Zimbabwe should promote adolescent access to sexual health services

Although Zimbabwe has one of the highest rates of contraceptive use in Southern Africa, sexually active adolescents who wish to protect themselves against sexually transmitted illnesses and unwanted pregnancies are not accessing them because of inconsistencies with current laws and other social and economic barriers.

Difficulties in accessing contraceptives had seen adolescent girls exposed to problems such as birth complications and deaths as a result of illegal abortions. Faced with this challenge, young girls and boys need to get sexual education and be able to access sexual reproductive health (SRH) services to protect themselves.

Speaking at a dialogue on the age of consent organised by Youth Engage and Right Now, Right Here, Zimbabwe (RNRH ZW) in Harare recently, chairperson of the Parliamentary Portfolio Committee on Health Dr Ruth Labode said her committee has always been pushing for Government to consider availing sexual reproductive health services such as contraceptives to young girls and boys to avoid unwanted pregnancies and sexually transmitted infections (STIs).

Dr Labode said the Public Health Act should be revisited to identify sections that hinder children below the age of consent to access the SRH and amend it.

“If a child goes to a clinic saying she is sexually active and wants family planning tablets, give them regardless of their age,” she said.

The current laws in Zimbabwe, particularly the Public Health Act, restricts children under the age of 16 from accessing SRH services such as contraceptives and emergency family planning pills because they are below the age of consent.

Age of consent laws serve as a means for regulating children and young people’s sexual activity and behaviour. But these laws do not, of course, guarantee that young people will remain abstinent in practice.

According to demographic health data for Zimbabwe, nearly 40 percent of girls and 24 percent of boys are sexually active before they reach the age of 18, a development which compromises their health.

A report by the Ministry of Health and Child Care, United Nations Population Fund (UNFPA) and Zimbabwe National Family Planning Council (ZNFPC) says 48 percent of adolescents have confirmed unplanned pregnancies. So, even if the age of consent is 16 in our country young girls and boys who are under the age of 16 are engaging in sexual activities.

Section 70 (2a) of the Criminal law (Codification and Reform) Act (Chapter 9:23) states that: “Where extra-marital sexual intercourse or an indecent act occurs between young persons who are both over the age of 12 years, but under the age of 16 years at the time of the sexual intercourse or the indecent act, neither of them shall be charged with sexual intercourse or performing an indecent act with a young person except upon a report of a probation officer appointed in terms of the Children’s Act (Chapter 5:06) showing that it is appropriate to charge one of them with that crime.”

So if these children can have sex among themselves there should have access to contraceptives to protect themselves against diseases and pregnancies.

Some children are born with HIV and they are having sex with others of their age: at 12 years a girl can fall pregnant hence they need protection against STIs and early pregnancies.

We also have to look at their rights as children. They have a right to education, they have the right to health care services. By denying to give SRH services we are depriving them of their rights. They should be educated and be able to access contraceptives openly with full information.

According to the 2015 Zimbabwe Demographic and Health Survey (2015 ZDHS), it is estimated that in Zimbabwe about 51 percent of adolescence access their contraceptives from private pharmacies.

However, incorrect use and failure to use contraceptives consistently is also higher among adolescents. Therefore, there is need therefore to equip these children with skills on how to use these services because despite not being educated on the use of contraceptives and being denied access, they are buying them from private pharmacies.

The age of consent should remain at 16, but the local authorities should also remove laws which restrict adolescents to access SRH services including contraceptives, HIV testing, information (about sex). Children should get access to information about SRH.

When they have access to information, they can request contraceptives to ensure they have safe sex. When children are allowed to get emergency pills, they avoid pregnancies, since some girls end up dying of illegal abortions.

Another issue is the difference between the age of consent and age of marriage. The current legal age of consent in Zimbabwe is 16, but the country’s new Constitution, introduced in 2013, says that those under 18 are not capable of starting a family, creating a conflict about the exact position of the law. This makes it difficult for sexually active teenagers to access SRH services since they are not yet married.

In South Africa and Nigeria they have services to assist sexually active adolescents. Nigeria and South Africa have adopted and implemented policies aimed at ensuring that adolescents have access to contraceptive and other reproductive health care services.

There are adolescent-friendly clinics operated by the government in Nigeria. Adolescent-friendly centres administered by non-governmental organisations (NGOs).

In South Africa, adolescent girls have access to contraception because there are policies that ensure the availability and accessibility of free family-planning services at public health centres.

Collaborative efforts between the government and NGOs have resulted in the initiation of the National Adolescent-Friendly Clinic Initiative (NAFCI) programme which sets standards that are used in regulating the provision of adolescent-friendly services within the country.

These efforts have resulted in various adolescent clinics being operated in different parts of the country.

Preventing teenagers from getting contraceptives won’t stop these children from having sex, but it will just drive them away from the services they need to protect themselves, leading to higher rates of unintended pregnancies and sexually transmitted diseases (STDs), including HIV.

Yes, some of us may be against this idea, but if one has seen teenagers in our neighbourhoods getting pregnant and suffering because poor access to SRH services, we have to reconsider our position.

Irresponsible people will always be there whether we like it or not.

Why would adolescents not use contraceptives regardless of their wish to avoid pregnancy? We know the reasons for only a small sample of these women, half of whom said they were not doing so because they were unmarried.

Our culture stigmatises sexual activity outside of marriage. It is not advisable for minors to have sex before marriage, but these children are doing it, and they need that education on sexual health and access to contraceptives to protect themselves.

In July 11, 2017, most countries across the world agreed at the Family Planning Summit in London to galvanise progress toward the Family Planning 2020 goal of enabling 120 million additional women and girls to use modern contraception by 2020 and to strengthen the foundation for universal access to sexual and reproductive health, including family planning, by 2030.

This vision is set out in the 2030 Agenda for Sustainable Development.

We need to invest more in our young children to have a brighter Zimbabwe and family planning can help us do this.