LINDA NYONDO, Lusaka
EARLY and unintended pregnancy (EUP) is a global concern affecting both high-income countries and low and middle-income countries. It has a major impact on the lives of adolescents, especially girls, in terms of their health, social, economic and educational outcomes.
The term ‘early’ relates to the correlation between lower age and the increased risk of adverse health and social consequences for the mother and her newborn while the term ‘unintended’ refers to unplanned or unexpected pregnancies, which should be addressed separately from pregnancies that are early and planned.
For adolescent girls (aged 10–19 years), experiencing pregnancy while still at school often means facing harsh social sanctions and difficult choices that have life-long consequences.
Becoming pregnant could mean expulsion from home and school; vulnerability to early marriage; being shamed and stigmatised by family, community members and peers; increased vulnerability to violence and abuse; and greater poverty and economic hardship.
This is why the launch of ‘Let’s talk’ campaign by United Nations Education, Scientific and Cultural Organisation (UNESCO) to stir discussions on early and unintended pregnancies (EUP) among girls aged between 15 to 19 years could not have come at a better time.
The campaign, which was launched on July 31, 2019 in Johannesburg, South Africa, in partnership with 10 implementing countries in Eastern and Southern Africa (ESA), including Zambia, who were represented by parliamentarians, aims to reverse the high numbers of girls who fall pregnant early or unintentionally.
Zambia’s involvement in this campaign is welcome as statistics released by Zambia Demographic Health Survey (DHS) reveal that 36 percent of girls who get pregnant are from rural areas while 20 percent are from urban areas, which is a clear indication on the need to accelerate provision of sexual reproductive health services (SRHS) to the endangered age group.
With 46 percent of all unintended pregnancies recorded in Zambia being of girls aged between 15 and 19, the country is on the right track to address challenges that are causing early and unintended pregnancies among the young girls.
Among the challenges, the Situational Analysis on Early and Unintended pregnancy in Eastern and Southern Africa (SAEUP-ESA), has identified poverty, culture and tradition, long distances to the nearest schools, lack of information on SRHS and lack of access to youth-friendly corners to be some of the factors responsible for pregnancies among the young girls.
Government is alive to this fact and has therefore shown commitment by formulating policy responses, guidelines and frameworks that address early and unintended pregnancies in Zambia.
Other policies include the 2017 Adolescent Health Strategy of 2017 to 2021 which gives guidance on the provision of HIV and sexual reproductive health-related information and services.
The above policy also strengthens the youth friendliness of existing services with a particular focus on reducing stigma and discrimination faced by young people and improving sexual reproductive health (SRH) service provider attitude.
SAEUP-ESA notes that other than policy formulation, Government under the Ministry of General Education has instituted interventions such as introduction of the re-entry policy, introduction of life skills-based Comprehensive Sexuality Education (CSE) framework which contains CSE health information for young people in school.
For the out-of-school adolescents, the Government has also developed an out-of-school CSE curriculum which is being implemented by Ministry of Youth, Sport and Child Development aimed at providing sexual reproductive health services (SRH).
The aforementioned measures and policies have cheered UNESCO regional representative Hubert Gijzen, who believes the ‘Let’s talk’ campaign will easily fit into already existing programmes by the Government and its partners, who are implementing other schemes such as the ‘He for She’ campaign and Boyz to Men.
Professor Gijzen is of the view that respective implementing countries should also endeavour to integrate topics which address challenges that adolescents’ girls and boys encounter.
“Strengthening of linkages in schools and improving the health sector to a level where they become youth-friendly will enable adolescents to get information on SRH.
“We believe that religious and traditional leaders are influential in most communities, therefore they have to be aggressive in the campaign against early and unintended pregnancies and child marriages to help reduce the number of girls who become victims,’’ he says.
Additionally, United Nations Population Fund (UNFPA) regional representative Julietta Onabanjo says development will only take place when challenges which young people face are addressed.
Ms Onabanjo says chances of completing secondary education for girls who get pregnant at a tender age are low.
She explains that such girls are likely to have uneducated children because the adolescent mothers themselves are not educated.
“Some of the girls who get pregnant at an early age suffer from fistula because their bodies are not fully developed, so as they try to deliver, they undergo complications.
Even just one early and unintended pregnancy is not acceptable, because it can lead to death,’’ Ms Onabanjo notes.
She says there is need to ensure that pregnancies happen at the right time, by choice and not by chance.
And Grace Sakala, a champion of early and unintended pregnancies in Zambia, believes the “Let’s talk” is an opportunity to raise awareness among the public, especially parents, about the re-entry policy.
Ms Sakala is of the view that the campaign be intensified in rural areas where Zambia is recording high cases of early pregnancies.
“We are hopeful that issues such as culture, religion and poverty, which are the major causes of early and unintended pregnancies, will be addressed with the urgency they deserve,’’ she says.
LINDA NYONDO, Lusaka