Bill & Melinda Gates Foundation

World Contraception Day: Stumbling Blocks to Contraceptive Services

September 20, 2012

This blog is part of a series, edited by Women Deliver, in partnership with Impatient Optimists, on youth perspectives to celebrate World Contraception Day. Share your thoughts in comments and join the conversation at #WCD2012. For more stories and to get involved further visit No Controversy.

In Tanga, Tanzania, young people aren’t a priority when it comes to family planning – from services, to education, to advocacy and awareness. Too often, young people don’t use family planning services because of fear or shame. There needs to be a serious increase in efforts to empower young people in this community to make a change.

Family planning clinics within hospitals do offer regular services, but they do not accommodate young people’s specific needs.  Often, young people are stigmatized, judged, and asked for parents’ consent before receiving family planning services. In addition, public facilities are often crowded, lack privacy, and comprehensive care.  Many young people fear visiting these facilities because they do not feel comfortable sitting in the presence of older people waiting to receive health services.  Also, health providers are not trained on delivering youth-friendly services and are therefore unable to provide young people with appropriate care. Facilities in rural, remote areas, where youth are more vulnerable, often lack any family planning supplies at all.

In the region, family planning services are also not available to unmarried girls. It is assumed that unmarried girls are not having sex outside of marriage, and thus do not need information about contraceptive methods. Girls who do use contraception are stigmatized and seen as “prostitutes” in the community. Because of these negative associations with contraception, unmarried girls choose not to use family planning methods.

Myths and traditions are also a barrier to services in Tanga. For instance, it is believed that if a girl who has never delivered a baby uses a contraceptive method, she will never give birth again in her life. Young unmarried girls sometimes believe that using contraceptives can leave women barren.  Still other young girls fear using hormonal contraceptives because they are told that it will cause them to “lose their shape”, gain weight, or grow very thin. All of these myths must be overcome in order to increase contraceptive use.

There are a number of solutions that can be put in place. First, safe spaces where young people can express themselves and access reproductive health education must be established.  Adding adolescent-only hours to health facilities and offering services in places where adolescents congregate (such as youth centers, sporting events or work sites) will allow young people to feel more comfortable when it comes to accessing family planning services. Affordable, accessible, non-judgmental, and youth-friendly family planning services need to be offered to everyone.    

Secondly, governments also have a role to play. Policymakers need to come up with youth-focused strategies to boost young peoples’ access to contraceptives by ensuring enough family planning supplies and availability of trained staff in all health centers. This includes health centers in rural, remote areas.  Additionally, laws and policies should respect the rights of young people to access family planning services without parental consent.

Lastly, the involvement of men and boys is a key strategy that can be used to increase youth uptake of family planning services. In Tanzania, men are the ones who decide the number of children a woman should bear. Yet, on the other hand, they perceive family planning as a “women’s issue.” If men and boys are empowered with accurate ,and gender-sensitive, information about family planning in a way that involves them, they will support the use of contraceptive methods by women and girls.

Young people need information about contraceptives. Family planning education should be taken into schools, market places, religious gathering places, and within households. Health centers should be equipped with all the necessary tools to meet young people’s needs. With the right information, young people will be able to make decisions about using contraceptives that are right for them.

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