What are the current factors contributing to the high prevalence of teenage pregnancy in Nigeria? And what are the risks associated with that trend?
Onyema Afulukwe-Eruchalu: A combination of socio-cultural, legislative, political and economic factors are currently contributing to the high prevalence of teenage pregnancy in Nigeria. They include socio-cultural perspectives that result in widespread bias against acknowledging adolescent sexuality by major stakeholders such as families, policymakers, healthcare providers, and educators; the absence of laws, policies and services that are targeted at meeting adolescents’ sexual and reproductive healthcare needs; the inadequate provision of comprehensive sexuality education to adolescents, in and out of school; as well as impunity for sexual violence, including in schools. The high incidence of child marriage in parts of the country and endemic poverty, which forces some adolescent girls to engage in transactional sexual activities in exchange for basic necessities, such as food, clothing, and school fees, are also important factors. Lastly, the chronically underfunded health system – which lacks youth-friendly services and has raised financial barriers such as high costs and stock-outs of contraceptive methods that prevent adolescents from accessing the contraceptive or family planning information and services they might need – constitutes another key factor.
The risks associated with these trends are grave. With little to no avenue to access necessary sexual and reproductive health information and services, many adolescents experience early, unplanned or unwanted pregnancies. Afraid of being stigmatised by society, disowned by their families or expelled from school, some seek out clandestine and unsafe abortion services, risking severe injury or death. Those who continue with the pregnancy are likely to be expelled from school with minimal opportunity for re-entry, or drop out, severely limiting their employment opportunities and economic empowerment for life.
They also face increased risks of maternal morbidity and mortality due to their physical immaturity and the heightened challenges adolescents encounter while seeking quality and affordable maternal health care services. To avoid the stigma and discrimination that result from being unmarried and pregnant, or to secure the financial means to undertake child-rearing responsibilities, some families force adolescents into early marriages, often to older men who are more likely to be financially secure. However, the unequal power relations in child marriages intensify girls’ risks of domestic violence and sexually transmitted infections, including HIV.
What are some of the rights instruments available to further the sexual and reproductive rights of adolescents in Nigeria?
A number of relevant human rights standards are entrenched in the Constitution and in international and regional human rights instruments. These guarantees include the rights to health, equality and non-discrimination, information, education, life, and freedom from cruel, inhuman and degrading treatment, among others. They contain components that have been interpreted to require states to address teenage pregnancy and its consequences and ensure adolescents receive appropriate sexual and reproductive health information and services.
Specifically, the United Nations Covenant on the Rights of the Child, which was developed for children, including adolescents, mandates states to guarantee their right to the highest attainable standard of health and provide access to family planning and education services, ensure their survival and development, and undertake appropriate measures, including legislative and administrative, to ensure they have the protection and care that is required for their well-being. At the regional level, the African Charter on the Rights of the Child, which Nigeria has ratified, also provides equivalent guarantees.
In which ways do entrenched traditional or religious values and practices hinder the realisation of sexual and reproductive health rights in Nigeria?
Although the rights guaranteed by the United Nations Covenant on the Rights of the Child were domesticated at the national level in the Child Rights Act in 2003, federal states had the authority to modify or refuse to implement the Act to the extent that it contravened local traditions and religions. Many chose not to implement the Act primarily because it prohibited child marriage.
This goes to show how widely-held traditional and religious values and practices in Nigeria play a substantial and multifaceted role in constructing and exacerbating the socio-cultural, legislative, political, and economic factors I mentioned.
In many parts of Nigeria, socio-cultural norms, which are common in most African countries, do not recognise adolescents’ evolving capacities and abilities to make decisions about their reproductive health. Religious values – both Christian and Islamic – require that they do not engage in sexual activity outside of marriage. Accordingly, providing adolescents with adequate, if any, sexuality education is viewed with suspicion and there is fear that it would increase their likelihood to engage in sexual activity or promote promiscuity.
This misperception reduces adolescents’ opportunities to receive information about sexual and reproductive health issues at home or at health facilities or to access accurate and evidence-based sexuality education in schools. Yet about 14 percent of adolescents in Nigeria have engaged in sexual activity. Those who seek reproductive health information and services, including contraceptive services, from healthcare facilities are frequently subjected to the personal bias of healthcare providers who deny them access based on their age or marital status, or require them to obtain consent from their spouses or parents without any legal basis.
Another unfortunate outcome of these misconceptions is that policymakers have neglected their responsibility to develop or implement relevant policies or faced stiff opposition when they have attempted to do so. The federal government of Nigeria established a national curriculum for sexuality education in schools in 2003. Prior to that, there was much resistance to the process, again stemming from misconceptions about the implications of providing sexuality education to adolescents. It became imperative to link its primary value to the reduction of HIV infections among adolescents, a burning issue at the time, and was ultimately given the title of Family Life and HIV Education Curriculum (FLHE).
All 36 states and the Federal Capital Territory were advised to adopt it. Yet again, a majority of states did not adopt the FLHE for several years, and most of the few states that adopted it early did not adequately ensure its implementation in schools, a reflection of the level of political commitment to implement it. Some states are yet to adopt it, despite reliable evidence that adolescents who received the FLHE exhibited considerably increased knowledge of sexuality and HIV, positive changes in their attitudes towards gender equality, and increased likelihood to want to abstain from sexual activity.
What efforts does Nigerian civil society pursue to promote the sexual and reproductive rights of adolescents?
Efforts include human rights advocacy, research and data collection, awareness-raising and capacity-building to influence decisionmakers at the national, regional, and international levels in order to achieve law reform and implementation. A pertinent example is the collaboration between global and Nigerian civil society to do in-depth human rights advocacy before the United Nations Committee on the Rights of the Child during its periodic reviews of Nigeria in 2005 and 2010. This engagement involved submitting shadow reports to the committee with independent and reliable research and data on Nigeria’s compliance with its obligations to children under the Covenant. As a result of those efforts, the committee expressed concern at “the high proportion of teenage pregnancies” and issued several recommendations. It urged the government to “formulate adolescent health policies and programmes with a particular focus on the prevention of sexually transmitted infections (STIs), especially through reproductive health education”. It also mandated the government to ensure all the states in the country adopt the Child Rights Act as a matter of priority, despite the government’s stance that this would be controversial.
Strategies to secure the full implementation of these and similar recommendations and to mobilise relevant stakeholders continue to date. Indeed, on September 25, 2015, governments worldwide adopted the 2030 Agenda for Sustainable Development Goals (Post- 2015 SDGs), which build on their commitments under the Millennium Development Goals. Civil society engagement, from both the global North and global South, including Nigeria, helped ensure that the Post-2015 SDGs include commitments to advance gender equality and sexual and reproductive health and rights.
Further, the African Union (AU) has declared 2016 the Year of Human Rights in Africa, and mandated all members states – of which Nigeria is one – to embark on targeted activities to bring this declaration to fruition in their countries. The Nigerian government and other stakeholders must use the concrete opportunity provided by both of these recent regional and international commitments to address the high prevalence of teenage pregnancy. It should develop both immediate and shorter-term strategies to achieve results in 2016, in keeping with the AU’s declaration, while also establishing medium- and longer-term measures as part of the commitment under the SDGs to ensure universal access to sexual and reproductive healthcare services, including family-planning information and education.
Is there any role that adolescents could play themselves?
Absolutely. Adolescents are the first and main stakeholders in the process and should be supported to actively engage decision- and policymakers at the national, regional and international levels, whether as individual advocates or members of youth coalitions, to draw attention to their concerns. Avenues to engage include attending the sessions of the Nigeria national assembly and state houses of assembly, the African Committee on the Rights and Welfare of the Child, and the UN Committee on the Rights of the Child to speak about their experiences and provide input on the development of laws or policies on children. They can identify these opportunities to engage with the support of their schools and civil society groups, and can make their views about teenage pregnancy and its consequences known through social media sites, particularly those that are popular in Nigeria. Adolescents should identify opportunities to hone the necessary research, writing, speaking and other skills to be their own best advocates at these policy- and decision-making fora by undertaking internship or volunteer positions at relevant non-governmental organisations or government offices.
This article was first published by the Heinrich-Böll-Stiftung’s Perspectives and is republished here with their permission.