For the majority of people in developing countries, basic resources and access to family planning services are inadequate. The most recent United Nations (UN) State of the World Population report 2012 estimates that 222 million women around the world still lack access to reliable services, information and supplies. This especially puts adolescents, the poor and ethnic minorities at risk of unintended pregnancy.
The United Nations Population Fund (UNFPA) warns that much more financial support and political commitment is needed to meet their international Millennium Development Goals for improving maternal health and reducing infant mortality by 2015.
In September 2012, Dr. Babatunde Osotimehin, UNFPA Executive Director and Under-Secretary General of United Nations visited Colombia and highlighted the high figures of teenage pregnancy in the country: one in five women between 15 to 19 years old has been pregnant.
“Colombia has one of the highest rates of teenage pregnancy in Latin America. This is an obstacle for the development of the country”, he said. More alarmingly, 64% of those pregnancies are not intended.
Since 2006 UNFPA has been supporting the Colombian government in designing a model for ‘youth friendly health services’, including counselling, contraceptive methods, HIV testing, right up to prenatal care. The Ministry of Health and Social Protection has been implementing this model, with continued technical and financial support from the UN.
Dr. Osotimehin visited the capital Bogota, touring two hospitals with ‘youth friendly services’ to see how the country is progressing towards achieving some of the international development goals and said:
“I am pleasantly surprised by the government’s commitment to the prevention of teen pregnancy. This program of youth-friendly services is an example for many countries in Latin America.”
Speaking at the launch of the most recent state of the world population report, Dr. Osotimehin makes the case that access to family planning is a human right and points out that for just one dollar for every person on earth, everyone could realise this right. He highlights that UNFPA’s participation in the Youth Friendly Services Program helps train professionals from health teams and provides technical expertise in the delivery of mass communication strategies to make sure everyone is aware of their rights to services.
Unchallenged though, Dr. Osotimehin says the lack of family planning and increasing teenage pregnancy rates especially amongst adolescents perpetuates poverty, gender inequality and can lead to population pressures in developing countries that are already struggling to meet basic human needs.
Are the UN on track?
Sylvia Wong, Sexual and Reproductive Health Specialist at UNFPA in New York, explains why teenage pregnancy prevention and improving maternal health continue to be important goals for the UN:
“We know that complications for pregnancy and childbirth is the number one killer of girls who are between 15-19 years old in developing countries worldwide and if you’re able to prevent the pregnancy in the first place, that would reduce her risk of maternal death.”
The UN has been criticised for their slow progress for meeting their goals by 2015. Sylvia tells me that the UN is on track but that it could be better.
“There has been some progress, but I don’t think the progress is good enough because there are still too many women who are dying from a preventable death”, says Sylvia.
Colombia’s case study
Sylvia highlights Colombia as one of the countries where there is good practice in place when it comes to sexual education and sees it as very ‘progressive and innovative’.
“Colombia is doing quite a lot in recognising the issue of adolescent pregnancy and getting at the root causes of some of the issues; so they are buttressing work on education, especially comprehensive sexuality education and ensuring access to services for young people,” says Sylvia.
Girls at the Juan Felipe foundation regularly receive sex education and self-esteem lessons Photo by Hannah Smithson
Profamilia assess adolescent pregnancy rates in new study
Psychologist Darly Naiyive at sexual health clinic Profamilia works to promote contraception and to provide family planning services Images by Hannah Smithson
An independent study from private sexual health clinic Profamilia, assessed the rates of Colombian teenage pregnancy in the first study of its kind in the capital. Results showed that adolescent birth rates had decreased by 1% in 2012.
Psychologist at Profamilia, Darly Naiyive, says that teenagers get pregnant in Colombia for many reasons, but boils it down to a lack of sex education, strong anti-abortion laws in a very Catholic country, and a traditionally macho culture embedded within society. She explains how Profamilia’s best practice in promoting contraception and providing family planning services can help women struggling with these obstacles:
“Profamilia has been highlighted because we protect women’s sexual and reproductive rights. We see family planning as a right for the women but also the patient needs to work together with the law.”
Human rights lawyers jump in to help fight for women’s rights
Katherine Romero is a Senior Attorney for Women´s Link Worldwide, a Non-Government Organisation (NGO) in Colombia working to enforce women’s sexual and reproductive rights, including the right to an abortion, and explains the work she does in Latin America and all over the world.
“Here at Women’s Link we understand that the legality of abortion has consequences among the vulnerable population and adolescent populations because they don’t have any information about how to get an abortion in a safe manner,” says Katherine.
She explains she was part of the legal team that part de-criminalised abortion law in Colombia in 2005. The Constitutional Court in Colombia then ruled in 2006 that abortion is legal in three cases; when a woman is raped, when there is a danger to the mother’s health or when there is a malformation of the foetus. Katherine and her team are now working hard to apply these rights among the women of Colombia, to spread awareness and access to treatment.
“The legality of abortion has a complete correlation with maternal mortality rates in adolescents because they don’t know how to do it in a safe manner.”
Consequently, it can be very dangerous for young women to get pregnant in these countries, Katherine explains. An underlying attitude in all these similar cases she tells me is that women´s bodies are seen as objects that in most cases don´t belong to them.
Photo by Hannah Smithson
“We have a specific exception for adolescents –all sexual relations with girls under 12 years old constitutes a rape. This is the interpretation of the penal code. So if a girl of 12 years or under gets pregnant she has the right to an abortion. But if a girl is over this age and isn’t in one of those three circumstances she doesn’t have the right to an abortion in the eyes of the law”, says Katherine.
Colombia therefore is in a transitional state as Katherine explains: “With our work to implement the constitutional courts decision we are one step forward in relation to Uganda, Tanzania, Peru, Nicaragua, El Salvador and Chile in recognising that all women’s rights are human rights and that the right to abortion in Colombia is for all women. We also make sure that the government and all their agencies have the obligation to give the service.” But she points out that there is still more to be done.
Sylvia from UNFPA praises the work of sexual health clinics such as Profamilia and NGOs like Women’s Link but concludes that improving maternal health and reducing teenage pregnancy are goals that need to stay on the development agenda after 2015.
“While we have seen the global mortality ratio decline over time which is good news, in my opinion it is still too high because even one death because of maternal causes is just one death too many.”