Rumbidzai Ngwenya Features Writer
Noster Shoniwa is a 30-year-old divorced mother of three who lives in Kadoma. She got married when she was young — before she could even secure a career for herself. She later got divorced.

After the divorce the burden of fending for her three children weighed heavily on her.
During this time she wished she had waited until she was at least a bit mature to get married.
After her experience, she took it upon herself to educate people, especially adolescents about the advantages of using contraceptives in and outside marriage.

She was trained by Population Services International Zimbabwe and now works at a clinic in Kadoma.
She is a “Choice Champion”.
She is not alone.
There are men and women across Zimbabwe who have been trained by Population Services International Zimbabwe as champions who are devoted to helping increase the uptake of contraceptives in the country.

Their efforts are aimed at reducing teenage pregnancies and the spread of HIV and AIDS.
Champions offer strong support for family planning (FP) at all levels to strengthen the FP programmes and contribute to positive social norms and health seeking behaviours.
They are one of many initiatives to reduce teenage pregnancies in Zimbabwe.

“My experience has taught me a lot.
“Working at this clinic has given me a chance to make a difference in other people’s lives,” said Shoniwa.
She also believes her work has helped to reduce the transmission of HIV and AIDS.
“I have about 12 sex workers now in my area who come to me for contraceptives.

“It was not easy to get them to open up about their sex lives, but when they gained my trust I taught them about practising safe sex,” she said.
Shoniwa wishes to see younger people living a healthy reproductive life.

“I teach young people who are sexually active in my community about the advantages of contraceptives.
“Because of lack of knowledge they have been practising unsafe abortions but now there is an increased number of teenagers who come to the clinic for contraceptives,” the health activist said.

So far eight percent of people who visit Kadoma Clinic for contraceptives are young people.
The rate of teenage pregnancies in Zimbabwe has been a major cause for concern.
Teenage pregnancies are highest in Mashonaland Central, at 31 percent and the least Harare at 10.

During a media advocacy workshop that was held in Kadoma recently, Clinical Services director Dr Raymond Chikowore said inaccessibility of contraceptives to teenagers remained a major crisis in Zimbabwe.

“There are many barriers to accessibility of contraceptives which include costs and most detrimental, taboo to sexuality in the country,” he said.

“As the Zimbabwe Family Planning Services (ZNFPS) we are offering outreach services which are free and we encourage young people to visit those places for contraceptives to safeguard their future.
“Everyone who wants our services are offered regardless of age but we offer counselling first.

“Our aim is to reduce the worrying rate of teenage pregnancy by 2020.”
For a long time there were outcries about rampant discrimination of teenagers at health facilities by staff.
This has led to many adolescents resorting to pharmacies but not all could afford.

In rural areas where there are no pharmacies the dilemma continues resulting in high rate of teenage pregnancies.
Adolescent Sexual and Reproductive Health (ASRH) programmes officer Mrs Hellen Machimbirike said ZNFPC was working towards ensuring friendly service provision in all parts of the country to mitigate the dilemmas teenagers were facing.
“Adolescents contribute one third of Zimbabwe’s population, so it is essential to ensure their needs are well taken care of,” she said.

“Health facilities used to have health corners but it seems they did not work hence we are now training nurses and staff at clinics to ensure that everyone receives service regardless of age.”

Machimbirike condemned discrimination on teenagers who sought contraception services.
“Adolescents are indulging in sex so discriminating them when they seek contraceptives only makes the situation worse,” she said.

“We are fighting to reduce teenage pregnancies hence the ministry made contraceptives accessible at all clinics without discrimination.”

She urged adolescents to report any clinics which were not teenager friendly to the Ministry of Health and Childcare.
The ministry was working with various global partners to increase the accessibility of contraceptives in its National Family Planning Strategy 2016-2020, (FP2020).

FP 2020 is objected to increase Contraceptive Prevalence Rate (CPR) from 59 to 68 percent by 2020 and reduce teenage pregnancy rate from 24 to 12 percent by 2020.

Health ministry reproductive health co-ordinator, Brighton Muzavazi said the ministry was aiming to reduce teenage pregnancies by 2020.

“As much as we do not have adequate funding for youth centres we are going to see to it that infrastructure and human resources are availed to ensure accessibility of contraceptives by young people,” he said.

“We are also engaging the private sector because we have noted that many adolescents in Harare and Bulawayo are depending on pharmacies for contraceptives, so when they go there they should receive enough information.”

The ministry is also vying for all tertiary institutions across the country to have functional facilities where college students can access contraceptives and reproductive health information.

This came after widespread reports showed that most female college student were depending on emergency pills as contraceptives which was detrimental to health in the long run.

Advocacy has since been raised by organisations such as Right Here Right Now (RHRN), to come up with a multi central approach to curb the problem of pregnancy in adolescents.

RHRN is looking for alignment and enforcement of policies that will change people’s attitudes towards sexuality.
According to RHRN, the taboo of sexuality in the country has led to young people not talking about sex and it hinders the accessibility of contraceptives.

When there is a policy there is dependency in terms of programming and people ought to comply.
“We are looking at the Public Health Bill which will guide everything to do with health including sexual reproductive rights,” said national coordinator, Tendaishe Changamire.

“We have made submissions on behalf of the young people after seeing some areas that were not youth friendly in the bill.
“The other law is the School Health Policy which will guide comprehensive sexuality education, it is still in the process of being drafted and to be signed.”

If it is passed it would help youngsters get essential information about reproductive health from abstinence to practising safe sex.

For young people to understand the risk of sex, comprehensive sexuality education should be promoted.
“We teach about abstinence first and then how to practice safe sex as it stands our young people do not have enough information,” she said.

There is also national adolescents and youth sexual reproductive health strategy II that is under the ministry which guides youth friendly services to promote confidentiality.

According to RHRN when confidentiality is guaranteed many young people would not fear visiting health centres.
As it stands there are a number of things that need to be done to reduce teenage pregnancies.

Economic empowerment of families, young people and adolescents was essential to reduce poverty which was identified as a major contributor to teenage pregnancies.

Improved availability of information to demystify the perception that contraceptive use in teenagers caused barrenness.
There was also need to strengthen ASRH policy and legal environment otherwise teenage pregnancies would never be reduced.
More importantly there was need to stop discrimination and stigmatisation of youth who sought contraceptives in health centres.

At the workshop, a call was made to increase awareness on the use of contraceptives especially by young people.
The media was urged to play a leading role in the fight to reduce the rate of teenage pregnancies in the country.

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