Following the Regional Conference on Increasing Access and Improving
the Quality of Family Planning and Selected Reproductive Health Services in Francophone
Sub-Saharan Africa, a team from the Hamdallaye Maternity in Bamako conducted a study
(December 1995 to March 1996) to investigate the situation of young people in the Commune
IV District of Bamako. We interviewed 843 unmarried young women between the ages of 12 and
18. Our study highlighted several socioeconomic factors that are responsible for
increasing the frequency of pregnancy among unmarried teenage girls, for instance: the
poor, even abysmal socioeconomic situation of the parents, the low level of education of
the adolescents, their lack of sex education, and the failure of the girls to use a
contraceptive method and of the boys to use a condom.
Factors directly related to reproductive health (RH) behavior showed
that these young women were at great risk of an unwanted pregnancy.
Eighty-seven percent (87%) of these adolescent girls were sexually
active.
Ninety-eight percent (98%) of the adolescent girls between the ages of
12 and 18 knew nothing about a woman’s fertile period, and 74% had absolutely no
source of RH information. A stratified analysis showed clearly that lack of knowledge
about the fertile period was associated with a high risk of pregnancy.
Only 14% of adolescents in our sample said that they had ever used a
contraceptive method.
After reviewing the results of the research project, we looked at our
counseling and interpersonal communication sessions aimed at young people. And, after
several discussions among the maternity staff, we changed our strategy for this young
population.
To respond to expressed needs, we changed our messages and
services to meet the needs of adolescents.
Whenever young girls came to the center, we explained their fertile
period to them. We informed them of the availability of contraceptive methods and asked
them to pass along the message to their friends. Some students returned
bringing friends with them for more information.This proved to us that the need for
information is a reality. We gave the same information to young
men who came to the center for condoms.
In talking to young women who came to the center for the insertion of
Norplant® implants, in addition to the usual counseling, we stressed that
Norplant implants do not protect against sexually transmitted diseases (STDs) or HIV. We
emphasized the importance of insisting that one’s partner use a condom regularly to
minimize the risk of transmission of these viruses.
The quantity of condoms distributed to each client was increased as was
the number of pill packets given to the young women.
The way in which clients were received at the center was improved and
adapted for the youthful clients, to reassure them and encourage them to come more often.
For example:
The clinic now stays open during the evening to accommodate young people
who are working and can’t come during the day.
The clinic staff have tried to create a nonjudgmental atmosphere.
Service providers— often reluctant to give condoms and oral contraceptives to young
people—have been made aware that it is not their place to determine who should get
services and who should not.
Services at the clinic have been reorganized to make it possible for
young women who might not have any money to receive services and contraceptives free of
cost.
Appropriate sex education for both girls and boys can delay the initiation
of sexual relations among youth who are not yet sexually active and promote safe sex
practices—such as the use of condoms to prevent unwanted pregnancies and transmission
of STD and HIV—among youth who are sexually active. These are the goals we are
striving to attain.
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This bulletin was produced by JHPIEGO, an affiliate of Johns
Hopkins University. JHPIEGO, a nonprofit organization dedicated to improving the health of
women and families throughout the world, works to increase the number of qualified health
professionals trained in modern reproductive healthcare, especially family planning.
The MAQ: Progress in Togo article was contributed by
INTRAH (Program for International Training in Health) of the University of North Carolina
at Chapel Hill. INTRAH’s global mission is to assist agencies, institutions and
countries to improve the development and delivery of essential reproductive health
services through better preparation and utilization of human resources.
Financial support for this publication was provided in part
by the United States Agency for International Development (USAID). The views expressed in
this bulletin are those of the editors/contributors and do not necessarily reflect those
of USAID.
Credits
Senior Editor: Bob Johnson
Writer/Editor: Chris Davis
Technical Editors: Kathy Jesencky, Noel McIntosh
Production Editor: Martha Taylor
Contributors: Fatimata S. Diabaté Diallo, INTRAH
Translation: Frances Kleeman, Eliane Lanusse
Logo: Courtesy of Johns Hopkins University/Population Communication Services
Photo: Anne Pfitzer |
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