Dispelling Family Planning Myths with Giant Puppets


Marie Stopes Uganda's giant puppets are helping spread the word about family planning.

Marie Stopes Uganda’s giant puppets are helping spread the word about family planning.

The drive to increase access to family planning in Uganda is gaining pace. In 1989, only one in 20 women in the country was using modern contraception to prevent an unintended pregnancy. Today, just one generation later, that figure is almost one in three. But Ugandan women still face barriers. Unsubstantiated fears, stigma, and myths are leading many women to forgo contraception altogether.

Marie Stopes Uganda (MSU), which provides a wide range of short-term, long-term, and permanent contraceptive methods across the country, has been trying to increase awareness to large groups by broadcasting messages and information over loud speakers from mobile vans. But over time, the vans became such a common feature that many people simply ignore them and continue their daily routines without so much as looking up.

The team realised they needed something new to create a greater impact. But what would capture people’s attention?

The answer came from a satirical puppetry programme called The Si Mimi Show, which uses puppets and humour to tackle serious political issues. Hoping puppets would work as effectively for them, Marie MSU enlisted some larger-than-life help to break down the barriers and raise awareness of the facts around contraception.

Ten feet tall with enormous heads, the giant puppets are now helping to draw crowds of interested onlookers to MSU’s Family Health Promotion Days, attracting everyone irrespective of age, social status, religious beliefs, or political affiliation.

The puppets, who represent a mother and father figure, entertain an audience of around 150 people for three to four minutes while a master of ceremonies provides an amusing but educational commentary. At the end of the show, the MSU team swoops into action to raise awareness about the benefits of family planning.

Two police officers pose with the puppets.Zoom

Two police officers pose with the puppets.

To guarantee results, at least six community-based distributors and SRH youth ambassadors trained by Marie Stopes are always part of the event, providing one-on-one counselling as well as registering potential clients, who will receive texts informing them about contraception.

The puppet shows have been conducted in 12 districts and have proven to be a remarkably effective tool in gathering crowds. The team has even noticed women stopping work and leaving their stalls to watch and film the show on their phones. It is also a fun, engaging way to discuss family planning that has led to an immediate increase in family planning clients and couple years of protection (CYPs).

In Mbarara in western Uganda and Gulu and Lira in northern Uganda, Marie Stopes centres achieved half of their total monthly target in just three days, as well as seeing an increase in income, new clients, and helpline calls during the same period. In Kabale district in the Western region of Uganda, our centre achieved its entire monthly target of 360 CYPs in just three days.

In fact, the puppets have proven so successful that they are now one of Marie Stopes Uganda’s key demand generation strategies that will continue into 2018 and beyond. The team is not resting on its laurels, though—we will be maximising impact by monitoring how the results vary over a longer period of time and focusing greater attention on one-on-one counselling, in addition to general community sensitisation.

Breast Cancer Awareness Month: 10 Myths About Breast Cancer

Breast cancer in Uganda is the third commonest cancer in women coming only next to cancer of the cervix and Kaposi’s sarcoma. The incidence of breast cancer in Uganda has doubled from 11:100,000 in 1961 to 22:100,000 in 1995. Knowing the facts about the disease can help you stay healthy, and to detect it early if it strikes. Remember: early detection is key to beating breast cancer.

Read more: How to do a breast self-exam.

10 Breast cancer myths debunked

1. Breast cancer is a ‘white’ disease

Although white women have the highest risk of developing breast cancer, with one in 12 developing it, all women across all racial groups are affected. Asian and Coloured women have a one in 18 chance of developing the disease, and Black women have a one in 49 chance.

2. Only women in ‘high risk’ categories will develop breast cancer

Although certain factors can increase your risk of developing the disease, anyone can be diagnosed with breast cancer. Family history, health, lifestyle and other factors are not a guarantee that you will or won’t get the disease – sometimes it is completely random.

3. Finding a lump means you have breast cancer

Only two out of 10 lumps are cancerous – but you should always get every lump checked by your doctor. Other symptoms of breast cancer include puckering of the skin and/or nipples, rashes, discharge from the nipples, pain, or change in the shape of the breasts or nipples.

4. Breast cancer is contagious

Breast cancer cannot be given to anyone else. It’s an illness that develops because of changes in the cells within your body, and can’t be passed on to another person.

5. Breast cancer can’t be treated

When detected early, breast cancer, like many other types of cancer, can be treated and even beaten. The success of treatment depends largely on how early the cancer is found, which is why regular self-exams are critical.

6. Breast cancer doesn’t affect young women

Although age is a huge risk factor for breast cancer, it can affect adult women of any age. The older you are, however, the greater risk you face, especially once you’re over 50.

7. Using deodorants can cause breast cancer

There’s no conclusive evidence that using deodorants can cause breast cancer, or that the ingredients in them can lead to the disease.

8. Men can’t get breast cancer

This is a myth that surprises a lot of people. Men can get breast cancer because although they don’t have breasts in the same way women do, they still have breast tissue. The percentage of men who get breast cancer is much smaller than women, but they are still affected nonetheless.

9. Age and/or family history are the only risk factors when it comes to breast cancer

There are several risk factors that contribute to your chances of developing the disease. Other factors include being a smoker, being overweight, not following a healthy diet, excessive alcohol consumption, not exercising, and living an overall unhealthy life

10. Having an abortion can increase your risk of breast cancer

Again, studies have found no conclusive link between having had an abortion at any stage of your life and developing breast cancer. Greater risk factors are likely to be your age, your general state of health, how much you drink and/or smoke, and other lifestyle factors that contribute to your overall well-being.

Read more: Early detection of breast cancer: 4 things to know

Book a breast exam at Marie Stopes

Whether you’re concerned about something in particular or just want to ensure you’re in good health, make an appointment at your nearest Marie Stopes centre. We can also give you advice on doing breast self-exams and what to look out for in future.

Find your nearest Marie Stopes centre or Whats-app us now on +256 754 001 503 now for more information.

Breast Self-Examination & Other Vital Health Checks For Women

Most important health checks for women

October is Breast Cancer Awareness month, but in truth, every month should be focused on the good health of women. The earlier illness is detected, the more effectively it can be treated.

The two most important health checks are monthly breast self-examinations and annual pap smears. These two critical checks can help detect cancer while it’s still early enough to treat it, which is why it’s so important to be vigilant about them.

How to do a breast self-examination

Make sure you do this test every month, ideally three to five days after your period ends. If you no longer get your period, choose a set day every month, like the first day of the month, and stick to it.

1. Stand in front of the mirror and look at your breasts. Lift your arms above your head as though trying to reach the ceiling, and look at your breasts in a stretched position.

2. Check to see that there are no obvious changes between the two sides: no nipple changes or visible lumps.

3. Now feel your breasts. Use the flat surface of your fingers. Always keep your hand flat on your breast. A good idea is to apply cream, shower gel, soap or oil to your breasts before beginning. This will help your hand glide easily over your skin and make it easier to feel for lumps.

4. Put one hand on your head, and use the free hand to check the opposite breast.

5. Begin by feeling for lumps in the armpit.

6. Now move in the figure of a six and around the entire breast, until you reach the nipple.

7. Now go back to the armpit, moving from the top to the bottom of the breast, covering the whole area once again.

8. Finally, move from the armpit in a side-to-side direction, again covering the whole breast. Remember that the breast starts from the collarbone and continues down to your abdominal wall, and it runs from your breastbone to mid-way through your side.

9. Also check for any discharge from the nipple. To do this, gently squeeze the nipple to see if any fluid comes out. The only time that fluid should come out is if you’re breast-feeding. If the fluid is yellow or green, it indicates infection. If it is clear, or if blood comes out, go to the doctor immediately for a check-up.

What to look out for during a breast self-exam

• A lump in the breast or armpit. These can range from marble-sized to tennis ball-sized.

• Increase in the size of one breast.

• Swelling in glands of armpit.

• Enlargement of one arm.

• Dimpling of the skin.

• Dimpling of or changes to the nipple.

• Discharge from the nipple.

• Lowering of one breast or nipple.

• ‘Orange peel’ appearance to the skin of the breast and/or nipple.

• Retraction of one or both nipples.

• Dry skin (eczema) of the nipple.

Pap smears

A pap smear is a quick, simple health test that checks for cervical cancer in women. You can learn more about pap smears and why they’re so important in this post and this post.

It’s essential that all women have annual pap smears once they become sexually active. These can be performed by your doctor or at a clinic.

Well Woman packages at Marie Stopes

Marie Stopes offers affordable Well Woman packages that provide all the vital health checks you need in a confidential environment. We’ll also take your medical history, advise you on performing breast self-exams and answer any questions you have.

Let us help you take the best possible care of your body.

Girls being deprived of normal life due to no access to contraception

According to the Performance Monitoring and Accountability (PMA) survey 2020, 78 per cent of youth aged between 15 and 24 live in the rural areas and majority of them do not attend secondary school. Early marriage and early child bearing in Uganda remains high with 34 per cent of 18 -24-year-old married before age 18 and 27 per cent having their first birth by age 18, in addition to almost 32 per cent of 18 – 24-year-olds having two or more children.

Furthermore, the average age at first sex among girls residing in the rural area is 16, while age of first use of contraceptives is 23. In urban areas, the age at first sex is 17 years and the age of first use of contraceptives is 21 years. Therefore, girls in rural areas are most disadvantaged and are prone to risk due to the significant 8-year gap between first sex and first time utilisation of contraceptives. The obvious consequence is unintended pregnancies, a number of which result in unsafe abortions, increased risk of maternal mortality and morbidity. Worth noting is that early pregnancy is a key driver of early marriage and school dropout.
Sadly, these girls are being deprived of a chance to a normal life due to limited or no access to contraception.

In an era where we have witnessed progress in many sectors and many programmes geared towards equality, and bridging the rural/urban divide, it is abundantly clear that being a girl born and raised in the rural areas places one in a default disadvantaged position that will further inequality. Therefore, the question is, “are we failing our girls?” Access to modern contraceptives in Uganda is being hindered by a variety of factors, including legal barriers such as the age of consent, afford ability, availability, inadequate knowledge characterised by myths and misconceptions and the unfriendly attitude of health workers towards young people seeking SRH services. For girls and women from rural and poor backgrounds, accessibility is further hindered by poverty, community perception, limited knowledge and exposure.

Knowledge and use of contraceptives are central elements to reduce unplanned pregnancies and sexually transmitted infections among young people, but it is obvious that the achievement of these goals requires a more comprehensive approach, with the development of a positive adolescent’s sexuality as a necessary component.
Evidence shows that there is a need to strengthen approaches to provide contraceptives.

Girls who are already sexually active must know about contraceptive use. This calls for ensuring affordability, availability and accessibility of these contraceptive services to give women the choice on whether or not to have a child, when and how to space child-birth as well as have control over their bodies and health. Studies have shown that sex education among adolescents plays a vital role in increasing knowledge and empowering young people, especially against unwanted pregnancy, HIV and STIs. This is contrary to the popular belief that access to SRH information will lead to promiscuity among young people. When girls and women have access to contraceptives, fewer girls drop out of school, fewer girls die giving birth and more women enter the work force.
It is critical to invest in young people through education and access to family planning information and services to seize the demographic dividend. We need to help lift the barriers preventing many women and girls from accessing contraception and empowering them with the information they need regarding their sexual reproductive health.

Therefore, as the world marks International Contraceptive Day today, the Ministry of Health, UNFPA, Uganda Family Planning Consortium and CSOs, including Marie Stopes Uganda, organised a youth conference yesterday and a National Family Planning conference starting today and ending tomorrow. The conference aims to provide a platform for young people to dialogue, share with and lobby policy makers to implement programmes that promote access to SRH information and services for young people to enable them seize opportunities to realise their potential.

Ms Kyateka is the head communications and public relations – Marie Stopes Uganda.

faith.n.kyateka@mariestopes or.ug

Marie Stopes Relocates the Jinja Centre

The month of August saw Marie Stopes relocate its Jinja centre from Lubas road to Kampala road. This was done in a bid to serve its clients better through ensuring accessibility and availability of the affordable contraceptive services.

The new location is located on Plot 39 Nile Garden, Kampala road and is highly visible. It is located at the zebra crossing near the Jinja nursing school.

The new location of Jinja centre on Plot 39 Nile Garden opposite Jinja Nursing School on Kampala road.

The new location of Jinja centre on Plot 39 Nile Garden opposite Jinja Nursing School on Kampala road.


During that whole week from 7-12th August, 2017, the clinic offered a number of services namely; free medical consultation, cervical cancer screening, free family planning, health education in the community and other services at a reduced price. The people of Jinja were availed with an opportunity of getting all family planning services free of charge that included switching from one method to another basing on the client’s choice.

According to a 2009 study by the Guttmacher Institute 2017, contraceptive use in Uganda averts approximately 490,000 unintended pregnancies and 150,000 induced abortions each year.

• Meeting just half of women’s unmet need would have resulted in 519,000 fewer unintended pregnancies in 2009, which in turn would have led to 152,000 fewer abortions and saved the lives of 1,600 women.

• If all unmet need for modern contraceptive methods in Uganda would have been satisfied in 2009, maternal mortality would have dropped by 40%, and unplanned births and induced abortions would have declined by about 85% that year(Guttmacher Institute 2017).

The contraceptive prevalence rate of Uganda is 26% (UDHS 2016). Eighteen percent of married women use modern methods, while 6% use a traditional method. As expected, current contraceptive use is higher among sexually active, unmarried women (54%) than among married women (24%) and, in turn, among all women (20%). The likely consequences of low CPR include rapid human population growth resulting in overpopulation, poverty, increased incidences of maternal and infant mortality.

The Marie Stopes team led by the Managing Director Dr Carole Sekimpi took part in a Corporate Social Responsibility and painted the zebra crossing which had faded and  needed an uplift in order to reduce the risk of accidents especially among the students that use that road.

Marie Stopes went further to work with a number of youth that sensitised the community on the number of services offered at the centre.

Contraceptive use among women in Jinja district has been associated with accessibility, availability, affordability and quality of contraceptive services(Tamale, Williams S, 2009).  Some of the community factors associated with contraceptive use include adequate knowledge on contraceptive methods and a perception that the contraceptive methods are effective. Among health services factors were accessibility, availability, affordability and quality of contraceptive services. we do hope that more people shall be able to access the services as a result of shifting the centre to Kampala road.

Marie Stopes has indeed done a service to the people of Jinja by bringing the affordable  services closer to the people while ensuring that the quality is paramount with no compromise.


Tamale, Williams S, 2009.  Factors associated with contraceptive use among women in jinja district. 

http://makir.mak.ac.ug/handle/10570/1296 (viewed 28/8/2017)

Guttmacher Institute 2017 . Contraception and Unintended Pregnancy in Uganda

https://www.guttmacher.org/fact-sheet/contraception-and-unintended-pregnancy-uganda (viewed 28/8/2017)

UDHS 2016  Key Indicators

https://dhsprogram.com/pubs/pdf/PR80/PR80.pdf (viewed 28/8/2017)


URHVP is a follow up to the successful maternal health voucher scheme (Healthy life and Healthy baby) implemented in Western Uganda from 2008-2012. The project finances the demand side through use of vouchers to reduce the likelihood of out-of-pocket payment for deliveries among women in communities served by the program. The four year Ministry of Health (MOH) project kicked off in September 2015 .It is funded by the Swedish Development Agency (SIDA) ,World Bank ,United Nations Population Fund (UNFPA). It is implemented by Marie Stopes Uganda (MSU) as the Voucher Management Agency (VMA) while BDO is the Independent Verification and Evaluation Agent (IVEA).

URHVP is  implemented in 12 districts of South Western Uganda (Mbarara, Kabale, Kanungu, Ntungamo Kiruhura, Sheema, Buhweju, Mitooma, Ibanda, Isingiro, Bushenyi, Rubirizi) and 13 districts of East and Central Uganda (Jinja, Bugiri Kamuli, Buyende, Kaliro, Luuka, Mayuge, Iganga, Namutumba, Kibuku, Tororo, Namayingo and Busia). The primary beneficiaries are the poor and vulnerable pregnant mothers resident within the catchment areas of the contracted health facilities. The contracted Voucher Service Providers (VSPs) and surrounding communities are the secondary beneficiaries.

The project overall aim is to increase access to skilled care among poor women living in rural and disadvantaged areas during pregnancy and delivery.

The project targets 3 key outputs;

  1. Support 142,400 pregnant women to deliver under skilled attendance;
  2. Out of all the vouchers purchased by pregnant women,70% are redeemed to support deliveries in a health facility;
  3. 90% of pregnant women enrolled under the project attend at least one ante natal care visit (ANC 1).

The project comprises of two components.

  • Package of Safe Delivery Services to Poor Pregnant Women.
  • Capacity Building and Project Management

The package of services consists of: four antenatal visits, safe delivery, one postnatal visit, Family Planning ,treatment and management of selected pregnancy-related medical conditions and complications (including caesarean sections), and emergency transport. The package also includes services for Elimination of HIV transmission from mother to child (eMTCT) as part of antenatal care. The VMA takes lead in implementing component one. The specified services are provided by the contracted VSPs that later submit reimbursement claims together with the appropriate voucher coupons to the VMA for settlement at the negotiated and agreed fees.

The pregnant mothers purchase vouchers at Uganda shillings (UGX) 4,000 (US$1.60) from members of Village Health Teams (VHTs) in their areas of residence. A combination of geographical targeting (based on poverty mapping) and a customized poverty grading tool is used to select eligible beneficiaries.

As at March 2017 a total of 247 health facilities were identified, assessed and contracted from both Public, Private not For Profit (PNFP) and Private for Profit (PFP) as illustrated below.

South  Western Region Eastern Region
Service Type Private (PFP/PNFP) Public Total Service Type Private (PFP/PNFP) Public Total
BEmOC 80 12 92 BEmOC 42 74 116
CEmOC 12 18 30 CEmOC 4 5 9
Total 92(75%) 30(25%) 122 Total 46(37%) 79(63%) 125

Component two supports project management functions including building national capacity to mainstream and scale up implementation of safe delivery voucher scheme in the health sector.

With the direct supervision and guidance from MoH, MSU has trained service providers (midwives) on the Basic Emergency Obstetric Care (BEmOC) package (ALARM) and Post-Partum Family planning (PPFP). The project has also trained Doctors and Anaesthetic officers in Comprehensive Emergency Obstetric Care (CEmOC) services.

Urinary Tract Infections: 9 Things You Can Do To Prevent UTIs

Ever sat down on the toilet and felt a searing, burning pain when you tried to urinate? It may also have felt like you couldn’t properly empty your bladder – hardly surprising when it feels like you’re pushing razor blades out of your urethra!

What you experienced was a urinary tract infection (UTI), and some experts say that as many as 50% of women will experience at least one UTI in her lifetime.

What is a UTI, what causes it and what are the symptoms?

A urinary tract infection is an infection in any part of the urinary system, or the urethra, bladder or kidneys. It’s usually caused by bacteria (like e-coli) from the large intestine travelling from the anus to the urethra. This is the primary reason women are taught to wipe from front to back, which limits the risk of contamination.

Once a UTI sets in, it can travel to the bladder and even the kidneys if left untreated, and it can cause serious damage if ignored.

The symptoms of a UTI include:

  • A burning sensation when you urinate
  • Increased urge to urinate, even though very little urine comes out when you go
  • Dark, cloudy or strange-smelling urine
  • Blood in the urine
  • Nausea, vomiting and/or dizziness
  • Pain or pressure in your back or lower abdomen
  • Feeling tired or shaky
  • Feeling fevery (which is a sign that the infection may have spread to your kidneys)

9 Ways to help prevent a UTI

Whether you’ve had one, none or countless UTIs, there are several things you can do to help reduce your chances of contracting an infection – even if you’re in a high-risk category (like if you’re diabetic or menopausal, for example).

You should always:

  • Drink enough fluids to help flush out your bladder regularly (most UTIs are caused by bacteria that’s already in the bladder but allowed to multiply to unhealthy levels. Regular urination helps prevent this build-up).
  • Always empty your bladder after sex, as sexual activity can cause harmful bacteria to travel into your urethra.
  • Never hold it in if you need to urinate.
  • Wipe from front to back after you’ve urinated.
  • Avoid feminine hygiene products as these kill both good and bad bacteria. The good bacteria helps fight the germs that cause UTIs.
  • If you’re prone to UTIs, avoid bathing – stick to showers instead.
  • Wear cotton underwear.
  • Include probiotics in your diet.
  • Always change out of wet or sweaty underwear right away, like after swimming or exercising.

Visit Marie Stopes for your next women’s wellness check-up

Whether you suspect you may have a UTI or you simply want to make sure you’re in the best possible health, pop into your nearest Marie Stopes centre for your annual women’s wellness check up. And, if you have any of the symptoms listed above, get to your doctor, gynae or clinic right away.

Find your nearest Marie Stopes centre or call our toll free hotline 0800220333 now.