Girls and women struggle to access Sexual and Reproductive Health services in health facilities. Journalist Francis Tayanjah-Phiri discusses some of the challenges the youth face with the Executive Director of Young Voices Kenneth Mtago
What are the challenges youth face as they access Sexual and Reproductive Health services?
Mtago: The challenges are many including those that on socio-economic, cultural, and environmental conditions. Most youths are not financially independent and it is difficult for them to access quality services. Furthermore, some health facilities do not have youth friendly services, forcing the youth to shun hostile service providers with staff who have negative personnel attitudes. Imagine a youth seeking condoms from a health worker who remarks: Inunso mwayamba za chiwerewere? (Have you resorted to promiscuity?). The other challenge is lack of comprehensive sexuality education, resulting in the youth failing to understand their bodies. Due to low levels of knowledge on contraceptives availability, unsafe abortions are another problem haunting many girls and women.
Do you have cases of girls suffering from the consequences of unsafe abortion?
It is sad to report that just here in Blantyre I know of three girls who died from unsafe abortions. The three deceased were from Ndirande, Chilobwe, and Bangwe Townships. We referred two girls to health facilities for post-abortion care after learning that their health was deteriorating due to unsafe abortion. Their ages ranged from 14 -26 years. In Lilongwe, I received a report of a girl who was saved after being referred for comprehensive abortion care. In Neno, a 19-year-old girl lost her uterus due to unsafe abortion. The problem of unsafe abortion is huge among the youth and even data from various district hospitals indicate the same.
What is your organisation doing about it?
As Young Voices Organisation, we have been working by engaging a group of Sexual and Reproductive Health and Rights (SRHR) champions who train our members and empower them with advocacy skills. We have also created an online platform where we make information on SRHR available. We regularly engage the media and provide them with information on SRHR issues affecting the youth. We are also members of a coalition and networks which are working to improve access to SRHR among the youth.
What are your views on the Termination of Pregnancy (ToP) Bill? Does it have an impact on the youth?
The proposed legislation is good because it seeks to empower women and girls to make reproductive choices about their bodies and their lives. Once enacted the Bill which is modelled on the provisions of the Maputo Protocol, which Malawi is a signatory to, will drastically reduce maternal mortality caused by unsafe abortions. The beauty of it is that even religious bodies contributed to its formulation hence addressing concerns which some sections of the society had; as it ensures that safe abortion will not be provided on demand but upon meeting some criteria.
Personally, what are your views on abortion?
Safe abortion is a health care and it should be available to those seeking such services. Restrictions on access to safe abortion are fueling unsafe abortion and thereby increasing maternal mortality in Malawi. Countries that changed their laws on abortion such as South Africa, Mozambique and Zambia are making good progress in addressing maternal mortality unlike us, here in Malawi where we are stuck with colonial law.
Are you satisfied with the country’s Youth Friendly Health Services?
No, I am not, due to restrictions that exist in accessing the services.
What ought to be improved?
We need to consider revising laws that ask for parents’ consent in accessing contraceptives. We need to design such clinics better as most youths do not patronise them as they are located close to the clinics that provide Anti-retroviral Therapies (ART).