By Independent Team
Sexually active adolescents want to avoid, delay, or limit pregnancy
More women are accessing contraceptives in Uganda today. However, some reports show that the Contraceptive Prevalence Rate (CPR) continues to hover around the 50% mark. That means one in every two women is not accessing contraceptives even when she might want to. The data is worse for adolescents. Globally, a new report “Adolescents and Family Planning: What the Evidence Shows” indicates that roughly one-quarter of the world’s population — 1.8 billion people — is between 10 and 24 years of age. Among the many sexually active adolescents worldwide, large numbers want to avoid, delay or limit pregnancy but lack the knowledge, agency or resources to make decisions regarding their reproduction.
On average, unmet need for contraception is greater among unmarried adolescents than those who are married. However married adolescents ages 15-19 experience a higher percentage of unmet need than all married women.
The new report by International Centre for Research on Women (ICRW) brings the perspectives and priorities of more than 500 adolescent girls from around the world to the global stage. Among the many critical issues raised by the girls was their need to access sexual and reproductive health services, as well as to better understand and be able to act on their sexual and reproductive rights. Simply put, the girls wanted to know their options, how they could use available services, and do so freely and safely. Whether married or not, adolescents must have access to gender-equitable and rights-based comprehensive sexuality education that enables them to expand their knowledge and their understanding of their bodies, their rights and the services that should be accessible to them. They should have the information and services needed to prevent – and treat when necessary – sexually-transmitted infections, including HIV.
And critically, adolescents need access to youth-friendly family planning services, including the information, skills and contraceptive supplies that can help them decide whether, when and how many children to have, not only during their adolescence, but throughout their lives. It’s a tall order, but we know the approaches that can work in making it happen.
Demand side barriers to girls desire to avoid, delay, space, or limit childbearing include gendered roles/expectations. Here girls are expected to be either a wife/mother or remain chaste. However, the girls may also feel a need to prove fertility. In some cases, family planning is not used because of a desire to secure a relationship, religious values, pursuit of a child of a desire sex, especially a son.
Even those who may wish to get family planning; there is stigma around accessing and using methods and adolescent sexuality. Girls might not be able to communicate certain subjects that are considered taboo, or they may lack understanding of reproductive health issues including family planning methods and side effects.
Access to family planning may result from limited decision making autonomy, early marriage, and family pressure to have children, sexual coercion and other forms of violence, transactional sex, and limited self-efficacy. Most of these barriers to family planning can be resolved by providing information about available alternative roles/options for girls. This could involve explaining the benefits of delaying, spacing, and limiting the number of children born. Most of this information could be availed in the mass media. The information could also form part of the school curriculum, work-place education, and inter-personal, peer-to-peer education through new media. On the supply side, many youth lack of awareness of services. On the other hand, the family planning service could be in an inaccessible location or the girl’s mobility might be limited. The service might be available only at inconvenient hours, involve long wait times, and be costly for young people with limited access to financial resources.
Important interventions on the supply side include provision of information on how methods work, and what methods are best for each adolescent’s needs.
Other interventions could include community-based distribution of family planning services through youth centres, vouchers, and other social franchises. All this means availing youth-friendly family planning services.