Investing in sex education
I AWAITED with bated breath the unveiling of Budget 2018, hoping to hear major allocations being invested for our nation’s most precious assets, our young people’s health. Unfortunately, there wasn’t much to shout about.
The Executive Summary of a 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, under-nutrition, HIV, sexual and reproductive health, injury, and violence will bring huge social and economic benefits.”
It is this powerful realisation of the benefits of protecting adolescent health that is making countries focus on this segment of their population. Adolescents and young adults have many needs in healthcare, particularly in the area of sexual and reproductive health.
Many are hampered in accessing healthcare due to their lack of experience and knowledge as well as confidentiality issues. Restrictive legal barriers, low purchasing power, stigma, community attitude and moral values further compound their problems.
Globally, gender inequality results in many young girls and adolescents being prevented from accessing sexual and reproductive healthcare. This means many are unable to receive family planning education and services.
Early motherhood increases the likelihood of maternal complications, disabilities or even death. Girls 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 bleak futures.
We need to tear down the barriers that prevent young women and girls from getting sexual and reproductive health information and services.
Sexual and reproductive healthcare preserves the health of women and girls, enabling them to become educated, employed and empowered.
Health systems, healthcare professionals and all stakeholders must strive to break down these barriers by providing non-judgemental, 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 the 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 wellbeing. It also advocates gender equality and protects the rights of all young persons. It provides scientifically accurate information about human development, reproductive health, as well as contraception, childbirth and sexually transmitted infections (STIs) including HIV.
CSE also provides information and discussions about family life, relationships, culture and gender roles, human rights, gender equality, threats to discrimination and sexual abuse.
Ultimately, CSE helps young people to develop self-esteem and life skills that promote critical thinking, clear communication, responsible decision-making and respectful behaviour.
Global evidence has shown that CSE does not encourage earlier sexual activity or riskier sexual behaviour. On the contrary, it reduces risky behaviours, delays sexual debut and unplanned pregnancies.
In contrast, abstinence-only programmes or education have been shown by studies to be either inconclusive or ineffective.
Every year, 13,000 to 17,000 teenage pregnancies occur in Malaysia while an equal number, or probably more, teenage abortions are performed, many in unsafe conditions. Also, more than 100 newborns are abandoned yearly but these figures represent only the tip of the iceberg as many more could have been dumped but were never found.
Data from the police show that between 2010 and May 2017, 13,272 children were raped. This equates to more than 1,800 children being raped annually. Again, there could be more cases that are not reported.
We cannot afford to ignore the problem anymore or continue to offer half-baked, half-hearted solutions for our nation’s most important asset, the youth.
Engaging parents and communities as part of CSE is critical. All stakeholders including the Health, Education, and Women, Family and Community Development ministries must cooperate and collaborate to push forward the implementation of CSE without any further delay.
DR JOHN TEO Consultant obstetrician and gynaecologist Kota Kinabalu