ZAMBIA yesterday marked the Youth Day celebrations with a number of activities across the country.
This year’s Youth day was commemorated under the theme, “Unity and innovation for a smart Zambia.”
Various pronouncements were made by a number of stakeholders regarding the well-being of youths in Zambia in the run up to the Youth Day, but it is the commitment to approach the reproductive health challenges for young people with renewed vigor that caught my attention.
Zambia’s population is predominantly young with half of the 13 million people under the age of 14 years. Yet, these young people face significant challenges that include HIV and, sexually transmitted infections (STIs), adolescent pregnancy, unsafe abortion, and gender-based violence (GBV).
The national HIV prevalence as at the last Demographic and Health Survey (DHS) of 2013/2014 stands at 13 per cent with 1.2 million people living with HIV. A total of 720, 000 people are eligible for antiretroviral therapy (ART) and out of this number, 46, 000 are children.
About 12 per cent of young women and 16 per cent of their male counterparts between 15 and 24 years old have had sexual intercourse before the age of 15 while the HIV prevalence in adolescents, currently stands at 4.8 per cent.
Furthermore, 29 per cent of adolescent girls aged 15-19 years have already had a birth or are pregnant with their first child and the percentage of women who have started childbearing increases rapidly with age, from five per cent among women aged 15 years to 59 per cent among the 19 year-olds.
Teenage Pregnancy is higher in rural areas at 36 per cent than 19 per cent in urban areas, and twice as many teenagers with no education (53 per cent) have begun childbearing than those with secondary school education (23 per cent).
In Southern Province, 36 per cent of young women aged 15-19 years have started giving birth and the national level proportion of teenage pregnancy has hardly changed in the last years.
While it is important to acknowledge the crucial role young people have played in Zambia’s development in the pre and post-independence era, there is need for serious introspection into their sexual and reproductive health rights.
Some of the gaps in the provision of reproductive health services to young people that need the attention of all stakeholders include:
Age of consent
The age of consent is not harmonised in different policies and guidelines, thus posing a serious challenge in dispensing reproductive health services, especially contraceptives to adolescents.
Decisions on whether a young person has adequate capacity to access reproductive health services is determined by age, rather than the capacity to assess understanding.
Article 50 of the penal code provides for teenagers who are 16 years and above to have adult rights of medical consent while those below 16 are considered as minors with limited legal capacity and require a legally authorised decision maker such as parent or guardian to decide for them.
Adolescents signify a very important age group in the provision of contraceptives owing to a lopsided share of Zambia’s health burden of STIs, HIV, and unplanned pregnancies, but the service providers are torn apart when teenagers below 16 walk in to seek family planning services to protect themselves from pregnancy and STIs.
They are usually placed in a tight spot on whether to abrogate the law and help a teenager prevent pregnancy, and STIs or to just counsel and turn them (Adolescents) away.
Low contraceptive use
The DHS shows that only 40 per cent of girls and 49 per cent of boys aged 15-24 years used a condom at last high risk sex.
Young people engage in unprotected sex for various reasons such as pressure to prove their fertility, misinformation on side effects of certain methods of contraception, and limited access to contraceptives especially in rural areas,
In addition to that, some religious and cultural beliefs that forbid the use of contraceptives has exposed teenage girls to the risks of unintended pregnancy, unwanted childbearing and abortion.
The relationship between parents and children is one of the most important avenues for improving sexual and reproductive health outcomes for young people.
Nonetheless, it is considered a taboo in the Zambian setup for parents to discuss issues of sexuality with their children and many parents feel uncomfortable to do so, which leaves young people vulnerable to misinformation from their peers.
The discomfort many parents feel in talking to their children about sexuality further impedes their ability to provide guidance on the best practices.
A number of young people engage in multiple sexual relationships, a situation that increases the risk of HIV transmission.
Mainly, youths resort to having multiple sex partners due to economic reasons taking into account that about 60 per cent of the population in Zambia lives below the poverty line.
Early marriages and sexual activity
The thorny subject of early marriage is one of the reproductive health risks for young women as it leads to early pregnancies that put young expectant mothers at risk for obstetric fistulae, as well as HIV infection.
In Zambia, early marriages are fueled by inconsistencies in the legal system that has seen the statutory law legalising marriage at the age of 21, but on the contrary, the customary law allows girls to get married once they reach puberty.
It is a known fact that Adolescent sexual activity, within or outside of marriage leads to negative reproductive health outcomes, hence there is need to strengthen coordinated efforts among all stakeholders to safeguard the life of a youth.
Youths have the right to lead healthy lives, and once provided with necessary requisites such as information, favourable legal environment, and quality health care services, they have the potential to protect themselves from negative sexual health outcomes.
There has been considerable success in Zambia on Adolescent reproductive health but there is need for a paradigm shift from intangible pronouncements to concrete action plans that translate into improved reproductive health lives of young people. youths.
Let me sum up with one of the readers’ contribution from my inbox.
I would like to comment on the article that appeared in the Times of Zambia (Last Monday’s edition) under the headline ‘MP raises teenage pregnancy concern.’ The lawmaker’s (Given Katuta) interest on teenage pregnancies as well as health matters is very encouraging and this could help deter those parents who marry off their daughters at an early age.
Nevertheless, my observation is, our society is more concerned about a girl child than a boy, and yet there are some incidents where a boy of 18 years of age impregnates a girl of almost his age, that boy will probably be expelled from school and he is asked to pay damage to the parents of that girl child. The expulsion of the boy from school usually has a negative impact on his education and the attainment of his dreams.
Therefore the plague of child marriages and teenage pregnancies continue to deprive young girls and boys of their childhood, and the potential to become drivers of Zambia’s development.
I really feel for the boys of that age because they have sex out of ignorance and the fact is that we are all born with sexual feelings, hence the need for parents to guide the children and be as open as possible to tell them the truth about sexual activities, they should know that sex is a pleasant game and we cannot run away from that.
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