Teenage pregnancy: Should children access family planning services?

It’s official. Our children are having sex. And not just sex, unprotected sex. But the parents are burying their heads in the sand.

 

“I have heard people say a girl fell pregnant. Do people fall pregnant?” Dr. Ian Clarke asked satirically drawing even more uncomfortable murmurs across the audience. 

 

 “Maybe,” he paused, “in a way, one falls pregnant, because she never intended to.”

Clarke, who is the chairman of the International Medical Group, was speaking at a dialogue on access to reproductive health. The dialogue was organised by the United Nations Population Fund (UNFPA) recently at Sheraton Hotel.

 

He cited a story of a 21-year-old woman who, seven years ago, gave up her baby for adoption because she was not able to raise it. 

 

“And now she is pregnant again! The fact is that young people will have sex.”

But is it right to talk sex to children? What about family planning for the sexually active children? Would that mean we are encouraging them to have sex?  And what about HIV/AIDS?

 

UNFPA’s country director Janet Jackson said by 15 years of age, 24% of girls and 10% of boys were sexually active.  

“There is silence on sex both at home and school. Because we do not give information, doesn’t mean that the youth do not have sex,” she said.

 

According to Charles Zirarema, the director of population secretariat: “We assume that our children are young. But they are having sex. Girls are getting pregnant at the age of 12 and 13. We need to have something on family planning.”

 

According to a report, protecting the next generation in Uganda: New evidence on Adolescent Sexual and Reproductive Health Needs, published by Guttmacher Institute in 2008, only 34% girls and 22% boys aged between 12 and 14 have received sex education in school. 

 

At home, 71% girls and 64% boys had never talked with parents about sex-related matters.

Experts believe that if family planning methods are freely given to the youth, there would be a difference in combating several problems, such as teenage and unwanted pregnancy. 

 

Jackson says one of every four pregnancies in Uganda occurs in a teenager, because only 11% of sexually active youth are using contraception.

 

She argues that if family planning were accessible, there would be no unwanted pregnancies, which many times result in unsafe abortions and unnecessary death. 

 

Citing a survey in schools around Kampala, Jackson says 21% of the girls had undergone abortion. “This can be avoided and helped through access to both sexuality education and youth friendly services.”

 

Zirarema adds that pregnancy-related complications such as fistula, or other issues like the high dependent population and school dropout rates would be curbed. 

 

Statistics show that nearly half of the 34 million Ugandans comprise youth below 15 years.

There are monetary gains as well. For every £1 spent on family planning at least £4 that would be spent treating complications from unintended pregnancies would be saved, according to a recent report by Save the Children. 

 

“Adolescent girls know little or nothing about family planning; let alone where to get it. Ensuring they are able to plan whether or when to have children means babies and young children are likely to survive and it saves the lives of adolescent girls and women who are pregnant. They will be able to decide whether or when to have a baby,” the report read.

 

During the UNFPA dialogue, participants argued that making family planning accessible to the youth would mean that they go ahead and have unprotected sex. With the HIV infections in the country shooting up, what would this imply?

 

Dr. Jessica Wanyana, a senior official at the health ministry’s reproductive health division is optimistic. She argues that it depends on the approach by the service providers.

 

“When someone asks for an injection or the pill, and you ask them ‘where is your mother, how old are you?’ This is not friendly! The best the person will do is to go have the sex anyway.

 

“True the injection will not help an adolescent from contracting HIV. But by the time she comes for family planning, it means she is sexually active,” Wanyana adds.

 

“She might be more worried about pregnancy than HIV, but it is your role to point out the dangers on both situations. When you have this girl brave enough to come and ask for family planning, that is the best time to advise them to abstain or use a condom,” Wanyana advises.

 

A Save the Children report states that condoms are the only form of contraception that can prevent sexually transmitted infections and are therefore, a critical part of the HIV response as well as unintended pregnancy.

 

Wanyana says the ministry is putting in place “youth corners” at all local health centres to provide as much information on sex and health. 

 

The ‘corners’ will also offer family planning counselling and methods, pregnancy tests, pre- and post-delivery examinations. 

 

Other services that will be given to the youth include diagnosis and treating STDs, HIV testing and dispensing anti-retroviral drugs.

 

She says there is need to be as friendly as possible to adolescents.  

“Let us draw closer to them. There are consequences they face because the teacher, the parent is not listening. They get support from the bad groups,” Wanyana says.