent girls the right to access Sexual and Reproductive Health (SRH) services—particularly family planning—without requiring parental consent. It lowered the legal age to access contraceptives from 18-15.
Mulisa stated that the country modified its new penal code by eliminating the court’s requirement for an abortion. The penal code also included sexual reproductive health rights.
“Previously, the government held the right to health, while individuals were obligated to comply with it. But now the constitution has an explicit right to health,” revealed Mulisa, the founder of the Great Lakes Initiative For Human Rights and Development, which does public interest litigation in Rwanda.
It is now a crime under the penal code in Rwanda if a woman is denied access to contraceptives. And there are fewer restrictions on safe abortion following the removal of the court order requirement.
Rwanda’s ministerial order on abortion defines the right to health more broadly, incorporating the scope outlined by the WHO.
According to the WHO, the right to health includes four essential, interrelated elements: availability, accessibility, acceptability, and quality.
IPS UN Bureau Report
!function(d,s,id){var js,fjs=d.getElementsByTagName(s)[0],p=/^http:/.test(d.location)?’http’:’https’;if(!d.getElementById({js=d.createElement(s);js.id=id;js.src=p+’://platform.twitter.com/widgets.js’;fjs.parentNode.insertBefore(js,fjs);}}(document, ‘script’, ‘twitter-wjs’);
South African Rand Exchange Rate