Most Zambian women have no access to contraceptives
By Michael Malakata
LUSAKA, Zambia – In Chiawa in southern Zambia, many people are poverty stricken, the majority living in mud-thatched houses, fishing and farming for income.
Christine Chisha is a 15-year-old girl in Chiawa, who worked hard at school in hopes she could become a teacher after she graduated.
However, in grade nine, she became pregnant and dropped out.
In a country where poverty is high, education meant a brighter future for her and other pupils.
The 2010 World Bank poverty report said poverty prevalence in rural Zambia stands at 77 per cent compared to urban poverty, which stands at 27.5 per cent.
However, Chisha’s hope of becoming a teacher was not immediately lost, because when her child was just a year old, Chisha intended to go back to school to continue her education.
But just six months after her first child, Chisha fell pregnant again and her hopes of becoming a teacher were finally lost because she had to take care of the two children.
In Zambia, by some accounts 40 per cent of young women fall pregnant before finishing their high school education. One of the reasons contributing to teen pregnancy is lack of access to contraceptives, says Dr. Patrick Chikusu, Deputy Minister of Health.
According to the Education Permanent Secretary James Mulungushi, about 28,500 males passed their grade 12 examinations in 2012, while only 18,520 females passed, suggesting something is keeping many girls from progressing in school.
As in many other countries in Sub-Saharan Africa, Zambia has a high birth rate and its population is expected to double in the next decade due to uncontrolled births.
According to the Central Statistical Office, Zambia’s population of 13 million grew at the rate of three per cent in 2012. The growth is expected to more than double in the next few years unless the Zambian government puts in measures to slow the birth rate.
In Zambia, a packet of birth control pills cost between $5 and $10 USD in drug stores, although they are given for free in government clinics, hospitals and health centres. Other common family planning methods, such as condoms, can be bought in shops and bottle stores and sometimes are even given for free in schools by NGOs.
Zambian law forbids abortions, except in instances where the expectant mother’s life is in danger. There are no abortion clinics in the country.
NGOs and doctors have been pushing the Zambian government to allow abortions as a way of controlling birth rates, but the authorities have been reluctant to change the laws.
Yet information obtained from the University Teaching Hospital, the country’s biggest hospital, shows that the hospital records more than 500 post-abortion cases in a month.
In Zambia, like many other African countries, sexual education is never taught in school.
Lack of health facilities in many areas, poor road networks and long distances to health facilities contribute to the low access to contraceptives and other family planning services.
Chisha told Gemini News Service that she had no intentions of having a child before completing school because she wanted to work as a teacher and help other family members to also go to school.
“My several attempts to get contraceptives at a nearby clinic proved futile because they were out of stock for several months. I was advised by a clinical officer at the clinic to go to Mutendere hospital in Chirundu, but I failed because the distance was too much for me,” Chisha says.
Mutendere Hospital is over 50 kilometres from Chiawa in the southern part of the country’s capital Lusaka. In the absence of reliable transport, it takes many hours of walking to reach the hospital. The hospital is jointly run by the Zambian government and the Catholic Church.
Chisha is not alone in facing family planning challenges. Diana Mwaba, 22, also resides in Chiawa, and is the mother of four.
Mwaba said though she is married, she and her husband never planned the third pregnancy, which resulted in twins less than two years after the second pregnancy.
She said the distance to the hospital was the biggest challenge in accessing contraceptives for her and other women in the area.
“We had planned to have our second born after four to five years, but then I noticed I was pregnant just after two years because I couldn’t continue going to Chirundu to get contraceptives owing to the distance. Taking care of four children is really a burden to us,” Mwaba says.
Zambia’s First Lady Dr. Christine Kaseba, who is also a family planning activist, says family planning can help relieve the pressure that a rapidly growing population places on the economy, and social and natural resources.
“Despite the knowledge of family planning, contraceptives prevalence rate remains low against the backdrop of high rates of unplanned pregnancies. I therefore want to urge the government to scale up the delivery of contraceptives in order to avoid unwanted pregnancies that are resulting in so many births and abortions,” Kaseba says.
The Minister of Community Development, Mother and Child Health Dr. Joseph Katema is aware of the challenges facing women in accessing contraceptives.
He says the Zambian government is aware that there is an erratic supply of contraceptives to hospitals and health centres, and that young women lack information about family planning services.
Except for Lusaka, where there are several clinics and hospitals, many health centers, clinics and hospitals around the country go for months without contraceptives because the Zambian government is slow to supply them.
The undersupply of contraceptives is occasionally caused by impassable roads during rain seasons.
There are a few non-governmental organizations, including the Planned Parenthood Association of Zambia (PPAZ), that help the government distribute contraceptives in rural areas.
Katema says the Zambian government is now committed to increasing access to contraceptives in the country in order to have a healthy nation.
Katema says the Zambian government has no specific budget for contraceptives, as they are procured by the Ministry of Health together with other drugs using the money in the national budget.
Despite not having a specific budget for contraceptives, Katema said the Zambian government will strive to meet needs for family planning and improve universal access through the expanded method. It’s a newly launched program that broadens the distribution of and access to contraceptives for women needing them.
The Zambian government is currently receiving financial support from the United Nations Population Fund (UNFPA) to scale up family planning programmes. The financial support from UNFPA is only aimed at helping the Zambian government procure more contraceptives for distribution in all health centres and hospitals around the country.
President Michael Sata has already kick-started a project to build over 650 health posts around the country to increase access to health facilities.access to health care, contraceptives, Education, Health, zambia