New strategy to tackle reproductive health issues

Ethiopia has launched a national strategy on adolescent and reproductive health that aims to tackle the problems of early marriages and pregnancies, female circumcision, abduction and rape, and poor access to healthcare for 10- to 24-year-olds.

Launched by the health ministry in collaboration with United Nations agencies on Tuesday, the Adolescent and Youth Reproductive Health Strategy (AYRH) will be implemented over eight years.

"Although adolescence generally is a healthy period of life, many are often less informed, less experienced, and less comfortable accessing HIV/AIDS and  sexual and reproductive health information and services," Monique Rakotomalala, country representative of the UN Population Fund (UNFPA) said.

Health minister, Tedros Adhanom, said the strategy reflected his government's commitment to improving the reproductive health status of young Ethiopians.

According to the AYRH document, young people aged 15 and below constitute 40 percent of Ethiopia's 77 million people. "This strategy calls for immediate tailored and targeted interventions to meet the diverse needs and realities of young people," it noted.

Saying most Ethiopian young married women have limited autonomy and control over their resources, the report said only half of married adolescents can actually decide how their own earnings will be used.

On harmful practices, it noted that abduction and early marriages were declining but still persistent. The report cites the 2005 Ethiopian Demographic Health Survey which showed that 80 percent of women and half of men believed that there were situations when a husband was justified in beating his wife.

Another widespread issue was female genital mutilation. More than half of 15- to 19-year-old girls had been circumcised. Although support for this harmful practice was declining, about a quarter of 15- to 24-year-old girls believed it should continue.

The AYRH document noted that abduction was common, especially in Oromia and
southern regional states, and young women in rural areas were twice as likely to be abducted. Nationwide, many married women reported having been abducted for marriage.

Limited access to targeted reproductive healthcare and services for young people contributes to and exacerbates many of their reproductive health problems

Rape was common in both rural and urban areas. A study in six peri-urban areas found that 9 percent of sexually active adolescent girls and six percent of boys had suffered rape. Another study among street girls in the capital, Addis Ababa, found that 15 percent had experienced rape while 43 percent had been coerced into their first sexual activity.

"Limited access to targeted reproductive healthcare and services for young people contributes to and exacerbates many of their reproductive health problems," the AYRH noted.

The strategy document also details the problems of polygamy, early marriages and pregnancies, poor use of contraception and abortions. According to the ministry of health, abortion accounts for 60 percent of gynecological and almost 30 percent of all obstetric and gynecological admissions, it said.

"One of the most effective interventions to address rapid population growth is to empower people to make informed choices on their respective health including their desired fertility," the AYRH explained.

Rakotomalala explained that while the strategy would help adolescents to make informed choices, it recognised that their sexual and reproductive health needs distinctly differed from those of adults.

"The strategy is designed to segment the target population by their different demographic, socio-cultural, residential and economic characteristic," she said.

tw/eo/jm