By Angela Kibwana, Morogoro
As with other social groups, the 2007 Health Policy emphasizes and provides guidance on the importance of providing youth with information, education, and appropriate health services, including reproductive health that addresses age-specific needs without discrimination.
Among the key issues that adolescents should be educated are on how to cope with body changes during puberty, such as: how to control sexual desire, how to avoid early sexual activity, and how to protect themselves from early pregnancies. This empowerment is crucial for fostering positive health, social, psychological, mental, emotional, and spiritual outcomes for youth.
One of the critical reasons for providing information, education, and services to young people, as outlined in reproductive health policy, is to reduce reproductive health challenges among adolescents, including early pregnancies.
This challenge is highlighted in the Sustainable Development Goals (SDGs 2030, 3 & 5), the National Agenda for Investing in Adolescent Health and Well-being (NAIA-AHW 2021/2022 and 2024/2025), and other existing national policies and guidelines.
For example, the Child Act (Tanzania) – 2009, protects children’s rights, including the right to education, health, and protection from all forms of psychological or physical abuse.
Adolescent pregnancies are often linked to violations of girls’ rights. Article 5 outlines children’s rights, including the right to education. Article 13 discusses the protection of children from violence, which significantly contributes to early marriages and pregnancies.
Furthermore, Article 16 pertains to the right to quality health services, which is closely associated with reproductive health education and services for youth, aimed at protecting them from teenage pregnancies.
Despite all existing policies, legal frameworks, programmatic, and service efforts, teenage pregnancies continue to pose a challenge to community health, economic development, and the overall well-being of adolescents and their offspring’s.
Nationally, the rate of teenage pregnancies (ages 10-19) has decreased from 27% to 22%, while in Morogoro; it has dropped from 39% to 28%, according to the Tanzania Demographic and Health Survey (TDHS) 2015/16 and 2022.
Factors contributing to the persistence of teenage pregnancies include a inadequate access to accurate reproductive health information from trustworthy sources, gender-based violence and violence against children, child marriages, cultural practices that hinder access to education and accurate information, challenges in accessing youth-friendly services, inadequate parenting, and poverty.
Teenage pregnancies affect both female and male youth in various ways, including psychological, mental health challenges, dropping out of school, being forced to child marriages, social isolation, and abandonment by partners, inability to care for children, poor nutrition, increased crime, gender-based violence / violence against children, increase of maternal and infant morbidity and mortality rates.
The author had the opportunity to interview several stakeholders about the challenges of teenage pregnancies, revealing personal stories that illustrate the gravity of the issue:
Mariam John (not her real name), a 16-year-old, said, “I was a girl with many dreams, like becoming a doctor to help people and make a big change in my community. I tried hard to study and enjoyed learning opportunities. However, my dreams faded when I discovered I was pregnant at 16. I had to leave secondary school at my form one level, and that was the beginning of a new miserable life and the end of my dreams; I lost friends and hope for a better life.”
This narrative reflects the reality for many other girls facing teenage pregnancies. They often lose educational opportunities while grappling with health, social, and economic challenges that hinder their dreams and future.
Joseph Pius (not his real name) from Mwembesongo, Morogoro, shared his testimony, “I had no knowledge about reproductive health when I engaged in sexual relationship with a girl who worked as a house maid in my neighbors’ house. As the result of this sexual relationship she became pregnant, and I received misleading advice from my friends so as to persuade her to have an abortion. She accepted to terminate the pregnancy, after this induced and unsafe procedure, she fainted and suffered severe complications, losing her job and affect her health. Our relationship ended, and to the moment I don’t know where is she and how is she doing now.”
Pius also experienced a family conflict and he was detained by the police regarding this issue, I felt shame and guilt. “I regretted every moment. My friends abandoned me, and I isolated. Now, I’m advising my friends to avoid risky sexual behavior like early sexual intercourse, unprotected sex and connect them with youth health peer educators.”
To address these challenges related to youth reproductive health, including teenage pregnancies, the Ministry of Health collaborates with the Women’s Global Network for Reproductive Rights (WGNRR) Africa and the Family Planning Association of Tanzania (UMATI) are implementing The Voice of Youth project, funded by Amplify Change from the UK. This project aims to influence various stakeholders both nationally and internationally to ensure effective implementation of policies, laws, and guidelines that enhance reproductive health and well-being for youth.
The implementation of these national, regional, and global policies is expected to improve access, availability, delivery, and utilization of youth-friendly reproductive health services without stigma and discrimination, benefiting today’s and tomorrow’s generations and ensuring a bright future for our nation.
According to Evans Rwamuhuru,Project Manager of a Voice of Youth project from UMATI, said through their collaborative efforts have trained 36 health service providers, 10 journalists, and 30 peer educators in Morogoro and Iringa regions, focusing on reaching youth through various ways.
By the end of the project, it was expected to reach 59,400 youth over two years (January 2023 to December 2024). By September 2024, they had already reached 222,674 youth in both Morogoro and Iringa regions with reproductive health education, information, and services through health service delivery points, outreach services and weekend clinics, peer educators, and media.
In Morogoro, the project has reached youth in various districts, including 26,854 in Mlimba, 31,053 in Kilosa, 114,207 in Morogoro Municipality, 40,830 in Iringa Municipality, and 9,730 in Kilolo.
Michael Mbele, Program Officer from the Ministry of Health emphasizes the importance of reproductive health education for youth. The government stresses this through its guidelines and ensures that those in school receive education based on these guidelines. They advise youth to abstain from sexual activity to prevent teenage pregnancies.
Catherine Thobias Madaha, Regional Reproductive and Child Health Coordinator (RRCHCo) from Regional Administrative Secretary office Morogoro region, stated that teenage pregnancy rate in Morogoro region has declined from 39% to 28% ( 2015/ 16 to 2022) the decline of 11%.
In collaboration with development partners, including UMATI and WGNRR Africa the region is working hard to reduce the problem of teenage pregnancy. She stated that becoming pregnant at a young age poses health risks, as mothers should ideally be at least 20 years old for their reproductive systems to be matured properly.
Despite ongoing efforts to reduce adolescent pregnancies in Morogoro region, cultural practices, especially in districts like Gairo, where child marriage is high young girls ended up with teenage pregnancies, significantly contributed to the persistence of this challenge.
Also Ms Catherine said “as health professionals, we are not only providing treatment but also education, encouraging youth to seek out friendly health services rather than relying on street information. Those struggling to resist pressures can be advised to wait until they are older to make informed decisions about their futures”.
Our aim as a region (Morogoro) to strengthen collaboration with development partners to reduce the teenage pregnancy rate from 28% to below 10%, significantly alleviating the adolescent health challenges.
Conclusion
Through collective action and sustained efforts, we can strive to improve the reproductive health landscape for adolescents, ensuring brighter futures for them and their communities.
