BY CHIOMA UMEHA,
Awareness and proper understanding of family planning has been recognised to reduce maternal death among young women of reproductive age between 15 and 49.
Data on Sexual Reproductive Health outcomes in Nigeria stresses the importance of focusing on adolescents. At 576 maternal death per 1,000 live births, Nigeria accounts for 14 percent of the global burden of maternal mortality (NDHS 2013/WHO 2014).
Global evidence shows that young girls bear a higher burden of maternal mortality and morbidity. Data shows that the average age at sexual debut is roughly 15 years of age among adolescent mothers in Nigeria. (NDHS 2003, 2008, 2013).
The National adolescent fertility rate in Nigeria is 122 births per 1,000 women aged 15 to 19 years. In the North Western States, it is as high as 171 births per 1,000 women aged 15 to 19 years.
To stem this, the government of Lagos State with support from partners and other donor agencies has put in place youth-friendly health care centres and trained health care providers to provide friendly services.
Despite the friendly centers, gaps that hinder youth access to SRH in the country still exist, including poor knowledge, awareness and absence of confidentiality in service delivery among others.
Many Lagos youths who are sexually active are not equipped with adequate information on the different method of contraception available for use due to some barriers.
These barriers include: provider bias, the attitude of the family planning officer, religious sentiments amongst others.
At a 3-day capacity building workshop on Investigative Journalism organised by Pathfinder International Nigeria, in Lagos, some Lagos based adolescents who spoke to journalists have expressed dismay over the attitude of some family planning providers.
Some adolescents who visited Ikotun, Alimosho and Agege youth friendly Centres complained of poor counseling, knowledge by the family planning counselors.
According to 25-year old Halima Abdullazeez and graduate of Business Admin said the service provider’s first question was on her age bracket adding that “on learning, I have three boyfriends at 25, the body language changed outside religious concerns and countenance, I was not given an opportunity of seeing a condom or counseled properly on other options of contraception, so, I had to leave.
Miss Abdullazeez said the family planning providers the welcome was not warm as anticipated, hence wondering if it should have been better to have unplanned pregnancy to receive required attention at family planning units of Public Healthcare Centre (PHC) despite being sexually active.
Another female youth, Helen Moses 22, who acknowledged being sexually active lamented that the health service provider, she accosted at the Hello Lagos Life planning centre, was visibly furious on noticing she is a Catholic, did not give her required attention and courtesy of offering her a seat or any attempt to make her relax before supposed grilling.
Helen said that in the course of their tensed-discussion, she understood that both female and male condoms were available at the facility, but she was not given the female condom which she had demanded but a male condom was offered to her.
She decided to take away the male condom roll-of-four but concerned that at her back, she became subject of gossip.
For 20-year Ayoshe, who is a makeup artist, the PHC centre she visited was near her community and because of their poor responses to her questions as a teenager wanting to access family planning services, she had to switch role from personal inquiry to on errand for her mother.
She was not shown any options of family planning but told that for her to access any available service, must be during ovulation, which family planning experts, Mrs. Abiola Adekoya disagreed with, even though some pregnant women still ovulate whilst pregnant.
In response, a retired nurse Adekoya Abiola said that these service providers in these cases were bad examples and opposite of what they should be, especially in the area of counseling these youths by sharing available options of contraception with them and possibly allows these youths make an informed decision.
Mrs. Adekoya insisted that those service providers need to be trained in the right contemporary path to help the teeming youth who may come across them.
She posited that with the narratives aforementioned, these youngsters may not likely return to the centres again eventually even when they may be ready for family planning, describing it as a missed opportunities to win for family planning and better equip the youth.
Speaking on the need to have knowledgeable family planning providers in health care centres, the Country Director, Pathfinder International Nigeria, Dr. Farouk Jega, said it would make a lot of difference in the nation’s health care sector.
Dr. Jega said well-informed service providers will bring about enormous change towards building trust in the adoption of family planning and increasing uptake in the country and make a lot of difference.
Also, Dr. Jega said that every woman, especially in developing economies like Nigeria deserves quality family planning information so as to make an informed decision, stating that, “every woman deserves quality information on family planning. Every woman no matter the age has the right to know and access quality family planning information.
Pathfinder International Nigeria pointed out that there should be provision of quality family planning information for families, and mostly women, insisting that there should be no coercion on the part of women as far as issues on family planning is concerned.
Kosi Izundu, Program Officer, Pathfinder International while presenting a topic on ‘Youth And Adolescent Access To Family Planning’ said the major challenges youth face in accessing family planning are structural barriers such as laws and policies requesting parental consent.
She added that socio-cultural barriers such as restrictive norms and stigma around adolescents and youth sexuality and individual barriers such as young people limited or incorrect knowledge of Sexual Reproductive Health (SRH).
Though the government has tried in terms of policies and laws to advance SRH, Izundu said there is the need for government to fully implement those policies.
Abiodun Ajayi, State Coordinator, Life Planning for Adolescents and Youths (LPAY) presented the topic: ‘Youth and Adolescent access to family planning in Lagos State’, said the population of the State is about 23 million with young people aged 15-24 constituting over 4 million.
He said the unmet sexual and reproductive health needs of young persons in Lagos State is very huge, adding that according to the NDHS 2013, only 38.4 per cent of women aged 20-24, who are in marriage/union are currently using a contraceptive method while 12.3 percent of these women have an unmet need for family planning.
The risk according to Abiodun is that sexual behavior among young people is leading to unplanned pregnancy, out of school and baby dumping amongst others.
Some of the barriers to youth access to family planning services according to him are; lack of access to adequate and accurate life planning information and services, providers’ bias, religious doctrine as well as policies barriers.
To tackle those issues, Abiodun said, government should integrate youth-friendly family planning services in all PHCs that meet their needs; community, religious and traditional leaders should speak positively about SRH of young people; parents should engage their children on SRH information and advocacy efforts should be made to key players by Civil Society Organisations (CSOs).
Abiodun also urged the media to raise awareness about LPAY/FP; inform listeners, readers and viewers about steps they can take to protect themselves and others. It should also serve as a source of accurate LPAY/FP information for young people; mobilise stakeholders to play their parts in promoting FP/LPAY and regularly generate discussions on FP/LPAY.