Despite advancement in education and the digital world we live in now where information is much easier to get, it’s unfortunate that many young people are still uninformed about many things regarding their bodies, puberty and reproductive health, especially in rural areas. For example, Prisca Muhimpundu, an S4 student at GS Gasaka in Nyamagabe District, says she was under a lot of pressure from her peers to have sex with boys if she wanted to get rid of the pimples on her face. What’s worse is that even some much older people that she sought advice from, told her to do the same. However, the 14-year-old wasn’t convinced, from the little knowledge she had, she was well aware that anyone her age is prone to skin problems. Unfortunately, she narrates, most girls had low self-esteem due to acne and pimples, and quite a number fell into the trap in desperation to make their skin clear, resulting in some getting pregnant. Alice Rwanamiza, another student from the same school, says it’s quite challenging to explain to an adolescent what are facts and what are myths, noting that most of the time they end up following myths because this is what those around them believe. Gloria Uwase, an S6 student, says it’s not just young people, some adults still believe in the myths of reproductive health, and because of this, they pass on this false information to younger people. For the young girls aforementioned, they now know that sexual intercourse will not cure a particular skin condition like they almost believed, thanks to Good Health Club that focuses on empowering adolescents and young people to realise their rights to equality, sexual and reproductive health services, and freedom from violence and discrimination. Through the club, students attest that they have been enlightened on issues facing them as young people. Funded by Korea International Cooperation Agency (KOICA) and implemented by United Nations Population Fund (UNFP), the club aims at helping young people become productive and competitive, as well as raise awareness among community leaders and parents in general. The club has 30 members, aged 12 to 18, both primary and secondary students, at GS Gasaka in Nyamagabe District. Teen education on reproductive health The National Institute of Statistics of Rwanda (NISR; 2018) indicated that about 78 per cent of Rwandans are below 35 years of age. This, according to experts, presents a great opportunity and yet at the same time also requires the establishment of programmes and interventions related to reproductive health to ensure a prosperous and healthy future for all. Meanwhile, reports have also indicated that about 49.6 per cent of teen mothers had their first pregnancy between the ages of 12 and 17, which is also associated with the rate of HIV infection that is estimated to be around three per cent among adolescent girls and young women. This data also shows that young people become sexually active at an early age, therefore, there is a need to increase and strengthen reproductive health interventions for young adolescents before it’s too late. According to Rajat Madhok, the chief communication advocacy and partnerships UNICEF-Rwanda reproductive, health is very important for young people as it prepares them to become responsible parents in the future. “It is important for parents to understand that they must be able to take care of their children in their education, health, protection, and wellbeing,” he says. Despite the multiple policy and programmatic measures implemented by the Government of Rwanda to reduce teenage and early pregnancies, research indicates that the rate is in fact increasing. For instance, according to the Ministry of Gender and Family Promotion, in 2016 alone, there were 17,500 pregnant 16-19 year-old girls. In 2017, the rate slightly decreased to 17,337 but in the first six months of 2018, approximately 9,172 teenage pregnancies were recorded in health facilities. The most recent Rwanda Demographic Health Survey (RDHS) shows that by age 19, 21 per cent of girls in Rwanda have started childbearing. Dr Aflodis Kagaba, Executive Director of Health Development Initiative (HDI), says the increasing rate of unwanted and unplanned pregnancies among young people is indicative of the lack of access to reproductive health services. His sentiment is backed up by 2015 RDHS which revealed that 65 per cent of married girls and 88 per cent of unmarried sexually active girls aged 15-19 do not use any contraceptives. It was also reported that 93 per cent of adolescent girls who are not using contraceptives have also not discussed family planning at a healthcare facility or with a healthcare worker. For Dr Kenneth Ruzindana, a consultant obstetrician and gynaecologist at University Teaching Hospital of Kigali (CHUK), reproductive health also contributes to better population management and improving lives of people while ensuring a good quality of life. Challenges Dr Kagaba says adolescents still face challenges in accessing sexual and reproductive health rights (SRHR), which include lack of information, stigma and judgment from healthcare providers. He notes that lack of parental support, and limited youth-friendly services are also a big setback. “Empowering young people helps them to make informed decisions about their reproductive health,” he says. Clementine Uwizeyimana, a parent and educator in Nyamagabe District, says there is a lack of positive and responsible parenting, whereby some parents still consider discussing reproductive health a taboo. She suggests that parents and the community at large work together to strengthen services related to reproductive health promotion among adolescents and other young people. Rajat says there are also challenges related to fast changing lifestyles, social media influence and peer pressure.
