Chioma Umeha
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 shows that there is need to improve access
to family planning information and services for Nigerian adolescents.
The 2014 World Health Organisation’s (WHO) report
and 2013 Nigeria 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 puts 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 from 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.
Lagos youth-friendly centres
To curb women’s death, the Lagos State government
with support from partners and other donor agencies has put in place
youth-friendly health care centres and trained health care providers to provide
youth friendly services.
But, despite the friendly centres, there are gaps
that limit youths’ access to SRH in Nigeria which include, poor awareness, lack
of confidentiality in service delivery among others.
Daily Independent investigations shows that most
young persons who are sexually active in Lagos State are faced with many
barriers in obtaining necessary information about the different method of
contraception that is available at the youth-friendly centres for use.
The barriers include; provider bias, attitude of
the family planning officer, religious sentiments among others.
The issue of improving access of youths 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 International Nigeria, in Lagos.At some of the Lagos-based
youth-friendly centres, some adolescents who interacted with Daily Independent
expressed dismay over the attitude of some family planning providers.
Unfriendliness in youth-friendly centres
The story of unfriendliness and poor counseling
about family planning from counselors was the same from Ikotun to Alimosho,
even Agege youth-friendly centres,
Halima Abdullazeez, aged 25 and a graduate of
Business Administration who spoke to DAILY INDEPENDENT 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 boy-friends 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 Abdullazeez regretted that the reception from
family planning providers was not warm as anticipated. “I wondered if it should
have been better to have 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, Helen Moses 22, who admitted
being sexually active also, decried the attitude of the health service provider
she met at the Hello Lagos Life planning centre. She 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.”
Helen further lamented; “In the course of our
tensed-discussion, I learnt that both female and male condoms were available at
the facility. Rather than giving me the female condom which I had demanded for,
a male condom was offered to me.”
“I decided to go with the male condom, a
roll-of-four,” the visibly distraught Helen told DAILY INDEPENDENT, 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 Ayoshe Victoria, who is a makeup
artist, she visited a PHC centre near her community, at Agege, Lagos. Following
the poor responses to her questions as a teenager seeking for family planning
services, she had to switch role from making 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 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 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 right choices about family planning.
She said youths like Halima Abdullazeez, Helen
Moses Ayoshe Victoria may not possible 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 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 quality family
planning information.
This will enable them make 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 government has tried in terms of policies
and laws to advance SRH, Izundu said there is 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).
