By Chief K.Masimba Biriwasha | Global Editor At Large
Harare, Zimbabwe – Young people in Zimbabwe face unprecedented challenges related to their sexual and reproductive health (SRH). They lack comprehensive knowledge of reproductive health issues, including their reproductive health rights.
This is despite the fact that young people are engaging in sexual intercourse at an early age, have limited use of contraceptives, have unintended pregnancies and are exposed to sexually transmitted infections and HIV, the virus that causes AIDS, at an early age.
With more than 90 percent unemployment rate due to more than a decade of economic decline and a high cost of living, most young people are being forced to engage in high risk behaviour to raise income.
Young women, in particular, are more vulnerable to SRH problems due to gender inequality, low access to education, early marriage, adolescent pregnancy and low access to SRH services.
Adolescents have little to no information of legal and policy provisions in place to protect their sexual and reproductive health rights. Rural adolescent are particularly affected by this lack of information.
According to the Zimbabwe National Adolescent Sexual and Reproductive Health Strategy (2010-2015), young people also lack comprehensive knowledge on SRH issues and services, with little knowledge more skewed towards child abuse and HIV and AIDS.
In the Zimbabwe culture, traditionally, it was the role of aunts and uncles to educate adolescents as they grew into puberty. However, this practice has been eroded by modern practices such as formal schooling, urbanisation, wage employment and access to television, radio and print media.
While adolescents are expected to obtain information and support from their parents, it is often not easy for all parents and guardians to respond to these needs. Parents and guardians are more likely to communicate with girls about sex than with boys, and when they do, the discussions are largely about avoiding pregnancy.
However, some parents or guardians not have information to impart to their children, while others still regard as taboo to discuss sexual issues with their own children, even when they might have the information required. An assessment by the Ministry of Health and Child Welfare (MOHCW) in 2008 revealed that the involvement of parents or guardians in the provision of SRH information to young people was very low and only noted in the management of sexual abuse cases.
Further, an Adolescent Sexual and Reproductive Health (ASRH) assessment commissioned by the MOHCW in 2008 in five of Zimbabwe’s ten provinces revealed that there is generally a limited appreciation of ASRH issues, especially at lower levels of care. Health institutions are faced with a number of challenges, which include limited appreciation and competence in dealing with ASRH issues among service providers.
Health workers and other service provider need to be sensitive and have appropriate skills to competently deal with adolescent SRH issues. They need skills to be able to treat young people with respect and gender equality.
“There are barriers that need to be unlocked to ensure young people access services without challenges,” said Ngoni Chibukire, adding that policies need to be constantly updated in line with new developments.
“We’ve so many policies in Zimbabwe but these policies are not linked. We need to move away from silo programming.”
Providing young people with SRH information and services is key to enable them to make well informed choices about their sexual and reproductive health.
According to the ASRH strategy (2010-2015), young people in Zimbabwe need to be empowered with correct, updated and age appropriate life skills to adopt and maintain safe, healthy and responsible sexual attitudes and behaviours. This includes equipping young people with skills that encourage abstinence, delayed first sex, faithfulness in relationships and contraceptive use among unmarried young people.
In addition, providing livelihood skills is an integral component of adolescents’ development and poverty reduction. Livelihood skills will also reduce vulnerability to risks such as abuse, poverty and exposure to sexually transmitted diseases.
MOHCW AIDS and TB Unit Director, Dr Owen Mugurungi said male circumcision among young men is key to addressing some of the SRH challenges facing young people, especially HIV. However, uptake of male circumcision is still very low in Zimbabwe with only 8 percent of men having been circumcised.
“We need to do something to make sure young people have access to male circumcision. We need to reach eighty per cent of young people within the next five years to reduce HIV infection by 42 per cent,” he said.
Mugurungi said that with male circumcision reduction of risk at personal level is 60 percent but translates to 70 percent at community level. He added that US$100 million is required to conduct approximately 1,2 million male circumcision among young men aged 15-30 by 2015 with an expected US$3 billion savings in public health savings.