Mildred Mushunje and Dean Mutata
Why Zimbabwe must urgently invest in youth reproductive health and safe abortion care to unlock its demographic dividend
Sub-Saharan Africa is recorded as having one of the world’s youngest populations, and Zimbabwe is a striking example. With adolescents and young people constituting roughly 60%–62% of the population, the country is experiencing a significant youth bulge. This is not a burden; it is a demographic opportunity. Healthy, informed, and empowered young people translate into productive economies, strengthened gender equality, and a foundation for sustainable development and social justice. But that promise is slipping away as we continue to sideline the reproductive health needs of Zimbabwe’s youth, especially girls. Teenage pregnancies, unsafe abortions, and preventable maternal complications have become alarmingly normalised realities, revealing a crisis we pretend not to see. Poor access to comprehensive Sexual reproductive health and rights services is a key factor in unplanned pregnancies and this often leads to unsafe abortions which is one of the contributory factors to adolescent mortality (ZDHS, 2015), and unsafe abortion contributes about 5% to maternal deaths (Ministry of Health, 2015).
Young People Are Not Reckless. They Are Systemically and structurally failed. Zimbabwean adolescents are often portrayed as irresponsible or morally deviant when they become pregnant or seek reproductive health services. This narrative is convenient, but false. According to the SRHR Africa Trust, 2025 regional survey, what we call “recklessness” is often a reflection of systemic neglect. Young people are navigating layers of cultural, social, and institutional barriers and moral compasses that make access to sexual and reproductive health (SRH) services nearly impossible.
Rigid cultural norms silence open conversations about sexuality, even within families. Girls are expected to be “good,” which in practice means uninformed. Boys who seek condoms are shamed for being “too young to be sexually active.” Many communities still believe that providing contraception encourages promiscuity, despite overwhelming evidence to the contrary. 1 in 6 teenagers has given birth, and about 5% more are pregnant with their first child. The risk rises steeply with age, from around 3% among 15-year-olds to nearly 48% among 19-year-olds. Many of these pregnancies are unintended. Fear, stigma, and moral judgment combine to lock young people out of safe, youth-friendly spaces.
A UNICEF[1] report published in September 2023 shows staggering and worrying statistics for adolescent pregnancies. An estimated 1,706,946 Ante Natal Care(ANC) bookings were made in 1,560 health care facilities captured in the DHIS- 2 platform from 2019-2022 among women and girls aged 10 years and above. Of these, 21% were among adolescents aged 10-19 years. A total of 1532 maternal deaths were recorded and of these 25% were among adolescent and young women under 24 years. Of the estimated 50,957 pregnant women newly testing HIV positive, 0.1% were among adolescents aged 10-14 years, 15% among the 15-19 years. Adolescent pregnancy prevalence was 23.7% (337/1418) for adolescents aged between 10 -19 years. Among the 337 pregnant adolescences, 4.0% (20) had disabilities.
Challenges faced by adolescents in accessing SRHR services include limited access to comprehensive SRHR services, high cost of contraceptives, stigma faced at health care facilities, child marriages in which adolescents cannot negotiate for use of contraceptives or safe sex[2]. Attitudes and social norms have negatively impacted on the advocacy agenda for SRHR services and safe legal abortion for adolescents and limited access to SRH services is one of the leading causes of clandestine abortions.
A Health System Failing Its Most Vulnerable
Zimbabwe’s public health system has committed, in principle, to universal and equitable health access. Policies such as the National Health Strategy, Vision 2030 and the NHS Investment Case all emphasise access to quality care for all, especially the marginalised. Yet we face a dismal reality. The 2023–24 Zimbabwe Demographic and Health Survey (ZDHS) reports neonatal mortality at 37 deaths per 1,000 live births, the highest ever recorded. Infant mortality rose to 56 per 1,000, and under-five mortality remains stagnant at 69 per 1,000. Maternal mortality hovers around 212 per 100,000 live births, still far too high for a country claiming to aim for universal health coverage.
The Guttmacher study suggests 70,000 illegal abortions annually in Zimbabwe, many involving adolescents under 16, a grim indicator of unmet need, desperation, and systemic neglect. These unsafe abortions, compounded by poor access to post-abortion care, contribute significantly to maternal morbidity and mortality, especially among young women denied agency over their bodies.
These preventable deaths persist even as nominal health budgets increase. The problem is not only insufficient resources, but it is also misalignment, erratic disbursement, and the lack of a ring-fenced policy for health-earmarked taxes. Without guaranteed and protected funding, many health facilities operate without essential medicines, with dysfunctional equipment, or without specialist staff. For maternal, neonatal, and especially adolescent reproductive health services, the result is stark: weak service delivery, long waiting times, frequent stock-outs, and refusal or shame from poorly trained providers. Young people, particularly adolescents, bear the brunt.
Human Cost and the Lost Dividend
Each teenage pregnancy and unsafe abortion is not just a personal tragedy; it is a national loss. When a girl becomes a mother in adolescence, her schooling is often interrupted. Her chances of finishing secondary education, let alone pursuing tertiary education or gainful employment, diminish sharply. According to the Deputy Minister of Primary and Secondary Education, approximately 3,433 primary and secondary school girls dropped out due to pregnancies in 2024 alone. Economic prospects shrink, and they become more vulnerable to poverty.
Conversely, investing in adolescent and young people’s sexual and reproductive health could yield major long-term gains. A healthier, educated generation could enter the workforce better prepared and more productive. Gender equality could improve, as girls stay longer in school, delay childbearing and have increased economic autonomy. Over time, reducing the social costs associated with early parenthood, from lost schooling to intergenerational poverty
Conclusion — From Crisis to Opportunity
Zimbabwe’s youth bulge is not a problem to be managed; it is a tremendous opportunity to shape a healthier, more equitable future. But only if we act now. Each teenage pregnancy, each unsafe abortion, each preventable maternal or neonatal death represents both a personal tragedy and a national waste of potential.
If we commit, through policy, funding, education and compassionate service delivery, to protecting the sexual and reproductive health and rights of young people, we can transform this crisis into a demographic dividend. A generation informed, healthy and empowered is Zimbabwe’s best investment.
What must be done
To unlock the demographic dividend, adolescents’ reproductive health should be treated as a national priority rather than a moral dilemma.
- Invest in the adolescent health budget, ring-fencing and timely disbursement of funds earmarked for health, particularly for contraception, and comprehensive abortion care abortion care.
- Collect and use data on teenage pregnancies, unsafe abortions, and service gaps to shape evidence-based policy.
- Policy and Legal frameworks reform: removal of legal barriers that hinder adolescents from accessing comprehensive SRHR services
[1] UNICEF, 2023
[2] Mushunje, 2022 Op-Ed Protecting adolescents from unplanned pregnancies through access to comprehensive SRHR services
