Agnes Malebna, (Not real name) was rushed in by her family to the Tinguri CHPS Out Patients Department (OPD) in the West Mamprusi Municipality in the North East Region already emaciated, dehydrated and anemic having lost so much blood.
The examination conducted by the medical team making efforts to keep her alive indicated it was an attempt to abort, which may have started at home by the 16-year-old, SHS form one student who felt she was still in school and too young to start making babies.
Unsafe abortions
Agnes ’missed abortion culminated, according to the medical Officer in the consulting room was retention of remnants of the dead foetus in her uterus and because of the over-the-counter medicines and combination of concoctions Agnes drank which could not help her, but had rather brought her the pain as the abortion attempt was carried out under unsafe medical procedures and by unqualified persons.
The Physician Assistant at the Tinguri CHPS also in North East Region, Mr Issahaku Rayal in an interview with the GNA said similar cases abound in the region and cited an instance, when an adolescent girl was elusive to the medical team, when she reported sick .
Realizing her pregnancy would be noticed, the young girl exchanged urine with a friend who accompanied her to the clinic when laboratory tests were requested for examination.
Reports also indicated that half a million die every year from pregnancy and childbirth related throughout the world and the deaths occur in high risk categories for pregnancy either the girl was too young or the woman too old.
Unsafe abortion is one of the causes of maternal mortality and aside that many as a result have contracted STDs, which HIV AIDS prevalence adds to the risks associated with early sexual activities complications.
A public health report on adolescent health and wellbeing, 2016 by Columbia Mailman School on public health indicates that unsafe sex is the fastest growing risk for ill-health in teens and finds that years of neglect and under investment have serious detrimental effects on health and well-being of adolescents.
The story and actions of Agnes and many other adolescent girls and boys and young women have contributed to high dropout rates among girls and, many are unable to go back to school thereby reducing opportunities for themselves, their future employment opportunities, their personal development as well as their ability to contribute to national development.
Rising unprotected sex among adolescents
Unprotected sex among adolescent youth has become a growing phenomenon and worry to families, the education sectors and governments.
In the 2022, Ghana Democratic Health survey report on teenage pregnancy conducted on 655 of girls aged 15 years old, indicated that 2.4 per cent of that population have ever been pregnant, 0.6 per cent were pregnant and 0.6 girls have ever had pregnancy loss.
At age 16, the same study conducted on 506 of them showed that 6.3 of them had been pregnant befoe, 1.6 per cent were pregnant and 1.3 per cent had pregnancy loss.
Sexual Reproductive health
Reproductive health of individuals or couples is a human right and rights of adolescent girls especially girls from the ages of 10 to 24 years is being trampled upon because of the lack of services on sexual and reproductive health.
The right to regulate their fertility without any risks to their health and have safe pregnancies and births when they choose to have children and also have sex safely without fear of sexually transmitted disease (STDs) is key.
Hikes in teenage and adolescent girls getting pregnant before attaining 18 years is an important indication of high sexually active adolescents and young women in the country whose lives are compromised for practising unprotected sex.
At the Gbani community in the North East Region, a group of adolescent boys and girls both in school and out of school who interacted with the GNA on contraception and family planning said it was not a topic discussed at family levels and in schools with them and where they do in schools they were yet to set eyes on any of the family planning commodities.
Some of the young boys who said they had seen a condom only indicated that they heard of the name of it when they were sent by parents to buy some medicine at the chemical shop.
About five young girls aged 15 and 16 years said contraceptives were for married people because according to Yahya, a Primary six school boy they were too small to know or discuss them.
This and many other young boys and girls who are sexually active, though have heard of contraceptives still have little knowledge about them and where they can find information especially in the rural communities.
Meanwhile, when the reproductive health of such young people are not adequately addressed , the only way they get information is either by learning from their peers from school and community and thereby endangering their lives with false information.
The consequences of unprotected sex are dire and apart from many young girls dying through unsafe abortion, those who survive it run into complications resulting in fistula, secondary infertility among others.
Sexual and Reproductive Health Rights (SRHR)
The fundamental human rights that encompass issues related to access to information and services such as family planning , maternal health care and prevention and treatment of STDs including unsafe abortion are key.
To this extend, OXFAM Ghana through its partners under the Power to choose (P2C) project which is a seven year Global Affairs Canada funded project has the objective to increase the enjoyment of health-related human rights by young women (YW) and adolescent girls (AG) who live in vulnerable conditions and who experience marginalization between the ages of 10 – 24 years by 2028 and implemented in 5 regions (Northern, North-East, Bono East, Central and Greater Accra regions) and seven Metropolitan, Municipal and District Assemblies.
Though Government of Ghana is signatory to many international, Sub Regional and National treaties and policies there is still a gap that needs to be filled especially including increasing knowledge of adolescent youth and young women on contraception, family planning among others.
Family planning commitment of 2030 of the SDGs, Ghana aim to ensure equitable and timely access to quality family planning information, commodities and services for all persons of reproductive age in Ghana by the end of 2030.
The Universal Declaration of Human rights article 25 also enjoins everyone to have access to health care and social services’ including SRHR and the International Conference on population (ICPD) 2019 was another compelling period for countries like Ghana to act for SRHR, as the convention on the elimination of all forms of discrimination against women are to back rights that girls and women have.
The SDG 3 target 7 ensures that by 2030 universal access to sexual and reproductive health services including family planning information and education and the integration of reproductive health into national strategies and programmes.
The Participatory Action and (PARDA), a local Non- governmental health Organization is implementing the P2C project in the North East Region where the GNA has been interacting with stakeholders on the project which reveal that contraception and family planning issues are only tailored towards married people.
The beneficiaries under the project reveal parents do not discuss reproductive health issues with them at family levels and none of the services were available in the communities, where they come from nor are able to access information on contraceptives.
Conclusion and recommendations
Gaps in knowledge of youth ,lack of information about their bodies and how pregnancy occurs and services that will give them access to information and contraceptives has been a challenge and this is what is contributing to unsafe abortions.
Therefore to promote positive health behaviours, adolescent young boys and girls need information that will equip them to fight for their rights and push for activities in their communities.
Families do not discuss sex issues at home because parents do not accept that children be seated where adults are and therefore communication about sex and sexuality is absent in homes and as a result the youth feed on wrong information shared by their peer which mostly may not be factual.
Finally, more adolescent friendly corners should be established in communities to enable them freely patronize them to access information and so family planning must start early in adolescent life.
To improve the situation Mr Issahaku Rayal at the Tinguri CHPS advocated more adolescent friendly corners in the district as places, where young girls and boys can visit for advice on their reproductive health issues which he said improved and saved lives and helped to prevent some conditions preventing them from becoming serious.
Government must also improve provision of sexual and reproductive health programmes that are sensitive to problems and needs of the young people.
