Nineteen-year-old Justina (not her real name) from the southwestern region of Nigeria had just been admitted to the Federal University of Technology in Minna, Nigeria, when she realized she was pregnant. Because she was unmarried, her parents refused to support her. Justina was on the verge of dropping out of school but then her community church stepped in. They arranged accommodation, healthcare, and other needs, allowing her to defer a year to take care of herself and her baby. I met Justina when her pastor brought her to the university clinic for ante-natal care where I also work as a physician. A year later, Justina entered university, eventually graduating, and is now fully employed.
Not every girl and young woman who is a new mother has a supportive community to help them return to school or to achieve their education dreams and that needs to change.
According to a recent report from the Mo Ibrahim Foundation, nearly one million girls in Sub-Saharan Africa may never return to school after getting pregnant during the pandemic. Even before Covid-19 prevented students from going to school, African girls, particularly from the Sub-Sahara region, have always been negatively impacted by pregnancies. Stigmatized, these girls are not only out of school but are often rejected by their families and shunned by their communities, leaving them with poor prospects. In countries like Togo, Equatorial Guinea, and Tanzania, girls who become pregnant out of wedlock are expelled from school by law and banned from ever returning.
As a physician in Nigeria, in my own interactions with teenagers and young adults who got pregnant before marriage, I've seen how much the societal treatment negatively affects them. Many of them have thoughts of suicide, dumping their baby, or running away, instead of facing such shaming behaviour. They are unfairly pejoratively referred to as "spoiled brats", "second hand", "finished product", and NFA (No Future Ambition).
The ramifications of these cultural norms go beyond the girls themselves. A national scourge in the country is the abandonment of babies. Unfortunately, for children who do live, those born out of these pregnancies often suffer the same fate as their mothers.
As a continent, we need to better protect young girls from early pregnancy, and if they do become pregnant, embrace them and their children in the community and at school. There are three main ways to do this.
First, we must improve sex education at school and discuss consent, what contraceptives are, and why waiting to have children is healthier for the mother and child. In Nigeria, there is no platform that provides contraceptive knowledge or awareness for adolescents. It is no surprise then that contraceptive use is very low. Only 6 percent of 15-19 years that are sexually active use them. In Kenya, while comprehensive sexuality education is allowed in schools, teachers are not trained to deliver this subject. These realities must change.
Second, we must make contraceptives widely available. We must accept that some girls will be sexually active while some will be sexually violated or forced into marriages and they are not ready to carry a pregnancy. These girls should be allowed to access contraceptives without discrimination. While some health facilities have contraceptives, health providers are biased. Due to their values and beliefs, they deny adolescents and especially those who are not married access to these lifesaving commodities. This must change and any girl in need of contraceptives should be counselled on how to use them and offered a method of their choice. Modern contraceptives prevalence rate is still reported to be very low in Sub-Saharan Africa despite the commitments made at the Family Planning conference in London 2012 to make contraceptives available to 120 million women in poorest countries
Third, we must eliminate the social stigma that adolescent mothers face. We must welcome them at school. Fortunately, there have been some positive developments. Zimbabwe for example, has amended its Education Act, making it illegal to expel girls who get pregnant while still in school. Last year, the Kenya government drafted new guidelines that created an enabling environment for pregnant girls to safely return to school by engaging all education stakeholders to show commitments to the implementation. If fully implemented, these guidelines will help girls who were out of school because of pregnancy to return especially post-Covid. More attention should also be paid to organizations such as the Empowered Girls Initiative, an NGO that in three years has successfully gotten over 200 adolescent mothers in Uganda and Kenya back into formal school and vocational training.
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But there is so much more that must be done to secure the futures of these girls in society.
In this era of Covid-19, it's especially important to ensure that girls who become pregnant have an opportunity to go back to school and continue to achieve their educational dreams without discrimination. Otherwise, Africa is running the risk of losing an entire generation of girls who could become educated and productive members of their communities. This should be avoided at all costs and African governments should rally behind these girls and ensure they can go back to school and achieve their dreams.
Dr Tijani Salami is a physician, sexual and reproductive health expert and founder of Sisters Caregivers Project Initiative which provides medical and social support for women and advocates for an end to child marriage and maternal malnutrition.
Jane Otai is a development worker in Kenya. Jane leads the Empowered Girls Initiative (EGI) program that advocates for the rights of adolescent mothers in achieving their education dreams and live a dignified life with access to health and employment.
