By THANDIWE MOYO-
ACCESS to sexual and reproductive health services has generally been difficult in many African countries including Zambia.
Additionally, the numbers of teenage pregnancies and unplanned pregnancies keep escalating due to the challenges women and girls face in accessing sexual reproductive health services.
For rural areas, the problem is even bigger because of fewer hospitals, most of which are located in the urban areas.
And the few health facilities in rural areas have a shortage of health workers as well as inadequate sexual reproductive health commodities.
To make matters worse, women in some rural areas lack adequate knowledge to help them make proper decisions regarding their health.
The lack of proper information on sexual reproductive health services among the women and girls in rural areas has a big challenge that has played a role in increasing the numbers of teenage and unplanned pregnancies.
The lack of access to sexual reproductive health services by women in the country’s remote areas is a serious concern.
Ruth Chulu, 25, a resident of Chinyunyu in Chongwe District said she lacks proper information on sexual reproductive health services.
Ms Chulu, who is currently pregnant and has a small baby, said she conceived because the contraceptive method she relies on did not work.
Besides that, she was not given any alternative birth control method that she can rely on.
She said after taking a contraceptive pill, which is often referred to as the birth control pill, Ms Chulu still conceived.
According to her, the pill was not effective.
She said the health worker at the local health facility who attended to her did not explain why the pills were not being effective.
Ms Chulu admitted to not adhering to the stipulated time for her contraceptives and that on some days, she did not take the pills because the local health facility did not have enough supply.
She further said she takes the oral birth control pills and hopes she could be educated on other methods birth control methods such as the female condom, the inplant (arm bar), IUD tubal ligation and others that do not have to be taken orally.
Ms Chulu said she travelled all the way from Chinyunyu to Lusaka in the hope of accessing proper information on the birth control methods and further access sexual reproductive health commodities.
“I have three children already. Once I deliver I will have four. I did not plan for this. My husband has no capacity to feed these children. Having more children is a burden and a cost already. However, I hope this time I will be equipped with information on the method I can use,” she said.
Mercy Chabala, 35, a resident of Lumpampa in Serenje District, said accessing sexual reproductive health commodities is a challenge as the health facility in her area is very far.
She urged Ministry of Health to ensure that it provides sexual reproductive health services near her community so that women and girls in the area can access the services.
Ms Chabala said she does not understand the various sexual reproductive health commodities as she is only conversant with the birth control pills.
Chilumba Mwamba, 41, of Chisomo in Serenje District said although she lives near a health facility and has information about sexual reproduction health, the local clinic does not have enough sexual reproductive health commodities.
She said in some instances, the clinic has inadequate supply of contraceptives.
She said because of that, the local women and the girls are sent to a district hospital or asked to wait for the supplies to be delivered to the clinic.
Ms Mwamba is also concerned with the mode of sensitisation used by the health facility where teenage girls are mixed with elderly women.
“We fail to express ourselves during the sexual reproductive health talks because we are mixed with teenage girls who are not strangers to us. If I ask something private in such a set up, I may end up becoming a laughing stock in the community,” she said.
Ms Mwamba said although a number of women are willing to participate in sexual reproductive health sensitisation programmes, they remained ignorant since the local health facility does not separate the teenage girls from the older women during talks.
Young Women Christian Association (YWCA) said women and girls in rural areas are more vulnerable to issues relating to sexual reproduction health due to various challenges.
According to YWCA programmes officer Miriam Mwiinga, it is depressing to note that the women and the girls face many health challenges due to ignorance and lack of sexual reproductive health commodities.
Ms Mwiinga said it is imperative for health facilities to provide outreach programmes on such information to ensure that the women in rural areas access the services.
Speaking in an interview, a nurse at Chinyunyu health facility in Chongwe District confirmed that the health centre does not have enough sexual reproductive health commodities.
The nurse, who spoke on condition of anonymity, said in cases where the health centre lack adequate sexual reproductive health commodities, the women and the girls are sent to a district hospital.
She said in additional to lacking the desired products, the health centre does not have sufficient staff that can be involved in outreach
initiatives.
The nurse said her clinic was built to provide health services in the community.
She said the women should feel free to ask private questions whenever they visit the clinic because the sexual reproductive health sensitisation cannot be organised for different age groups.
“We have sexual reproductive health sensitisation when the women bring children for checkup, such as under-five programmes, because we understand the importance of this issue,” she said.
Currently the need for sexual reproductive health services in the country has grown dramatically.
However, meeting the demand and providing the required supplies will need not only increased financing, but also improvement in logistics and service delivery systems in the health sector.
For Zambia to attain sexual reproductive health rights, the country needs to ensure that women’s lives are not put at risk by reason of pregnancy, gender or lack of access to health information and services.
This also means that all sexual and reproductive healthcare services should be confidential.