Awareness should be championed for young girls

The cultures of many African countries, including Tanzania, have had an adverse impact on the way information on Sexual Reproductive Health (SRH) and the use of contraceptives is imparted to youth.

This has deprived the adolescents of critical information about SRH and contraceptive use, limiting their access to affordable and acceptable contraceptives of their choice.

In addition, they are also denied protection against unwanted pregnancies and sexually transmitted diseases, including HIV/AIDS.

In most African cultures, such as Tanzania, parents do not often talk to their teenage girls about SRH, the use of contraceptives, and issues to do with early pregnancies and the effects these issues have on their lives.

As a result, young girls are receiving incorrect information from various social media platforms and peer groups. In these instances, they receive an influx of information but aren’t fully equipped to analyse it, which leads them to make wrong decisions that, inadvertently, shatter their life dreams and, in worst-case scenarios, lead to the loss of lives.

Dr Elius Kweyamba, an Obstetrician and Gynecologist at St Francis University College in Morogoro, told Your Health that parents must be actively involved in educating their daughters about SRH and contraception use in order to raise awareness and create a more informed generation.

He shares how common it is for teenagers with failed, unsafe abortions to be rushed to hospitals after prolonged bleeding, experiencing fistula and other uterine problems.

“Young girls have been known to use strong black tea, tea leaves, bicycle spokes, cassava leaves, and many other substances to induce miscarriages illegally. We need to educate them on the alternatives to avoid getting these unintended pregnancies,” he says.

According to Dr Kweyamba, by not talking to them, these adolescents are then exposing themselves to early pregnancies, which pose adverse effects on their health.

“Unsafe abortion practises may also lead to cervical and uterine cancer and other complications, including barrenness,” he says.

Empowering Women and Adolescent Girls Tanzania’s (EWAGITA) Executive Director, Eddah Duncan, said a lack of knowledge among the youth about SRH and an equally low understanding in communities were among the reasons for increased unsafe abortions in our communities.

“We still have our African traditions and cultures that oftentimes make our women deliver at home, and because they lack knowledge and access to health experts, they end up using traditional methods that often lead to loss of life,” she says.

Ms Duncan says the time is now to start talking about unsafe abortion among young girls if they are to know the effects it has in the long run.

“Young girls also need to know that there are several options they can use to avert unwanted pregnancies, like the use of condoms, and we should teach them that by carrying out unsafe abortions, they put their lives at risk,” she pointed out.

She added: “We need to accept that girls need to have their rights.”

According to her, imposing jail terms on girls for carrying out abortions illegally was not only reducing the country’s manpower but also derailing development.

A graduate in tax administration, Ms Pendo Mofat, said that the knowledge adolescents should have on contraceptives is used to protect them against unwanted pregnancies, as well as understanding their sexual and reproductive health in general, which is very crucial.

She claims that in recent years, there has been an increase in the use of misoprostol to terminate pregnancies among adolescent girls.

Misoprostol, a prostaglandin E1 analogue drug, is said to be widely used by adolescents in the country for terminating pregnancies.

Ms Mofat, now an advocate for young girls on sexual and reproductive health and the use of contraceptives by teenage girls, noted that early this year, she attended a workshop on SRHR and contraceptives organised by health experts for the first time in her life.

“It was during that time that I realised how most young teenage girls lack information on sexual and reproductive health in general,” she says, adding that had she had the information then as a young teen, aged 17, she wouldn’t have gotten herself pregnant.

Ms Mofat, the victim of early pregnancy, says she battled with the pregnancy when she was still in secondary school in Mwanza.

“It was a hard experience for me. I didn’t have any information on sexual and reproductive health back then, let alone access to and the use of contraceptives,” she says.

She explained that many young girls in primary and secondary schools were lacking knowledge on sexual reproductive health and contraceptive usage and have ended up with unplanned and unwanted pregnancies, some of which have symbolically marked the end of their educational journey and cut their aspirations short.

Ms Mofat says a one-night encounter she had with a primary school teacher, whom she had met at a bus stand, got her in trouble and was about to shut out her lifelong dreams of reaching the university level of studies.

“We just did it once, and that was the first time I met him, and there I became pregnant. I never said this to him until we met again a month later,” she says.

She further says that, to her surprise, the teacher who seemed to love her so much the first day they met rejected her and denied responsibility for the pregnancy.

“I had hoped for a positive answer and that maybe he could opt for us to keep the pregnancy and start building our life together of which I was very much willing to do,” she says.

However, the teacher, she claims, didn’t want to hear anything about the pregnancy, or even have her near him, and it became even more difficult for her at that age to tell her devoted Christian parents.

Two months later, she says her friend advised her to abort the pregnancy using boiled tea leaves, which she did, narrowly escaping death due to prolonged bleeding as she aborted without involving any professional health expert because such an act was illegal in Tanzanian law.

Under the Penal Code, the protection of a woman’s life is the only explicit legal ground for abortion, having regard to the woman’s state at the time and to all the circumstances of the case.

According to the law, any woman found guilty of procuring an abortion on her own may be sentenced to seven years in prison, and the performer of the abortion may face 14 years in prison, with the supplier facing a three-year sentence.

Although pregnancy termination is restricted by law in the country, it is widely practised, almost always unsafe, and contributes to the country’s high maternal morbidity and mortality.

Yet, the majority of abortion-related deaths are preventable, as are the unintended pregnancies associated with abortion.

According to her, there are numerous unsafe abortion cases happening in society, and mothers should open up and talk about sexual and reproductive health issues with their teenage girls.

“Parents need to talk to adolescent girls about sexual and reproductive health and the effects of early pregnancies, as these have adverse effects not only on their future but also on their lives and bring poverty to families,” she says.

“We need parents to be hand-in-hand with their young girls. There are a lot of illegal abortions taking place in our societies simply because parents are afraid to face their young girls and teach them,” she says.

She asks the government to introduce sexual and reproductive health subjects in primary and secondary schools so as to create awareness among young girls that have otherwise been at a disadvantage, most of whom, she says, are already in active sexual relationships.

Selina Joseph was also another victim of early pregnancy after she fell pregnant at the age of 16 while in form two in Arusha.

According to her, after realising that she was pregnant and not wanting to reveal it to her parents and teachers at school, her friend at school advised her to abort the pregnancy by drinking a hot solution of boiled fresh tea leaves, which made her bleed continuously for two weeks before being saved at a nearby hospital in Arusha.

According to data released in 2013, the rate of unsafe abortions in Tanzania was estimated to be 93 per 1,000 women who were of reproductive age.

Sexual and reproductive health and contraceptive knowledge among teenage girls are also major challenges in the country, with a 2019 health review showing that adolescents engage in high-risk sexual behaviours and are experiencing their adverse consequences.

Pathfinder and other health organisations have been working closely with the government and other partners to strengthen health systems by raising awareness about SRH and contraceptive use and providing access to voluntary family planning to prevent unintended pregnancies.

There has also been a deliberate move by the government in various public health centres to ensure that young pregnant girls and women receive high-quality, respectful maternal care at every health facility.