FEATURE: Why We’re Promoting Contraceptive Use Among Adolescent Girls – Experts

…Parents Justify Awareness Campaign

…Teachers Kick

A teenage’ s life took a devastating turn when she was impregnated by her uncle, a man she trusted and looked up to. The result was a male child, born into a world of shame and silence. By tradition, the child is considered “rootless,” a stigma that will follow him for the rest of his life.

The teenager’s story is a heart-breaking example of the devastating consequences of unprotected sex which also brought on the front burner the issue of teenagers and access to contraceptives.

Also, last month, a viral post in the social media disclosed a story of a 17-year-old SS2 student with an implant contraceptive who, upon confrontation by her teacher, dropped a bombshell: about 40 of her schoolmates were also using the implant.

The news, which many debated of the veracity, sparked a heated debate amongst Nigerians. While some Nigerians were left wondering how these teens got access to such procedures at their age, others argued it was better to equip them with knowledge than leave them in the dark.

However, a Sexual and Reproductive Health Advocate, Oluyinka Adebanjo-Shokunbi, in her Facebook post, questioned the shock surrounding teenage girls using contraceptives.

She probed further, questioning why many would consider teenagers with implants as morally wrong, or think it threatens the moral fabric of society.

Why, she asked, would they object to trained health workers providing contraceptives, a service government offer to protect lives?

Adebanjo-Shokunbi stated in her post that all these are unnecessary propaganda and attempt to disregard that there is indeed an epidemic of unsafe sex going on in our society and everywhere in the world.

Parents’ concerns…

However, a parent, Mrs. Helen Chiazor, admitted that it is right to educate every child on sex once they are of puberty age, but cautioned that contraceptives should not be something for a little girl that should face her education, instead they should learn how to be responsible with their bodies.

She cited that there are so many parents right now that are not using contraceptives, but because they took responsibility as young adults, they are still able to control the number of kids they have.

While reacting on the viral video, she vehemently condemned what she termed “illegal act”, suggesting that the government and the law enforcement should question the girls, trace it back to whoever that is providing them with the access, adding that even though they are trying to avoid abortion they did not consider the downside of it.

She also lamented that even after educating these girls in their houses, they’ll still go out there and start having access to things like this, hence the need for the government to put an age limitation on who can access contraceptives.

NGO’s perspective on the issue….

Seeking clarifications, THE WHISTLER visited Planned Parenthood of Nigeria (PPFN), a leading healthcare provider and advocate for sexual reproductive health and rights.

The Executive Director of PPFN, Dr. Okai Aku explained that sexual education is very crucial for every mature child so as to help reduce the maternal child death, abortion and indiscriminate child bearing.

He added the organisation pushes for it by Providing positive information and services like integrated services, contraceptive services, non-contraceptive services in accordance with the medical practice rule which ensures that any underaged girl must present eligible citizen as a chaperone to countersign a consent before getting any service of such.

According to him, going by the Nigerian Law, someone at the age of 18 is allowed to make choices but must present a consent before undergoing any clinical examination.

Weighing in on the age factor, he noted that the organisation is even advocating for the government to improve on the policy, by bringing it down to age 15, as Rwanda government did, so that a 15-year-old child can go to the clinic and get the services without requiring consent from an elderly person, but must be educated on the use, advantages and disadvantages, hence the reason they carry out counselling session before any service is rendered to a client.

Asked how and what kind of counselling is being given to the clients, the PPFN Programme Manager and Service Delivery, Dr. Paul Odigbo, explained that when it comes to providing contraceptive services, the organisation dives into counselling that involves counselling for choice, which is providing the array of all the contraceptive options, not just implants, but all the varieties of contraceptives.

Odigbo highlighted the varieties to include, abstinence, condom, the oral, the injectables, implant, and IUD, stressing that the counselling is carried out on each of the contraceptives one after the other, educating the client on the use, advantages, disadvantages and demonstrations on how it is being used.

He pointed out that most often, after counselling some clients would opt for condom because of its double protection, unlike other forms that do not protect against sexually transmitted infection, having them, one still has to use condoms to protect against diseases especially for those that have multiple sexual partners, while some will even choose to abstain.

According to him, when the client chooses their preferred option based on side effects, advantages and disadvantages, the organisation would also let them know the need to have their partners screened of any infectious diseases.

Odigbo further explained that people also have medical conditions that might interfere the use of a particular contraceptive, such as heart problems, diabetes, hypertension, cancers, sickle cell diseases among others, and as such, the organization always go through World Health Organisation (WHO) eligibility criteria to know if the client is eligible for the preferred option.

“Even when we are counselling, or we’ve ended up counselling this client, and they make a choice, we pass through the WHO medical eligibility criteria, by putting the age of the patient, the medical conditions based on the interaction, and click to itemize those that are safe and those that are not safe,” he explained.

He also stated that based on the organisation’s experience in the field, condom has been the most popular form of contraception, considering the availability and accessibility, in the sense that even without being told, people know where to get it.

Highlighting the success of the contraceptive awareness for adolescents, Odigbo cited a situation in Bauchi state, where a parent presented a teenage girl to obtain an implant, on the reason that she is always alone in the house, and considering the epidemic of unsafe sex in the society, they are afraid something might happen to her in their absence.

And teachers’ reaction…

However, a teacher and a counsellor at a renowned government school in Abuja, with 30 years of experience, who spoke to THE WHISTLER condemned the action, questioning why a minor in secondary school should involve herself in contraceptive measures.

“She is still a minor, why should a child, a teenager, protect herself from pregnancy? That means they want sex to be really legalized for everybody to have sex anyhow. It’s very wrong.” she said, insisting that is possible the parents were not aware of what these girls did.

Another teacher with 15 years of experience, who also spoke to THE WHISTLER, argued that the problem in society started from home training offered by parents.

She stated that some parents spoiled their children at home by countering teachers’ instructions at school and by keeping vital information away from teachers who mostly nurture these children at school in their absence. She also pointed out that some parents sponsor their children to bring in contra-bound items to school.

According to her, gone are those days when a parent or a teacher will reprimand another person’s child outside for doing wrong and get commended by the child’s parents, instead you will be attacked.

Medical Doctor weighs in…

A gynaecologist, Dr Emeka Ayogu, described contraceptive implants as hormone-based devices that prevent pregnancy. While noting that any woman can use them, he expressed concerns about teenagers, citing moral and social implications.

Ayogu stated that removing the fear of pregnancy in teenagers may lead to such teenagers engaging on risky sexual behaviours, adding that implants are over 99 per cent effective but don’t protect against STIs.

He added that teenagers should not use implants due to their age and lack of informed decision-making capacity. However, he suggested condoms as a better option, considering their dual protection against pregnancy and STIs.

When asked if he would perform the procedure on a teenager, Ayogu said no but would consider parental requests to avoid abortion-related risks following unwanted pregnancy, weighing the pros and cons.

“The risk of dying because of abortion, is worse than a child getting an implant. So, in this case, you have to weigh the options when such a request comes from the mother. Not necessarily because you want the child to be promiscuous, but because you want to prevent maternal death or death from such a premature termination,” he explained.

The gynaecologist, and Chairman, Nigerian Medical Association, FCT chapter, while advocating for safer contraception options like condoms for teenagers, emphasised that doctors should prioritise preventing death and morbidity over preventing sex.

“What I want to advocate is that even though we also cannot say, or generally welcome teenagers to come for family planning, to seek for other contraceptive methods, which is even safer, when abstinence is not possible, when you counsel a child and he or she is not ready for abstinence, it is safer to leave them with condom, which is more acceptable. So, ethically and otherwise, doctors will prefer to prevent death than prevent sex,” he added.