birth control in Uganda
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birth control in Uganda
| Sun, 06-20-2004 - 9:59pm |
A friend of mine who is a grad student in anthropology has recently left for Uganda to do a study. She just wrote me an e-mail saying that one of the girls she had met is among several in her village planning to attend a university (so far no girls have done so), but that she was worried about getting pregnant before completing secondary school and asked my friend what could be done to prevent pregnancy. My friend was a little stunned that this girl had no other resources to turn to and the only answer she could give on the spot was to use condoms. When she suggested it, the girl said her boyfriend doesn't like to wear them, and every other form of birth control requires a visit to a clinic but there aren't any near by.
My first thought was spermicidal foam, jelly or film, but those also have negative side effects, such as UTIs, and I'm assuming it would be difficult for her to see a doctor to get the antibiotics for that. Does anyone have any ideas on what other kinds of birth control methods that someone like this girl in this village in Uganda, or other places, without accessible clinics could use?
Thank you!

You could ask your friend if her village is visited by a traveling clinic. There is a lot of effort by the World Health Organization trying to get villagers use better contraceptive practices. Studies are underway for new barrier methods for use in the 3rd world but unless she can participate in a clinical trial her options, as you suggest, could be quite limited. Unfortunately, only condoms provide any protection against STIs which are rampant in Africa. If her BF isn’t faithful she could be at considerable risk of something far worse than pregnancy.
Spermicides don’t usually cause UTIs though some women can have allergic reactions to the active ingredient or something in the gelling agent. UTIs are usually associated with contraceptive diaphragms that are too large for the wearer or from bacteria forced into the urethra during IC. That cause can be substantially reduced by urinating immediately after IC to flush any bacteria out of the urethra. Ideally, a traveling clinic could fit the girl with a diaphragm and using spermicide with it that method should be as effective as condoms, but only for contraception. A diaphragm will provide some protection (to a degree) from STIs as it covers her cervix and the anterior vaginal wall limiting her exposure but she would still be at risk. Ask about the possibility of a traveling clinic or perhaps, depending on your friend’s resources, she could take the girl to a clinic for a fitting. Diaphragms do require maintenance so as she grows or changes weight (+/-7 lbs) she would need to be refitted for her diaphragm.
The clinic might also have contraceptive implants or Depo Provera injections which would address the contraceptive concerns but do nothing about the risk of STIs.
Men are so terribly stubborn about this sort of thing. What a great pity! I wish her well. Please let us know how your friend and the village girl are doing, ok?
Hugs!
Jill