Alvine Kapitako
Windhoek-A good sexual reproductive health package involves more than just providing access to contraception services.
It is also about getting rid of inequality “particularly for women and girls”, says Dr Shonag Mackenzie, a senior lecturer at the University of Namibia’s Health Sciences campus.
Mackenzie, who is a specialist obstetrician and gynecologist, is of the view that when it comes to poverty and inequality, disadvantaged Namibians are much more vulnerable to diseases such as human immunodeficiency virus (HIV) and human papilloma virus (HPV) that causes cervical cancer.
When a person is malnourished, their chances of fighting diseases are decreased compared to a healthy person, explained Mackenzie. “That’s why our teenage pregnant girls are the ones who get HIV positive and other sexual infections and that’s why providing good sexual health is also about getting rid of inequality,” said Mackenzie in an interview with New Era.
Making a comparison between Namibia and the United Kingdom (UK) where she hails from when it comes to access to contraceptives and practising safe sex, Mackenzie said the Namibian Government, through the Ministry of Health and Social Services, as well as the Namibian people need to “be kind to themselves”.
This is because it has been “only 28 years old that we’ve been beginning to offer sexual reproductive health services to everyone”.
Despite campaigns on access to contraception, including condoms – which, if used correctly, can prevent HIV, teenage pregnancy and HIV remain high in Namibia.
Statistics from the Namibia Demographic Health Survey (NDHS) of 2013 (which is the latest of this survey), the national adolescent pregnancy rate is 19 percent.
The highest teenage pregnancy rates are observed in Kunene (38.9 percent), Omaheke (36.3 percent), Kavango East and West (34 percent) and Zambezi (28.1 percent) regions.
According to the survey, some adolescents have their first sexual experience before the age of 15.
About 48 percent of these first experiences are unwanted and among these, the pressure mostly comes from peers and older sexual partners.
Mackenzie believes that it is important to educate people on access to contraception at all levels of society.
This is because poor access to contraception and the improper and inconsistent use, thereof, is a societal problem.
Additionally, it takes time for people to act on the correct information.
“If we can get rid of the myth that contraception makes women infertile that’s one battle we’re beginning to win,” added Mackenzie.
“We’ve had services in the United Kingdom since the 1960s and we still have a high teenage pregnancy rate compared to some of our European colleagues. And, we have enough doctors, we have enough campaigns,” said Mackenzie.
Young people, in particular, should know that with the exception of condoms, contraceptives do not protect against HIV and other sexually transmitted infections, which if untreated can cause infertility.
“HPV causes cervical cancer, chlamydia and gonorrhea cause the Fallopian tubes to be blocked, which makes young people (who are sexually active and do not practice safe sex) infertile when they are older,” said Mackenzie.
Therefore, in addition to using contraceptives to prevent unwanted pregnancies, it is advisable to practice safe sex, emphasized Mackenzie.
“Safe sex is using condom 100 percent of the time unless you know your partner is HIV negative and you continue to have couple testing,” she stated.
A 2014 United Nations Population Fund (UNFPA) study concluded that there are clear economic benefits to investing in family planning.
This is considering that for every dollar spent on contraceptive services will save almost US$2.22 in the cost of providing pregnancy-related, HIV and newborn health care.
“Evidence has shown that ensuring access to affordable, quality contraceptives and sexual and reproductive health services is a smart economic investment,” said Dennia Gayle, the UNFPA Country Representative.
In addition to deciding on the number of children, women are better enabled to complete their education. “Women’s autonomy within their households is increased and their earning power is improved. This strengthens economic security and well being and that of their families. Cumulatively, these benefits contribute to poverty reduction and national development. This is how human rights meet gender equality, promotion of women empowerment and sustainable development,” said Gayle.