The NGOs should be heard in the school condom debate

Local NGOs have been reported in the media renewing their calls for introduction of condoms in schools. And though the government introduced sex education in schools early this year and the impact is yet to be determined, maybe somebody should lend the NGOs an ear. Whether or not to introduce contraceptives in schools remains a highly emotive issue. But while the morality of it is important to recognize, the reality of our teenagers engaging in sex and the resulting pregnancies cannot be overlooked (see “The moral argument must not be naïve in the contraceptive debate”). The Rwanda Demographic and Health Survey (RDHS) 2014-2015 found that while “few women reported having had sexual intercourse before age 15 (2 percent), approximately one in five women (19 percent) had sexual intercourse by age 18. At age 20, two in five women (39 percent) have had sexual intercourse.” The reality of it cannot be starker than revealed in the numbers. The RDHS 2014-15 goes on to paint a vivid picture: “Seven percent of young women between age 15 and age 19 have already begun childbearing (6 percent are already mothers and 2 percent are pregnant for the first time). At age 15, 1 percent of young women have begun childbearing. The percentage increases steadily and rapidly with age: 4 percent of young women age 17 have already had at least one child or are pregnant for the first time. At age 19, 21 percent of young women have begun childbearing (16 percent have already had at least one child and 5 percent are pregnant for the first time).” The numbers are overwhelming to the eye, but it is important to dispassionately look at them. The RDRS enumerates the negative effects of “teenage fertility”. But, overall, births to adolescents remain both an individual and public health issue. And socially, if unchecked, part of a continuum of risky reproductive behaviours. It is for this reason sex education in schools is laudable. Indeed, nobody will deny that we are all for the health and well-being of all young people; and that we strongly support the many sensible calls that the teenagers postpone sexual activity until they are grown up – that is, until they are fully ready for the emotional, physical, and financial consequences of sex. We, however, should recognise that some of them choose not to postpone sex until they are “grown up”. I will not even mention the maze of sexual temptations they have to wade through, or excuse that many of our teens carry smartphones with the easy internet access and all it entails. What is important to recognise is that they are having sex and it behoves us to help them in every manner possible to reduce risks and negative health consequences associated with teenage sexual behaviours, including unintended pregnancies and sexually transmitted infections. I believe this is the message the NGOs are trying to put through. A government official is quoted somewhat conceding that “the success of the comprehensive sexuality education programme will depend on how open the teachers are to discuss all preventive options.” Open discussion is all very well knowing some of the adolescents are sexually active, but the issue is the availability of the contraceptives “putting your money where your mouth is.” For instance, would it probably be more practical to “openly” talk sex in the classroom and perhaps have contraceptives discretely available in the washrooms? The government is aware of the issues and the reality as currently obtains is this: “All preventive options” are available, including “youth spaces” being provided in health centres across the country through which the young people are supposed to access contraceptives. However, the young people are not using them. Available research shows the spaces are not youth friendly. In a society still culturally conservative in matters sex, the youth find the spaces “too open” and their purpose 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.

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The NGOs should be heard in the school condom debate