By THANDIWE MOYO
ACCESS to sexual and reproductive health services has for long been generally difficult in many African countries, including Zambia.
Factors for this low accessibility by women and girls are numerous, resulting in escalating numbers of both teenage and unplanned pregnancies.
For rural and densely populated urban areas, the problem is even bigger because of few health facilities.
Sub-Saharan Africa has high fertility rates, early age at birth of first child, and high birth rates among adolescents.
These are closely associated with the risk of HIV infection and cervical cancer.
According to estimates, close to 70,000 maternal deaths annually, which is 13 per cent, are due to unsafe abortions.
Yet universal access to reproductive health and rights is unavailable for millions of young women and girls living in low and middle income countries.
Of the 32 million adolescents aged 15-19, some 14 million do not have modern contraception, notes the World Health Organisation.
At least 10 million unwanted pregnancies occur among this age group, leading to 5.7 million abortions, the majority of which are unsafe.
In Zambia, the 2018 Demographic Health Survey indicates progress in some areas, such as increased contraceptive knowledge and use, reduced under-five mortality rates, and declining maternal mortality rates.
However, the survey shows that teenage pregnancies continue to rise.
In the first half of 2022, close to 600 teenage pregnancies were recorded in Chipata District.
This is according to Seth Chongo, the acting Chipata District adolescent focal point person at that time.
Mr Chongo said the district health office recorded 596 teenage pregnancies from January to June in that year.
The persistent challenge of teenage pregnancies underscores the necessity for further concerted efforts.
In many cases, access to safe abortion services remains unattainable or heavily restricted, regardless of the Termination of Pregnancy Act of 1972 which legalises abortion on grounds such as risk to life or health, fetal abnormalities, rape or incest, the victim being under 16-years-old, mental health and social or economic reasons.
Many adolescents remain at risk of unplanned pregnancies despite advances in contraceptive technology, knowledge and availability of birth control options.
The lack of access to sexual reproductive health services is contrary to the provisions of international human rights instruments, such as the Maputo Protocol of the African Charter on Human and People’s Rights of 2005.
It is against this backdrop that the Network of African National Human Rights Institutions (NANHRI) held a regional follow up workshop in Zambia to bridge the gap between policy, advocacy, and implementation of Sexual Reproductive Health and Rights (SRHR) on the continent.
SRHR are a fundamental facet of human rights that encapsulate an individual’s right to make informed choices about their reproductive health.
Despite commendable progress in some health indicators, such as declining under-five mortality and increased contraceptive knowledge, the persistence of challenges like teenage pregnancies, underscores the need for more focused interventions in reproductive health.
In this regard, the regional workshop was a significant milestone towards efforts to address concerns and achieve sustainable as well as comprehensive solutions.
It is imperative to recognise that the responsibility for ensuring SRHR rests upon governments.
However, systemic gaps and discriminatory laws often hinder the fulfillment of these rights despite protocols and international agreements stipulating such rights, like access to safe abortion services.
Speaking at the workshop, NANHRI Executive Director Gilbert Sebihogo stressed the need to oblige to the Maputo Protocol, which was adopted in Maputo, Mozambique, in 2003 and entered into force in 2005.
He said to ensure SRHR are observed, it is important for countries like Zambia to promote women’s rights and end discrimination against women.
“The Maputo Protocol is described as one of the most comprehensive and progressive instruments in the world for women’s human rights. The African Union is committed to promoting, realising, and protecting women’s rights in order to have women and girls fully enjoy all their human rights,” he said.
Speaking in a speech read for him by NANHRI Senior Programme Officer David Barissa, Mr Sebihogo described the Protocol as the first regional instrument to call for an end to all forms of violence against women in public and private spheres.
“It prohibits all forms of harmful cultural practices including Female Genital Mutilation and child marriages.
“It promotes various social and economic rights including the right to work, right to equal pay and the right to health including sexual and reproductive health,” he said.
Mr Sebihogo said, “The Protocol protects the rights of adolescents and young people as well as widows, elderly and disabled women, including women from marginalised groups, among others.”
He said it is important for National Human Rights (NHR), together with other non-State actors, to continue monitoring compliance and holding governments accountable for their commitments under the protocol.
It is evident that national human rights commissions play a pivotal role in advocating for inclusive societies that guarantee reproductive health and rights for all.
Despite this crucial role, the voices of the commissions are often absent in decision making spaces.
To ensure that the rights of people are respected and protected, the Human Rights Commission (HRC) in Zambia, pursuant to Article 230 (2) of the Constitution, is mandated to ensure that the Bill of Rights is upheld and protected.
HRC has a Department of Investigations and Legal Services, and which is fully decentralised in all the country’s provinces to receive and conduct investigations.
HRC Principal Planning and Collaboration Officer Lisbon Chaamwe informed NANHRI participants at the regional meeting that lack of information on the services being provided by the commission on the rights of adolescents is a huge challenge.
He said in most cases, social and cultural norms restrict adolescents’ access to information on sexual and reproductive health, besides that fact that gaps in the law increase inequalities, such as children being married off, and sexually abused.
Mr Chaamwe said it is imperative to understand the mandate that HRC possesses in protecting SRHR of women and adolescents nationwide.
“Based on our mandate to investigate human rights violations and abuses, the commission receives and handles complaints and conducts investigations in matters relating to adolescent health rights. This includes cases of discrimination, forced marriages (child marriages) and child sexual abuse,” he said.
To ensure proper health services for women and girls, it is imperative to foster close collaboration between HRCs, civil society organisations, office bearers, rights holders, the media, legislators and partners present on the margins, to enact impactful change in realising SRHR for all.
Article 14 of the Maputo Protocol guarantees women’s rights to health, including sexual and reproductive health, the right to decide the number of children, child spacing, the right to choose a family planning method, the right to access family planning services and the right to safe abortion.