Teenage pregnancy is a major issue of concern in the world, with Uganda being one of the countries affected most. According to the State of the World Population Report 2013, 20,000 girls below age 18 give birth in developing countries everyday. Of the 7.3 million girls below age 18 who give birth each year in developing countries, two million are under age 15. In addition, each year, 13.1 million children are born to mothers aged 15-19 and worse still, this age group accounts for as many as 3.2 million unsafe abortions annually in developing countries.
In Uganda, one out of four girls between the ages of 15 and 19 are pregnant or have had a baby. Looking at maternal health, girls who become pregnant before 15 have double the risk for maternal death and obstetric fistula than older women. Girls who become pregnant at 15 or younger are more likely to experience premature delivery, low infant birth weight, perinatal mortality and health problems with their newborns.
Teenage pregnancy creates a negative impact on the health and education of the girls but also the future economic productivity of a nation. For instance, the UN estimates that Uganda’s productivity would be $15 billion higher if teenage girls delayed pregnancy until their early 20s, got a skill and worked.
One of the main reasons that teenage girls get pregnant is lack of access to youth–friendly services including family planning services. According to the United Nations Population Fund (UNFPA) modern contraceptive use among adolescents is generally low, and decreases with economic status, with fewer than 5 per cent of the poorest young women using modern contraception.
In most cases, young women often find it hard to negotiate safer sex with their male counterparts due to social norms and attitudes, health service provider attitudes as well as unclear policies that restrict young people from accessing family planning services.
These, among other issues, that position young men and women in vulnerable states need to be addressed to ensure that they can access family planning and related sexual reproductive health services in a manner that is friendly to them, encourages to access the services and facilitates them to adopt recommended behaviours such as condom use.
It should also be noted that if we are to address population issues, young people should be a major target as the decisions and choices they make now will determine how many children they will have in future.
We need to ensure that they have access to all the information and services they need to help them to make the right choices. We must acknowledge that young people have sexual and reproductive health needs and, therefore, rights to information and services.
Policy makers need to make the required changes and revise policies and regulations to ensure that young people have access to youth-friendly services including family planning.
Among the strategies recommended by the World Health Organisation is service integration which has led to better outcomes in health situations where it has been applied.
In Kenya, for example, progress has been reported in programmes that involved integration of reproductive health education into the school curriculum, and incentives such as school uniforms and books provided to students. This in turn reduced the dropout rates of both boys and girls in schools that implemented such programmes.
Uganda could, therefore, borrow a leaf and implement strategies such as creation of girl-friendly spaces that combine literacy and life skills building sessions with recreation. Information and services should also be availed to young people that may be out-of school and those who may have married at an early age.
These may include provision of contraceptives including condoms, coupled with edutainment that is, combining education with entertainment, establishment and promotion of toll free hotlines as well as youth spaces or corners in health facilities and communities.
Ms Kyeyune is a Behaviour Change Communication and Marketing Specialist at Marie Stopes Uganda.firstname.lastname@example.org