July 08, 2007

IT is a known fact that reproductive health is critical to the health and well-being of young women and children in the developing world. Take the issue of young pregnancies for example. According to Save the Children statistics, each year, over 500,000 women die of pregnancy-related causes, and millions more suffer life-long disability. Sadly, 98 per cent of these deaths occur in the developing world, and most are preventable. Pregnancies that occur among younger women face higher rates of maternal and infant death. Despite these well-known risks most women in developing countries lack access to basic pregnancy-related care, as well as access to information and services that married or un-married couples and single mothers need to delay or prevent pregnancy.

The situation is grim and the root of the problem is unawareness, lack of literacy and basic education or know-how about reproductive health related issues in youngsters. One is well aware of the fact that even the most reputed of our schools, colleges or other institutions hesitate towards imparting reproductive health related or sex education to their students due to obvious social and religious barriers. One doesn’t even feel the need of mentioning the scenario at our local or rural schools.

Living in a conservative single-minded society, one feels a dire need for parent-child communication as far as these sensitive issues are concerned. This is because children need support and guidance and someone to talk to when their bodies start going through certain changes during puberty. This sort of education should rightly be imparted to them by their respective schools, however, as the possibility of that happening is minimal, the burden falls on the parents’ or older siblings’ shoulders to provide the teenager with all the answers s/he might be searching for.

It is possible to carry out interventions to improve adolescents’ knowledge of reproductive health topics despite the sensitive nature of this question in Pakistan’s socio-cultural context. The interventions will provide an opportunity not only to promote positive values such as abstinence until marriage and respect for adolescents of the other gender, but also to discuss responsible sexuality.

However, interventions require a lot of hard work, courage, trust and good communication skills. The younger generation of today is open to a lot of information through various channels and feels more at ease finding answers through their friends, peers, television or the internet instead of talking to one of their older siblings or a parent. The communication gap is vast. Most parents today have a hard time gaining their attention let alone talking to them regarding reproductive health and the preventive measures that should be taken to save them from any health risks, teenage pregnancies, STIs etc.

Haleema Sadiq, a mother of four young teenagers 13, 17, 18 and 12 years of age, has a hard time talking to her kids about such issues. “I have three daughters and a son. The oldest is a daughter, then a 17-year-old son and two young daughters. It took me a while to get my three daughters together and talk to them about issues such as that of teenage pregnancies, HIV/Aids and other STIs, our societal values and customs etc.” According to Haleema, a parent, especially a mother has to put in a lot of effort to be able to get the right message across to her children. She says that one has to talk to them in their language on their terms and think like them in order to get the message across. “However difficult the task, I manage,” says Haleema proudly. “I talked to my husband to have a conversation with my son as well. Things look promising so far. My daughters trust me and confide in me. I am glad I had the talk with them. Now I’m not worried when they go to parties or hang out with friends because I know they are aware and they know their boundaries,” she adds optimistically.

A lot of parents these days are acquiring help from confidential reproductive health services to educate their children regarding reproductive health issues.

However, there are complexities in parents’ opinions regarding adolescents’ right to confidential reproductive health services. Many parents perceive value in having confidential reproductive health services available, but they also know that adult family members can be a safer and more dependable source of information and guidance.

The sad part is that most parents and families are not very comfortable with parental involvement into such matters at all. They are of the opinion that such matters are better left undisscussed and untouched for too much information corrupts. There are innumerable families both in urban and rural areas of our country who completely refrain discussing matters related to reproductive health because of religious and social barriers. What they need to realise is that their denying a very natural phenomenon by not discussing it. If parents refuse to impart reproductive health related knowledge to their children, and schools don’t contribute towards spreading awareness and basic knowledge regarding these issues, the younger generation will suffer and the vicious cycle will continue for generations.

Family participation in the provision and improvement of reproductive health information and services is essential. There are many a NGOs as well as government organisations and centres where information and services designed for and by youth to address their sexual and reproductive health needs are available. What parents and adults need to do is to better encourage youth in their development and advocacy to enhance understanding of the reproductive health situation, and the critical links between reproductive health and basic health.

Parents and other adult family members play a central role in the lives of most adolescents, so they should facilitate and improve their involvement in their children’s or adolescents’ lives, whether it is through dialogue, discussion etc. Formal educational programs can be the most suitable for encouraging parent-child communication about sexual health issues. Local NGOs are and can play a very positive role as far as encouraging parent-child communication regarding reproductive health is concerned, providing parents with the right information on how to talk to teenagers, sponsoring media campaigns that encourage parents to talk to their teenagers about sex, providing communication tips etc. Communication between 10- to 19-year old boys and girls and their parents and community networks can influence the adolescent family environment and, in turn, reproductive health.