By Josephine Chinele:
It is not an issue for young people in urban areas to share website links, videos, pictures and other related materials on fashion trends and many other ‘trendy’ things on social media platforms.
They are also privileged to get the latest news on issues that concern them through modern news avenues such as Twitter, Facebook, newspaper, radio and television. But rural youths of the same age have a different story to tell.
Chairperson for Mphatso Youth Club in Traditional Authority Kunthembwe in Blantyre, Matthews Mulaka, says their main avenue of information sharing, especially on sexual reproductive health and rights (SRHR) is through youth club meetings and weekly youth friendly health services (YFHS) gatherings they hold with healthcare workers.
Youth clubs in the area have an agreement with Chikowa Health Centre to be meeting every Saturday, where they discuss SRHR issues including how and where to seek medical attention within the health facility should they have reproductive health challenges.
“Youths of this area have for long been in information ‘blackout’, a thing which has greatly contributed to an increase in teenage pregnancies and sexually transmitted infections [STIs] including HIV and Aids,” he says.
Mulaka says for years, many organisations ignored the role the youths play towards their SRHR needs until 2015 when organisations started to go to the area with youth-tailored programmes.
“There was very little interest initially in the involvement of the youths on issues related to their sexual and reproductive needs. I am glad that we are now involved and I believe this will not end at youth club level but going beyond this,” Mulaka says.
Apart from the teen pregnancies and STIs, youths of this area have been involved in alcohol and substance abuse.
“This has been perpetuated by the high levels of poverty and orphanhood. When faced by both of them, they usually have limited options so they end up in transactional sex or getting married,” says Chrifa Stelevazio of Chikowa Youth Club.
Kunthembwe Youth Network, an umbrella of all youth clubs in the T/A, has over the years been establishing youth clubs and linking them with organisations and health service providers.
The network’s chairperson, Caroline Nkhata, says youth club meetings and youth friendly health services gatherings which are held with health care workers once a week are one of the few platforms available for information sharing with the youths.
“When we hold such meetings or attend trainings organised by various organisations, we expect the trained youths to reach out to many youths in their catchment areas on family planning, general health and sexuality among others,” Nkhata said on the sidelines of a Youth Advocates training which Pakachere Institute of Health and Development Communication (IHDC) organised for 14 youth clubs from T/A Kunthembwe’s area recently.
Nkhata said the area has had a lot of SRHR issues because the youths have limited exposure to the information their urban counterparts are access.
“We are glad because we even have the support of traditional leaders whenever we are doing our activities. Initially, it was a problem due to prohibitive normative beliefs but things are now improving. We have had meetings with the T/A, Area Development and Village Development committees,” she said.
District Youth Officer (DYO) for Blantyre, Getrude Franscisco, says there are a lot of teenage pregnancies in T/As Kunthembwe and Somba due to harmful cultural practices.
“Many parents see no problems in marrying off their daughters when they have reached puberty. The girls also feel dis-empowered to refuse having sex with men because most of them lack comprehensive information that can help them make positive choices about their sexual health,” she says.
Francisco, however, says her office in collaboration with various organisations, including Pakachere IHDC, has been holding trainings for the youths to fill the knowledge gap.
Malawi Demographic and Health Survey (MDHS of 2015-16) indicates that 19 percent of women aged 25-49 have first sex before age 15 and 64 percent before they turn 18. By 20, 85 percent of women have had sexual intercourse.
Between 2000 and 2015-16, says the MDHS, the median age at first sexual intercourse has not changed among women aged 25-49 (16.8 years in 2000 and in 2015- 16).
The MDHS of 2015-16 indicates that Malawi has recorded an increase in teenage pregnancies from 26 percent (in MDHS of 2010) to 29 per cent, a clear sign that young people are also missing on contraceptives uptake.
Information sourced from Chikowa Health Centre indicates that in the months of October, November and December 2019, 22 STI cases were recorded among 15-19 year olds. In the same months, 47 STIs were recorded among 20 to 24-year-olds.
In the same quarter, 562 pregnancies were recorded among girls aged 10 to 24. Two of these cases were recorded in girls aged 10- 14 and 301 teenagers and 259 among 20 to 24-year-olds.
YFHS Coordinator for Blantyre, Maness Segula, says despite the high rates, there is a slight improvement.
“In the last quarter, 66,000 youths accessed YFHS, a 15 percent increase from the previous quarter which saw 45,000 youths accessing youth friendly health services,” she says.
Segula adds: “Condoms are the most accessed youth friendly health service followed by information on sexuality. Some also access contraceptives but most of them are discouraged due to myths and misconception related to the use of contraceptives. .”
Pakachere IHDC’s Advocacy and Training Manager, Jonathan Mbuna, says the organisation has been implementing the project in two districts of Dedza and Blantyre. These trainings are held in collaboration with District Youth Officers (DYOs) who assist in reaching out to District Youth Networks and Youth Club leaders with trainings.
“At the end of the trainings, we want to groom youth advocates who can work with the healthcare system to demand easy access and availability of sexual and reproductive health services for young people in hard-to-reach areas.
“Again these youths should demand that there should sign service charters with health facilities so that they are recognised and be in a position to engage service providers to ensure that youths are accessing SRH and YFH services,” he says.
Mbuna discloses that Kunthembwe area was considered by the DYO due to several youth issues such as having untrained youth leaders and high teenage pregnancies, among other issues.
Goal three of the 2015 United Nations Sustainable Development Goals states the need for nations to ensure healthy lives and promote wellbeing for all their people at all ages.
One of this goal’s targets says by 2030, there is need to ensure universal access to sexual reproductive health care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes.
The Malawi National Youth Policy of August 2013 recognises the fact that youths remain vulnerable to many health risks such as STIs including HIV and Aids.
The policy pledges to promote general health and non-discriminatory sexual reproductive health and rights of young people.
It further promises to ensure that sexual and cultural practices that promote the spread of STIs including HIV, early pregnancies and teenage pregnancies are discouraged.