Raped, defiled and abandoned. Such is the grim account that expectant teenage mothers offer health workers at Kawempe National Referral Hospital in Uganda’s capital, Kampala.
The facility opened the doors of its tailored antenatal clinic for teenagers in 2021. And word about it appears to have gained traction among girls, with pregnant ones checking in, in record numbers every week, mainly to seek abortion services.
However, the public hospital does not terminate pregnancy because it is illegal under Ugandan laws.
Instead, the young girls – many aged 12 to 18 – are counselled and, together with caregivers, taught the recommended feeding, personal physical care and pain management techniques during pregnancy, as well as the required preparations for childbirth and how to care for newborns.
In a country where the police reports that eight in every 10 victims of sexual crimes in 2025 were girls, medics say rising cases of young girls not knowing the fathers of their babies is both unsurprising and worrying.
Fifteen-year-old Sandra Amule (not real name) is supposed to be a Primary Seven pupil at a school in Kasangati, Wakiso District, preparing to take Primary Leaving Examinations (PLE) by year-end.
Sadly, she is not. Instead, Amule is at home, preparing to give birth, probably in August or September, to a child conceived out of rape.
A hooded attacker, Amule says, waylaid her while returning home from evening lessons at her school. The teenager never alerted her mother, the police or local council officials.
Investigators say the lapse of time and unwillingness of the victim to lodge a complaint dim the prospect of tracing the suspect and bringing them to book.
Another victim of sexual assault, Shamila Nambaziira (not real name), also aged 15, has dropped out of school in Primary Six at a school, off Bombo Road, after finding out she was pregnant.
A resident of Katanga, Wandegeya in the outskirts of Kampala City, Nambaziira does not know the father of her unborn child. Why? Because, she says, she was raped, never made an alarm and the sexual assaulter fled.
Katanga is a lowbed shanty settlement sandwiched between Uganda’s intellectual powerhouse of Makerere University and the country’s national referral hospital on Mulago Hill.
However, in this ghetto residence, petty thieving, burglary, drug abuse and commercial sex work are commonplace.
The population is largely transient. Indeed, it is unsurprising to encounter a new neighbour in the morning different from the one who occupied the room the previous evening, making a recollection of who is a resident or passerby elusive.
It is in this complex setting that twin misfortunes struck Nambaziira. First, the father abandoned her and two siblings in a rented single room in this crime-plagued slum. There is no word on the whereabouts of their mother.
The children, eventually, ran behind on rent. Then their neighbour, fondly called Aunt Sarah Pony, stepped in to shelter them.
Pony noticed something unusual about Nambaziira’s cravings, prompting her to take the teenager to Kawempe National Referral Hospital for pregnancy check.
The positive test result spelled for the teenager a second mischance, resulting in a drop-out of school, without certainty that the break from formal learning will be temporary.
Medics at the facility also handled the case of Irene Nasuuti (not real name), who told this newspaper that she did not, for months, know that she was expecting until a pregnancy test.
Her paternal grandmother with whom she lived in Janda, Namugongo in Wakiso District, had noticed unusual physical changes on her 16-year-old granddaughter, but, for unexplained reasons, ignored them.
In late February 2026, the girl left Janda and relocated to Lukuli, a Kampala suburb. Her observant host and maternal grandmother wasted no time. She took the teenager to a clinic, where she was confirmed pregnant.
Sadly, Nasuuti says she does not know the prospective father. Nasuuti’s recollection of events surrounding the conception are hazy.
On August 3, 2025, her school took them to swim in Namugongo, where her boyfriend, who purportedly studied in Jinja, was present as were students from other institutions.
She says she was offered a drink which made her feel dizzy, only to be woken up naked by her friends in the washrooms around 2pm on the fateful day.
The friends cleaned and dressed her up. The girl says she does not know the school of her lover, does not have his telephone contact and has no idea where he lives.
Ms Kristine Blokhus, the UNFPA country representative, said 24 percent of Ugandan girls get pregnant before their 19th birthday.
The downside for the girls and country, she noted, is that they drop out of school, become economically less productive and are short on savings and investments.
Ms Blokhus said Ugandan can reduce the problem of teenage pregnancies when both men and women work together to understand and practise their gender roles in society.
For Ms Barbara Atuhaire, the East Africa Safeguarding Officer for Horizont3000, an Austrian government human rights non-governmental organisation, the tragedy in Uganda is that cases of men impregnating young girls are ‘killed’ at household level under the guise of protecting the name of families.
She said they have observed instances of fathers impregnating daughters and forcing them to abort, while women are also sleeping with their sons.
Both acts under the Penal Code Act constitute the criminal offence of incest, punishable with prison terms.
‘Cultural leaders are shielding the perpetrators and they end up doing mediation at family level,’ said Ms Atuhaire, noting that remedies envisaged in the Marriage and Divorce Bill remain a pipe dream due to opposition to enactment of the proposed legislation.
In the end, she noted, perpetrators are shielded, accountability and justice denied and victims ‘married off’ to mask abuse as legitimate union.
Is there hope?
Ms Lillian Mpabulungi Ssengoba, the sexual reproductive health technical advisor for Care Uganda International, said successful prosecution of defilement and other sexual offences cases is challenged by weak laws and enfeebled justice systems.
She noted that once a girl gets pregnant, she immediately starts to seek help. She said at this stage, the girls will tell the whole story because at that time, they are scared and just want to get rid of the pregnancy. That explains why some will give birth and abandon the baby in hospital.
‘They will give you the wrong name because the person responsible has run away, the parents don’t want them (the girls) to come [home] with that child, or because the mother and father [of the teenager] are fighting because the girl is pregnant. In most cases, the child ends up with the grandmother who will normally okay the pregnancy,’ Ms Ssengoba explained.
She noted that a number of girls do not know that they are pregnant even in the eighth month because, due to poverty, missing their monthly menstruation is presumed beneficial in savings on sanitary pads.
The legal pathways to terminate a pregnancy are often not available to such girls. Although the laws prohibit abortion in Uganda, the Centre for Health, Human Rights and Development (CEHURD) says exemptions exist for life-and-death situations.
In such situations, CEHURD’s advocacy officer Rhodine Kitandwe said the removal of a foetus must be done by a licenced skilled medical professional and through a surgical procedure to save the life of the mother or preserve that of the unborn baby.
She said it is imperative that teenage girls are educated about reproductive health services, including circumstances leading to pregnancy and its socioeconomic and psychological effects so that the person can choose whether to use contraceptives to avoid another pregnancy.
Obstetrician-gynecologist Simon Kayondo said 25 percent of all pregnancies in the country are of teenagers, mainly due to poverty, non-use of contraceptives and differing customs.
Most women from poor families, he noted, are lured by men into unprotected sex in exchange for cash for upkeep or gifts they cannot buy for themselves.
Dr Kayondo noted that sometimes health workers turn young girls seeking contraceptives and family planning methods away from the health facilities, because they assume the teenagers require consent of their parents or guardians.
Citing the necessity for sexuality education, he argued that girls should be given all the necessary information they need to stay free of pregnancy and sexually-transmitted.
‘Give them age-appropriate sexuality education. If they (girls) engage in sex, teach them how to prevent sexually transmitted diseases, how to prevent unwanted pregnancies, and access to contraception,’ he said.
Ms Carol Amase, the programme manager at Local Maternity Newborns Systems, told this newspaper that the Health ministry is working to reduce teenage pregnancies in the country but results require ‘multi-sectoral approach’
‘We need the participation of political leaders, teachers, religious and cultural leaders. Whenever a rape [or defilement] case is reported, there is a tendency of parents of the victim to negotiate with the family of the perpetrator,’ she said, noting the practice is illegal.