By Dr Florence Temu, Country Director – Amref Health Africa, Tanzania
But as millions of men and women across the globe used their voices and platforms to #ChooseToChallenge, not much was said about the threat that is silently spreading through Sub Saharan Africa; one characterised by stories of young girls who have become mothers prematurely, often after being coerced into having unprotected sex.
The World Bank estimates that 5,500 Tanzanian girls drop out of school each year as a result of teen pregnancy, while the Tanzania Demographic Health Survey of 2015/16 reported an increase in the teenage pregnancy rate among girls aged 15-19 years, from 23 per cent in 2010 to 27 per cent in 2015.
While sexual initiation occurs at an increasingly younger age (less than 15 years), as a result of cultural practices such as early marriage as well as peer pressure, a corresponding spike in the adolescent fertility rate is reported, with at least one in seven girls conceiving in their adolescent years.
The same survey puts the use of modern contraceptives is at 18.9 per cent amongst teenage girls, with the unmet need for contraceptives standing at 26.5 per cent within this demographic.
Teenage pregnancy and the unmet need for modern contraceptives continue to negatively affect the health status of adolescent girls and young women in Tanzania.
It is an unfortunate reality and one that requires us to consider various measures and interventions to curb the impending crisis.
Like in many developing countries, access to youth-friendly sexual and reproductive health (SRH) information and services remains a challenge in Tanzania.
According to a recent Service Availability and Readiness Assessment (SARA, yet to be released to the public), while there has been a steady increase in the availability of adolescent-friendly SRH services in the country over the years, their reach is still suboptimal, with only 38 per cent of health facilities employing health personnel trained in youth-friendly skills.
These worrying statistics underscore the need for multifaceted efforts, supportive social and cultural systems to prevent teenage pregnancies. We need to have the right policies in place, with funded strategies that prioritise resource allocation in support of adolescent and youth-friendly reproductive health services. This will promote ease of access to the right information and services for sexually active youth.
The arguments against providing such access are centred largely on morality and culture, with health workers who provide SRH services to youth often accused of encouraging immorality among young people. As such, girls become easy victims or scapegoats where the lines between culture, religion and human rights are often blurred.
We cannot continue to shy away from discussing the factors that expose young girls to misinformation on sex, early sexual activity, teen pregnancy and the resultant stigma, higher maternal mortality, forced marriage and sexual violence.
We need to address the root causes of this threat to our national prosperity: poverty, poor education, lack of access to SRH information, and unfair and dangerous cultural practices that dehumanize young girls and women.
Comprehensive sexuality education for in-school and out-of-school youth needs to be geared towards preventing early sex initiation and harmful traditional practices including female genital mutilation and cutting (FGM/C), which expose girls to early and forced marriage.
This education also needs to promote life skills such as critical thinking, problem-solving and effective communication, health and well-being, and enhance the dignity of young people.
More healthcare workers need to be equipped with basic skills in youth-friendly SRH services, and access to these services expanded and mainstreamed in all healthcare facilities.
It is encouraging to note that several organisations, including Amref Health Africa, are delivering interventions to curb the rise in teenage pregnancies. For example, Amref, through the DREAMS programme, is working with adolescent girls to empower them through the provision of age-appropriate SRH education geared towards delaying sexual activity and addressing harmful traditional practices such as early marriage.
Our aim is to strengthen linkages between school retention, school-based sexual and reproductive health and rights (SRHR) education and youth-friendly health services, and by so doing keep more girls in school. In the past two years we have reached close to 21,000 adolescent girls and young women with SRH, menstrual hygiene and gender violence response and recovery services, contributing to an increase in the school attendance rate from 65 per cent in 2017 to 81 per cent by the end of 2019 in regions such as Shinyanga, Simiyu and Magu in northern Tanzania. By addressing these issues from the grassroots level, we hope to empower a generation that can change the course of a nation and guide Tanzania towards holistic prosperity.
Our collective interventions in health and education need to be based on human rights principles. Access to education, the right information and SRH services are fundamental human rights. Enshrining these rights is not about promoting immorality; it is about empowering youth with the information and services they need to keep themselves safe, make the right choices and give them a better chance at completing their education and contributing meaningfully to economic growth and development.
Children should not be having children. So as we seek to safeguard the health of our young people, let us also offer them sociocultural, political, moral, psychological and legal protection. Our statements and actions should not contradict our wishes for our young generation.
Article first published on IPPMedia.com