Open Up Space For Adolescents To Access SRHR Services

RECENTLY, I was saddened to read that a dead infant was found during a burst sewer pipe at a primary school in Bulawayo. I imagined the state of hopelessness the parent must have felt to resort to infanticide. And I felt angry about the lack of prioritization of women’s and girls’ sexual and reproductive health and rights (SRHR), especially during this time of COVID-19 lockdowns, that may have contributed to this horrific outcome.

By Edinah Masiyiwa

The insufficient attention to women’s and girls’ needs and disruptions in health systems during COVID-19 has resulted in an increase in unwanted pregnancies. In January and February 2021, for instance, more than 5,000 teenage pregnancies were reported. The United Nations Population Fund and partners estimated in 2020 that six months of significant health service disruptions could result in 47 million women in low- and middle-income countries going without contraceptives, leading to an additional 7 million unintended pregnancies.

Rape and incest have greatly contributed to the increase in adolescent pregnancies in Zimbabwe. According to Nyaradzayi Gumbonzvanda, the Executive Director for Rozaria Memorial Trust, most of the child pregnancies were a result of rape and incest. Justice for such cases has not been easy to obtain and some people have withdrawn or have just not followed up on their cases because of the challenges brought about by COVID-19. This means there are some unwanted pregnancies which could have been terminated under the law, but this has not been possible. Further, the laws on SRHR are so punitive on women particularly adolescents who in most cases find themselves in very difficult circumstances and end up having unsafe abortions or throwing infants in drains.

Overall, adolescent girls are facing the most challenges in Zimbabwe right now. The legal framework has made it more difficult for them to access SRHR services as the Public Health Act (2018) restricts adolescents below the age of 16 years from accessing contraceptives. Despite having the highest rates of contraceptive use in Southern Africa, sexually active adolescents who wish to protect themselves from sexually transmitted infections and unwanted pregnancies thus are not accessing the services because of inconsistencies with the current laws and other economic barriers. The adolescents are therefore accessing contraceptives through other means such as pharmacies. This form of access is greatly affected when there are lockdowns because the girls cannot justify why they are getting into town.

A report by the International Federation of Gynecology and Obstetrics highlighted that COVID-19 is being used as an excuse to ignore SRHR service provision. This has also been the case as clinics in Harare where the City Health department closed some clinics whilst arguing that health workers were focusing on COVID-19 patients. Combined, the situation has been very challenging for adolescents and young women in Zimbabwe, leading to the rise in unintended pregnancies.

On the flip side, the COVID-19 pandemic has also presented an opportunity for governments to assess their health delivery systems and address the gaps. Indeed, this is the time where lawmakers and all Zimbabweans should critically look at this problem that the country is facing: access to SRHR services, including contraceptives for adolescents.

It is encouraging that debate has started in Parliament in a view to review the age restriction on access to reproductive health services including access to contraceptives by persons 12 years and above. Parliamentarians should note that sexuality education according to World Health Organisation does not lead to early or increased sexual activity among adolescents. WHO further states that evidence has shown that promotion of contraceptive use to address early pregnancies among adolescents has shown to be effective. Parliament must therefore use evidence as they deliberate on this issue.

Further, I would encourage all Zimbabweans to remove personal biases as we follow discussions on access to contraceptives for adolescents that are happening in Parliament. We made our contributions during the consultative meetings. Moreover, research shows that poverty, exposure to technology, alcohol and drug abuse and poor communication between parents and their children being some of the drivers of early sexual debut among adolescents. Let us remember that young people have dreams for their lives which are shattered when they have unplanned pregnancies.

We should also understand that allowing adolescents to access SRHR services will save on costs to the health system as complications related to post abortion care services and complicated deliveries will be reduced. This will put the country at a better position to respond to COVID-19.

And most of all, it can create options for those who need them so that no one feels they need to resort to flushing a baby down a toilet again.

Edinah Masiyiwa is the Executive Director for Women’s Action Group and an Aspen New Voices Senior Fellow

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