Investing in strengthening access to family planning services for young people

By A Correspondent

What would you have done if, as a parent, you learned of a sudden death of your 18-year old daughter from an unsafe abortion? Disbelief, frustration, desperation, anger that you were not there for her or simply resignation to fate that we are all destined to die one day?

Sad stories of young girls dying from abortion are not uncommon. In Tanzania, abortion accounts for 16% of maternal deaths. Girls die either from bleeding profusely or infection complications. Undeniably, girls dying early from abortion is a harsh reality to accept by most parents and the society in general; it is life lost too soon.

There are few and scattered studies that show the magnitude of abortions on a girl’s life mainly because abortion is illegal in Tanzania, allowed only under specific medical conditions confirmed by a qualified medical doctor. But the prevalence of complications among women and girls hospitalized for an incomplete abortion indicates that such terminations are common.

Abortion studies conducted in Tanzania in the early 90s found that 455 (47%) out of 965 women with incomplete abortion had an induced abortion. Other studies showed that In Dar es Salaam alone, as many as 60% of allegedly spontaneous abortions are in fact induced terminations.

Yet parents and guardians in the country are in denial that girls and boys engage in early and unprotected sex. The mean age of sexual debut is 17 years according to the Demographic and Health Survey (DHS) of 2010. In some parts of the country, sexual activity begins at an early age of 12.

But parents and society at large continue to deny adolescent girls and boys the necessary sexual and reproductive health (SRH) information, education, and services to help them make informed decisions on sexuality matters. The 15-19 year old age group constituting the most vulnerable group is generally inadequately informed about sexuality and sexual health on the pretext of socio-cultural practices and beliefs.

The DHS says that the majority of young people especially in rural areas are ignorant of SRH issues and the effects of early sexual activity. They also cannot easily access reproductive health services, especially contraceptives in most clinics without facing the “wrath” from service providers prejudiced against early sexual activity among adolescents and young people.

The fact that 23% of the 15-19 years old girls are either pregnant or nursing their first babies means access to family planning services, which include contraceptives, information and counseling, is of utmost importance for young people. Only 9.4% of this group use contraceptives according to the DHS, which also shows that the unmet need among this group is 12%.

To let young people live through adolescence - a period of great opportunity but one marked with anxiety and uncertainty – without proper guidance and care is to abandon a whole generation of resourceful individuals. Adolescents and young people especially in African countries including Tanzania find themselves at crossroads facing a number of risks including infections, poor access to social services such as family planning, and being more commonly excluded in public debates making them voiceless clients in the provision of these services.

The hypocrisy evident in condoning cultural practices that deny young people the right to access reproductive health and family planning services, and the grief accompanying the numerous untimely deaths of young girls as a result of abortion, some of which go unrecorded, should stop.

It is indeed deplorable that millions of young people and especially adolescents in most countries in Sub-Saharan Africa, Tanzania included, are left to “feed” on unauthentic SRH information from their peers while minimum investment is made to strengthen their access to SRH services.

For Tanzania for instance, neglecting young people only adds to the already overwhelming burden that the country shoulders as a result of high fertility of 5.4 children per woman of reproductive age (15-49 years) and a rapid annual population growth rate of 2.7%, according to the National Census, 2012 - all of which contribute to a high dependency ratio. Currently, more than four out of ten (44.7%) of the country’s 44.9 million people are a dependent population of below 15 years

This situation must change and the First Ladies conference in Dar es Salaam this week ought to reflect on this generation of young people who carry the promise for Africa’s and global advancement in many years to come.

The young girls and boys who are sexually active need and deserve guidance on SRH issues and services. They need access to family planning services that decades of research indisputably show that they save lives by reducing the number of high-risk pregnancies, unintended pregnancies, and recourse to unsafe abortions.

For the majority of young girls out there struggling through school or living through an unintended pregnancy or worse still agonizing over an unending stigma following an abortion experience that became public, the First Ladies conference provide hope for such challenges to be tabled and addressed.

We therefore, are strongly convinced that it should not be an either or issue but one that calls for commitment to come up with real solutions to real problems that young people face. The First Ladies seize the moment to set the tone in order to preserve life, protect the young generation, and to take a step forward by equipping them with information, knowledge, and tools to help their growth and development. We all owe them that!

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