Reproductive health rights for women, girls
By Watipaso Mzungu, Contributor:
Esther Maliko had barely celebrated her 14th birthday when she fell pregnant.
Her 17-year-old lover denied responsibility on the premise that Esther had slept with many boys before falling in love with him.
Now the girl, from Chakhaza Village, Traditional Authority (T/A) Chakhaza in Dowa District, has dropped out of school and, like many sexually-active youth in the district, faces an uncertain future.
Malawi has made strides in some areas of reproductive health, including stemming new HIV infections, according to the Ministry of Health.
However, local and international non-governmental organisations, including United Nations agencies, have raised a red flag on the rising number of adolescent pregnancies.
Health experts have attributed the problem to low access and utilisation of sexual and reproductive health (SRH) services and lack of other family planning methods.
Parents and educators agree that levels of sexual activity among high-school students are on the rise.
However, what they do not agree on is how to deal with the corresponding sharp rise in teenage pregnancies.
The 2015 Youth Friendly Health Services (YFHS) in Malawi Policy says there are approximately five million young people in the country between the ages of 10 and 24 who are involved in active sexual activities.
Dan Odallo, UNFPA Malawi Country Representative, says adolescent fertility rate is a big challenge in Malawi at 136/1000.
Odallo states that many young people in Malawi continue to give birth before they are mature and that this is a big contributor to poor health and the rapid population growth in the country.
In addition, there is still a large percentage of women who fail to access contraceptives and end up having children they had not planned to have.
Odallo, therefore, stresses that expanding family planning options for women is the most important thing to mitigate the impact of “too many births” on the health and welfare of women of Malawi.
“By empowering women and girls to make their own decisions about the timing and spacing of pregnancies, we open an important pathway towards their economic security and independence, as well as the realisation of all the Sustainable Development Goals [SDGs].
“I also feel that the continued threat of HIV among young people remains a challenge because many young Malawians, especially girls, are getting infected with HIV. This is a threat to the realisation of the demographic dividend as well because of the heavy dependency burden at family level,” he says.
YFHS is a key component of Malawi’s National Sexual and Reproductive Health Programme, which can facilitate the attainment of Malawi’s Family Planning (FP2020) Agenda to achieve a 60 percent contraceptive prevalence rate, with a focused increase among ages 15-24 years.
But as Girls Empowerment Network (Genet) director, Faith Phiri, notes, there have been challenges ranging from social and cultural norms to lack of resources hindering the attainment of this ambitious commitment.
This has a devastating impact on young people’s lives, particularly girls living in rural areas of Malawi.
“Many girls have dropped out of school due to unintended pregnancies, unsafe abortions and child marriages caused by poor decision-making skills and access to SRH services, particularly YFHS,” Phiri explains.
She says lack of adequate, medically accurate information on puberty leaves young people, dependent on uninformed peer sources and unguided internet searches for information.
Phiri adds that this is the reason Genet, with funding from AmplifyChange, rolled out an SRH-related project titled: Improving Girls’ Access to SRH Information and Services-Igasi) targeting T/As Kayembe and Chakhaza.
The project, which works with 10 health centres, seeks to reduce barriers that prevent girls and young women’s access to SRH information and services in Dowa District by 2019.
Its direct beneficiaries are vulnerable girls and young women while indirectly, the project is working with parents, teachers, community police, traditional and religious leaders, journalists, magistrates, child protection officers, community health providers and policy makers, among others.
Liviness Malitoni, 18, is one of the direct beneficiaries of the project in Lipenga Village, T/A Chakhaza.
Liviness hails the Genet approach in that it informs and empowers young people to protect themselves from sexually transmitted infections (STIs) and early pregnancies.
She says this helps them make to good choices about their sexual and reproductive health.
“The project has made a huge contribution towards reducing early marriages and unplanned pregnancies and cases of school dropouts in the area. By empowering young people, we are walking together towards universal access to sexual and reproductive health and rights,” Liviness says.
Dowa Youth Friendly Health Services coordinator, Kumbukani Sendeza, says the district has registered a dramatic increase in demand for SRH and cancer screening services among the youths following the intervention by the network.
Sendeza discloses that access to SRH services and utilisation among the youth used to be a big challenge because they did not have providers in most of the health centres.
“But with the formation of youth clubs by Genet and the training of some of the health workers to be certified YFHS providers, access to SRH has greatly improved,” he narrates.
The YFHS coordinator adds that young people are now able to walk into their health facilities to access the services because service providers are always available.
“They are also able to know how they can prevent teenage pregnancies. On average, utilisation has risen from five percent to 35 percent. Demand, too, has improved because in the first place, the youths didn’t know that they can access these services in their respective health facilities,” Sendeza stresses.
Yamikani Moses of Malenga Village, T/A Chakhaza, says three times a week, club members conduct awareness meetings on SRH and cancer screening services in their respective villages.
Early this year, the Ministry of Gender, Children, Disability and Social Welfare launched the National Strategy on Ending Child Marriage.
The major intention is to involve all key government sectors and other entities through a robust multi-sectoral approach to reduce pregnancy among youth and reduce family sizes.
Genet Project Coordinator, Naomi Nkhonjera-Banda, says the network draws a clear connection between reproductive health, human rights and sustainable development.
Nkhonjera-Band notes that when sexual and reproductive health needs are not met, individuals are deprived of the right to making crucial choices about their own bodies and futures.
“Because women bear children and often bear the responsibility for nurturing them, sexual and reproductive health and rights issues cannot be separated from gender equality. Denial of these rights exacerbates poverty and gender inequality,” she explains.
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