“The Stories Behind the Statistics” is a series we developed for the Gates Foundation blog, “Impatient Optimists.” The following post is the second in our three-part series on contraception. The original post, located on “Impatient Optimists,” is available here. Primrose Nanchani Manyalo is a field officer at Restless Development, a youth-led development agency.
No matter where you live in the world, contraceptive access is essential to the sexual and reproductive health of young people. This is also true of young people in Zimbabwe, where I live and work. My experiences with young people in this country have taught me that they face numerous challenges in trying to access contraceptives and the repercussions young people deal with when they can’t: teen pregnancies, unsafe abortions, death due to child birth, and HIV/STIs (sexually transmitted infections).
At Restless Development, a youth-led organization to address the most urgent issues facing young people around the world, we have set up youth-friendly corners and centers around Zimbabwe (the country where I’m from and in which I work) that are a haven for young people who need services. These services include providing access to condoms, and offering ways to meaningfully engage in advocacy about the reproductive health and rights of young people. At one of the youth-friendly corners we run, young people tell us that contraceptives are available at the local pharmacies and clinics. These include morning after pills, barrier methods, implants and other hormonal methods. Nevertheless, there are still many hindrances that lead to the overall unavailability of contraceptives among young people in Zimbabwe.
Young people in the city of Harare say they cannot walk into a pharmacy or clinic and purchase or request contraceptives because they think providers will feel that “they are still too young.” Others revealed that they fear being laughed at by their peers or treated as outcasts in their community because they “shamefully indulged in sex before marriage.” These psychological and social barriers are further exacerbated by provider bias, cultural barriers, the high cost of contraceptives at private pharmacies, and a lack of youth-friendly services.
Natsai, one of our youth group members, told us she could not speak openly about contraceptives with her peers, teachers, or parents. When she became pregnant at 16, her mother took her to the clinic to get the hormonal IUD (a type of contraceptive), which would prevent her from becoming pregnant again until she was at least 23. Though the move was noble, it came too late. If the contraceptive service had come earlier, it would have prevented her from becoming pregnant at such a young age, dropping out of school, being rejected by her boyfriend, and living with the psychological trauma that comes with motherhood at an early age.
Finally, some young people in my community decide not to use contraceptives because of myths they’ve heard and misconceptions about how contraception works. Some young people believe that if you use contraceptives you will not be able to bear children later on. Clearly, there is a need to educate young people about contraception.
Having contraceptive access and choice is a basic health right. If contraceptive access is realized, some of the appalling sexual and reproductive health challenges faced by young people, particularly by girls and young women, will be addressed. Efforts to ensure contraceptive access for young people, coupled with provision of comprehensive sexual and reproductive health education, can help young people make healthier and informed choices about their lives.
Finally, advocacy efforts should address not only issues of access, but also young people’s need for youth-friendly and affordable services provided by nonjudgmental health care workers. Policy-makers, donors, young people, and other relevant stakeholders should work together to develop policies and strategies to improve access to contraceptives and other sexual and reproductive health services for young people in Zimbabwe. By also addressing societal attitudes, and cultural barriers we could go a long way in protecting young people’s lives.
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