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Feb 10
OPINION PIECE | Promoting healthy mothers and babies is essential, and so is keeping young girls at school while safeguarding them from pregnancy and STIs

By: Lunga Memela (Communications Engagement Lead)

In January this year, the South African-based news website Independent Online published a disturbing article, reporting that the country's capital City of Tshwane was calling on young people to avoid risky sexual behaviour following the recording of nearly 10 000 teenage deliveries over the past three years by public health facilities.

It is not only the soaring numbers of teenage (and unintended) pregnancy that is alarming, but also the evident lack of health education together with incorrect and inconsistent condom use that results in preventable rates of sexually transmitted infections (STIs) such as HIV – and the human papillomavirus (HPV) –the leading cause of cervical cancer. Failing to protect young girls from engaging in risky sexual behaviour ultimately works against UNAIDS' fast-track strategy to end the AIDS epidemic by 2030. 

Why this matters today

In the month of February, South Africa's health calendar draws us to the important commemoration of Pregnancy Awareness Week. This also coincides with STI/ Condom Awareness Week, begging the pertinent maternal and child health question of how best the country should promote planned healthy pregnancies amongst women of child-bearing age, whilst also protecting young girls from falling victim to unplanned pregnancy and STIs.

In a December 2021 opinion piece published by UNAIDS titled Fulfilling our promise to adolescents and young people, the Co-chair of the Global HIV Prevention Coalition and Former Minister of Health Botswana, Professor Sheila Tlou wrote that it tires her that there are still some people who want to 'rob our children' of the education that gives them all the possible options and choices of protection, "including abstinence, delaying sexual activity, condoms and other contraception." She insists that young people need to know how to prevent an illness before they come in contact with it or before they act in a way that allows their body to be vulnerable to it. 

The local context

The Health Systems Trust (HST) was privileged to be part of a DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored and Safe) initiative officially launched at the iNanda township of eThekwini on World Health Day, 7 April 2021. The DREAMS initiative is supported by the United States President's Emergency Plan for AIDS Relief (PEPFAR), the Bill & Melinda Gates Foundation and Girl Effect.

Of grave concern is that the Inanda, Ntuzuma and KwaMashu (INK) areas of eThekwini record the highest HIV statistics in KwaZulu-Natal (KZN), which is the epicentre of the AIDS pandemic in South Africa. School-going youth attending the event reported that they often fall victim to gender-based violence including rape, various forms of sexual assault and abduction. Unwanted pregnancies, HIV transmission and transactional sex with older men were said to be rife within the community.

Caring about Adolescent and Paediatric HIV

Rakshika Bhana.

HST's Health Systems Strengthening Programme Manager for the Unfinished Business for Adolescent and Paediatric HIV (UB) project, Rakshika Bhana said, "Adolescents in South Africa face many challenges in accessing public health services, and early adolescent pregnancy may result in young mothers facing barriers to timely access to maternal health services. This results in the missed opportunities for HIV testing and treatment and the early detection of pregnancy complications."

"Through the UB Project for Paediatric and Adolescent HIV in KZN, HST focuses on strengthening the Adolescent and Youth Friendly Services (AYFS) programme at facility level to ensure that matters relating to adolescent sexual and reproductive health are identified and addressed. In addition to the ongoing education sessions that are held, our HST Psychosocial Advisors play an important role in assisting pregnant adolescents to deal with their fears and to understand and explore their barriers to access to care."

Enshrined in the South African Constitution's (1996) Bill of Rights for all citizens are the Right to Education and the Right to Health care, food, water and social security. It stipulates:

27. Health care, food, water and social security

(1) Everyone has the right to have access to ­

(a) health care services, including reproductive health care;

(b) sufficient food and water; and

(c) social security, including, if they are unable to support themselves and their dependants, appropriate social assistance.

29. Education

(1) Everyone has the right—

(a) to a basic education, including adult basic education; and

(b) to further education, which the state, through reasonable measures, must make progressively available and accessible.

The even bigger problem is that maternal and child healthcare isn't reaching everyone in urban sub-Saharan Africa, according to an article published by The Conservation earlier this year. If you think about the issue of teenage pregnancy on a broader scale, it runs counter to the United Nations Sustainable Development Goals 1 to 5 of (1) no poverty, (2) zero hunger, (3) good health and well-being, (4) quality education [ensure inclusive and equitable quality education and promote lifelong learning opportunities for all] and (5) gender equity [achieve gender equality and empower all women and girl].

It appears that until health education, health systems, access to health, and clamping down on criminal sexual activities are prioritised at a national level and cross-culturally, rape culture and teenage pregnancy will continue to cripple society economically and bio-psychosocially. 

Speaking at the recent International AIDS Society webinar titled Ethical youth engagement in the HIV response, the guest speaker Kenyan-based activist, Irene Ogeta said, "Adolescent girls and young women have a higher chance of being affected by HIV/AIDS and if not prioritised, the goal of eradicating HIV by 2030, will remain nothing but a fantasy. She said the world's biggest population are young people. "Adolescent girls are disproportionally affected by HIV and can only achieve their dreams when they are in good health," she advised.

Let us promote and uphold the basic human rights of health and education for young girls. HST runs HIV testing services at various health facilities in support of the Department of Health. Women and young girls can visit their nearest clinic or general practitioner for convenient HIV and STI screening. 


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