Nataliya Nakawooya was born in Lulagala, a small village in the Mubende district of central Uganda. She and her five siblings were raised by her grandparents in a small hut with no electricity or running water. When asked what she wished for as a child, Nataliya said simply, “I didn’t have any dreams, because our times were not easy.” Nataliya’s sister convinced her to drop out of school at 16 to get married, but it did not last. “I got married to him, but I didn’t stay long,” explained Nataliya. “He used to treat me very badly …. I only delivered one child with him and I left.” She was 19 when she had her first child.
Nataliya wither daughters Madelina and Viola outside her home in Mubende, Uganda
She eventually married again and today has seven children. Nataliya works on her small farm, growing cassava and sweet potatoes. She keeps most of the food she grows to feed her family, but sells any extra cassava she harvests to buy sugar. In addition to working on her own farm, Nataliya also works her neighbors’ fields and sells bottled fuel on the roadside in front of her house and pancakes from a stand in town.
Nataliya and her husband, who is also a farmer, work tirelessly to provide food for their seven children and earn enough to send them to school, but they often fall short. “We don’t have enough money. Life is not easy. It’s not easy to take care of so many children,” Nataliya explained. “I worry about food sometimes, because the season hasn’t been good.” When she runs low on funds the children are forced to stay home from school until she can raise enough to send them back. “When I get the money, I am going to take it and make sure she goes back to school,” Nataliya said, gesturing at her daughter Viola.
After the birth of her sixth child, Nataliya decided to start using family planning, but accidentally got pregnant again, “Something just didn’t work out. It’s my fault because I didn’t consult a health provider.” Once her last child was born, Nataliya went to the community health center to learn more about her options. “I went to the medical [doctor] and he gave me health education. So I said, ‘Let me try this new injectable and see’ … because I didn’t want any more children,” Nataliya said.
Today, Nataliya uses Sayana Press, a three-month injectable delivered to her doorstep by a village health team (VHT) worker trained by PATH, a USAID-supported global health organization. Nataliya stressed the convenience of having her contraception delivered saying, “when you call the VHT or the health worker they drive their car, they ride their bicycle or motorcycle — they come and give you the injection and you’re good to go … It’s very convenient.”
Alfunsi Sentongo, village health team (VHT) worker trained by PATH to counsel and provide contraception in his community, outside his home in Mubende with a Sayana Press injection
“I can’t even imagine my life without family planning. I imagine either 7, 8, 9 children, maybe up to 12,” Nataliya says. For her, the ability to prevent future pregnancies is one of the keys to building the better life she envisions for the children already has. “I want to work so hard so my children’s lives can be different than mine,” she explained. “I want them to go to school. I want them to go study to the end so at least my kids can be something. I didn’t go to school myself.”
Nataliya added that she hoped all the women in Uganda could access the contraceptives they want, saying, “I would like all the women to get the family planning method, especially Sayana Press, so they can get peace of mind — their lives can be better.”
Nataliya’s access to her three-month injectable contraceptive is thanks to a partnership between PATH, USAID, the Government of Uganda, the UN Population Fund (UNFPA), and other partners. PATH leveraged assistance from USAID to develop the Sayana Press Uniject injection system that combines drug and needle in one, making it easy to distribute and use by both community health workers like Alfunsi and women who may want to inject themselves. UNFPA also plays the critical role of purchasing Sayana Press and distributing it for free. PATH has trained over 1,200 VHT workers, distributed 70,000 doses of Sayana Press in Uganda, and plans to expand provision to other women, like Nataliya, in need. Click here to learn more.
“I would like all the women to get the family planning method, especially Sayana Press, so they can get peace of mind — their lives can be better.”