Budget 2018 lacks investment in adolescent health
Writer says it is regrettable that little, if any, is being done to support the critical need for comprehensive sexuality education.
FMT LETTERS
By Dr John Teo
I waited with bated breath to hear the Budget 2018 tabled yesterday hoping that there would be major investments in our nation’s most precious assets, our young people’s health.
It is with much regret, that I can see there isn’t much.
Every year in Malaysia, 13,000 to 17,000 teenage pregnancies occur. An equal number or more of teenage abortions also take place, many under unsafe conditions and more than 100 babies are dumped representing only the tip of the iceberg with many found dead and many more never found.
Data provided by the police revealed that between 2010 and May 2017, 13,272 children were raped. That equates to an average of more than 1,800 annually with possibly many more cases going unreported.
The executive summary of the Lancet Commission into Adolescence Health 2016 states: “Investments in adolescent health and wellbeing bring a triple dividend of benefits now, into future adult life, and for the next generation of children.
“Tackling preventable and treatable adolescent health problems including infectious diseases, undernutrition, HIV, sexual and reproductive health, injury, and violence will bring huge social and economic benefits.”
It is this powerful realisation of the benefits of investing and protecting adolescent health by the international communities that bring countries into sharp focus on where their priority should lie.
Adolescents and young adults have many unmet needs for healthcare and in particular in the area of sexual and reproductive health.
Many experienced barriers that include their inexperience and lack of knowledge about accessing healthcare as well as confidentiality issues.
In addition, restrictive legal barriers, low purchasing power, stigma, community attitude and moral values further compound the problems.
Globally, gender inequalities result in too many young girls and adolescents not having access to sexual and reproductive healthcare. This means many are unable to receive family planning education and services.
The resulting early motherhood increases the likelihood of maternal complications, disabilities or even death.
They are less likely to finish their education and indeed many teenage mothers have to stop school. They are also less likely to enter the workforce, leaving their families poorer and their children with bleaker futures.
We need to tear down the barriers that prevent young women and girls from accessing sexual and reproductive health information and services.
Sexual and reproductive healthcare preserve women’s and girls’ health. It also enables them to become educated, employed and empowered and yet when trying to access sexual information and services, the myriads of legal, social and community barriers prevent many from doing so.
Health systems, healthcare professionals and all stakeholders must strive to break down these barriers to essential care by providing non-judgmental, confidential care and services with factual information.
Every young person will one day have life-changing decisions to make about their sexual and reproductive health. Yet, the majority of adolescents lack essential knowledge required to make those decisions responsibly, leaving them vulnerable to coercion, sexually transmitted infections and unintended pregnancy.
Comprehensive sexuality education (CSE) enables young people to protect their health and well being. It also advocates gender equality and protects the rights of all young persons.
CSE provides scientifically accurate information about human development, reproductive health, as well as information about contraception, childbirth and sexually transmitted infections (STIs), including HIV.
Additionally, CSE provides information and discussions about family life, relationships, culture and gender roles, including human rights, gender equality, threats to discrimination and sexual abuse.
Ultimately it helps young people develop self-esteem and life skills that encourage critical thinking, clear communication, responsible decision-making and respectful behaviour.
Global evidence has shown CSE does not lead to earlier sexual activity or riskier sexual behaviour.
On the contrary, CSE reduces risky behaviour, delays sexual debut and unplanned pregnancies.
In contrast, studies of abstinence-only programmes are either inconclusive or show abstinence-only education to be ineffective.
Engaging parents and communities as part of this education is critical.
Cooperation and collaboration by all the stakeholders including the health ministry, education ministry and women and family ministry is critical.
Lets walk the talk and translate it into real effective solutions without further delay.
We can’t afford to ignore the problem anymore and continue to offer half-baked, half-hearted solutions to our nation’s most important assets, the youths.
Dr John Teo is a consultant obstetrician & gynaecologist based in Kota Kinabalu.
The views expressed are those of the author and do not necessarily reflect those of FMT.
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