Let the contraceptive debate yield to practical compromises this time around
Sunday, October 23, 2022

Yet another contraception debate has predictably erupted, this time after Parliament last week deferred a bill for further consultations on whether 15-year-old girls should be allowed access to pills and similar methods.

On the face of it, the reasoning behind the bill seems persuasive as articulated by its proposers. They chose 15 years as the minimum age in accordance with the National Family Planning and Adolescent Sexual and Reproductive Health Strategic Plan (2018–2024) which includes girls aged 15-19 among women cohorts targeted for increased contraception uptake.

Another reason one might think compelling is the high number of unwanted teenage pregnancies, whose figures have been climbing each passing year.

In 2016, more than 17,000 girls aged 15-19 got pregnant. In 2020, the figure was over 19,700 and in 2021 the number of teenage pregnancies had risen to 23,000.

That is an alarming 35 per cent rise in teenage pregnancies from 2016 to 2021. It is a scary figure to contemplate, considering the trend suggests 2022 might yet see another increase in unwanted and preventable teen pregnancies.

It is apparent therefore the bill has good intentions. Its deferment is also welcome, as it suggests the Parliament views the bill worth consideration so long as contentious issues such as objections on faith and cultural grounds are addressed.

This, however, is not the first time the debate has raged. In 2016, this column noted a similar proposal by NGOs to introduce of condoms in schools. It emphasised how even a mere suggestion of contraceptives in schools remains an emotive issue.

That was the year the government introduced sex education in schools. The introduction of sex-ed acknowledges the need for multifaceted solutions. Evidence-based studies show that giving comprehensive information and education is critical to reducing adolescent risk of unintended pregnancies and sexually transmitted infections.

Sex-ed enhances the skills and attitude of youth and adolescents regarding sexual and reproductive health, leading to behavioural change enabling young people to make evidence-based and informed decisions with responsible choices.

But with the rising number of teen pregnancies, how effective sex-ed presents an issue worth looking into even as the Parliament has urged an all-inclusive consultation of stakeholders and the breadth of issues that must be addressed. Remember that sex-ed presupposes availability and access to all possible options, including female and male contraceptives.

With 23,000 teenage pregnancies, the reality we cannot avoid is that adolescents are engaging in sex. And as previously pointed out, this makes it statistically definitive that a far larger number than the 23,000 of our teenagers are engaging in sex, whether it is resulting in pregnancy or not.

Acknowledging this is to recognise that not allowing the teenagers access to contraceptives does not stop them from having sex, it just ensures that unwanted teenage pregnancies continue unabated.

Notably, also, studies show that making contraceptives available to teenagers does not increase sexual activity as some faith-based opponents claim.

The studies also show that programmes that ignore comprehensive sex education and exclusively encourage abstinence do not seem to reduce the incidence of pregnancy and sexually transmitted infections, including HIV.

As I’ve noted elsewhere, either some of the faith-based opponents preaching abstinence and blaming moral decay are unaware of the scientific studies or choose to ignore them.

To quote Aflodis Kagaba, Executive Director Health Development Initiative (HDI), "When we talk about contraceptives, [some] people think that they will be distributed like drugs or chocolates. But, they will be given to those who need them, who are sexually active and want to prevent [pregnancy].”

It is a good thing therefore that the government is aware of the issues and has had some solutions in place such as "youth spaces” in health centres across the country through which the young people are supposed to access contraceptives.

The only hitch, as one research I was involved in showed, young people are not adequately using them, one of the reasons being they may not be youth friendly.

Many of the youth place a higher premium on confidentiality than going for accessible contraception.

In a society still culturally conservative in matters sex, the youth find the spaces "too open”, while their purpose is known to everyone in the Umudugudu (village).

They avoid approaching community health workers, who are often their elders and known to their families to dare ask for contraceptives.

But these are surmountable issues. All it might take are pragmatic compromises if the alarming rate of teen pregnancies is to be reversed.