Shanshan He: Leading the Way for Young People

It all started when I hadn’t seen one girl for a couple of months. I was told her boyfriend had broken up with her because she was pregnant. Then the rumors started. “She borrowed money, she is probably going to take an abortion.” “She should be expelled from school.” “Her parents were angry and they beat her.”

I felt sad that young people weren’t being given the chance to receive comprehensive sex education at school and learn how to protect ourselves. I was outraged that when a girl found herself in these circumstances, people and society simply criticized her behavior rather than providing help and supporting her.

When I first participated in an event hosted by UNFPA in 2014, I was astonished to learn the tremendous number of adolescent girls giving birth every year – 7.3 million in developing countries. In China, 4 out of every 100 unmarried girls aged 15 -24 become pregnant, and almost 90% of those have an abortion.

Taking into account the huge population in China, I cannot imagine how many young people are suffering due to a lack of information and biased gender attitudes.

What youth leadership means to me

I started to volunteer at the China Family Planning Association (CFPA) – an IPPF Member Association – as a youth peer educator. I travelled to different provinces and cities providing training on sexual and reproductive health and rights to young people.

Next, I worked with Dance4life as an international trainer. I delivered Journey4life – a programme designed to build young people’s social and emotional competences so they are able to make healthy choices about their lives and feel confident about their future.

Through my interaction with different generations, I gradually realized that leadership is something that happens within yourself. You feel confident about your life, can see a different world, and are empowered to make changes.

Shanshan He, IPPF Board Member

Being a young leader at IPPF

20% of IPPF’s board must be represented by young people under the age of 25. I was elected to the board of my Member Association, the East and South East Asia & Oceania Region, and the global board. I attend meetings, participate in discussions and vote on the important matters – just as any other member.

My fellow youth representatives and I struggled when we first entered this unfamiliar territory, and had a difficult time finding our position.

Were we supposed to comment and participate solely on youth-related issues? Or should we engage with all the matters and discussions? When we speak, which hat are we wearing – young people who receive services, young activists on the ground, or youth leaders shaping the rules?

We learned that we could define our role. It was important to keep reminding ourselves of our focus and shifting hats to ensure more young people are truly represented.

We didn’t elect a chair among the youth representatives. Instead, the youth meeting is chaired by all the members in rotation. We also share the reporting and presentation responsibilities. This shared leadership approach avoids power dynamics and makes sure we don’t forget why we are all here.

Having been through the journey in IPPF, I realized that there is no point waiting until we ‘grow older’ to be a leader.

Leadership has nothing to do with age or gender. We are the leaders, now and in the future: here and beyond!

Sex Education is Everyone’s Right

Sex education is the teaching of knowledge and understanding of our bodies in their natural sexuality. It’s important for many reasons. Many privileged sectors of society have access to this knowledge and understanding, but in many parts of the world, it can’t be taken for granted.

There is a huge problem with sex education worldwide.

In the United States, a survey showed that of 1000 participants between 18 and 29 years, only 33% reported having had some sex education. In the United Kingdom, a similar poll proved that from the same number of participants, 16-17 years old, only 45% felt confident to define their sex education as ‘good’ or ‘very good’.

Meanwhile, in South Africa, the adolescent pregnancy rate is 30%. Mexico has the highest rate of teen pregnancies among the 34 member countries of the Organization for Economic Co-operation and Development (OECD).

Sex education simply means teaching young people to know how their bodies work and how to take care of them.

A sex education of quality provides us with the tools to respect our own bodies and the bodies of other people. It enables us to be conscious of the respect sexuality deserves, to prevent sickness, and to value the importance of open, shame-free dialogue.

Sex education should be part of every education. Sadly, many cultures still think that sex education is not a priority matter. Many people believe it shouldn’t be included in basic education because for them, talking about sex is a synonym for shame.

Consistent, high-quality sex education must not be only an option.

The importance of the subject goes beyond the individual. It matters deeply because a correct education can actually save lives. According to The United Nations Educational, Scientific and Cultural Organization (UNESCO), sex educations is:

“[…] teaching and learning aspects of sexuality. It aims to equip children and young people with knowledge, skills, attitudes and values that will empower them to realize their health, well-being and dignity; develop respectful social and sexual relationships…”

Sex education can:

  • Prevent sexually transmitted diseases
  • Provide knowledge of how to use contraceptive methods
  • Prevent unwanted pregnancies
  • Create understanding of the menstrual cycle
  • Reduce stigma and shame

A thorough sex education also gives young people an understanding of the boundaries of their body’s intimate space. This helps them to identify sexual abuse.

With the correct information, people are more able to make responsible decisions.

Sex education must be a right. It is about more than just sexual life. Education helps young people to take decisions about their bodies, health and lives in their own hands. This can, in turn, create a better lifestyle for all.

It’s important to visualize the body as the natural thing that it is. If parents and textbooks would teach about the naturality of our bodies, it would be easier for people to demand respect over their own.

In the world I envisage for the future, everyone will receive high quality sex education. They’ll understand what sex is about, and there won’t be more fear or taboo. No child, woman or man will be limited in speaking about sexuality as a personal and social priority.

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Teenage Girls in Argentina Deserve Better

As multilateral organizations continue to research sexual and reproductive rights in Latin America, I’ve been learning many sad truths about my country.

This year, we learned that Argentina’s teenage pregnancy rates are the highest in the Southern Cone (Brazil, Argentina, Chile, and Uruguay). It’s estimated that 109,000 teenagers and 3,000 girls under 15 years old give birth to a child every year. These numbers make up 15% of annual births in the country.

Most of these pregnancies are unplanned and unwanted. UNFPA’s latest study, The Power of Choice, shows that Argentina’s maternal mortality rates are also much higher than in the rest of this region. For every 100,000 births per country, 52 mothers die in Argentina, 44 in Brazil, 22 in Chile and 15 in Uruguay.

The results of this study have strengthened the call for inclusive sexual education, accessible contraceptives and the decriminalization of abortion in Argentina. 

Adolescent maternity rates are higher in communities living in poverty, where girls are also less likely to go to school or have access to healthcare and contraceptives. When a girl gets pregnant at an early age, she’s very unlikely to continue her studies, which perpetuates a circle of poverty for the girl and her family. She’s also less likely to survive the pregnancy and the birth.

Earlier this month, a 13-year-old girl had a baby in the Chaco province in northeast Argentina, where poverty and early maternity rates are among the highest in the country (according to UNICEF more than half of children under 17 years old in Chaco were living in poverty in 2016).

Her name has been kept secret, but her living conditions have shocked the country. She was malnourished, anaemic and had pneumonia, yet never received treatment for any of these conditions. She was living with an older man, her boyfriend, and wasn’t going to school.

When her 20-year-old aunt took her to the hospital for a fever, they discovered she was 28 weeks pregnant. The fact that this girl was pregnant for 7 months without knowing it…it’s hard to imagine how neglected she was. She had to have a C-section because of her extremely weak condition. The baby lived only a few hours, and the girl died less than a week later.

So many things went wrong for her.

The health system in the province went beyond failing her, because it didn’t even know she existed until it was too late. She didn’t have family to take care of her and the system did nothing. Her health was gravely deteriorating and the system did nothing. She was in an abusive situation and the system did nothing.

Her story breaks my heart. And it hurts me even more to know that she’s not the only one living like this and won’t be the last to end up like this. She deserved better. All of them deserve better. 

“A world of hope for adolescent girls” – Olive’s story

This is the fourth and final blog in a series sharing personal family planning stories from around the world – presented by CARE and Girls’ Globe in the lead up to the 2018 International Conference on Family Planning. Catch up on the whole series with stories from HawaParmila, and Oun Srey Leak.

Rwanda has made significant strides in empowering women and girls and ensuring they have access to affordable healthcare, including access to family planning.

Access to contraception has steadily increased from 17% in 2005 to 53% in 2015.

The government has decentralized and subsidized healthcare to ensure the most remote areas are reached and the most vulnerable communities can access services. However, the biggest unmet need for family planning is predominantly among young and unmarried women. In 2016 alone, 17,000 girls reportedly became pregnant before turning 18!

In 2016, the Government of Rwanda began providing comprehensive sexuality education in schools, however there is still a long way to go to ensure teachers are equipped with the skills and information needed to engage in age-appropriate, open and honest conversations with students.

I work for CARE in Rwanda, where I advocate for increased access to age-appropriate, integrated sexual and reproductive health services, rights, and education for in-school and out-of-school adolescent girls. Although the country has made notable progress in promoting women’s and girls’ rights in recent years, teenage pregnancies have continued to rise, leading to dire socio-economic and health consequences for Rwandan girls.

A few weeks ago, I attended an information session for young women in Kigali where a medical doctor explained available methods of contraception. I realised then that there is a lot young people do not know. But it made me wonder…

If the youth of Kigali don’t know how to prevent pregnancy or to take care of their sexual and reproductive health, what about women and girls who reside in rural areas where access to information and services is still a challenge – even a luxury?

In my time at CARE, I have seen the tremendous work the organisation is doing around the world to increase demand for sexual and reproductive health information and services, including contraception. Much of our work focuses on addressing underlying causes of poverty and vulnerability and helping communities to challenge harmful and negative socio-cultural norms that hinder women and girls from enjoying their rights and reaching their development potential.

Two weeks ago, I met a group of adolescent girls in Karongi District, Western Rwanda, where CARE is implementing the Better Environment for Education (BEE) project to increase chances of girls staying in school. During my visit, the girls talked to me about the various problems that they faced, including unwanted and early pregnancy. As I listened to their stories, I wondered whether we are doing enough to address these issues.

One particular 17-year-old stood out to me. As she narrated her story with teary eyes, she recalled the difficult time she went through when she found out she was pregnant, and described how she was abandoned by her family. She felt she had failed them and failed herself. At some point she was forced to quit school to raise her infant. But when the BEE project began, she decided to join one of the clubs and suddenly found hope. According to her, the clubs have provided a space and a voice for girls to talk and to get accurate and comprehensive sexuality education.

Although the local health centre is just a few metres away from the school and provides condoms and other contraceptive methods, young people in Karongi told me they feel judged and shamed when they go there to seek services that they are entitled to. The BEE project aims to address this as well by giving adolescent girls a platform to dialogue with the school administration and local leaders to express their needs.

Studies have shown adolescents are increasingly becoming sexually active before they turn 18 and this is a reality we should not ignore. Too often, in countries like Rwanda, adolescent girls do not have information regarding their changing bodies or sexuality in general.

Adolescent pregnancy undermines a girl’s ability to exercise her rights to education, health, and autonomy. It’s not only a health issue, but a human rights and development one too. 

I believe that CARE’s integrated approach to empowering adolescent girls, including economic empowerment through savings clubs, sexuality education, addressing gender-based violence and engaging power holders such as parents, boys, school administration officers, and local leaders is powerful in ensuring the problem is addressed from all sides. I have no doubt that this will bring about transformation in the lives of girls and their communities.

We have no more time to lose.

Turning the Tide in the Caribbean to Educate Adolescent Mothers

The Caribbean, known for its white sandy beaches, clear waters and vibrant culture is also home to the second highest adolescent pregnancy rates in the world – second to Sub-Saharan Africa. The highest rates of adolescent pregnancy within the Caribbean are found in the Dominican Republic and Guyana.

When a girl becomes pregnant she faces many challenges, such as being kicked out of school, ostracism from family and friends, lack of support from the father of the child(ren), and lack of access to continuing her education. 

These challenges lead to a cycle of intergenerational poverty, unemployment and gender based violence.

Despite a societal culture that does not encourage adolescent mothers returning to school, strides have been made to ensure that they have the opportunity to continue and complete their education. Specifically, in Jamaica, multi-sectoral approaches have led to the establishment and implementation of the Policy for the Reintegration of School Aged Mothers into the Formal School System, which mandates that adolescent mothers be allowed to return to school after having their child.

To date, approximately 2,850 adolescent mothers have been reintegrated into the formal school system. Jamaica is the first Caribbean island to have such a policy, while the implementation of Guyana’s reintegration policy is currently underway.

There have also been advances in supporting adolescent mothers through programming. Jamaica, Guyana, Trinidad and Tobago and St. Kitts and Nevis are a few of the Caribbean countries that have programs or organizations dedicated to advancing the health and rights of adolescent mothers.

In Jamaica, the Women’s Centre Jamaica Foundation is promoting a new approach to problems associated with teenage pregnancy, especially in the area of interrupted education. Women Across Differences in Guyana implements the Empowerment Programme to provide a safe and friendly learning environment for mothers to acquire sexual & reproductive health information and services , as well as life skills to create a better life for themselves and their children.

The Adolescent Mothers Programme (Trinidad and Tobago) and Project Viola (St. Kitts and Nevis) are programs established through collaborative efforts of ministries and community-based organizations. Both provide a wide range of support such as counseling, career development, parenting courses and skills training.

As a native of Jamaica and the founder of Pearls of Potential – an organization providing support and services to adolescent mothers in the developing world – I am proud of the work that has been done in the Caribbean in supporting adolescent mothers.

Caribbean leaders must understand the importance of educating adolescent mothers. They must also establish and strengthen resources and policies that will support the completion of their education.

It is important for governing bodies such as the Caribbean Community (CARICOM) and Organisation of Eastern Caribbean States to create agendas that include goals in support of adolescent mothers and ensure that these goals align with the Sustainable Development Goals. The continued tangible support of international non-governmental organizations such as UNFPA, UNICEF and UNESCO is also paramount to the sustainability of current programs.

On this International Day of Girl, with the theme With Her: A Skilled GirlForce, we must make a commitment to ensure that adolescent mothers have the opportunity to continue and complete their education, which will give them a chance to gain skills for employment, provide for their child(ren) and contribute to a growing society.

We must remember that when we invest in our girls, we invest in our future.

The Contraception Situation in Africa

Anne’s Story

Anne Anyango is a 35-year-old mother to five children and a wife to her 40-year-old husband. Anne’s family resides in one of Kenya’s biggest slums – Kibera, in Nairobi – where access to basic needs can be a challenge.

Before Anne started using contraception, she was consumed by the myths and misconceptions peddled around by fellow women. “They told me that I would not get pregnant, I would grow fat and that I would be ‘cold’ in bed which would make my husband divorce me,” she disclosed.

She believed these myths for a long time. Her husband was not pro-family planning either, for he believed the side effects would break their marriage. But after Anne gave birth to five children in the space of eight years, she knew she needed to do something urgently to curb the pregnancies and births, for she did not have enough resources to support them. She also said her health was quickly deteriorating. “I became weak,” she said.

During one of her clinic visit days at Family Health Options Kenya, she spoke to a nurse about her fears regarding use of family planning. She was offered guidance and is now secretly using an IUD. “My husband has no idea that I am on family planning,” she said. She fears that if her husband knows about it, he might divorce her.

It has been two years now and Anne has experienced no side effects. “I am still the same,” she shrugged. She also said, however, that her husband wonders why she is no longer getting pregnant.

Anne’s situation reflects a true picture for millions of women across Africa today.

The Statistics 

The recently launched State of African Women Report 2018 (SoAW) shows that the total fertility rate for the African Continent is the highest in the world, at an estimated 4.6 children per woman. The report indicates that 1 in 3 women use modern contraception and that about 1 in 5 women who are married have an unmet need for contraception.

The same report further states that adolescent pregnancy rates are highest in Sub-Saharan Africa, and it’s incidence is strongly related to child marriage. More than 1 in 4 girls in West Africa and Central Africa are pregnant before the age of 18 and 1 in 20 before turning 15.

These statistics indicate that Africa is still merely limping towards achieving its agenda regarding access and provision of sexual and reproductive health services to its people.

The Declaration on Human Rights states that every woman has control over her fertility, the number, timing/spacing of pregnancies and her method of contraception. In addition, it provides the right of women and girls to information and education on family planning and contraception, to non-discriminatory access to SRH services and to access abortion on specific grounds.

Although various Africa Union (AU) member states have made commitments to policy implementation frameworks, it is evident that challenges exist around domestication and implementation of human rights.

The reality is, national-level legislation often does not articulate women’s reproductive freedoms and rights. These issues are only reflected in policy or strategic frameworks. Very few countries realised the commitments expressed in the Abuja Declaration (2001) on health expenditures, which required Africa Union countries to allocate at least 15% of their annual budget to improve their health sectors.

Many girls and women in Africa living in rural areas and poorer communities face obstacles to their access to, and use of, SRH services. The challenges include: long distances to health facilities, unavailability of preferred contraceptive methods, absenteeism of family planning providers, high cost of managing side effects, desire for large family size, children dying under five-years-old, husbands forbidding women from using family planning and lack of community leaders’ involvement in family planning programs.

However, some countries have made initiatives to enhance access. These include allocation of budgets, integration of SRH services into primary health care and the provision of free services including contraceptive methods. Some countries have also introduced mobile clinics to enhance access to SRH services for rural women.

Comprehensive Sex Education

There have been policies and frameworks that place comprehensive sexuality education and information programs as key institutional obligations for states to implement in school curricula and out-of-school programmes. Some countries have adopted them well, while others are still facing challenges in doing so.

Similarly, adolescent access to SRH services is limited when countries lack youth-friendly services. Many young people shy away from discussing their sexuality around older people. Such services provide them with safe spaces to inquire freely about anything they want to know.

Safe Abortion

Legal guarantees for access to safe abortion as articulated in the Maputo protocol indicate that abortion can only take place when the life of the mother is threatened, when pregnancy poses a threat to the mental and/or physical health of the mother, in case of foetal impairment, or in case of sexual assault, rape or incest. Abortion is not allowed on any grounds not specified in the Maputo protocol.

Every year, an estimated 1.4 million unsafe abortions take place among girls aged 15-19 in Africa. Both married and unmarried adolescent girls are at high risk of being exposed to unsafe abortions. In most countries, guidelines regarding Safe Abortion Care and Post Abortion Care are missing. These are of critical importance to ensuring the quality of accessible safe abortion services.

Effects of the Global Gag Rule

Finally, the global gag rule – otherwise known as the Mexican City Policy – imposed by the current US administration has immensely affected provision of quality SRH services across Africa.

Women in Africa are currently suffering from disruptions in reproductive health services, more unintended pregnancies, higher rates of maternal mortality, and an increase in unsafe abortions. Multiple studies have shown that the global gag rule has notdecreased rates of abortions overall, but has instead increased the number of unsafe abortions. NGOs are also suffering from significant funding shortages to provide comprehensive sexual and reproductive healthcare services.