Gender Gender

Adolescents’ challenges to SRH services

ZAMBIA has a youthful population, 25 percent of whom are adolescents. Adolescence is a period characterised by various developmental changes with key health needs and rights.
During this stage of life, access to information and services is crucial for informed decision-making and positive health seeking behaviours among young people.
However, in Zambia, adolescents experience various challenges in accessing sexual reproductive health (SRH) information and services.
About 65 percent of adolescents aged 15 to 19 experience barriers in accessing SRH services, with distance and transportation problems being the most common barriers.
Other barriers are lack of confidentiality and privacy given that the health care providers, support staff and youth volunteers are from within their communities.
(The actual names of the adolescents in these quotes have been withheld to protect their identities).
“We don’t go to the clinic here because we don’t want everyone in the community to know that we went there to get this or that service… When you tell those people [health care providers and volunteers], the next thing is you will hear it from your parents,” Mwape Chembo says.
Other adolescents are concerned about negative provider attitudes such as being sent back from a health facility or given incomplete information as the provider feels it is not right for them to access information because they are young.
“When we went to the clinic, the nurse decided what information to give us. She said she was not going to promote promiscuous behaviour among us,” Margaret Mwenda says.
The pubescent young people also noted that the youth-friendly spaces and corners in health facilities are mostly managed by youth volunteers, who have limited training in providing SRHR information or limited to providing particular SRHR information such as HIV.
This results in inadequate SRH information and lack of access to services to help them prevent unwanted pregnancies.
Adolescent pregnancy is recognised as a major demographic and public health challenge with 29 percent of pubescent girls aged 15 to 19 having experienced childbirth.
In rural areas, adolescent pregnancy is higher at 37 percent than in urban areas at 19 percent. This is compounded by early and forced child marriages. For unmarried adolescents, pregnancies are likely to be unintended or unwanted.
Where the youths do not have reliable information on SRHR, they instead opt for illegal abortions, which are performed under unsanitary and unsafe conditions.
While there are limited statistics of the impact of unsafe abortions on adolescents, the Ministry of Health estimates that about 23 percent of incomplete abortions are among women younger than 20 years, while 25 percent of maternal deaths due to induced abortions are in girls younger than 18 years.
Hospital-based studies show that 30 to 50 percent of acute gynaecological admissions are currently as a result of abortion complications.
It is for this reason that the Zambia Association for Gynaecologists and Obstetricians (ZAGO) has launched the nationwide SafeChoices campaign aimed at enhancing reproductive health rights of adolescents.
ZAGO president Swebby Macha believes that without the campaign, Zambia’s adolescent population faces the risk of death or contraction of infectious diseases.
Dr Macha is of the view that young people must be presented with accurate information and also services to enable them (adolescents) make informed SRH decisions.
“To ensure that reproductive health of adolescents is enhanced, the SafeChoices campaign, primarily targeted at adolescent girls in Zambia, will sensitise the target audience on their social reproductive health and rights, available reproductive health services available, and dangers of early pregnancy and unsafe termination,” he says.
Dr Macha explained that the key outcome of the campaign is to provide information on safe methods of avoiding early and unwanted pregnancy, as well as seeking professional medical services that would prevent unsafe and sometimes fatal abortions.
He, however, says the foremost message that ZAGO sends to young people is to abstain to avoid unwanted pregnancies and diseases.
And a Lusaka-based youth, Mputa Ngalande, has welcomed the SafeChoices campaign, saying it has come at the right time when pregnancies among youths in the country are high.
Similarly, Esnart Chishi, a youth from Youth Action Zambia, believes SafeChoices has come at the right time when adolescents have nothing much to do and can involve themselves in the campaign.
It is, therefore, important that Government and stakeholders promote SRHR of women and adolescents to prevent deaths or risk of diseases.

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