Comprehensive sexuality education is a universal right
Comprehensive sexuality education (CSE) has been a hot topic over the past few months. Some see the benefits of CSE in delaying sexual debut and promoting safe sex for those who are already sexually active. Others see CSE as promoting sexual activity among learners.
At the International Conference on Population and Development (ICPD) held in Kenya in November 2019, delegates gathered to take stock of successes and failures in the realisation of sexual and reproductive health rights (SRHR). Controversial issues such as lack of access to comprehensive sexuality education and lack of access to safe abortion were at the top of the agenda.
As these matters are discussed in conference halls, what we see on the ground are young people who do not have access to information and services related to sexual and reproductive health. This has detrimental consequences on young people’s lives. Some become teenage mothers, if they do not die due to maternal mortality or have to bear the burden of living with HIV from a very young age – all of which may have been prevented if they had access to both information and services.
The realisation of the Sustainable Development Goals (SDGs) is reliant on the fulfilment of SRHR of everyone, especially the young. These goals are interdependent. For instance, the fulfilment of SDG 4 – (the right to quality education) - can lead to the realization of SDG 5 (gender equality).
If girls and boys have access to sexual and reproductive health information and services, they can be kept in school for longer – helping to achieve more of the SDGs.
According to the Uganda Demographic Health Survey 2016, 25% of women between the ages of 15 and 19 in the country have begun childbearing; 19% have had a live birth, and 5% are pregnant with their first child.
Meanwhile, the sexuality education that is provided in the country’s schools is centred on preservation of ‘sexual purity’, abstinence and make no mention of measures like condoms to prevent pregnancy or HIV. The current approach is clearly ineffective in preventing adolescents from having unsafe sex and preventing pregnancy – and has led to a high number of girls dropping out of school.
Some of the drivers of teenage pregnancy and sexual violence in the country are linked to old superstitions about having sex with virgin girls. In some fishing islands in the Kalangala District, some people believe that sleeping with a young girl helps you attract more fish, others believe that young girls are cheaper to maintain. These superstitions have contributed to high rates of sexual violence against young girls.
According to some Ugandan SRHR activists who work with adolescents and young people in schools, learners, mostly from some single sex schools in Uganda, reported having ingested food that is infused with paraffin by the cooks in an attempt to lower their libido. This is reportedly due to the high number of learners that would escape from boarding school to go and visit their partners. Not only is paraffin toxic, it induces nausea, fatigue and vomiting which all hinder participation and concentration in class.
In South Africa
In South Africa, teenage pregnancy accounts for 10 percent of births in the country and over 40 percent of maternal mortality. The quality of education received in different schools is determined by geographical location and racial diversity within the schools.
Life Orientation as a subject has failed a substantial number of learners, especially in rural and peri-urban settings. This is because some teachers are uncomfortable to teach particular topics linked to SRH based on personal or religious beliefs. Conversations around sex are simply seen as taboo in many settings.
There are shifting responsibilities between the institutions that are supposed to be providing information to children. Parents, teachers, the church all condemn sex but are rarely willing to talk about the topic openly and in depth.
This leaves young people with the option of consulting their peers or the internet for information, or simply going without information. Growing up I remember how curious I was to know more about sex after my mom told me not to play with boys because I had just started menstruating. Her discomfort in talking about sex left me hesitant to ask further questions about it.
South Africa has made great strides in getting the correct policies in place in relation to SRHR. However, as with most policies, there are a number of barriers to the policies being implemented, particularly when it comes to population groups such as adolescents.
Adolescents that are sexually active and are on contraception face issues of stock-outs in clinics, negative and judgemental attitudes from healthcare providers, internal and external stigma, and lack of information about alternative methods of contraception, just to name a few.
When you visit township schools you hear about stories of young girls using Domestos (a household cleaning agent) or Stameta (laxative) to terminate a pregnancy. This obviously has detrimental effects on their health.
What we see both in East and Southern Africa urgently calls for age appropriate CSE to curb the scourge of HIV, deaths due to unsafe abortion and maternal mortality among young people.
It also calls for reform of restrictive laws and for more resources to be allocated to SRH for the fulfilment of SRHR for everyone.
*Mbatha is a researcher at Section27.