BY CHIOMA UMEHA
Lagos – When women and girls have access to
contraception, fewer babies and mothers die. Around the world, millions of
women can’t get the contraception they want.
Numerous studies show that the ability to plan
pregnancy is directly and unequivocally linked to lower maternal mortality,
lower infant and under-five mortality, lower mother-to-child transmission of
HIV, and a whole host of improved health indicators.
Here is just one example: when a woman spaces her
births by at least three years, her newborn baby is twice as likely to reach
its first birthday.
However, negative reports on sexual reproductive
health (SRH) outcomes in the country show that there is a need to improve access
to family planning information and services for Nigerian adolescents.
The 2014 World Health Organisation’s (WHO) report
and 2013 Nigeria by our Reporter Demographic and Health Survey (NDHS) presented
the worrisome statistics of Nigerian young women whose lives are cut short due
to reproductive health complications.
At 576 maternal deaths per 1,000 live births, the country accounts for 14 per cent of the global burden of maternal mortality.
Statistics put the average age of first sexual
experience at roughly 15 years among Nigerian adolescent mothers (NDHS 2003,
2008, 2013).
Similarly, the National adolescent fertility rate in
Nigeria is 122 births per 1,000 women aged 15 to 19.
Imagine what life would be like if you were not able
to make your own decisions. Take a minute and step into the shoes of a young
woman who does not share the same power to make choices about family planning.
To curb maternal deaths, the Lagos State government
with support from donor agencies has set up youth-friendly health care centres
with care providers to offer an appropriate response to youths’ sexual
reproductive health needs.
Barriers to sexual reproductive health services
But, despite the friendly-centres, gaps that limit
youths’ access to SRH in the country still persist, including, poor awareness,
lack of confidentiality in service delivery among others.
Our Reporter’s investigations show that many Lagos
youths who are sexually active remain confronted with several barriers in
obtaining necessary information about the different method of contraception,
available at the youth-friendly centres.
The barriers include; provider bias, the attitude of the
family planning officer, religious sentiments among others.
The issue of improving youths' access to family
planning was a major agenda of a three-day capacity building workshop on
investigative journalism organised recently, for Media Advocacy Working Group
(MAWG) by Pathfinder In family planning International Nigeria, in Lagos.
Youths decry care providers’ attitude
At some of the Lagos-based youth-friendly centres,
some adolescents who interacted with our Reporter expressed dismay over the attitude of some family planning providers.
The story of unfriendliness and poor counseling
about family planning from counselors was the same from Ikotun to Alimosho,
even Agege youth-friendly centres, Mary Ibrahim, aged 25 and a graduate of
Economics who spoke to Our Reporter confirmed the situation. She said that the first question from a service provider at the youth-friendly centre was
targeted on her age bracket.
Decrying the situation, she said; “Immediately I
declared that I have three boyfriends at 25, the body language of the service
provider changed. This may not be unconnected with religious sentiments,
judging from her countenance. I say this because; I noticed the way she was
looking at me.
“So I was neither given an opportunity of seeing a
condom nor counseled properly on other options of contraception, so, I left the
centre.”
Miss Ibrahim regretted that the reception from
family planning providers were not warm as anticipated. “I wondered if it should
have been better to have an unplanned pregnancy than to receive such cold and
disdainful treatment from family planning units of a Public Healthcare Centre
(PHC), despite being sexually active,” she said.
Another female youth, Yomi Martins 22, who admitted
being sexually active also, decried the attitude of the health service provider
she met at the Hello Lagos Life planning centre. Martins said; “The service
provider was obviously furious on noticing that I was a Catholic. I guess that
was why she denied me the required attention and information on family
planning. She neither showed courtesy of offering me a seat nor made any
attempt to make me feel relaxed before grilling me.”
Martins further lamented; “In the course of our
tensed-discussion, I learned that both female and male condoms were available at
the facility. Rather than giving me the female condom which I had demanded,
a male condom was offered to me.”
“I decided to go with the male condom, a
roll-of-four,” the visibly distraught Martins told Our Reporter, with an air of
dejection.
“As if that was not enough, I became a subject of
gossip in the facility. Immediately, I turned my back, I noticed one of the
counselors pointing and jeering at me, while the other two wore a sneering
outlook.”
For 20-years-old Adeola Esther, who is a filmmaker,
she visited a PHC centre near her community, at Agege, Lagos. Following the
poor responses to her questions as a teenager seeking family planning
services, she had to switch role from making a personal inquiry to doing an
errand for her mother. Her words; “When I noticed the facial expressions of the
family planning counselors, I pretended that I was on an errand for my mother to
make inquiries about family planning.”
Also, she was neither counseled nor shown any option
of family planning, but was told that for her to access any available service,
she must be ovulating.
Training of family planning providers
Training and retraining for family planning
providers reacting, family planning experts, disagree that a woman does not
need to be in ovulation to do any method, though some women still ovulate while
pregnant.
Commenting, Adekoya Abiola, a retired nurse said
that these service providers in these cases were bad examples and opposite of
what they should be, especially in the area of counselling 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 ways to help the teeming youths
who need proper counseling to make the right choices about family planning.
She said youths like Mary Ibrahim, Yomi Martins,
Adeola Esther may not possibly return to the centres again eventually even when
they may be ready for family planning. She described their case as ‘missed
opportunities’ to win for family planning and better equip the youth.
Concerning the need for experienced family planning
providers in health care centres, Dr. Farouk Jega, the Country Director,
Pathfinder International Nigeria said it would make a lot of difference in the
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.
Also, the Pathfinder boss said that every woman,
especially in developing economies like Nigeria deserves a quality family
planning information.
This will enable them to make an informed decision,
stating that every woman deserves quality information on family planning, he stressed.
Jega said; “Every woman no matter the age has the
right to know and access quality family planning information.”
Restrictive norms and stigma
On her part, Kosi Izundu, Programme 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.
Speaking on the topic: ‘Youth and Adolescent access
to family planning in Lagos State’, Abiodun Ajayi, State Coordinator, Life
Planning for Adolescents and Youths (LPAY) said some of the barriers to youth
access to family planning services are; lack of access to adequate and accurate
life planning information and services, providers’ bias, religious doctrine as
well as policies barriers.
To tackle these issues, Abiodun said, government
should integrate youth-friendly family planning services in all PHCs to meet
their needs.
He said, 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).
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