If you love life, you go plan am well!
If you love me, you go wait for me.
Having babies no be joke o
You go feed, give them cloth, give them love too
If you never ready to carry the load
Why put am for another person head
Many pre-90’s and 90’s children who grew up in Nigeria will remember the melodious blend of Onyeka Onwenu and King Sunny Ade’s voices crooning ‘Wait for me’, in perhaps the sultriest appeal for the practice of family planning that there ever was. This song, together with ‘Choices’, was performed by these two celebrated musicians as part of a USAID supported intervention to increase contraceptive uptake. With an estimated population of about 180 million people in a nation that is fair bursting at its seams, contraception conversations are a must-have for us. There are many barriers to access to contraceptives in Nigeria, for even for women who are supposed to ‘rightly’ be able to access these services; i.e. married women. Ideally, every woman in the reproductive age group – women between the ages of 15 and 49 – who is desirous of contraceptive services should have easy access to it. However, the unmet need for contraception, which is defined as the proportion of reproductive age women who want contraception but have no access to it, is currently 16.1% in Nigeria (NDHS 2013). In absolute figures, this represents millions of women.
Married women often face an uphill task in accessing contraceptive services; they’re sometimes asked to bring their husbands, or prove they have permission from him, before being allowed to have contraception. In Niger state, a provider was recently sued to court by a woman’s husband, for providing the woman contraception. Others face censorship from their in-laws and community, because some people still believe that contraception is an excuse for promiscuity, and a married woman would not be desirous of contraception unless she intends to cheat on her husband. In the light of these sometimes insurmountable obstacles faced by adult women seeking contraceptive services, you may well imagine that the discussion about adolescent contraception is nonexistent.
As a people, we tend to shy away from topics that border on sex and sexuality – a vast majority of young people never had the sex talk with their parents. Among the few who did, it probably went something like ‘Now that you’re growing breasts/started menstruating if you follow boys, I will know o!’– always targeted at the girl-child.Leaving teenagers to be misinformed by their peers, and believing things like ‘If you have sex standing up, you can’t get pregnant’. The other thing is that we are overtly religious, so we convince ourselves that our young people are all virgins, and no one is having sex, despite the overwhelming evidence to the contrary. In 2013, almost one-quarter of women in Nigeria reported to have had sexual intercourse by the age of 15yrs, this figure rising to 54% by the age of 18yrs; and 8% of women aged 25 – 49yrs had already had a baby by 15yrs. Yet there is still a reticence in promoting contraceptive use to this demographic, due to religious and sociocultural beliefs and attitudes that regard contraceptives as promoting promiscuity in the young. Consequently, majority of adolescent girls in Nigeria continue to choose unsafe abortions as the contraceptive method of choice. It is therefore unsurprising that our Maternal Mortality Rates, of which unsafe abortion is a leading cause, are sky high.
Contraception and family planning have been identified as a key component of improving Maternal and Child health and contraceptive use is inversely proportional to Maternal Mortality Ratio (MMR). An estimated 16 million births – 11% of total deliveries worldwide – occur in adolescents between the ages of 15 and 19, a large percentage occurring in Low and Middle Income Countries (LMICs). Pregnancy and childbirth-related complications are the second leading cause of death within that age group, and every year, about 3 million girls undergo unsafe abortion. Although childbirth below 15yrs is uncommon, they occur in Sub-Saharan Africa, where the incidence was said to range between 0.3% and 12% as at 2000.
Contraceptive use among adolescents is important, not just for pregnancy prevention but for the prevention of Sexually Transmitted Infections (STIs), chief of which is HIV/AIDS, which they are potentially at risk for, due to the high-risk behaviours that characterize this phase of life. Although HIV-related deaths are declining overall, it is rising among adolescents.
Therefore, to paraphrase the words of Onyeka Onwenu and KSA, let’s be responsible adults; make we help them plan am well!
And if you’re up for a dose of nostalgia, here’s a link to the video of the song: https://www.youtube.com/watch?v=PZXLH29oFL0