A few years ago, Mansa faced a critical challenge as the prevalence of teenage pregnancies and school dropout rates among adolescents surged.
Take for instance in 2020, the prevalence rate stood at 25.1 percent, according to the Luapula province health office, the number has since come down to 21.1 percent.
Recognising the urgent need for intervention, a collaboration of dedicated partners came together to implement a proactive sensitisation programme aimed at addressing the root causes of these issues.
Robert Zimba is executive director at Integrated Youth Development, a youth focused Mansa based non governmental organisation that works around four thematic areas that include health, human rights, governance and advocacy.
His organisation has been working closely with the Government through the the Ministry of Health and Ministry of Education as well as organisations such as the German Agency for International Cooperation (GIZ), Natwampane, and also Medicines Research and Access Platform (MedRAP) to address issues affecting youths and adolescents in Mansa, Samfya, Chembe and Kawambwa districts - all of which are in Luapula.
He has seen it all.
“We had a lot of these cases,” he said. “It’s just that I cannot provide you with exact figures just yet, but compared to past years, we are at a better place because of the many things that we have been doing to address these issues.”
Much as he is happy with the current trajectory, Mr Zimba still reckons that more can still be done, especially to address the lapses that may have been identified.
“Some of the health facilities that we had sampled had no structures for youth friendly services, instead the adolescents meet under mango trees, in areas like Kale, Buntungwa and Namwandwe,” he said. “We suggest that the Government comes up with some youth friendly structures that offer privacy in the mentioned facilities to improve the sexual and reproductive health service delivery among adolescents and young people.”
Mr Zimba is also of the view that Government and other stakeholders should increase awareness on services so that adolescents and youths are made aware about the family planning commodities found at the centres.
“The government and other stakeholders should continue to monitor the utilisation of family planning commodities among adolescents and young people. The district health office should put up adequate monitoring mechanisms that will allow to reduce stock outs,” he said. “According to the findings, we discovered that adolescents and young people prefer using male condoms more than other family planning methods.”
One key factor contributing to this positive shift has been comprehensive sex education. Through workshops, seminars, and awareness campaigns, cooperating partners have worked hand-in-hand with schools to ensure that adolescents are equipped with the knowledge and skills necessary to make informed decisions about their reproductive health.
This has not only empowered young people to take control of their lives but has also fostered a culture of open communication and understanding.
Patricia Njowe is senior nursing officer in charge of adolescents at the Luapula province health office. She says, among the 14 districts in the province, Mansa has performed exceptionally well in dealing with teenage pregnancies.
“To improve this picture further, the district has embarked on conducting quality improvement projects to reduce teenage pregnancies in selected zones. The outcome of this intervention can only be appreciated by mid-year of 2024 after monitoring and evaluation of the said projects,” she said. “All facilities in the district have adolescent health focal point persons coordinating adolescent health services and we have been conducting community dialogues with gatekeepers such as the traditional and religious leaders and others to promote adolescent health.”
Ms Njowe however notes that even though most parents may not allow their child to access family planning services during adolescence, they engage gatekeepers to enable those that are sexually active to be linked to adolescent health spaces where they can get more information on teenage pregnancies and its effects.
“Access to family planning or contraception is one of the rights of women in the childbearing age. Adolescents access this service through counselling and allowing them to make informed decisions on when to have children and how many to have,” she said.
Additionally, the cooperating partners have implemented mentorship programmes that provide guidance and support to teenagers facing challenges. By connecting adolescents with positive role models from various fields, these programmes have instilled a sense of purpose and aspiration among the youth, reducing the likelihood of engaging in risky behaviours.
Furthermore, the community has witnessed a boost in extracurricular activities and skill development programs. By offering alternatives and avenues for personal growth outside the traditional academic setting, cooperating partners have played a crucial role in keeping teenagers engaged and motivated to stay in school.
The success of these initiatives is evident in the declining rates of teenage pregnancies and school dropout in Mansa district.
The community is experiencing a positive shift, with more adolescents realising their potential and seizing opportunities for a brighter future. The proactive sensitisation programmes have not only addressed immediate challenges but have sowed the seeds for long-term sustainable change in the district.
According to a research by the National Library of Medicine, an official website of the US Government, about three in ten young women aged 15–19 have begun childbearing among the Zambian population, with adolescent pregnancy levels as high as 35 percent in rural areas – with Luapula reportedly posting 32.1 percent adolescent pregnancies as of 2019.
The mean age of the adolescent mothers was 15.5 years. Mothers younger than 20 years faced a higher risk for eclampsia, anaemia, haemorrhage, Cephalopelvic disproportion, prolonged labour and caesarean section.
Children born to mothers younger than 20 were at increased risk for low birth weight, pre-term delivery, low Apgar score and neonatal death; the risk for asphyxia, however, tended to increase with age.
The Government has committed to providing adolescents and young people with comprehensive sexual and reproductive information and services, including in the ESA Statement of Commitment. However, parents, teachers, health care workers, and religious or traditional leaders often have reservations about young people's access to HIV prevention, family planning or information on gender-based violence, due to social taboos and discriminatory gender norms. In addition, there is a lack of appropriate tools and methods for providing quality services in these areas.
“These are some of the things that we have always been advocating for - to have a lot of people come on board, talk about these things and denounce them as church leaders,” said Davison Lemba, a Seventh-Day Adventist pastor in Mansa.
He says the more the church, parents and traditional leaders begin to openly discuss issues of sexual and reproductive health, positive trends will soon be recorded as far as teenage pregnancies and HIV infections among adolescents and young people is concerned.
“It has to start with us,” he said.
Luapula province deputy permanent secretary, Prudence Chinyama attributed the drop in teenage pregnancies and early marriages to conducive policies that the government has put in place.
“There is the issue of free education which has come on board, the classrooms are full. The province, like any other place, is a construction site, increasing the school infrastructure, manufacturing desks and a lot of rehabilitation,” she said. “There is actually quite a lot that we have been doing to make sure that these numbers come down and stay down.”
Like many others, the GIZ through the National HIV/AIDS Council, has been implementing the Strengthening Girls’ Rights project in Luapula, Southern, Lusaka and North Western provinces, with the aim of addressing the triple threat of HIV, teenage pregnancy and gender-based violence.
“The goal is for young people, especially young women and girls, to be able to exercise their rights, access counselling services, and take action for their sexual and reproductive health, HIV prevention, and non-violent gender relations.”
Note that this story was also published in the Zambia Daily Mail newspaper of ****.
