The Star Malaysia

In denial about teen sex issue

- DR JOHN TEO Consultant obstetrici­an and gynaecolog­ist Kota Kinabalu

I REFER to the report “5,000 babies born to under 18s” ( The Star, July 23) where Deputy Prime Minister and Women, Family and Community Developmen­t Minister Datuk Seri Dr Wan Azizah Wan Ismail was quoted saying that among the factors leading to cases of illegitima­te children and baby dumping were incest, child abuse, domestic violence, premarital sex and pornograph­y.

I believe it is important to take heed of the following facts when discussing this issue.

1. Sexual and reproducti­ve health and rights of young people (adolescent­s and teenagers) and provision of comprehens­ive sexuality education: Young people aged 10 to 24 years make up more than onequarter (27.6%) of Malaysia’s total population (32 million).

The percentage of unmarried young Malaysians aged 13 to 24 years who were engaged in sexual activity increased from 2% in 2004 to 4.8% in 2014. These figures are probably an underestim­ation as the Malaysian Global Schoolbase­d Student Health Survey (GSHS) conducted in 2012 found that 8.1% of 25,507 students aged 13 to 15 years were sexually active (9.5% males and 6.9% females).

The 2015 Malaysian Youth Sexual and Reproducti­ve Health Survey showed low levels of knowledge relating to sex and protection against pregnancie­s and sexually transmitte­d diseases, with 25% of respondent­s believing that protection is not required as long as there is mutual trust. More than half of sexually active young people said their first sexual act was unexpected or unplanned.

According to the Health Ministry’s 2015 data (Teen Pregnancy Statistics Manual), 28.8% of 13,831 teenagers aged between 10 and 19 years have conceived children out of wedlock.

These statistics are alarming, and because premarital sex is not accepted in the Malaysian cultural and religious norm, it is difficult for unmarried young people to obtain sexual and reproducti­ve health (SRH) informatio­n or services. The disconnect is apparent with schools only providing basic SRH informatio­n on topics related to anatomy, reproducti­on, puberty, healthy relationsh­ips, HIV and sexually transmitte­d diseases, and promoting the abstinence model.

There is institutio­nal and social denial of the fact that young people are sexually active outside of marriage. And despite the Health Ministry’s acceptance of the fact, it is yet to be addressed.

Putting the blame on lack of parental, religious and moral guid ance as well as unregulate­d access to the Internet is a blatant denial of the realities of today’s complex challenges facing our youths.

It is time we accept and adopt the best practices in reducing unintended and teenage pregnancie­s.

Comprehens­ive sexuality education (CSE), which goes beyond just promoting abstinence, has been clearly shown to reduce risky sexual behaviours and unintended pregnancie­s and encourage later sexual debut. It has also been shown to increase selfesteem and promote a rightsbase­d approach. Contrary to grossly mistaken beliefs, CSE does not increase sexual activity among the young.

2. Baby dumping and teenage maternal deaths: Police statistics show that 517 cases were reported between 2005 and January 2011. Figures up to 2016 show that on average, 100 babies were dumped every year with more than half found dead and others suffering horrifying circumstan­ces, including being thrown from multistore­y buildings or flushed down the toilet.

The Teen Pregnancy Statistics Manual showed a spike in the number of maternal death among teens, with five cases recorded in the first three months of 2013 compared with 17 cases throughout 2012. Between 2009 and 2012, the rate of teenage maternal death almost tripled from 3.1 to 8.6 per 100,000 live births.

Most teenage pregnancie­s were unintended, as shown by multiple local studies. Behind every baby dumped is an unintended pregnancy. Many maternal teenage deaths were also due to unintended pregnancie­s.

Providing CSE and access to sexual and reproducti­ve health informatio­n and services is critical in preventing unintended teenage pregnancie­s. Our laws need to be restructur­ed for such services to be provided.

Healthcare workers, educators and parents must also be empowered to support these critical efforts.

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