SCHOOL CLOSURES HEIGHTEN THE RISKS OF UNWANTED PREGNANCY AND CONTRACTING HIV FOR ADOLESCENT GIRLS AND YOUNG WOMEN
Download PDF The COVID-19 pandemic led to the closure of schools in most countries as a measure to slow the spread of the virus. A side effect of these closures is that they deprive young people of the social protection that school offers and exposed them to risks of sexual violence and abuse at home, child marriages, and unwanted pregnancies….Article Type:
Upsurge in teenage pregnancy during the COVID-19 crisis
ABSTRACT School closures as a measure to contain the spread of COVID-19 has not only deprived young people of learning opportunities but has had other negative consequences for them as well. A surge in teenage pregnancies has been attributed to school closures and lockdowns during the COVID-19 crisis that left girls vulnerable to social situations conducive to sexual violence and abuse (including rape by close family members). This indicates that the gains made in the fight against HIV, and sexual and reproductive health services are being eroded. Governments need to include sexual and reproductive health services in their COVID-19 response plans, ensure that young people have access to these services, and consider the safe reopening of schools.
The COVID-19 pandemic led to the closure of schools in most countries as a measure to slow the spread of the virus. A side effect of these closures is that they deprive young people of the social protection that school offers and exposed them to risks of sexual violence and abuse at home, child marriages, and unwanted pregnancies. Lockdowns and curfews also made it harder for girls to access sexual health care, which confined them to homes with predatory neighbors and family members. Left with a lot of “idle” time, some teenagers engaged in risky behaviors such as unprotected sex while others fell victim to rape that resulted in increased cases of teenage pregnancies. Unprotected sex, if not promptly addressed could erode the gains made in the fight against HIV and have other consequences for young people, particularly adolescent girls and young women (AGYW).
Significant investment to fight HIV among adolescent girls and young women
The Global Fund, along with other global health actors, has made significant investments to fight HIV among adolescent girls and young women, particularly in the southern and East African regions. This is based on the finding that adolescent girls and young women are twice likely to contract HIV than young men of the same age in eastern and southern Africa. One of the interventions to combat HIV in this vulnerable group is to offer social protection, which includes activities to keep girls in school. To demonstrate the support directed to this issue, we sampled data from funding requests for the 2018–2020 implementation cycle. Data for seven out of the 13 countries in East and southern Africa was publicly available.
The seven countries are Cameroon, Eswatini, Kenya, Mozambique, Namibia, Tanzania, and Zambia. In total, these countries requested $72 302 426 from the Global Fund to support the fight against HIV among adolescent girls and young women. About 13% of these funds (Figure 1), amounting to $9 343 036, was for keeping girls in school. This followed evidence that keeping young people, especially girls, in school lowers their risk of contracting HIV.
Figure 1: Interventions for adolescent girls and young women in HIV funding requests to the Global Fund for 2017–2019 funding cycle
Source: Aidspan, based on data from funding requests to the Global Fund for the 2017–2019 funding cycle
Teenage pregnancies increase during the COVID-19 crisis
There has been an increased number of teenage pregnancies in many countries. World Vision has estimated that about one million girls in sub-Saharan Africa risk being blocked from returning to school due to pregnancy. In this article we highlight a few countries where an increase in teenage pregnancies has been reported. In most cases these are underreported.
In Malawi, where the government closed schools in March 2020, the Mangochi district registered 7 274 teenage pregnancies by June 2020, which is 1 039 more than the same period last year. According to the East African, harmful social norms, such as early marriages, have spiked since the closure of schools due to COVID-19. These are partly to blame for the surge in teenage pregnancies in the country.
COVID-19 may have aggravated the problem in Kenya, as well. The country had 152 000 teenage pregnancies over a period of three months of restricted movement and school closures due to COVID-19. This is a 40% increase in the monthly average. According to the Kenya Health Information System survey, a total of 3 964 girls aged between 10 and 19 years were impregnated between January and May 2020 in Machakos county, one of the 47 devolved governments in Kenya. Some of these teenage pregnancies are a result of defilement by close family members. Due to the withdrawal of parental support and the tendency to marry girls off due to pregnancy, their education may be discontinued.
According to World Vison Ghana, teenage pregnancies increased nine times in Karachi West, Ghana, during the COVID-19 crisis. Between March and May 2020, 51 cases of teenage pregnancy were reported in the region, compared to eight reported in all of 2018. The surge in teenage pregnancies coincided with the government-instituted lockdown to curtail the spread of COVID-19. Poverty, sexual exploitation and abuse, parental neglect, and risky adolescent behavior are to blame for the increased number of teenage pregnancies in the country.
In Zambia, there have also been reports of increased cases of teenage pregnancy during the COVID-19 crisis. In Masaiti district, the Senior Chief Chiwala of the Lamba has complained of the increased rate of teenage pregnancies in his Chiefdom, which are attributed to school closures due to COVID-19. Chief Chiwala blamed the confinement of young people to their homes without productive work for the surge in teenage pregnancies, as they are more likely to engage in unwanted practices such as unprotected sex. However, this is one among many causes of teenage pregnancies in Zambia. Lack of sexual and reproductive health information, poverty which leads girls to engage in transactional sex, and social and cultural factors, such as child marriages and peer pressure, are determinants of teenage pregnancies in Zambia.
Lessons the world can learn from Sierra Leone on teenage pregnancies during the Ebola outbreak
Evidence that school closures are associated with teenage pregnancy existed prior to COVID-19. During the Ebola outbreak in Sierra Leone in 2014–2016, primary and secondary schools closed for more than nine months and teenage pregnancies rose by 65%. During the Ebola Crisis more than 18 000 girls, of which 11 000 were enrolled in schools, became pregnant. When schools reopened, girls’ enrolment figures dropped by 16%.
Consequences of the surge in teenage pregnancies
Teenage pregnancy is an indicator that young people are engaging in unprotected sex. While not all who engage in unprotected sex get HIV, unprotected sex puts them at risk of contracting HIV. Besides placing a huge burden on already overstretched health systems due to COVID-19, an unprecedented surge in teenage pregnancies may erode the gains made in the fight against HIV. A study conducted in South Africa revealed that early adolescent pregnancy is associated with the risk of contracting HIV.
Early pregnancy makes it problematic for girls to return to school in most developing countries. According to a World Bank report, 10–30% of school dropouts in West and central Africa are attributed to early pregnancy and child marriage, especially in marginalized communities. Pregnant adolescent girls and young women face several barriers to returning to school. These include shame and stigma associated with childbearing out of wedlock, a lack of financial support to continue with education, exclusive policies which require expulsion of pregnant girls from school, and competing caregiving responsibilities as young mothers. And yet, there are no laws or policies that hold males accountable for teenage pregnancies.
Discriminatory laws against pregnant girls should be abolished
All stakeholders need to make concerted efforts to protect girl children during the COVID-19 crisis and beyond. Governments should ensure that all girls, including those who are pregnant and those who have already given birth during the COVID-19 crisis, are given the opportunity to continue with their education. In countries, such as Equatorial Guinea, Tanzania, and Togo, with laws and policies that prohibit girls to continue schooling once they become pregnant, policy makers, political leaders, civil society and other actors should advocate for the review of these exclusive laws in order to provide them with educational opportunities.
The way forward
Adolescent girls and young women should be given access to sexual and reproductive health services, such as modern contraceptives and the promotion of abstinence and safer sex behaviors, during the COVID-19 crisis and beyond. Governments should include these services in their COVID-19 response plans and address the disturbing issue of child marriages. Just as there is significant investment in the fight against HIV for adolescent girls and young women, significant investment to educate boys and men on safe sex and gender-based violence, including rape, is required. They need to be educated to take responsibility for the spread of HIV and their own sexual and reproductive health. Furthermore, African countries should heed to calls by the World Health Organization and the United Nation Children’s Fund for the safe reopening of schools, as these will not only help to reduce the number of teenage pregnancies, but also provide a safe haven for many children. Keeping children out of school due to COVID-19 is harming them in other ways.