By Sophie, SRH youth champion
By the time I had left secondary school at the age of 13, ten of my friends had become pregnant. As time went by, many of my friends had dropped out of school because of pregnancy. Although we have a re-entry policy for pregnant girls in primary and secondary school, these policies are toothless because when girls become pregnant, they are expelled from school and most of the time aren’t allowed to resume their studies after delivery.
Realistically, in the prime of their youth, young people are sexually active. Little or no education is extended to them on how to go through such situations. The few bold ones seek help but the majority choose to figure things out for themselves. At first, I was tempted to think that this only happens in Uganda, where 78% of the population is below the age of 30, only to learn the same happens elsewhere. The challenges that young people face are not any different. They are similar.
The question of social, religious and cultural perceptions is one that has least been tended to. None of these three arms of the community is receptive to contraceptive use among women. Young women who muster the courage to use contraceptives are labelled as prostitutes. It is seen as a taboo to use contraceptives and this is a huge stumbling block. Pastors openly declare their lack of support on their pulpits in church, so do community elders, as is the case among families.
Those who are brave enough to seek family planning services, in most cases, are met with unwelcome attitudes of family planning service providers. This creates fear and intimidation. As a result, they end up not seeking any services. At times, they are even denied a chance to share their problems and are forced to find answers elsewhere. When these young women, especially teenage girls are denied an audience, they fear going back to seek help. And this leaves them ignorant. Many teenage pregnancies could be avoided if all girls were listened to or guided. This comes coupled with a high level of illiteracy, especially among young women in rural areas who only rely on medical personnel for information regarding contraception. They are the only ones who can read and interpret the information written on those labels. This is quite devastating especially to single, but also, young mothers. It becomes worse in a situation where the man, because of his ego, is afraid of seeking help.
A lack of sexuality education leaves huge information gaps
The ban on sexuality education in Uganda has left an information gap for the youth who end up falling victim to inaccurate but also misleading information that affects their health. In the past, we had structures where young people could receive sexuality education through their uncles and aunties but all of these structures no longer exist. Therefore, young people, both in and out of school rely on their peers for information. And yet, you find that out of school, sexuality is treated as a sacred issue. Sadly, information received from peers is, more often than not, distorted. A story is told by a friend who was advised by her peers that washing one’s vagina after sex with Coca Cola eliminates any chance of getting pregnant. Or that when you have sex while standing or jumping it reduces the chances of getting pregnant. But since when was Coca Cola marketed as a contraceptive? How many more myths are doing the rounds among girls? How then shall we curb teenage pregnancy which stands at 24.3% in Uganda?
The price is too high:
One challenge we cannot run away from is the high price of the contraceptives. The only affordable readily available contraception are condoms, which are more accessible in urban areas. In hard-to-reach areas they are not in the shops, yet sexually active rural youth outnumber youth in urban centres. There is inadequate space and time to discuss contraception. Youth friendly service corners are scarce in health centre IVs and they only stand at 3%, even though it is mandated *.
Young people are left out of decision-making processes:
There is no meaningful participation of young people in the drafting and designing of policies and guidelines with regards to contraception and other issues concerning their health. As a result, unfavourable policies are put in place that do not necessarily address the needs and interests of young people. In 2016, we had issues with the launch of the national youth policy when young people went on strike after the government sent a representative who was above 70 years of age. They claimed he was neither involved in youth affairs nor did he ever consult them.
What needs to happen?
Young people should be included in the drafting, designing and implementing of all policy processes. Their participation and involvement is highly called for, and needed. There should be monitoring and follow up on commitments to ensure they are implemented because one cannot guarantee that the work is done, without outputs. For every pledge, there should be the will to effect it. This includes the government and civil society organizations.
There is a need to ensure that a diverse set of young people are well catered for because youth ranges from 12 to 35. Their interests and demands are different depending on their backgrounds, training, exposure and the will to buy contraceptives.
Today, there is an advantage that quite a number of youth initiatives have been established in various parts of the country. These platforms are ripe for the government to work closely with them. It is much better in terms of helping them learn more about family planning and its importance to them. Ideas on how to acquire affordable and relevant services is key. Young people need to know what the appropriate family planning methods are for them, through education and increased access to youth-friendly services.
*In Uganda, health provision is decentralized. There are Village Health Teams (VHTs) working at the community level, Health Centre II working at the parish level, and Health Centre III working at a sub-county level. Health centre IVs work at the county level and at the national referral hospital.