A Well-Resourced Health System Essential For Zimbabwe to Attain Reproductive Justice

By Edinah Masiyiwa,

Executive Director Women’s Action Group

Attending a recent workshop organized by the Community Working Group on Health on “reproductive justice” reminded me how much the core values of reproductive justice are being violated in Zimbabwe and how much we need to protect girls and young women from injustice.

The term reproductive justice has a history in feminist ideology and has three core values: the right to have a child, the right to not have a child, and the right to parent a child or children in safe and healthy environments.

Firstly, one of the big challenges around the right to have a child is safely delivering babies. One barrier is cost. The policy in Zimbabwe stipulates that maternal health care is free, but this is not true. In city council clinics, women are asked to pay for maternity services. This causes some women not to book and receive antenatal care. Economic factors may also force women to deliver unsafely at home.

With the public health delivery continuing to deteriorate, there are some risks associated with mismanagement of patients when in labour. These include complications such as obstetric fistula or even death. Obstructed labour associated with obstetric fistula has been identified as a major cause of maternal mortality worldwide, and in as many as 90% of cases, women who experience obstetric fistula also suffer a still birth. Factors that cause obstetric fistulae include cultural preferences of forcing delivery at home without the supervision of skilled health workers. Even if the delivery occurs in health institutions, the lack of skilled personnel there can result in a woman getting obstetric fistula.

Secondly, when we look at the right to not have a child, it is least accessible to young women and girls and that should change. A publication by UNFPA showed that early sexual debut and sexual abuse of female adolescents contribute to the high number of pregnancies among adolescents. Adolescent girls in rural Zimbabwe face a multitude of barriers to accessing SRHR because of social, traditional and legislative constructs that perceive adolescents as asexual and adolescents’ sexuality as taboo. Currently, at one of the major hospitals, teen pregnancy (12 to 16 years) accounts for 30% of deliveries. Further, many girls seek abortion services which are not safe and can result in maternal deaths.

Lack of social protection also results in young girls being raped and then falling pregnant. The current law on termination of pregnancy allows women and girls to have an abortion if the pregnancy is because of rape. However, adolescents are giving birth after being raped because of late reporting as well as their lack of awareness of the law. Zimbabwe recorded an 8-year-old who fell pregnant in 2022 and gave birth at nine years old, when she was mere years away from having been a baby herself. This girl was probably raped by a close relative and the pregnancy was discovered when it was too late. This is just one example of young girls who are being denied the right not to have a child.

The right to not have a child is also violated by early forced marriages. A study by UNICEF revealed that the proximal drivers of child marriage are deeply embedded in normative expectations, especially those related to the family’s honour. At times, the family would marry off a girl, so they do not face backlash from the community for failing to reprimand the child. These behaviours are seemingly centred on the need to control and regulate the behaviour of the girl child to ensure she remains “pure” for her future husband.

Thirdly, the right to parent a child or children in safe and healthy environments is violated when girls and young women are married off at a tender age, despite the laws against it. The current socio-economic situation in Zimbabwe affects this right when parents fail to fend for their children. According to a report released by a commission convened by World Health Organization (WHO, no single country is adequately protecting children’s health, their environment, and their futures. The capacity to provide child protection services in Zimbabwe, particularly in more rural areas, is already weak and inadequate, but worsened in humanitarian situations.

In view of these and other challenges faced by women and girls in realising reproductive justice, Zimbabwe should ensure that the health delivery system is well resourced for it to respond to the needs of pregnant people. All deliveries should be done by skilled personnel.

While awareness on the current Termination of Pregnancy Act is raised, the law should be reviewed as it has its own challenges. Women should be given an opportunity to make a choice on whether to continue with a pregnancy or not. Processes on obtaining a certificate to terminate a pregnancy should be reviewed to allow women and girls to get a termination before rape/incest cases are taken to court. The Ministry of Health and Child Care should lead the process of reviewing the law to make sure adolescents have a termination when they fall pregnant.

Programmes which promote harmful cultural norms such as early pregnancies should be addressed through community engagement. Chiefs and headmen should lead in these processes.

The socio-economic challenges facing Zimbabwe should be addressed for children to grow in a healthy environment.
Always, a focus should be on the girl child, as was highlighted by UNICEF in the following statement, “Adolescent girls are worth the investment. When girls thrive, we all thrive.”

There is so much that needs to be done to ensure reproductive justice is realised in Zimbabwe.

“Celebrating 40 years of feminist movement building in Zimbabwe!”

Women’s Action Group can be contacted via email: wag@wag.org.zw, Tel: +263 242 339161 or via tollfree: 08080495

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