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Empowering Adolescents and Youths will yield long-term benefits

Adolescents have the highest rate of unintended pregnancies and their unmet need for contraception is much higher. In developing countries, roughly half of the pregnancies among adolescents aged 15-19 are unintended, and half of these result in abortions, the majority of which are unsafe.

BY RODNEY KITANDWE

Sustainable development requires ensuring healthy lives and promoting well-being at all ages. To achieve the Sustainable Development Goals of excellent health and well-being, the world must harness the full potential of all generations.

As a young person, I constantly come across contradictory and perplexing messages about gender and sexuality. With the help of a comprehensive and high-quality curriculum-based sexuality education program, I believe that all children and young people can navigate these messages and develop healthy norms about themselves and relationships that can help them become responsible citizens from an informed point of view. Although most governments have some sort of sexuality education program in place, these programs are frequently ineffective or poorly implemented. The emergence of new resources for putting these approaches into practice, as well as newly emerging research findings about effective approaches to sexual and reproductive health and rights, make this a very advantageous time to advance this fundamental human right.

As we commemorate the international youth day 2022 under the theme Inter-Generational Solidarity: In Preventing Teenage Pregnancies and Child marriages, we must promote access to comprehensive contraceptive care and contraceptive methods as an essential component of women’s health care by enacting policies and taking actions that ensure the availability of affordable and accessible services. There is a need to underpin all advocacy and programming work that ensures sexual and reproductive health and rights for all without discrimination. Fulfilling these rights and empowering adolescents and youths to make timely, informed decisions about their own bodies and their place in the world will yield long-term benefits.

Efforts should be made to increase access to emergency contraception, including the removal of the age restriction for contraception products, and to create over-the-counter access to oral contraceptives with full insurance coverage or cost assistance. Adolescents have the highest rate of unintended pregnancies and their unmet need for contraception is much higher. In developing countries, roughly half of the pregnancies among adolescents aged 15-19 are unintended, and half of these result in abortions, the majority of which are unsafe.

When designing programs for young people, it is critical to consider their reasons for not using contraception despite the fact that they do not want a pregnancy. Infrequent sex, concerns about contraceptive side effects, breastfeeding, or opposition to contraception, believing that its use conflicts with their traditions and religious directives are examples of such reasons. In this context, contraception information and education are required, as are efforts to understand and address myths and misconceptions. The revised International Technical Guidance on Sexuality Education establishes key concepts and learning objectives for use in school and community-based sexuality education that are scientifically accurate, comprehensive, age and developmentally appropriate, and based on human rights and gender equality.

The writer is an intern in the Strategic Litigation programme at the Center for Health, Human Rights and Development (CEHURD.

Teenage pregnancies: Let’s deal with root causes, not outcomes

By Doris Kwesiga

How can we expect girls to aspire to greatness when they are dealing with teenage pregnancies?

Uganda has a predominantly young population, with 53 per cent projected to be under the age of 18 years in 2020 according to the Uganda Bureau of Statistics’ 2020 Statistical Abstract. The country also has a high number of teenage pregnancies, for example among girls aged 15-19 years, 25 per cent have started childbearing, with higher rates in the rural areas according to the Uganda Demographic and Health Survey 2016 report. These rates are worsened by the COVID-19 pandemic lockdown and closure of schools. Different studies and media reports show an increased rate of defilement, pregnancies and early marriages. For instance in 2020, the Daily Monitor newspaper reported that there were 3,430 teenage pregnancies in Kitgum, 1,014 in Kabale, 200 among school girls in Kibuku and 130 underage girls in Lwengo were married, among others. These are the reported cases. Several others remain unreported.

Many of these pregnancies are as a result of defilement. Some are due to engagement in early sexual relationships, sometimes with peers, without accurate information on how to avoid pregnancy, beliefs in ineffective myths, fear of seeking Sexual and Reproductive Health (SRH) services or denial of access when they do. 

The immediate consequences of teenage pregnancies are several but the high mortality rate during birth for teenage mothers, plus frequently conducting unsafe abortions are a serious issue. Other effects, some long term, are the interruption in the girls’ education. Many girls will not return to school, a few may later join vocational education and even fewer will return to the formal education structures they were part of. Other possible effects include contracting HIV, in addition to unemployment and thus lower income. These limit their ability to provide good nutrition and care for their children, thus negative trickle-down effects. 

I would like to commend the Government of Uganda for its recent directive allowing pregnant girls to sit for their final exams that are currently underway, giving them extra time, as well as making provisions for those breastfeeding. This is a positive step in trying to ensure girls are educated and acquire the necessary qualifications. 

However, what next for the girls who then go home to look after their babies? As we continue reflecting on this year’s International Women’s Day theme,“Women in leadership: Achieving an equal future in a COVID-19 world”, we need to reflect on the path to leadership for girls. One of the fundamental boosters to getting into leadership, especially at a national, regional or global level, is education. Although we do have leaders within communities and beyond who may not have gone far with their education and are doing amazing things, to go to higher levels one needs more skills picked up along the education pathway. It also helps with building networks and increasing exposure, among others.

How then can we get girls to aspire to greater things when many of them have had their dreams suddenly brought to a standstill by pregnancy at an early age? While it is good to address the visible issues like ensuring they sit exams, are these not majorly outcomes of policies, approaches and cultures that are detrimental to the lives of teenagers, their babies, families and communities? I believe we need to understand the root causes of the problems and be bold in addressing them. 

One of our focus areas should be on increasing access to SRH information and services among adolescents. For instance, with adequate information about SRH, pregnancy and its negativities among younger women, they would know how to protect themselves and avoid pregnancy in the first place or other diseases like HIV/AIDS, where possible. More so, actually ensuring availability of services to those who make informed decisions to use them, would be helpful. However, this goes hand in hand with passing national policies that are progressive to this end.

Additionally, the issues of Sexual and Gender Based Violence (SGBV) are key and should not be avoided. Part of this could involve engaging boys and men as partners in fighting SGBV, alongside provision of safe reporting avenues for victims, and ensuring access to justice. Indeed, another challenge to adolescents realizing their SRH rights is our cultures and beliefs. However, changing cultures is not an overnight process, but one step at a time could make a difference, starting with sensitising communities that SRH services are not necessarily promoting immorality but also saving lives. 

Ms Kwesiga is a Research Fellow at Center for Health, Human Rights and Development (CEHURD).

A version of this article was published in the Daily Monitor Newspaper on 15th March 2021 page 17.