Family Planning Atlas 2020 Page 1 FAMILY PLANNING ATLAS

May 2020

Family Planning Atlas 2020 Page 2 Table of Content

Abbreviations ...... 4 Key Findings ...... 6 Introduction ...... 8 Estimated population distribution of Uganda, June 2020 ...... 10 Estimated Poverty levels, 2019 ...... 11 Total Fertility Rate ...... 12 Number of Registered Family Planning users, 2019 ...... 13 Permanent family planning Methods ...... 17 Number of Users of Permanent Methods ...... 18 Number using Female Sterilization (Tube Ligation), 2019 ...... 19 Number using Male Sterilization (Vasectomy), 2019 ...... 20 Long Acting Reversible Contraceptive Methods ...... 22 Number of IUDs Inserted, 2019 ...... 25 Pieces of IUDs dispensed, 2019 ...... 27 Number of New Implant Users, 2019 ...... 28 Number of Implant Removals, 2019 ...... 30 Number of Implant Revisits ...... 31 Short Acting contraceptive methods ...... 32 Number of Family Planning Injections given, 2019 ...... 33 Number of doses of Injection dispensed, 2019 ...... 35 Stock out of Depo provera in health facilities, 2019 ...... 36 Number of male condom users ...... 37 Number of pieces of Male Condom dispensed, 2019 ...... 38 Number of pieces of Female Condom dispensed, 2019 ...... 40 Number of persons receiving Natural methods, 2019 ...... 42 Number of Pill users ...... 43 Number of Oral contraceptives cycles dispensed ...... 45 Pregnancy Management ...... 46 Confirmed Laboratory pregnancy tests, 2019 ...... 47 Number of pregnant women who received 2nd dose of fansidar for IPTp, 2019 ...... 48 Financing for Family Planning ...... 50 Gender issues that can influence FP use ...... 53 Estimated prevalence of spousal physical violence against women, 2019 ...... 55 Estimated prevalence of Sexual violence against women, 2019 ...... 56 Estimated prevalence of psychological violence against women, 2019 ...... 57 Number of abortions due to Gender Based Violence, 2019 ...... 58 Number of Injuries due to Gender Based Violence, 2019 ...... 59 Persons with Sexual Transmitted Infections due to Gender Based Violence, 2019 ...... 60 Appendix Tables ...... 61

Family Planning Atlas 2020 Page 3 Abbreviations

CPR Contraceptive Prevalence Rate FP Family Planning FP CIP Family Planning Costed Implementation Plan GBV Gender Based Violence IUD Intra Uterine Device LARC Long Acting Reversible Contraceptive MCPR Modern Contraceptive Prevalence Rate NDP III National Development Plan III STI Sexually Transmitted Infections SGBV Sexual Gender Based Violence TFR Total Fertility Rate UDHS Uganda Demographic and Health Survey

Family Planning Atlas 2020 Page 4 Key Messages Generally, districts which are less populous have high fertility and also have high poverty levels, high prevalence of violence against women and low numbers of registered users of Family Planning (FP). This is specifically evident in Karamoja region compared to the other regions. The low FP utilization cannot be attributed to stockouts because this region also has the least number of facilities with stockouts of especially depoprovera injection.

Although Karamoja has consistently had low uptake of family planning between 2018 and 2019 it registered a progressive improvement for the following methods: 24% for natural methods, 50% for vasectomy, 14% for IUDs inserted. This therefore may imply that the LARCs and permanent methods seem more acceptable in the region and therefore require more targeted investment.

There has been a steady increase in the amount of finances received to facilitate family planning service provision. However, only a quarter of the expenditure (25%) was spent on contraceptives, medicine, and other consumables in 2018 in Uganda, but this was an increase from the 12% reported in 2017. Continued reprioritization of FP resources towards FP commodities will go a long way in addressing stock outs.

In terms of Long Acting Reversible Contraceptive (LARC) methods used, the number of IUDs inserted recorded an unsteady increase in 2018 while number of new implant users has had a progressive increase between 2017 and 2019. This gives hope for increased use of LARCs and therefore more substantial FP user benefits for instance it is time saving to both provider and user, at the same time, LARCs save government resources which can be used to provide contraceptives to additional womeni. Demographic Dividend/population integration & compliance In order to achieve objective three of the National Development Plan (NDP) III, one of the key human capital interventions is to increase access to family planning services, which is one of the drivers for harnessing the demographic dividend (DD). The DD compliance for the Financial Year 2019/20 conducted in 43 districts, showed that the overall DD alignment for the district health departments is still low at 38.4% (which is weak).

Regarding the key FP indicators, unmet need for FP scored 19.1%, while the percentage of health facilities without stock out of tracer FP commodities scored 9.3%. This is an indication of efforts to address FP although still inadequate at the district level. The possible contributors to high unmet need include: fear of side effects and commodity stockouts, therefore, there is need for a comprehensive programme to address side effects and stock outs of FP commodities.

The Family planning Costed Implementation Plans at the district level aimed at putting in place strategic mechanisms for addressing the various gaps in FP service delivery. Local Governments further developed district FP action plans, however, there is limited integration of FP interventions in the District Development Plans & annual workplan and budgets. Therefore, the FP atlas is a reference document for identification of gaps/areas of disparity and further prioritization of harnessing increased FP use and will hence harness the demographic dividend. For districts to ensure compliance to the DD priorities, they should then ensure resources are allocated within the district budgets to implement FP interventions in their workplans. The assessment of local governments compliance to the DD priorities will then monitor the FP resource allocations during planning and expenditure on FP priority interventions. Fertility reduction and a lower rate of population growth are critical to Uganda’s ability to achieve its national vision of transforming society from a peasant to a modern and prosperous country. This is possible through achievement of a demographic dividend specifically through increased use of FP across the districts. Family Planning Atlas 2020 Page 5 Key Findings

There are regional variations in the use of family planning but also the use of specific methods are not well distributed across districts within a given region. Some districts are the biggest influencers for a region’s status as shown in the subsequent sections of this atlas. Registered users of Family planning region registered the highest number of Family Planning users in 2019 with 380,374 cases. This is a 31% increase from what was registered in 2018. It was followed by Bukedi region, with 323,038 cases. The Bukedi 2019 cases are triple those of 2018 in the same district. Within Busoga region, district ranked highest, followed by district while in Bukedi region, ranked highest followed by district.

Injectables Busoga region also had the highest number of women using injectable contraceptives in 2019, with 174,065 cases. This was followed by North region, with 164,168 cases. Within Busoga region, recorded the highest number of family planning users, followed by while in North Buganda region district had the most recorded cases, followed by district.

Pills and IUDs South Buganda recorded the highest number of users of the different FP methods in 2019 including the oral contraceptive pills (57,750) and Intra Uterine Device (IUD) with 22,554 insertions which were the most popular and the region ranks top for these two methods. recorded the biggest users of pills and implant insertions within this region. district ranked second amongst the pill users in South Buganda while Kalungu and districts followed Wakiso in number of IUDs inserted.

Implants The number of new implant insertions in 2019 almost doubled those of 2018 in North and South Buganda i.e. from 47,099 in 2018 to 74,586 in 2019 for North Buganda and 37,471 in 2018 to 64,843 in 2019 for South Buganda . In North Buganda, the highest number of implant insertions was from followed by Mukono and Luwero districts. On the other hand, in South Buganda the push was from Wakiso district followed Kalungu and Lwengo.

Male condoms West Nile Region ranked highest in distribution of the male condoms, with 5.1 million pieces in 2019, this is a 52% increase from 2018. This was followed by North Buganda with 4.1 million pieces, this is a 64% increase from 2018. In the West Nile region, district alone distributed 4.2 million pieces, followed by with 152,427 pieces in 2019. In North Buganda, district ranked highest (1.6 million pieces), followed by Buikwe district (1.1 million pieces) in 2019. At country level Arua topped in male condom distribution.

Female condoms The number of female condoms dispensed tripled in and West Nile region in 2019 i.e. from 29,777 in 2018 to 74,625 in 2019 for West Nile region and for Kampala from 42,404 in 2018 to 136,571 in 2019. In terms of districts in the West Nile region, Arua had the greatest coverage of 51,768 pieces in 2019. On the other hand, nine of the 15 regions registered a reduction in number of female condoms dispensed in 2019.

Family Planning Atlas 2020 Page 6 Male Sterilization (Vasectomy) The year 2019 recorded a 23% increase in the number of new cases of vasectomy from 2018 with Bukedi and Teso region having the highest rate of increase. Bukedi region had the highest record of 216 vasectomy cases while Karamoja had the least with 24 cases in 2019 registering a 50% increase from 2018. Male sterilization is highest in Kampala, Arua and districts. Six of 15 regions registered a decrease from 2018 with Kigezi having the highest decrease of 39%.

Natural methods The use of natural methods had the highest record in Tooro region for both 2018 and 2019, followed by Kampala city and Karamoja region. In Tooro region, , followed by , had the highest recorded cases. In Karamoja region, Napak, Moroto and districts had the highest number of users of natural methods.

Karamoja region Karamoja region consistently ranked lowest in the number of FP users and across the different methods over the three-year period (2017-2019). The use of natural methods is the only method where Karamoja performs well in the third position compared to the other regions. In addition, Karamoja registered a progressive improvement between 2018 and 2019 of: 24% for natural methods, 50% for vasectomy, 14% for IUDs inserted. This therefore may imply that family planning is becoming more acceptable among the men.

Family Planning Atlas 2020 Page 7 Introduction

Family Planning (FP) is one aspect of the global targets around universal access to sexual and reproductive health in Sustainable Development Goals (SDG) 3.7 and SDG 5.6. The two global indicators aim at universal access to sexual and reproductive health care services by 2030, including FP information and education, and the integration of reproductive health into national strategies and programs and a right to have access to these services. Uganda is a focus country/commitment maker on the Family Planning 2020 (FP2020) and committed to scale up the use of modern family planning methods to ensure that Ugandans can choose when and how many children to have. At the National level, one of the key interventions in the third National Development Plan (NDP III) towards harnessing Uganda’s human capital is to increase access to family planning services in order to improve population health, safety and management.

The United Kingdom (UK) Department of Foreign and International Development (DFID), through the Reducing High Fertility Rates and Improving Sexual Reproductive Health Outcomes (RISE) Programme, is supporting the Government of Uganda (GoU) to implement the Family Planning Costed Implementation Plan (FP-CIP) to accelerate the uptake of contraception and reduce the negative health, social and economic consequences of high fertility rates. This plan requires timely and reliable data to track family planning indicators. Long-term investment and prioritization of Monitoring and Evaluation (M&E) in FP programmes globally results in well-established and validated indicators. Some of these indicators are presented in this atlas.

Objective

The main Objective of this atlas is to: • Help explain factors associated with FP use as well as trends in the FP indicators; • Provide analysis that will support policy advocacy and direct intervention areas; and • Give a pictorial presentation of the family planning situation in Uganda to bring out inequalities in utilization and service delivery.

This atlas presents National results from the 135 and 15 subregions. District groupings into the 15 sub-regions are as follows: • South Buganda: , Butambala, Gomba, Kalangala, Kalungu, Kyotera, Lwengo, , , Mpigi, , and Wakiso; • North Buganda: Buikwe, Buvuma, , , , Luwero, Mityana, Mubende, , Mukono, and ; • Kampala: Kampala; • Busoga: Bugiri, Bugweri, , Iganga, Jinja, , Kamuli, Luuka, , Namayingo and Namutumba; • Bukedi: Budaka, Busia, Butaleja, Butebo, , and Tororo; • Elgon: , Bulambuli, Bukwo, , Kween, Manafwa, Mbale, Namisindwa and ; • Teso: , Bukedea, Kaberamaido, , Kumi, , Kalaki, Kapelebyong, Serere and ; • Karamoja: Abim, Amudat, , Karenga, Kotido, Moroto, Nabilatuk, Nakapiripirit and Napak; • Lango: , , Apac, Kwania, , Kole, Lira, Otuke and Oyam; • Acholi: Agago, Amuru, , Kitgum, Lamwo, , Omoro and Pader; • West Nile: , Arua, , Maracha, Madi Okollo, Moyo, Obongi, Nebbi, , Yumbe and Zombo; • Bunyoro: Buliisa, , , , Kibaale, , and ; • Toro: , Bunyangabu, Kabarole, Kasese, , Kitagwenda, , , and

Family Planning Atlas 2020 Page 8 • Kigezi: , , , Rubanda, Rukiga and ; and • Ankole: Buhweju, , Ibanda, , Kiruhura, , Mitooma, , Rubirizi, Rwampara, Kazo and .

The information presented is mainly from the Ministry of Health-District Health Information System and Uganda Bureau of Statistics, based on existing datasets and statistical models from the SPECTRUM software in conjunction with the National Population Council.

Family Planning Atlas 2020 Page 9 Estimated population distribution of Uganda, June 2020

Source: Uganda Bureau of Statistics

Uganda’s population has continued to grow over time. It increased from 9.5 million in 1969 to 34.6 million in 2014, representing an average annual growth rate of 3.0 percent between 2002 and 2014. The high growth rate is attributed to the high fertility level (over 5 children per woman). The population is projected to be 41.6 million persons by mid-year 2020. Wakiso and Kampala are the most populous districts in Uganda (2.9 million and 1.7 million respectively) and Obongi the least populated (less than 50,000 persons). The districts in Karamoja region generally have the lowest population size. The details for each district are in appendix Table 1.

Family Planning Atlas 2020 Page 10 Estimated Poverty levels, 2019

Source: Uganda Bureau of Statistics

Globally, eradication of poverty in all its forms has been identified as the Number One Goal in achieving the Sustainable Development Goals (SDG, 2015). Nationally, poverty eradication as indicated in the NDP III is one of the binding constraints to growth and development. So, Uganda targets to reduce national poverty rate from 21.4 percent to 14.2 percent by 2024/25. People and families are considered poor when they lack the economic resources necessary to experience a minimal living standard. The poverty estimates, therefore, show the percentage of people living on less than $1 a day. The map shows that the incidence of poverty was highest in the districts of Karamoja with all districts having more than half of their population living in poverty except Abim with 47%.

Family Planning Atlas 2020 Page 11 Total Fertility Rate

Source: National Population and Housing Census 2014 The Total Fertility Rate (TFR) is the average number of children a woman would have by the end of her childbearing years if she bore children at the current age-specific fertility rates. The map paints the picture that fertility is highest in Karamoja sub-region and the districts around Lake Kyoga. Within the districts in Buganda, Rakai has the highest TFR. In Tooro sub-region, Kyegegwa and Bundibugyo have the highest TFR. Although Acholi sub-region has lower fertility, Lamwo and Agago districts have very high rates. The district specific TFR is presented in appendix Table 2.

Family Planning Atlas 2020 Page 12 Number of Registered Family Planning users, 2019

Source: Ministry of Health, DHIS 2 The number of registered family planning users is a proxy for the total number of Family Planning users. The number of registered family planning users refers to the number of persons who obtained a contraceptive method from a health facility during any one year. It captures the users of a method at a given time so it can capture the same person multiple times as long as they go to a health facility to obtain a method. The map shows that Kampala, Wakiso, Busia, Kabarole and Obongi districts had the highest number of registered FP users in 2019. However, according to the map, all the districts in Karamoja as well as those to the north of Lake kyoga and those in part of the Western region have low contraceptive utilisation. The total numbers of district specific registered FP users is presented in appendix Table 3. Some sub-regions registered an increase in the use of family planning. Those were Family Planning Atlas 2020 Page 13 Busoga, Bukedi, North Buganda, South Buganda, Tooro, West Nile and Acholi. There is no observable change in Karamoja sub-region, despite all the efforts to increase FP uptake in the region. Kampala City, on the other hand, recorded a 34% reduction in number of FP users between 2018 and 2019.

Trend of registered FP users by region

Source: Ministry of Health, DHIS 2

Family Planning Atlas 2020 Page 14 Number of HIV+ Family Planning Users, 2019

Source: Ministry of Health, DHIS 2 Global commitments to eliminate new pediatric HIV infections recognise that preventing unintended pregnancies among women with HIV is essential to achieving this goal. Family Planning offers the added benefit of helping to prevent mother-to-child transmission of HIV (PMTCT) for women living with HIV who do not wish to become pregnant.

Family Planning Atlas 2020 Page 15 There was a 34% reduction in the number of HIV positive family planning users across all sub-regions between 2017 and 2019. The following regions had the greatest decrease in 2019 compared to 2017: Kigezi (66%), Busoga (61%) and Kampala (51%), only Acholi and Bunyoro registered an increase of 7% and 22% respectively.

Trend of HIV+ family planning users

Source: Ministry of Health, DHIS 2

Family Planning Atlas 2020 Page 16 Permanent family planning Methods

Permanent Family Planning methods of contraception are highly safe and provide continuous protection against unwanted pregnancy. The methods have the ability to meet a range of intentions such as can help them delay, space, or limit births as well as promote greater continuation of family planning (FP). These methods include female and male sterilization.

Family Planning Atlas 2020 Page 17 Number of Users of Permanent Methods

Source: Ministry of Health, DHIS 2 Permanent methods of Family Planning refer to use of either tuba ligation for females or vasectomy for males. Generally, the rate of utilization of permanent Family Planning methods is low in Uganda compared to other methods. The map above shows that the districts of Kasese, Tororo, Manafwa, Mbale and Butaleja recorded the highest number of users of permanent FP methods. Detailed numbers per district are shown in appendix table 4.

Family Planning Atlas 2020 Page 18 Number using Female Sterilization (Tube Ligation), 2019

Source: Ministry of Health, DHIS 2 According to the 2016 Uganda Demographic and Health Survey (UDHS), three percent of the married women were sterilized. The above map shows that the number of women who got tuba litigation varies considerably by district with high numbers observed in the districts of Mbale, Manafwa and Kasese. Detailed numbers per district are shown in appendix table 3.

Family Planning Atlas 2020 Page 19 Number using Male Sterilization (Vasectomy), 2019

Source: Ministry of Health, DHIS 2 Male sterilization is generally low across the country, 26 out of 135 districts did not report any cases. The highest numbers were recorded in Kampala (139), Butaleja (138) and Arua (61) districts. There is need to establish the reasons why the method is not popular in many districts so as to embrace the opportunity to provide permanent methods in these districts.

Family Planning Atlas 2020 Page 20 Over the last five years, vasectomy peaked in 2016 and then had a downward trend but the year 2019 recorded a 23% increase in the number of new cases. Detailed numbers per district are shown in appendix table 4. Trend of Vasectomy between 2015 -2019

Trend of Vasectomy by Region

Bukedi region had the highest record of 216 vasectomy cases while Karamoja had the least with 24 cases in 2019 registering a 50% increase from 2018. Bukedi also had the highest increase in vasectomy- it almost quadrupled from 2018 to 2019. Teso region had second highest increase of 91% from 2018 to 2019. Six of 15 regions registered a decrease from 2018 with Kigezi having the highest decrease of 39%.

Family Planning Atlas 2020 Page 21 Long Acting Reversible Contraceptive Methods

Long-Acting Reversible Contraceptives (LARC) are methods of birth control that provide effective contraception for an extended period without requiring user action. They include intrauterine devices (IUDs) and subdermal contraceptive implants. They are the most effective reversible methods of contraception because their efficacy is not reliant on patient compliance. In addition to being long-lasting, convenient and well-liked by users, those methods are very cost effective. In other countries, use of LARCs is recommended for adolescentsii to help decrease the teen pregnancy rate. The LARCs are also recommended for women of any age no matter how many times they have given birth. Women and couples considering using LARCs should obtain contraceptive counseling from reproductive health professionals because those who undergo the counseling are more satisfied with them and use them for longer periods of time.

Family Planning Atlas 2020 Page 22 Users of Long Acting Reversible Contraceptives (%)

Source: 2016 Uganda Demographic and Health Survey.

Using of Long Acting Reversible Contraceptives (LARCs) - Intrauterine Devices and implants is generally low in Uganda with Kigezi sub region having the highest proportion of users. Karamoja and Busoga region have the least percentage of users.

Family Planning Atlas 2020 Page 23 Fig 3: percent of women using LARCs

Source: 2016 Uganda Demographic and Health Survey.

Family Planning Atlas 2020 Page 24 Number of IUDs Inserted, 2019

Source: Ministry of Health, DHIS 2 According to the 2016 UDHS, only two percent of married women reported using the Intra Uterine Device (IUD) as a family planning method. The map shows that there is a higher number of women using IUDs in the districts of Kampala (17,234) and the surrounding districts namely: Wakiso (11,468), Mukono (6,856) and Buikwe (5,942). In the northern region, the method is more used in the districts of Arua (2,500), Gulu (3,339), Lira (2,554) and Kitgum (2,226). Detailed numbers per district are shown in appendix table 3.

Family Planning Atlas 2020 Page 25 The year 2018 and 2019 shows tremendous increase in the use of IUDs compared to 2017. The use of IUDs has generally reduced across the regions except for South Buganda and Kampala that registered a slight increase in 2019.

Trend of IUDs inserted by Region

Source: Ministry of Health, DHIS 2

Family Planning Atlas 2020 Page 26 Pieces of IUDs dispensed, 2019

Source: Ministry of Health, DHIS 2 Districts with more pieces of IUDs dispensed also have a higher number of users of those IUDs, although it is not a one to one match. This implies that some of the IUDs are either wasted or lost. For example, Wakiso had 14,534 pieces dispensed but only 11,468 were inserted ( the difference is not mentioned anyway). The reverse is also true that fewer IUDs are dispensed but more are inserted. For instance, had three pieces dispensed and had nine women inserted. Detailed numbers per district are shown in appendix table 3.

Family Planning Atlas 2020 Page 27 Number of New Implant Users, 2019

Source: Ministry of Health, DHIS 2 The districts of Buikwe, Kampala, Mukono and Wakiso had the highest number of implant users. In the Karamoja sub-region had the highest number of new implant users. Generally, across all regions the number of new implant users increased in 2019 except for Karamoja and West Nile regions. Almost all districts, therefore, should aim at increasing the number of new implant users in order to reap the benefits of LARCs. Detailed numbers per district are shown in appendix table 3.

Family Planning Atlas 2020 Page 28 Trend of new implant users by Region

Source: Ministry of Health- DHIS2

Family Planning Atlas 2020 Page 29 Number of Implant Removals, 2019

Source: Ministry of Health, DHIS 2 The districts of Buikwe, Kampala, Mukono and Wakiso had the highest number of implant users. In the Karamoja sub-region Napak district had the highest number of new implant users. Generally, across all regions the number of new implant users increased in 2019 except for Karamoja and West Nile regions. Almost all districts, therefore, should aim at increasing the number of new implant users in order to reap the benefits of LARCs. Detailed numbers per district are shown in appendix table 3. It is, therefore, important to establish the main reasons behind this and avoid reversing the benefits gained.

Family Planning Atlas 2020 Page 30 Number of Implant Revisits

Source: Ministry of Health, DHIS 2 Kampala City and Wakiso district recorded the highest number of new implant users as well as implant removals and, therefore, a high number of implant revisits. High numbers of revisits are also noted in Kasese and Tororo districts.

Family Planning Atlas 2020 Page 31 Short Acting Contraceptive Methods

The short acting contraceptive methods are used in short time intervals from single use (such as the condom) and daily intake (such as the pill). Methods of this contraceptive category require couples or other persons who are sexually active to take a decision about using or taking them regularly or each time they have sex.

Family Planning Atlas 2020 Page 32 Number of Family Planning Injections given, 2019

The short acting contraceptive methods are used in short time intervals from single use (such as the condom) and daily intake (such as the pill). Methods of this contraceptive category require couples or other persons who are sexually active to take a decision about using or taking them regularly or each time they have sex.

Source: Ministry of Health, DHIS 2 According to the 2016 UDHS, about one in every five women used injectables as a family planning method, making it the most widely used method in Uganda. (19% among married women and 21% among sexually active unmarried women) However, the use of injectables is lowest in the districts of Karamoja sub-region. In the West Nile sub-region, only Arua and Yumbe had some significant numbers of users in 2019 (i.e. more than 8,700 injections given). In Bunyoro sub-region, Bullisa has the least number of users (3,366). In Tooro sub- region, Ntoroko and Kitagwenda have the least number of users while in in South Buganda sub-region has the least number of users (5,400). In order to increase the use of Long Acting Reversible Contraceptives (LARCs) these districts are good targets to increase coverage.

Family Planning Atlas 2020 Page 33 Over the last three years, Busoga sub-region has progressively had an increase in the use of injectables registering a 16% increase between 2017 and 2019. The rest of the regions did not have the same pattern as Busoga. However, the sub-regions of Ankole, Bunyoro, Kigezi, Elgon and Lango recorded an increase in the number of injectables given to women during the period 2018 to 2019. And Karamoja sub-region still ranked the lowest. Trend of FP injection given by region

Family Planning Atlas 2020 Page 34 Number of doses of Injection dispensed, 2019

Source: Ministry of Health, DHIS 2 The number of injectable doses dispensed does not match the number of injectables given and this is true across all regions. This could be for the reason that the majority of clients get the injection out of the health facilities (on the overall 64% are not given in health facilitiesiii). Depo Provera is a contraceptive injection containing progestogen. It is commonly referred to as “the injection”. Progestogen is similar to one of the hormones produced naturally in the ovaries. The injection is given every 12 weeks.

Family Planning Atlas 2020 Page 35 Stock out of Depo provera in health facilities, 2019

Source: Ministry of Health, DHIS 2 The country has consistently experienced stock outs of DMPA in some regions yet some regions have been over stocked. Being the most preferred family planning method. Depo-Provera stock outs create a missed opportunity for family planning in a given population. had the highest number of Depo- Provera stock outs during 2019, followed by Adjumani.

Family Planning Atlas 2020 Page 36 Number of male condom users

Source: Ministry of Health, DHIS 2

The male condom provides double protection to avoid STIs and pregnancy. Kampala City recorded the highest number of new users and revisits for the male condom from health facilities in 2019 (139,565). The other districts with high male condom utilization include Kabarole (59,179), Wakiso (37,854), Kikuube (36,619), Kamuli (34,655), Lira (33,742), Katakwi (29,317) and Mbale (26,906).

Family Planning Atlas 2020 Page 37 Number of pieces of Male Condom dispensed, 2019

Source: Ministry of Health, DHIS 2

Arua and Tororo districts have the highest number of male condoms dispensed (over 2 million pieces). The general observation is that in 2019, 4.8 million pieces were dispensed and health facilities gave out only 1.1 million, a utilization rate of 23%. Important to note is that Arua also has the highest number of men with vasectomy while Tororo has consistently done well on use of other contraceptives. These districts can be harnessed to further reduce the population growth and TFR (5.6 for Arua and 6.3 for Tororo, according to the 2014 National Population and Housing Census). During 2019, male condom distribution was highest in the West Nile and the push was mostly effected by . The sub-regions of Bunyoro, Kampala, Karamoja, Kigezi and Lango registered a huge decline in the number of male condoms distributed in 2019 compared to 2018. Family Planning Atlas 2020 Page 38 Trend of pieces of Male condoms dispensed by region

Source: Ministry of Health, DHIS 2

Family Planning Atlas 2020 Page 39 Number of pieces of Female Condom dispensed, 2019

Source: Ministry of Health, DHIS 2 The districts of Arua, Kampala, Kamuli and Wakiso have the highest number of female condoms dispensed. Kampala registered the highest number of female condoms distributed in 2019. The West Nile region registered the second largest increase in the number of female condoms distributed after Kampala. However, Ankole, South Buganda, Elgon, Karamoja, Kigezi, Teso and Tooro registered a reduction in already numbers of the pieces distributed.

Family Planning Atlas 2020 Page 40 Trend of female condoms given out

Source: Ministry of Health, DHIS 2

Family Planning Atlas 2020 Page 41 Number of persons using Natural methods, 2019

Source: Ministry of Health, DHIS 2 Natural Family Planning (NFP) refers to a variety of methods used to prevent or plan pregnancy, based on identifying a woman’s fertile days. The methods include abstinence or avoiding unprotected intercourse during the fertile days i.e. prevents pregnancy. Besides abstinence, natural family planning also includes Withdrawal (Coitus interruptus) and the Calendar methods - based on calculations of cycle length and Lactational Amenorrhea Method (LAM). The Ministry of Health promotes natural family planning through the use of moon beads. Kabarole and Kampala have the highest number reported to be using natural methods. There has been a progressive increase in the use of natural methods over the last three years in Bunyoro, Kampala, Karamoja and Tooro sub-regions while a steady decline was noted in North Buganda and the Elgon sub-region.

Family Planning Atlas 2020 Page 42 Number of Pill users

Source: Ministry of Health, DHIS 2 Contraceptive pills contain hormones similar to those naturally produced by a woman’s body. The pill needs to be taken at the same time every day to effectively prevent pregnancy. The pill’s ability to prevent pregnancy depends on the person using it correctly. It is widely used in Uganda except Karamoja sub-region where, as reflected on the map, there is the least usage. According to the Ministry of Health, the Microgynon is the most popular type of pill used in Uganda.

Family Planning Atlas 2020 Page 43 Diversity and Types of oral pills used

Source: Ministry of Health, DHIS 2 There has been a general increase in the number of women using contraceptive pills in 2018 and 2019, although some sub-regions such as Busoga, Elgon, Kampala, Karamoja, Kigezi and West Nile had a decline in 2019.

Trend of pill users by region, 2017-2019

Source: Ministry of Health, DHIS 2

Family Planning Atlas 2020 Page 44 Number of oral contraceptive cycles dispensed

Source: Ministry of Health, DHIS 2 has the highest number of pills dispensed while the districts of Napak and Nakapiripirit (Karamoja ) have a higher number of pills dispensed, even though, in terms of use, all the Karamoja districts are within the same range of usage. Detailed numbers per district are shown in appendix table 4.

Family Planning Atlas 2020 Page 45 Pregnancy Management

Nonuse of family planning among sexually active couples can result into pregnancies which if not well managed can result into fatal consequences for either the mother or the baby or both. This section of the atlas will focus on some of the issues addressed by the Ministry of Health such as pregnancy confirmation, malaria prevention in pregnancy and antenatal care attendance.

Family Planning Atlas 2020 Page 46 Confirmed Laboratory pregnancy tests, 2019

Source: Ministry of Health, DHIS 2

Although the laboratory pregnancy tests are lowest in the Karamoja sub-region, it does not imply that the total fertility rate is low in this region. It could reflect the low utilization of health facility services, which is linked to a missed opportunity for family planning uptake to those who test negative. As seen earlier, districts with high FP uptake are most likely to have a high number of laboratory pregnancy tests.

Family Planning Atlas 2020 Page 47 Number of pregnant women who received 2nd dose of fansidar for IPTp, 2019

Source: Ministry of Health, DHIS 2 Intermittent preventive therapy or intermittent preventive treatment (IPT) is a public health intervention aimed at treating and preventing malaria episodes in pregnant women (IPTp). Fansidar is the drug currently recommended by the WHO because of its safety and efficacy in pregnancy. The dark colours show that over three quarters of pregnant women in the respective districts had received the second doze of fansidar as recommended (e.g Napak district in Karamoja sub-region and in western region). The districts of Kampala, Kiruhura, Moyo, Namutumba, Wakiso and Yumbe had the lowest percentages of pregnant women who had received the second doze of fansidar.

Family Planning Atlas 2020 Page 48 Number of pregnant women who received 4 visits of antenatal care, 2019

Source: Ministry of Health, DHIS 2 Antenatal care (ANC) includes regular screening which can detect and prevent early pregnancy complications that may dramatically affect the mother and the foetus. According to 2016 UDHS, six in 10 women (60%) with a birth in the 5 years preceding the survey (60%) attended the recommended four ANC visits during the pregnancy leading to their most recent birth. The darker colour on the map shows higher percentages and the lighter colour shows lower percentages. More than 55% of pregnant women from the districts of Kaabong, Kabarole and Nebbi, among others, received four ANC contacts while less than a quarter of pregnant women from the districts of Bukedea, Rubirizi, Kampala, Moyo, Namutumba and Wakiso received four ANC contacts.

Family Planning Atlas 2020 Page 49 Financing for Family Planning

Statistical information on Family Planning expenditures within a country is critical for evidence-based policy and decision making in family planning resource allocation. The information is also critical for monitoring progress in achievement of the Government commitments to FP service provision in Uganda. The Uganda Bureau of Statistics (UBOS) has been conducting the Resource Flows Survey (RFS) in Uganda since 2011.

Family Planning Atlas 2020 Page 50 Financing for Family Planning Total Income Received and Spent on Family Planning Activities, (UGX ‘Billions) There has been a steady increase in finances received to facilitate family planning service provision. Notably, there was a 41 percent increment in funds received for family planning activities in Uganda between the year 2017 and 2018.

Source: Resource Flows Survey on Family Planning in Uganda. UNFPA/NIDI: United Nations Population Fund and Netherlands Interdisciplinary Demographic Institute Resource Tracking Project on Family Planning Expenditures

About a quarter of the expenditure (25%) was spent on contraceptives, medicine, and other consumables, an increase from the 12% reported in 2017. Other notable expenses in 2018 were on Monitoring, Evaluation and Research (14%) as well as on Internal service staff costs (11%).

Trend of Pattern of Family Planning Expenditures

Recurrent Expenses 2016 2017 2018 Internal service staff costs 35.2 27.5 11.0 Contraceptives, medicine & other consumables 25.5 11.7 25.4 Information, Education and Communication (IEC) 9.2 7.7 6.9 Logistics/transportation of contraceptives etc. 8.0 12.1 3.4 Management Information System (MIS) and Health Information System 5.5 2.7 7.7 Program Management Staff costs 3.6 3.7 7.1 Capacity building/training 3.0 3.2 9.3 Other Recurrent expenses 2.8 7.8 3.5 Operational expenditures 2.3 2.4 4.0 Policy Development and Advocacy 1.9 11.3 5.6 Monitoring, Evaluation and Research 1.8 0.2 14.4 Outsourcing of services 0.6 0.2 0.6 Capital Investments Infrastructure and Upgrading of Facilities 0.2 1.9 0.5 Equipment 0.1 0.2 0.5 Total 100.0 100.0 100.0

In Uganda, about a third of the expenditure on family planning consumeables is spent on purchasing condoms. There has also been an observed increase in the share of pills and injectables methods of Family planning between 2016 and 2018. Family Planning Atlas 2020 Page 51 Distribution of expenses on consumables by type of commodity purchased, 2016-2018, (%)

Source: Resource Flows Survey on Family Planning in Uganda. UNFPA/NIDI: United Nations Population Fund and Netherlands Interdisciplinary Demographic Institute Resource Tracking Project on Family Planning Expenditures International organisations remain the main source of income for Family Planning activities in Uganda. In 2018, international organisations contributed to about Shs 91 Billion, representing 61 percent of the total income received (UGX 149 Billion).

Source of income Received for FP Activities in Millions, 2016-2018, (UGX ‘Millions)

Family Planning Atlas 2020 Page 52 Gender issues that can influence FP use Gender-based violence (GBV) is defined by the United Nations as any act of violence that results in physical, sexual, or psychological harm or suffering to women, girls, men, and boys, as well as threats of such acts, coercion, or the arbitrary deprivation of liberty.

Violence against women has been described as “perhaps the most shameful human rights violation, and the most pervasive. Uganda has not only ratified the United Nations’ Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW – 1985), but has provisions in its Constitution for gender equality and prohibits laws, cultures, customs or traditions that undermine the welfare, dignity and status of women.

Family Planning Atlas 2020 Page 53 Estimated prevalence of all forms of violence against women, 2019

Source: small area estimates based on UDHS 2016 estimates and administrative data.

The map above shows the percentage of women who have experienced all the three forms of violence (emotional, physical and sexual). The darker colour on the map shows that more than half of the women in that district have experienced all the three forms of violence (e.g ). Detailed numbers per district are shown in appendix table 5.

Family Planning Atlas 2020 Page 54 Estimated prevalence of spousal physical violence against women, 2019

Source: small area estimates based on UDHS 2016 estimates and administrative data.

Physical violence can be severe and recurring, hence the need to know those who have ever experienced physical violence. The prevalence of spousal physical violence against ever-married women in 2016 was above 20% in more than half of the districts in Uganda. The districts with a prevalence over 50% include Adjumani, Amuria, Buhweju, Kabale, Kalangala, Kyenjojo, Lamwo, Masindi, Moroto, Moyo, Nabilutuk, Nakapiripirt, Nakasongola, Napak, Otuke and Pallisa. These districts also have lower numbers of registered family planning users. Detailed numbers per district are shown in appendix table 5.

Family Planning Atlas 2020 Page 55 Estimated prevalence of Sexual violence against women, 2019

Source: small area estimates based on UDHS 2016 estimates and administrative data.

Sexual violence is generally slightly lower than physical violence. Sexual violence is more predominant in the districts of Buhweju, Kalangala, Kabale, Kyenjojo, Moyo, Nakasongola, Otuke, Pallisa and Sheema. Detailed numbers per district are shown in appendix table 5.

Family Planning Atlas 2020 Page 56 Estimated prevalence of psychological violence against women, 2019

The districts of Moyo, Otuke, Pallisa, Nakasongola, Kalangala, Kyenjojo, Buhweju and Kabale rank high in the prevalence of all the three forms of spousal violence (physical, sexual and psychological violence). Detailed numbers per district are shown in appendix table 5.

Family Planning Atlas 2020 Page 57 Number of abortions due to Gender Based Violence, 2019

Source: Ministry of Health, DHIS 2

Women who are faced with GBV in pregnancy can result into termination of a pregnancy and other fetal risks. Such survivors report to health facilities for care and in due course they can be offered a family planning method to hold on after recovery. Gulu and Kampala had the highest number of cases resulting into termination of pregnancy reported. Detailed numbers per district are shown in appendix table 5.

Family Planning Atlas 2020 Page 58 Number of Injuries due to Gender Based Violence, 2019

Source: Ministry of Health, DHIS 2

GBV can inflict injuries on the survivors. As the victims report to the health facilities they can be offered a family planning method. Kampala city and had the highest number of reported cases of injuries due to GBV in 2019. Detailed numbers per district are shown in appendix table 5.

Family Planning Atlas 2020 Page 59 Persons with Sexual Transmitted Infections due to Gender Based Violence, 2019

Source: Ministry of Health, DHIS 2

Sexual Violence can lead to sexually transmitted infections (STI). The numbers of reported cases with STIs due to GBV were generally low in 2019 across all districts, with about two thirds of the districts reporting less than 200 persons in a year. Kampala and Wakiso had the highest number of cases of violence leading to STIs registered in health facilities during the year 2019. Detailed numbers per district are shown in appendix table 5.

Family Planning Atlas 2020 Page 60 Table 1: Estimated 2020 Mid-year population projection by district

District Population District Population District Population Abim 153,500 Kalangala 67,200 Mayuge 565,100 Adjumani 235,900 Kaliro 88,500 Mbale 586,300 Agago 251,200 Kalungu 194,100 Mbarara 390,700 Alebtong 266,100 Kampala 1,680,600 Mitooma 194,300 Amolatar 170,100 Kamuli 558,500 Mityana 362,500 Amudat 134,900 Kamwenge 35,200 Moroto 118,500 Amuria 225,000 Kanungu 277,300 Moyo 109,500 Amuru 216,800 Kapchorwa 123,800 Mpigi 286,600 Apac 226,600 Kapelebyong 103,800 Mubende 554,800 Arua 751,000 Karenga 68,500 Mukono 701,400 Budaka 253,100 Kasese 793,200 Nabilatuk 89,700 Bududa 271,100 Kassanda 312,700 Nakapiripirit 113,300 Bugiri 480,400 Katakwi 194,600 Nakaseke 234,600 Bugweri 191,600 Kayunga 407,700 Nakasongola 215,200 Buhweju 144,100 Kazo 217,600 Namayingo 237,000 Bukedea 259,300 Kibaale 198,200 Namisindwa 231,500 Bukomansimbi 156,600 Kiboga 171,200 Namutumba 306,500 Bukwo 119,100 Kibuku 250,600 Napak 158,300 Bulambuli 230,600 Kikuube 358,700 Nebbi 282,600 Buliisa 149,300 Kiruhura 185,700 Ngora 165,800 Bundibugyo 263,800 Kiryandongo 313,800 Ntoroko 76,000 Bunyangabu 195,100 Kisoro 315,400 Ntungamo 540,800 Bushenyi 248,300 Kitagwenda 178,300 Nwoya 236,000 Busia 384,000 Kitgum 223,600 Obongi 49,100 Butaleja 300,500 Koboko 258,000 Omoro 196,400 Butambala 107,800 Kole 284,300 Otuke 133,500 Butebo 121,200 Kotido 206,500 Oyam 453,700 Buvuma 128,900 Kumi 284,800 Pader 197,300 Buyende 414,600 Kwania 216,600 Pakwach 196,800 Dokolo 215,500 Kween 109,500 Pallisa 353,400 Gomba 173,800 Kyankwanzi 282,800 Rakai 317,700 Gulu 325,600 Kyegegwa 441,000 Rubanda 208,500 Hoima 374,500 Kyenjojo 525,400 Rubirizi 144,100

Ibanda 277,300 Kyotera 261,000 Rukiga 105,400 Iganga 402,600 Lamwo 143,800 Rukungiri 333,800 Isingiro 596,400 Lira 478,500 Rwampara 144,600 Jinja 515,100 Luuka 267,100 Serere 359,500 Kaabong 125,400 Luwero 523,600 Sheema 220,500 Kabale 248,700 Lwengo 290,500 Sironko 274,300 Kabarole 337,800 Lyantonde 110,500 Soroti 363,600 Kaberamaido 132,700 Madi Okollo 164,200 Ssembabule 296,100 Kagadi 430,200 Manafwa 175,200 Tororo 597,500 Kakumiro 473,400 Maracha 208,300 Wakiso 2,915,200 Kalaki 138,700 Masaka 335,700 Yumbe 663,600 Masindi 340,500 Zombo 283,100 Source: UBOS

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Family Planning Atlas 2020 Page 61 Table 2: Total Fertility Rate by district, 2014 Table 3: Contraceptive methods used by district

District TFR District TFR District TFR District No of Female No of No of FP No of No of No of No of Abim 6.8 Kalaki 7.6 Mbale 5.3 Sterilizations IUDs Injections users New Implant Implant Adjumani 6.2 Kalangala 4.8 Mbale city 4.3 (Tube Ligation) Inserted given of pill Implant Removals Revisits Agago 7.7 Kaliro 7.7 Mbarara 5.0 Users Abim 15 56 1327 169 112 135 64 Alebtong 7.0 Kalungu 6.1 Mbarara City 4.4 Adjumani 11 378 6555 1744 1660 448 501 Amolatar 6.9 Kampala 3.3 Mitooma 5.2 Agago 21 1730 6906 1783 4189 758 428 Amudat 9.8 Kamuli 7.0 Mityana 5.6 Alebtong 88 433 4008 2415 2936 651 889 Amuria 7.9 Kamwenge 6.2 Moroto 7.0 Amolatar 45 696 4287 1880 1283 199 147 Amuru 7.3 Kanungu 4.7 Moyo 5.6 Amudat 0 0 1181 199 48 53 12 Apac 6.4 Kapchorwa 5.2 Mpigi 5.4 Amuria 28 147 8703 1902 959 112 188 Arua 5.6 Kapelebyong 7.8 Mubende 6.2 Amuru 35 1444 5503 1377 4749 730 854 Arua city 4.4 Karenga 7.5 Mukono 4.7 Apac 49 1309 10427 4029 3606 457 1156 Budaka 7.5 Kasanda 6.1 Nabilatuk 7.6 Arua 16 2500 15,728 4898 11,976 2741 1079 Bududa 6.4 Kasese 6.1 Nakapiripirit 7.7 Budaka 217 347 6969 1223 3,403 361 742 Bugiri 7.3 Katakwi 6.6 Nakaseke 5.7 Bududa 25 172 9221 3169 3059 673 742 Bugweri 7.0 Kayunga 6.3 Nakasongola 6.4 Bugiri 73 629 20,145 4019 5211 1051 828 Buhweju 5.8 Kazo 4.5 Namayingo 6.9 Bugweri 24 369 8375 1701 2347 529 498 Buikwe 5.4 Kibaale 7.0 Namisindwa 7.2 Buhweju 1 427 9433 6064 1298 344 285 Bukedea 8.0 Kiboga 6.0 Namutumba 7.8 Buikwe 34 5942 24,889 8605 17,846 2309 4004 Bukomansimbi 6.1 Kibuku 7.7 Napak 6.7 Bukedea 59 214 2362 830 2603 797 547 Bukwa 7.0 Kikuube 6.5 Nebbi 6.2 Bukomansimbi 19 598 3082 871 1548 332 193 Bulambuli 5.8 Kiruhura 5.4 Ngora 7.1 Bukwo 0 353 4505 1063 1254 619 434 Buliisa 6.8 Kiryandongo 6.7 Ntoroko 6.4 Bulambuli 14 174 10303 1689 1472 499 358 Bundibugyo 6.7 Kisoro 5.6 Ntungamo 5.6 Buliisa 0 77 3326 249 579 210 91 Bunyangabu 5.7 Kitagwenda 6.3 Nwoya 7.4 Bundibugyo 4 301 12271 3966 3557 405 453 Bushenyi 4.2 Kitgum 6.5 Obongi 5.8 Bunyangabu 0 765 9908 3084 2373 486 453 Busia 6.0 Koboko 6.8 Omoro 6.7 Bushenyi 53 2303 18741 6382 6679 1282 1775 Butaleja 8.0 Kole 6.4 Otuke 7.2 Busia 45 1387 14446 7092 7785 1432 2040 Butambala 6.4 Kotido 7.7 Oyam 6.3 Butaleja 466 509 14176 1694 4785 499 783 Butebo 7.6 Kumi 6.8 Pader 7.0 Butambala 16 229 6017 1086 1018 309 546 Buvuma 6.2 Kwania 6.2 Pakwach 6.5 Butebo 60 214 3224 481 1807 436 327 Buyende 8.3 Kween 6.8 Pallisa 7.5 Buvuma 4 153 1292 907 1310 91 145 Dokolo 6.5 Kyankwanzi 6.5 Rakai 6.7 Buyende 43 278 18257 3624 2908 736 692 Fortportal 3.6 Kyegegwa 7.0 Rubanda 4.8 Dokolo 64 500 6223 1851 3727 622 1207 Gomba 6.6 Kyenjojo 6.4 Rubirizi 6.2 Gomba 20 219 5654 1534 668 398 395 Gulu 4.9 Kyotera 5.7 Rukiga 4.5 Gulu 27 3339 14,092 6259 7,727 1977 2231 Gulu city 3.9 Lamwo 7.6 Rukungiri 4.7 Hoima 52 735 19518 5283 3742 958 929 Hoima 5.8 Lira 5.4 Rwampara 5.1 Ibanda 40 887 14,373 3043 4517 965 496 Ibanda 4.9 Luuka 7.1 Sembabule 6.3 Iganga 81 1564 41,681 9700 7840 1366 1514 Iganga 6.3 Luwero 5.6 Serere 7.9 Isingiro 15 1645 15,120 3376 6901 1306 1045 Isingiro 5.7 Lwengo 6.3 Sheema 4.2 Jinja 49 2904 20,744 8235 9,893 2686 1689 Jinja 5.4 Lyantonde 5.9 Sironko 6.2 Kaabong 0 5 344 222 83 50 25 Jinja city 3.8 Madi-Okollo 6.4 Soroti 6.3 Kabale 20 2435 23,212 6809 7302 1498 882 Kaabong 7.6 Manafwa 7.0 Terego 6.7 Kabarole 42 2437 21996 7460 6660 2227 2092 Kabale 4.2 Maracha 6.3 Tororo 6.3 Kaberamaido 20 1273 2697 1190 2467 467 547 Kabarole 4.8 Masaka 5.0 Wakiso 4.1 Kagadi 12 561 12357 3348 6294 929 644 FamilyKaberamaido Planning Atlas7.8 2020 Masaka city 4.1 Yumbe 7.2 66

Kagadi 6.7 Masindi 5.7 Zombo 6.7 Family Planning Atlas 2020 68 Kakumiro 6.9 Mayuge 6.8 Source: 2014 National Population and Housing Census Family Planning Atlas 2020 Page 62

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Table 3: Contraceptive methods used by district

District No of Female No of No of FP No of No of No of No of Sterilizations IUDs Injections users New Implant Implant (Tube Ligation) Inserted given of pill Implant Removals Revisits Users Abim 15 56 1327 169 112 135 64 Adjumani 11 378 6555 1744 1660 448 501 Agago 21 1730 6906 1783 4189 758 428 Alebtong 88 433 4008 2415 2936 651 889 Amolatar 45 696 4287 1880 1283 199 147 Amudat 0 0 1181 199 48 53 12 Amuria 28 147 8703 1902 959 112 188 Amuru 35 1444 5503 1377 4749 730 854 Apac 49 1309 10427 4029 3606 457 1156 Arua 16 2500 15,728 4898 11,976 2741 1079 Budaka 217 347 6969 1223 3,403 361 742 Bududa 25 172 9221 3169 3059 673 742 Bugiri 73 629 20,145 4019 5211 1051 828 Bugweri 24 369 8375 1701 2347 529 498 Buhweju 1 427 9433 6064 1298 344 285 Buikwe 34 5942 24,889 8605 17,846 2309 4004 Bukedea 59 214 2362 830 2603 797 547 Bukomansimbi 19 598 3082 871 1548 332 193 Bukwo 0 353 4505 1063 1254 619 434 Bulambuli 14 174 10303 1689 1472 499 358 Buliisa 0 77 3326 249 579 210 91 Bundibugyo 4 301 12271 3966 3557 405 453 Bunyangabu 0 765 9908 3084 2373 486 453 Bushenyi 53 2303 18741 6382 6679 1282 1775 Busia 45 1387 14446 7092 7785 1432 2040 Butaleja 466 509 14176 1694 4785 499 783 Butambala 16 229 6017 1086 1018 309 546 Butebo 60 214 3224 481 1807 436 327 Buvuma 4 153 1292 907 1310 91 145 Buyende 43 278 18257 3624 2908 736 692 Dokolo 64 500 6223 1851 3727 622 1207 Gomba 20 219 5654 1534 668 398 395 Gulu 27 3339 14,092 6259 7,727 1977 2231 Hoima 52 735 19518 5283 3742 958 929 Ibanda 40 887 14,373 3043 4517 965 496 Iganga 81 1564 41,681 9700 7840 1366 1514 Isingiro 15 1645 15,120 3376 6901 1306 1045 Jinja 49 2904 20,744 8235 9,893 2686 1689 Kaabong 0 5 344 222 83 50 25 Kabale 20 2435 23,212 6809 7302 1498 882 Kabarole 42 2437 21996 7460 6660 2227 2092 Kaberamaido 20 1273 2697 1190 2467 467 547 Kagadi 12 561 12357 3348 6294 929 644

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Family Planning Atlas 2020 Page 63 Table 3: Contraceptive methods used by district, cont’d Table 3: Contraceptive methods used by district, cont’d No of Female No of No of FP No of No of No of No of District No of Female No of No of FP No of No of No of No of Sterilizations IUDs Injections users New Implant Implant Sterilizations IUDs Injections users New Implant Implant (Tube Ligation) Inserted given of pill Implant Removals Revisits (Tube Ligation) Inserted given of pill Implant Removals Revisits Users Users Manafwa 50 315 2,984 784 4760 711 1011 Kakumiro 21 603 9765 3195 9249 1067 884 Maracha 8 95 3,581 316 1,556 538 141 Kalaki 29 196 2735 391 1458 300 352 Masaka 54 1166 10959 2795 3773 1076 630 Kalangala 10 143 4202 727 764 167 101 Masindi 7 416 18,456 2470 4203 1063 845 Kaliro 103 221 6054 516 2527 487 490 Mayuge 44 359 18627 4105 6173 1165 967 Kalungu 17 2,684 5,400 4219 5,865 863 322 Mbale 510 2122 25533 7189 14217 1899 4633 Kampala 103 17234 86,822 50773 28095 6067 5939 Mbarara 70 2326 21089 6536 7122 1707 994 Kamuli 69 688 20,356 7160 7779 1403 1385 Mitooma 3 239 8,298 2609 1774 568 388 Kamwenge 66 798 10,176 4331 3643 822 634 Mityana 63 928 19,611 3964 4159 3173 1572 Kanungu 22 1358 19130 4917 4389 2132 1462 Moroto 3 30 1140 569 453 243 151 Kapchorwa 53 909 8871 2298 2238 664 318 Moyo 0 107 2233 872 629 246 184 Kapelebyong 27 72 1,625 623 643 123 42 Mpigi 34 1252 5522 4911 4,004 1173 2147 Karenga 0 1 125 31 14 15 12 Mubende 29 1152 22303 5183 3,875 831 1353 Kasese 428 1369 22876 6651 13293 1936 5035 Mukono 115 6856 19214 4468 13248 2987 4415 Kassanda 26 1011 12083 6355 2223 596 705 Nabilatuk 1 2 95 24 40 31 8 Katakwi 97 285 10093 2308 1539 588 250 Nakapiripirit 3 9 547 101 72 78 14 Kayunga 15 870 15902 2342 8044 1293 1889 Nakaseke 49 856 8447 3388 5840 616 1324 Kazo 6 408 4521 1581 1933 230 120 Nakasongola 21 184 10590 1862 673 347 142 Kibaale 1 552 5561 851 3440 519 512 Namayingo 43 180 10472 1015 2465 588 478 Kiboga 18 179 8,003 1456 1,602 416 185 Namisindwa 31 545 6,010 647 8042 757 1641 Kibuku 207 319 6357 1784 3761 769 831 Namutumba 53 224 10988 2454 2607 536 517 Kikuube 21 614 9909 4181 3488 434 482 Napak 3 44 59 56 53 43 24 Kiruhura 2 265 5814 1142 1,567 308 190 Nebbi 47 633 2202 654 5140 1131 563 Kiryandongo 14 470 11472 4682 3888 827 903 Ngora 56 257 4596 1098 1,645 345 585 Kisoro 64 269 11120 2029 1494 569 408 Ntoroko 0 28 1,348 337 300 107 67 Kitagwenda 6 656 2665 1439 3214 488 209 Ntungamo 44 2050 15187 5152 6724 1853 1036 Kitgum 8 2226 6435 2278 5212 1213 1240 Nwoya 8 617 7125 2305 2926 776 769 Koboko 0 206 1739 797 2965 921 174 Obongi 2 266 2539 2423 1513 310 233 Kole 113 144 2804 614 3457 434 321 Omoro 20 1268 4983 4262 3698 732 688 Kotido 0 20 422 148 180 57 21 Otuke 24 394 3620 1036 1707 288 663 Kumi 149 308 9235 1778 4247 731 815 Oyam 128 1289 10757 2715 3998 923 1106 Kwania 16 47 5754 2643 1885 333 182 Pader 46 1662 5,725 1448 2740 456 381 Kween 5 284 5936 595 1051 242 213 Pakwach 6 753 1931 696 2451 360 247 Kyankwanzi 13 481 4612 3315 3592 491 363 Pallisa 153 548 5525 2338 7724 1271 1187 Kyegegwa 30 587 5196 4257 2517 424 973 Rakai 41 1049 9192 477 2863 266 221 Kyenjojo 21 2467 8506 5210 5349 910 1844 Rubanda 12 873 5232 2240 2742 1133 611 Kyotera 62 1570 7,241 1708 3,644 736 706 Rubirizi 3 2129 8569 1459 1408 460 410 Lamwo 3 973 6425 1737 3152 973 771 Rukiga 18 199 6,634 3064 1,280 593 330 Lira 125 2554 15066 6330 10358 1182 1635 Rukungiri 84 1,123 22,779 9066 3,806 1473 836 Luuka 17 150 8837 3043 2673 450 397 Rwampara 2 545 7347 1420 1433 320 229 Luwero 20 1194 17222 5014 12174 2185 1561 Sembabule 68 820 10114 2718 2637 435 453 Lwengo 18 1026 6455 3083 5774 393 387 Serere 90 314 4927 849 2606 500 258 Lyantonde 8 330 4,063 984 1,196 191 265 Sheema 8 717 16467 5020 2289 712 460 Madi-Okollo 5 293 3,239 601 1288 346 179

Family Planning Atlas 2020 70 Family Planning Atlas 2020 69

Family Planning Atlas 2020 Page 64 Table 3: Contraceptive methods used by district, cont’d

No of Female No of No of FP No of No of No of No of Sterilizations IUDs Injections users New Implant Implant (Tube Ligation) Inserted given of pill Implant Removals Revisits Users Manafwa 50 315 2,984 784 4760 711 1011 Maracha 8 95 3,581 316 1,556 538 141 Masaka 54 1166 10959 2795 3773 1076 630 Masindi 7 416 18,456 2470 4203 1063 845 Mayuge 44 359 18627 4105 6173 1165 967 Mbale 510 2122 25533 7189 14217 1899 4633 Mbarara 70 2326 21089 6536 7122 1707 994 Mitooma 3 239 8,298 2609 1774 568 388 Mityana 63 928 19,611 3964 4159 3173 1572 Moroto 3 30 1140 569 453 243 151 Moyo 0 107 2233 872 629 246 184 Mpigi 34 1252 5522 4911 4,004 1173 2147 Mubende 29 1152 22303 5183 3,875 831 1353 Mukono 115 6856 19214 4468 13248 2987 4415 Nabilatuk 1 2 95 24 40 31 8 Nakapiripirit 3 9 547 101 72 78 14 Nakaseke 49 856 8447 3388 5840 616 1324 Nakasongola 21 184 10590 1862 673 347 142 Namayingo 43 180 10472 1015 2465 588 478 Namisindwa 31 545 6,010 647 8042 757 1641 Namutumba 53 224 10988 2454 2607 536 517 Napak 3 44 59 56 53 43 24 Nebbi 47 633 2202 654 5140 1131 563 Ngora 56 257 4596 1098 1,645 345 585 Ntoroko 0 28 1,348 337 300 107 67 Ntungamo 44 2050 15187 5152 6724 1853 1036 Nwoya 8 617 7125 2305 2926 776 769 Obongi 2 266 2539 2423 1513 310 233 Omoro 20 1268 4983 4262 3698 732 688 Otuke 24 394 3620 1036 1707 288 663 Oyam 128 1289 10757 2715 3998 923 1106 Pader 46 1662 5,725 1448 2740 456 381 Pakwach 6 753 1931 696 2451 360 247 Pallisa 153 548 5525 2338 7724 1271 1187 Rakai 41 1049 9192 477 2863 266 221 Rubanda 12 873 5232 2240 2742 1133 611 Rubirizi 3 2129 8569 1459 1408 460 410 Rukiga 18 199 6,634 3064 1,280 593 330 Rukungiri 84 1,123 22,779 9066 3,806 1473 836 Rwampara 2 545 7347 1420 1433 320 229 Sembabule 68 820 10114 2718 2637 435 453 Serere 90 314 4927 849 2606 500 258 Sheema 8 717 16467 5020 2289 712 460

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Family Planning Atlas 2020 Page 65 Table 3: Contraceptive methods used by district, cont’d

No of Female No of No of FP No of No of No of No of Sterilizations IUDs Injections users New Implant Implant (Tube Ligation) Inserted given of pill Implant Removals Revisits Users Sironko 63 260 9762 1563 2173 342 423 Soroti 58 1323 10511 5866 4841 920 2094 Tororo 267 3072 22839 8266 16994 2906 6690 Wakiso 64 11468 65538 32637 31089 6559 7753 Yumbe 0 193 9620 2627 3595 1170 604 Zombo 7 732 983 1084 3481 880 307 Source: MoH- DHIS2

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Family Planning Atlas 2020 Page 66 Table 4: FP users and contraceptives dispensed in 2019

District Total Number dispensed No of Male perma FP HIV+ Sterili nent Female Male IUDs Injectables No of Oral FP sation metho users (Vasec Condom Condom (pieces) (doses) Natura contraceptives users ds (pieces) (pieces) l (cycles) tomy) Abim 5422 0 83939 19 4179 600 117 62 12 27 Adjumani 13038 4223 125240 401 23344 796 20002 200 6 17 Agago 45228 2481 244569 1711 7412 1298 2034 462 2 23 Alebtong 9230 151 63714 468 5522 142 1119 265 2 90 Amolatar 8772 3323 100668 129 4154 64 445 267 0 45 Amudat 2226 0 15969 0 1248 97 75 90 5 5 Amuria 10439 540 70971 161 6061 45 751 63 14 42 Amuru 12821 3137 158561 2125 5574 158 1498 170 5 40 Apac 31765 6251 862258 1348 12022 155 5040 671 0 49 Arua 64611 50178 4217138 2370 37297 244 18362 992 61 77 Budaka 13347 975 217682 331 8341 202 2240 498 3 220 Bududa 15905 406 76798 2605 9580 56 1542 182 3 28 Bugiri 33588 4479 301327 890 32432 22 3928 716 6 79 Bugweri 13928 1146 86363 469 10208 410 1651 165 0 24 Buhweju 17329 402 31940 297 11101 647 1197 631 0 1 Buikwe 56196 6767 1061156 6464 40118 1398 9061 2255 4 38 Bukedea 3791 0 25590 223 2493 62 604 66 1 60 Bukomansimbi 6385 932 15863 471 3652 165 1034 315 21 40 Bukwo 8162 955 53727 533 4279 74 2931 55 9 9 Bulambuli 16547 424 72920 234 10770 93 2340 681 3 17 Buliisa 4963 3155 21363 75 3010 0 691 144 2 2 Bundibugyo 22275 633 92961 209 11709 109 15004 173 3 7 Bunyangabu 20255 56 45873 485 8231 1121 3197 1007 0 0 Bushenyi 31872 2569 1104683 8448 18314 53 13644 1607 10 63 Busia 186886 3765 207641 1640 20930 295 11955 460 0 45 Butaleja 22324 2264 292606 492 39192 9 1583 160 138 604 Butambala 11732 490 32163 153 8252 36 1290 473 9 25 Butebo 4699 382 62652 173 7385 5 1133 34 0 60 Buvuma 3420 5376 168752 122 1164 38 330 200 1 5 Buyende 44009 2296 281885 237 22467 118 2835 266 5 48 Dokolo 11981 2 135919 473 6686 286 1263 492 0 64 Gomba 8972 5 78721 141 5421 152 447 515 3 23 Gulu 43624 6669 628987 3510 16797 4070 8437 1763 11 38 Hoima 28284 2155 195776 2082 18987 77 8986 1068 45 97 Ibanda 21149 906 67729 1430 14410 321 18861 802 9 49 Iganga 76218 3654 771804 2588 50107 1523 12328 443 5 86 Isingiro 24953 804 53714 1629 16187 582 6040 1576 9 24 Jinja 51405 4395 690172 2933 21204 852 9925 1843 17 66 Kaabong 1033 0 2931 3 265 176 90 0 0 0 Kabale 40864 65 84015 2421 22765 1105 10700 1293 3 23

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Family Planning Atlas 2020 Page 67 Table 4: FP users and contraceptives dispensed in 2019 District Total Number dispensed No of Male perman FP Female Male IUDs Injectab No of Oral HIV+ Sterilisa ent users Condom Condom (pieces) les Natura contracepti FP tion method (pieces) (pieces) (doses) l ves (cycles) users (Vasecto s my) Kabarole 13457 8340 167994 1739 24548 6332 9893 3713 7 49 3 Kaberamaido 6656 15 49406 1211 3159 44 803 69 0 20 Kagadi 6250 124 103205 538 11542 67 2420 646 4 16 Kakumiro 16177 2700 66330 670 10221 82 2672 962 40 61 Kalaki 10988 24 51779 180 3135 792 846 130 0 29 Kalangala 6809 1214 141377 101 3705 210 1024 1599 5 15 Kaliro 13359 525 131807 199 6673 52 1729 109 1 104 Kalungu 11484 970 50026 2445 4219 496 2632 833 2 19 Kampala 315850 136571 1323393 26599 2046145 10856 122339 15145 139 242 Kamuli 71063 19405 629400 11167 20596 1580 10950 1030 27 96 Kamwenge 25147 78 213095 475 19599 963 5035 820 0 66 Kanungu 33125 440 53046 1576 33445 1155 8129 1948 6 28 Kapchorwa 17663 1871 463561 811 8506 265 2557 41 26 79 Kapelebyong 3692 20 52168 72 1878 3 425 51 0 27 Karenga 565 0 4318 1 237 60 4 0 0 0 Kasese 52781 7838 260103 1709 29163 3317 9808 2450 40 468 Kassanda 18891 3033 108067 954 11991 182 2365 757 10 36 Katakwi 23065 753 206953 1943 11485 288 1863 539 4 101 Kayunga 21402 30 21100 888 14713 493 1937 584 5 20 Kazo 7013 255 25543 307 4238 115 1408 272 2 8 Kibaale 9255 7834 69578 524 5459 12 1199 422 0 1 Kiboga 10072 0 30915 143 6704 269 2861 623 17 35 Kibuku 11283 589 242011 314 6769 52 1166 37 26 233 Kikuube 29946 10089 104433 3361 10713 155 4523 641 0 21 Kiruhura 9840 67 34240 291 6390 198 2294 534 2 4 Kiryandongo 23179 1874 255384 2339 24961 429 2395 349 17 31 Kisoro 14096 144 13437 349 20030 23 3946 445 4 68 Kitagwenda 18304 1 87755 601 3433 22 6718 392 3 9 Kitgum 17438 409 235848 2232 7375 157 5209 736 1 9 Koboko 4213 222 38733 183 1763 5 5128 167 0 0 Kole 5066 307 71255 346 2723 160 2472 323 2 115 Kotido 1883 0 29349 21 410 325 236 21 0 0 Kumi 14075 611 88084 314 10774 421 1112 370 16 165 Kwania 11125 141 62495 70 6342 82 6431 326 6 22 Kween 13047 0 59455 335 6816 66 449 79 3 8 Kyankwanzi 9327 449 160647 435 4253 32 1889 330 13 26 Kyegegwa 13035 564 126244 2529 7803 699 1594 293 20 50 Kyenjojo 13516 0 65788 4061 12613 398 3549 1430 12 33 Kyotera 14266 75 11849 1325 7029 180 1435 854 2 64 Lamwo 13868 1631 1564659 1031 7104 16 3207 323 0 3 Lira 30730 3923 386653 2320 24096 804 6963 1027 8 133 Luuka 22304 7042 334050 394 15439 30 3136 238 7 24

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Family Planning Atlas 2020 Page 68 Table 4: FP users and contraceptives dispensed in 2019, cont’d District Total Number dispensed No of Male perman FP HIV+ Sterilisa ent Female Male IUDs Injectab No of Oral users FP tion method Condom Condom (pieces) les Natura contracepti users (Vasecto s (pieces) (pieces) (doses) l ves (cycles) my) Luwero 45337 1510 255727 3885 19166 423 5424 2423 29 49 Lwengo 9718 3563 42553 945 6235 81 7942 825 1 19 Lyantonde 8379 393 27562 312 3808 91 2826 805 10 18 Madi-Okollo 6222 6890 112597 187 20744 156 12579 39 5 10 Manafwa 9454 179 39113 300 3307 466 843 95 8 58 Maracha 5492 0 40233 63 44115 31 1003 56 8 16 Masaka 18370 1609 173482 1202 10884 761 3687 2780 1 55 Masindi 25414 341 228217 509 18337 128 2330 775 3 10 Mayuge 32694 8573 520268 428 24945 603 3478 335 4 48 Mbale 48360 8100 1019802 2178 25266 484 9945 1944 17 527 Mbarara 46721 5227 659484 2098 20855 619 40842 6051 54 124 Mitooma 14112 60 17943 177 8505 733 3737 790 7 10 Mityana 34063 1476 1605750 970 22465 494 9642 2071 18 81 Moroto 9551 2845 80163 31 2740 2518 904 155 5 8 Moyo 4677 40 42116 277 3462 39 1384 64 0 0 Mpigi 13433 107 14632 1227 5452 1011 29399 778 10 44 Mubende 32095 1188 156084 1164 25461 327 190531 1287 3 32 Mukono 48285 2131 142431 9532 123584 414 202379 1405 27 142 Nabilatuk 544 0 417 1 193 352 962 0 0 1 Nakapiripirit 4799 41 17226 3 1681 2396 22069 32 0 3 Nakaseke 25726 1731 218692 1017 10736 990 247166 813 3 52 Nakasongola 11637 358 144452 303 10572 126 156750 442 15 36 Namayingo 16599 819 210176 441 10767 37 228035 568 1 44 Namisindwa 31444 659 216406 1040 5175 1727 249549 120 1 32 Namutumba 21806 2203 167078 423 12351 198 191510 252 11 64 Napak 5912 1394 18572 7 41 2525 25885 10 2 5 Nebbi 16339 724 152427 500 1920 5330 169990 268 23 70 Ngora 10823 4176 82245 287 51631 374 97531 516 9 65 Ntoroko 2328 1446 30800 12 2725 238 34586 57 1 1 Ntungamo 25684 1098 72583 1980 15654 298 101345 1211 33 77 Nwoya 34193 772 140778 528 7254 52 176271 305 0 8 Obongi 131710 266 126442 366 3304 284 258784 69 1 3 Omoro 17088 193 101747 1593 7584 586 120621 426 7 27 Otuke 5838 2 33083 412 3585 32 39335 275 5 29 Oyam 20259 1072 162384 1911 13023 1517 185626 942 18 146 Pader 15765 6241 228919 2151 8188 168 253076 623 22 68 Pakwach 5682 364 59338 737 1946 139 66121 159 0 6 Pallisa 12295 873 130075 406 5534 167 143649 88 31 184 Rakai 11339 20 3198 951 9504 282 15508 739 4 45 Rubanda 9629 115 14156 884 5731 102 24784 129 8 20 Rubirizi 12574 27 64806 97 8511 236 77504 853 1 4 Rukiga 11417 2541 13975 192 6672 138 28125 417 12 30 Rukungiri 36332 224 112862 1110 22037 1827 150528 2132 18 102

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Family Planning Atlas 2020 Page 69 Table 4: FP users and contraceptives dispensed in 2019, cont’d District Total Number dispensed No of Male perman FP HIV+ Sterilisa ent Female Male IUDs Injectab No of Oral users FP tion method Condom Condom (pieces) les Natura contracepti users (Vasecto s (pieces) (pieces) (doses) l ves (cycles) my) Rwampara 11235 396 33249 385 6883 128 45265 285 0 2 Sembabule 18654 222 68508 726 9878 58 88110 3611 31 99 Serere 10809 918 53746 578 6226 357 66051 209 3 93 Sheema 25536 3144 69242 538 17270 389 98460 1397 14 22 Sironko 15142 6027 83013 154 9738 249 104336 242 9 72 Soroti 20777 5068 224547 1480 24373 185 251872 861 60 118 Tororo 55605 10598 2381016 2138 40608 554 2449357 2250 17 284 Wakiso 170669 18720 818747 14534 88344 1553 1022670 9650 37 101 Yumbe 19192 11690 118368 210 9480 614 149460 115 0 0 Zombo 7551 28 48189 623 889 888 56391 76 6 13 Source: MoH- DHIS2

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Family Planning Atlas 2020 Page 70 Table 5: Gender Based Violence by district, 2019

District Physical Sexual Emotional All Injuries Sexually VAW VAW VAW forms Abortions Due To Transmitted of Due To GBV* Infection Due VAW GBV* To SGBV* Abim 25.1 10.0 28.7 38.9 4 106 12 Adjumani 45.6 24.4 59.3 60.5 16 507 175 Agago 28.9 6.3 26.1 39.0 1 312 174 Alebtong 29.4 14.3 29.4 39.3 6 367 74 Amolatar 35.6 17.3 35.6 47.6 1 233 10 Amudat 37.6 14.9 43.0 58.2 139 10 Amuria 49.9 28.1 59.3 60.5 1 473 15 Amuru 21.5 4.7 19.4 29.0 4 214 9 Apac 17.2 8.3 17.2 23.0 5 319 70 Arua 27.8 14.8 42.5 51.4 7 966 262 Budaka 2.0 2.2 2.6 3.7 15 555 120 Bududa 12.3 8.3 13.5 20.1 3 252 197 Bugiri 21.2 22.9 31.1 44.4 12 623 806 Bugweri 7.2 7.8 10.6 15.2 1 196 233 Buhweju 46.4 41.4 59.3 60.5 185 64 Buikwe 29.6 22.4 39.9 56.2 21 1175 298 Bukedea 16.4 9.2 20.8 29.6 1 283 15 Bukomansimbi 39.0 26.2 46.5 60.5 15 152 13 Bukwo 35.4 24.1 39.0 58.1 3 450 95 Bulambuli 7.6 5.2 8.4 12.4 115 133 Buliisa 32.1 13.7 33.4 49.0 1 79 8 Bundibugyo 11.2 10.4 17.0 21.4 21 140 110 Bunyangabu 21.8 20.4 33.1 41.8 2 270 70 Bushenyi 25.1 22.3 45.4 52.6 2 231 89 Busia 15.1 16.5 19.1 27.3 2 382 78 Butaleja 14.6 16.0 18.5 26.5 1 416 79 Butambala 28.0 18.8 33.4 46.1 1 116 13 Butebo 3.1 3.4 4.0 5.7 1 95 94 Buvuma 15.7 11.9 21.1 29.7 3 320 130 Buyende 6.5 7.1 9.6 13.7 585 88 Dokolo 13.6 6.6 13.6 18.2 2 326 47 Gomba 31.9 21.5 38.1 52.5 1 184 110 Gulu 19.8 4.3 17.9 26.8 116 574 268 Hoima 18.8 8.0 19.6 28.7 18 235 174 Ibanda 33.9 30.3 59.3 60.5 4 236 390 Iganga 19.0 20.6 28.0 40.0 4 418 156 Isingiro 20.2 18.0 36.6 42.4 3 433 292 Jinja 10.5 11.3 15.4 22.0 38 585 628 Kaabong 8.2 3.3 9.4 12.7 2 101 24 Kabale 49.2 43.7 59.3 60.5 14 802 209 Kabarole 19.1 17.9 29.0 36.6 3 413 412 Kaberamaido 7.2 4.0 9.1 12.9 1 110 18 Kagadi 2.8 1.2 2.9 4.2 33 172

Family Planning Atlas 2020 76 Family Planning Atlas 2020 Page 71 Table 5: Gender Based Violence by district, 2019 – cont’d Table 5: Gender Based Violence by district, 2019 – cont’d District Physical Sexual Emotional All Injuries Sexually District Physical Sexual Emotional All Injuries Sexually VAW VAW VAW forms Abortions Due To Transmitted VAW VAW VAW forms Abortions Due To Transmitted of Due To GBV Infection Due of Due To GBV Infection Due VAW GBV To SGBV VAW GBV To SGBV Manafwa 18.7 12.8 20.7 30.7 2 228 6 Kakumiro 15.0 6.4 15.6 22.9 7 74 13 Maracha 8.4 4.5 12.9 15.6 1 46 33 Kalaki 18.5 10.4 23.4 33.4 4 90 5 Masaka 8.9 6.0 10.6 14.7 11 488 319 Kalangala 56.0 56.0 56.0 60.5 6 303 171 Masindi 46.8 20.0 48.7 60.5 4 369 64 Kaliro 8.1 8.7 11.9 17.0 8 117 110 Mayuge 9.5 10.2 13.9 19.9 20 533 433 Kalungu 16.5 11.1 19.7 27.2 5 297 57 Mbale 19.3 13.1 21.3 31.6 43 3385 916 Kampala 11.3 9.8 16.1 22.2 197 2598 2354 Mbarara 31.0 27.7 56.3 60.5 35 715 494 Kamuli 20.0 21.6 29.4 42.0 30 352 700 Mitooma 33.9 30.3 59.3 60.5 1 76 326 Kamwenge 24.0 22.4 36.4 46.0 11 316 220 Mityana 11.9 9.0 16.1 22.6 3 213 213 Kanungu 19.0 16.9 25.2 32.4 7 303 274 Moroto 56.5 22.4 59.3 60.5 6 285 11 Kapchorwa 21.9 14.9 24.2 35.9 2 36 3 Moyo 56.0 56.0 56.0 60.5 5 422 18 Kapelebyong 17.6 9.9 22.2 31.7 71 3 Mpigi 36.0 24.2 43.0 60.5 24 281 344 Karenga 1.1 0.4 1.2 1.7 33 4 Mubende 14.8 11.2 19.9 28.0 1 640 527 Kasese 11.3 10.6 17.2 21.7 25 313 448 Mukono 8.4 6.4 11.3 15.9 105 508 376 Kassanda 17.7 13.4 23.8 33.6 21 666 411 Nabilatuk 51.9 20.6 59.3 60.5 160 35 Katakwi 37.4 21.0 47.3 60.5 2 746 135 Nakapiripirit 54.5 21.6 59.3 60.5 1 138 60 Kayunga 6.7 5.1 9.1 12.8 257 64 Nakaseke 27.3 20.7 36.8 51.8 1 379 253 Kazo 8.6 7.7 15.7 18.2 139 252 Nakasongola 56.0 56.0 56.0 60.5 15 581 170 Kibaale 35.6 15.2 37.1 54.4 13 129 109 Namayingo 29.3 31.6 43.0 60.5 14 288 205 Kiboga 24.6 18.6 33.1 46.6 2 309 98 Namisindwa 24.9 17.0 27.5 40.9 96 66 Kibuku 6.4 7.0 8.1 11.5 3 249 81 Namutumba 24.9 26.9 36.6 52.3 29 1015 44 Kikuube 19.0 8.1 19.8 29.1 12 297 132 Napak 51.6 20.5 59.0 60.5 14 118 55 Kiruhura 24.2 21.6 43.9 50.9 2 58 113 Nebbi 23.9 12.8 36.6 44.2 6 169 64 Kiryandongo 23.0 9.8 24.0 35.2 4 187 36 Ngora 16.7 9.4 21.1 30.1 1 78 41 Kisoro 13.9 12.3 18.5 23.7 9 237 29 Ntoroko 30.5 28.5 46.3 58.4 3 14 68 Kitagwenda 31.0 28.9 47.0 60.5 8 141 191 Ntungamo 19.9 17.7 36.1 41.8 10 295 290 Kitgum 41.1 8.9 37.1 55.5 27 491 228 Nwoya 27.8 6.0 25.1 37.5 6 149 76 Koboko 7.7 4.1 11.8 14.2 1 7 6 Obongi 27.9 14.9 42.6 51.5 2 286 170 Kole 26.8 13.0 26.8 35.9 3 262 85 Omoro 25.9 5.6 23.3 34.9 5 96 3 Kotido 27.3 10.8 31.1 42.1 24 321 30 Otuke 56.0 56.0 56.0 60.5 3 274 6 Kumi 33.5 18.9 42.4 60.5 1 975 131 Oyam 42.0 20.4 42.0 56.1 19 656 253 Kwania 32.6 15.8 32.6 43.5 3 110 25 Pader 21.9 4.7 19.7 29.5 2 147 71 Kween 18.6 12.6 20.5 30.4 70 10 Pakwach 18.0 9.6 27.5 33.2 165 4 Kyankwanzi 3.8 2.9 5.2 7.3 2 317 187 Pallisa 56.0 56.0 56.0 60.5 18 445 25 Kyegegwa 17.6 16.4 26.7 33.7 8 278 177 Rakai 22.5 15.2 26.9 37.1 2 204 115 Kyenjojo 50.1 46.8 59.3 60.5 34 568 767 Rubanda 24.9 22.1 33.0 42.5 11 247 54 Kyotera 32.1 21.6 38.3 52.8 10 202 146 Rubirizi 39.3 35.0 59.3 60.5 6 79 121 Lamwo 53.1 11.5 47.9 60.5 7 213 29 Rukiga 34.5 30.6 45.8 58.9 9 457 100 Lira 20.9 10.2 20.9 28.0 2 668 417 Rukungiri 17.8 15.8 23.7 30.4 2 429 294 Luuka 8.5 9.2 12.5 17.8 11 77 318 Rwampara 16.0 14.3 29.0 33.6 4 72 97 Luwero 17.0 12.9 22.9 32.2 33 870 452 Sembabule 40.0 26.9 47.8 60.5 7 351 223 Lwengo 24.6 16.5 29.3 40.5 2 267 182 Serere 14.5 8.2 18.3 26.1 2 384 54 Lyantonde 25.7 17.3 30.7 42.3 43 112 Sheema 41.7 37.2 59.3 60.5 3 164 207 Madi-Okollo 15.3 8.2 23.4 28.2 2 92 77

Family Planning Atlas 2020 Family Planning Atlas 2020 77 78 Family Planning Atlas 2020 Page 72 Table 5: Gender Based Violence by district, 2019 – cont’d District Physical Sexual Emotional All Injuries Sexually VAW VAW VAW forms Abortions Due To Transmitted of Due To GBV Infection Due VAW GBV To SGBV Manafwa 18.7 12.8 20.7 30.7 2 228 6 Maracha 8.4 4.5 12.9 15.6 1 46 33 Masaka 8.9 6.0 10.6 14.7 11 488 319 Masindi 46.8 20.0 48.7 60.5 4 369 64 Mayuge 9.5 10.2 13.9 19.9 20 533 433 Mbale 19.3 13.1 21.3 31.6 43 3385 916 Mbarara 31.0 27.7 56.3 60.5 35 715 494 Mitooma 33.9 30.3 59.3 60.5 1 76 326 Mityana 11.9 9.0 16.1 22.6 3 213 213 Moroto 56.5 22.4 59.3 60.5 6 285 11 Moyo 56.0 56.0 56.0 60.5 5 422 18 Mpigi 36.0 24.2 43.0 60.5 24 281 344 Mubende 14.8 11.2 19.9 28.0 1 640 527 Mukono 8.4 6.4 11.3 15.9 105 508 376 Nabilatuk 51.9 20.6 59.3 60.5 160 35 Nakapiripirit 54.5 21.6 59.3 60.5 1 138 60 Nakaseke 27.3 20.7 36.8 51.8 1 379 253 Nakasongola 56.0 56.0 56.0 60.5 15 581 170 Namayingo 29.3 31.6 43.0 60.5 14 288 205 Namisindwa 24.9 17.0 27.5 40.9 96 66 Namutumba 24.9 26.9 36.6 52.3 29 1015 44 Napak 51.6 20.5 59.0 60.5 14 118 55 Nebbi 23.9 12.8 36.6 44.2 6 169 64 Ngora 16.7 9.4 21.1 30.1 1 78 41 Ntoroko 30.5 28.5 46.3 58.4 3 14 68 Ntungamo 19.9 17.7 36.1 41.8 10 295 290 Nwoya 27.8 6.0 25.1 37.5 6 149 76 Obongi 27.9 14.9 42.6 51.5 2 286 170 Omoro 25.9 5.6 23.3 34.9 5 96 3 Otuke 56.0 56.0 56.0 60.5 3 274 6 Oyam 42.0 20.4 42.0 56.1 19 656 253 Pader 21.9 4.7 19.7 29.5 2 147 71 Pakwach 18.0 9.6 27.5 33.2 165 4 Pallisa 56.0 56.0 56.0 60.5 18 445 25 Rakai 22.5 15.2 26.9 37.1 2 204 115 Rubanda 24.9 22.1 33.0 42.5 11 247 54 Rubirizi 39.3 35.0 59.3 60.5 6 79 121 Rukiga 34.5 30.6 45.8 58.9 9 457 100 Rukungiri 17.8 15.8 23.7 30.4 2 429 294 Rwampara 16.0 14.3 29.0 33.6 4 72 97 Sembabule 40.0 26.9 47.8 60.5 7 351 223 Serere 14.5 8.2 18.3 26.1 2 384 54 Sheema 41.7 37.2 59.3 60.5 3 164 207

Family Planning Atlas 2020 78 Family Planning Atlas 2020 Page 73 Table 5: Gender Based Violence by district, 2019 – cont’d District Physical Sexual Emotional All Injuries Sexually VAW VAW VAW forms Abortions Due To Transmitted of Due To GBV Infection Due VAW GBV To SGBV Sironko 41.5 28.2 45.7 60.5 7 302 326 Soroti 5.8 3.2 7.3 10.4 22 252 226 Tororo 30.9 33.7 39.0 55.8 6 1195 244 Wakiso 9.7 6.5 11.6 16.0 94 1066 1669 Yumbe 5.9 3.1 9.0 10.8 3 324 51 Zombo 28.8 15.4 44.1 53.3 6 250 54 Source: small area estimates based on UDHS 2016 estimates and administrative data. * MoH-DHIS2

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