This week Correspondent GERALD KITABU talked to REBECA GYUMI, a lawyer and TV and radio presenter at FEMINA on youth access to information on reproductive health. Excerpts:
QUESTION: Are youth having enough access to information on reproductive health?
ANSWER: I think the answer is no. Different studies done in Tanzania with local and international organizations report on the persistent of sexual and reproductive health (SRH) problems resulting from lack or not having enough access of information on reproductive health, which affects decision making capacity among young people.
However my response should not be regarded as downplaying the tremendous job done by different agencies in dealing with the problem. I recognize efforts done by organization such as Femina through its media vehicles such as Fema and Si Mchezo, TV and Radio shows which are distributed freely to, in and out of schools across the country. However it’s the plain truth that a lot of young people don’t have enough access of information on reproductive health. There are many reasons to this and here are few examples:
There is stigma in our society attached to adolescent sexuality; community discourages free access of sexual and reproductive health information among young people for the fear of promoting promiscuity. The notion which is not right. I believe information is power. A young person who is well informed on the issues of reproductive health is more likely to be resilient and make informed decision compared to the one who is not.
Q: Are hospitals and health centers friendly regarding youth on reproductive health?
A: It sounds Yes and No. For example, there are number of health centres I know which provide friendly service to young people. For instance, Marie Stopes. Health providers are trained to receive young people and treat their issues with utmost care. However not all centers are friendly, I would arguably say private hospitals are easy to listen to young people and help than public hospitals.
Major reason is, adolescent issues are sidelined; some of health providers are reluctant to share key information on reproductive health for fear of promoting sex practice. But in reality the minute we become sexually active, the urge to know more increases, I think it is proper to get correct information in a friendly environment to assist in making informed decisions.
Q: Do youth have time to discuss reproductive health issues with parents, teachers, doctors, or relatives?
A: In 2012, I was lucky under the programme I host (Fema TV Talk Show) to visit a Maasai community in Kilosa, Morogoro region, where the major issue was to explore the role of parent-child communication in reducing the rate of HIV infection in Maasai community. In reality, our tradition and customs don’t promote open talk on the issues of sexuality, reproductive health and HIV/AIDS. Major myth being openness promotes promiscuity. “Jando” and “Unyago” in some societies are considered right place to speak those issues, or an Aunt (The father’s sister) is given responsibility of educating daughters and not parents. So you find that many youth don’t have time to communicate these issues with parents, maybe with a trusted teacher or a doctor in a hospital.
Q: You have hinted on trusted teacher or a doctor in a hospital, so when they attend the health centres or hospitals, what exactly are they told?
A: I would say experience differ. But through our work at Femina, we have learnt that, most young people feel secluded in health centers. Many experience harsh language or treatment when inquiring information on contraceptives, safe sex, on general info on sexuality.
Q: How do they prevent themselves from pregnancy or disease?
A: It should be noted, in Tanzania young people aged 15–24 are at risk as they account for an estimated 45 percent of new HIV infections (UNAIDS, 2008). Proportion of 40.3 percent of population aged 15 – 24 has correct knowledge of HIV and AIDS (UNSTATS Millennium Development Goals, July 2011). Most young people don’t know how to protect themselves; condom usage plus other protection methods is extremely low among this age category. Behavior like cross-generational sex decreases bargaining power on which protection method to use, same applies to transactional sex.
So, you will find that many young people in Tanzania are at risk of so many problems relating to lack of proper reproductive health education. Problems like unsafe sex, early pregnancy which leads to increasing school drop outs, unsafe abortion, HIV and AIDS, STIs and pregnancy related complications. Youth are more vulnerable to these problems due to lack of proper education on Sexual and reproductive health rights (SRHRs). They lack skills on how to protect themselves from unplanned and unprotected sex, also don’t know how to bargain for safe sex and indulge in multiple partners or sex for money due to economic hardships.
However, the major challenge is lack of friendly health service which hampers provision of correct information to help make informed choices. Our customs and traditions on SRH education are somewhat to blame.
Q: So, given your experience, how can such challenges be addressed?
A: Tanzania National Policy Guidelines for Reproductive and Child Health Services (2003) is inline with provision of friendly service to young people; however effective implementation has been its major setback. The work of providing reproductive health information is left to NGOs; our government should take the leading role in this, considering almost 80 percent of young people live in rural areas. Why don’t we utilize the public health facilities which are already in place country wide? It’s hard for NGOs to build facilities all over the country, why don’t we build capacity to our own public centers and provide standard training to health providers on youth friendly service? It’s high time our government through the responsible ministry to come up with relevant reproductive education strategy that should be mainstreamed in all educational institution.
Also community should be matron and patrons in seeing to it that, reproductive health is widely taught and bit all myth surrounding provision of SRH education. Let’s all join our hands; we should leave this to neither Government nor NGOs.