In 2022, the Federal Government paying scant attention to a health and social menace that has life-altering effects, directed the removal of sex education from the Basic Education Curriculum (BEC). The latest edition of the National Health and Demography Survey (NDHS) 2023-24, which shows that approximately 15 per cent of young Nigerian women aged 15-19 have experienced unwanted pregnancy, indicates that the move by the government is laden with more peril than a promise. ENO-ABASI SUNDAY writes that fears are rife that the absence of sex education in the BEC may widen the burgeoning pool of pregnant teenagers, with attendant risks ranging from maternal mortality, health complications including deaths, loss of educational opportunities, and increased poverty levels, among others. Comprehensive sexuality education and awareness of reproductive health rights, stakeholders say, is a panacea for adolescent childbearing.

Sometime last February, Suleiman Adefemi, in the company of a couple of friends, was within the fringes of Alhaji Abdul Razak Sanusi (Ogo-Oluwa) Central Mosque, 119 Isolo Road, Mushin, which is located along Isolo Road, by Palm Avenue Junction, in the Mushin area of Lagos State.

A teenager, who was suspected to be between 16 and 17 years old let out a shrill cry while clutching at her abdomen. In minutes she stooped, and shortly thereafter knelt. As a few came to her aid, she was helped to the pedestrian walkway where she sprawled out while still writhing in pain.

According to Adefemi: ?Minutes later, she delivered on the walkway, a baby girl, who was stillbirth. Shocked as everyone was, she could only mutter to a few women who engaged her that she was returning from a hospital, where she was given an injection and thereafter asked to hurry home.

?It was one of the good Samaritans, who is knowledgeable with child delivery that helped took care of the afterbirths, while another donated a sheet of wrapper for the body of the baby to be wrapped up,? Adefemi stated, adding that further interaction with the teenager revealed that the fellow responsible for the pregnancy denied responsibility.

She refused to admit whether the injection that she received earlier on at an unnamed hospital was meant to force the baby out.

The teenager is just one of the hundreds of girls that find themselves in the ever-expanding web of teenage or adolescent pregnancy.

From whatever prism she was looked at, Folashade Makinde was a good mix of beauty, brain, and brawn. Indeed, the future held a lot of promise for the heavily built black beauty, who, at 14, was almost the same height as her barely literate petty-trader mother.

A stormy petrel of some sort, many in the Ipaja area of Lagos State where she lived with her mother suspected that something might be wrong with the Senior Secondary II student when she began losing weight and being scruffy. It was not long before it became clear that Folashade, 15, had been impregnated by an apprentice auto mechanic, who was putting up with his master.

Peeved and disappointed by Folashade?s action, her mother bundled her and her scanty belongings to the apprentice master?s residence, who in turn asked the 22-year-old apprentice to return to his parents? home in Akure.

Months after Folashade relocated with her apprentice boyfriend to Akure, she communicated to her mother how tough life was with her in her ?new home? and how she had also started trading. The situation with Folashade remained unchanged until her mother, a single mother, left the neighbourhood with her second daughter to a different location.

While Folashade is facing a bleak time, Mrs Katherine Mowah recalls suicidal thoughts searing through her mind the first time that she discovered that she was pregnant while still in secondary school.

According to Mowah: ?After initially accepting ownership of the pregnancy that I was carrying, the boy who impregnated me (who was eight years older) suddenly denied being the father of the baby that I was carrying. That period became the darkest part of my existence, and I was filled with suicidal thoughts. It was only the support of my mother and grandmother that sustained me.?

She continued: ?The baby that I delivered has started school now but with no input from her father. I was lucky to get married to my husband, who is also providing for her. If not for that pregnancy, my life would have been better than it is now, but I still thank God that I?ve been able to move on from the challenges imposed on me by teenage pregnancy, get married, and settle down. Many girls are not that lucky.?

True to Mowah?s assertion, many teenagers in different parts of the country, who are put in the family way, suddenly begin to see the life that they envisage begin to peter out gradually.

This partly explains why, for instance, the Challenged Parenthood Initiative (CPI), a Non-Governmental Organisation (NGO), last month called for a sexual and reproductive health awareness campaign as it decried the spate of teenage pregnancy in Kogi.

The Director of the initiative, Eunice Agbogun, who spoke when her foundation settled the hospital bill of a teenager who gave birth out of wedlock, called for a massive sensitisation and awareness campaign on sexual and reproductive health in the state over the observed rise in teenage pregnancy.

Last June, the World Health Organisation (WHO) called on the Delta State government and other stakeholders to address the increasing cases of adolescent pregnancy among girls in the state to reduce the dangerous trend.

The WHO Coordinator in the state, Dr Faith Ireye, who made the observation said that pregnancy in adolescents, especially between the ages of 14 to 19 in Delta State, was worrisome, stressing that there is a need to address the menace because currently, four per cent of pregnancies in the state occur among adolescents.

Ireye stated that it was high time the government took a firmer decision to drastically reduce adolescent pregnancy, through rigorous education and alerting of the girl-child to the hazard of early and needless pregnancy because if they have information, and are well guarded with the information at their disposal, it will be possible to crash teenage pregnancy below four percent,? she said.

Teenage pregnancy has been gradually burrowing its way deep into society, but its magnitude was recently made clear by the latest Nigeria Demographic and Health Survey (NDHS) 2023-24, which indicated a 15 per cent rise in pregnancy involving Nigerian girls aged 15-19 across the country.

The report, which described the situation as a pressing national health issue that requires urgent intervention, added that the rates were significantly higher in rural areas, particularly in the North West and North East regions.

It further indicated that 11 per cent of these girls had already given birth, with four per cent currently pregnant and two per cent experiencing pregnancy loss, reflecting potential gaps in healthcare access and support.

In focusing attention on the socioeconomic and educational impacts, the report said that teenage pregnancy rates were notably higher among girls from lower wealth quintiles and with limited educational attainment. It further explained that explained that poverty and restricted opportunities contributed to the problem.

Barely one year ago, the United Nations Children?s Fund (UNICEF), which described teenage pregnancy as a ?massive crisis,? in Nigeria, called for immediate and comprehensive intervention by the governments at all levels, noting that it had ?committed $1billion investment in Nigeria over the next five years.?

The Chief of Health at UNICEF Nigeria, Eduardo Celades, speaking during the stakeholders forum on Adolescent and Youths Health Policies in Africa with the theme: ?Fostering International Partnerships to Contribute to Adolescents? and Youths? Health in Nigeria, said: ?We are facing a massive crisis affecting our adolescent population. One in 10 girls in Nigeria is projected to become a mother before the age of 18, with a disproportionate impact in the North-Central and North-West regions, where 50 per cent of young girls, particularly in states like Bauchi and Gombe, are expected to have a child by the age of 18.

?Half of adolescent girls are unlikely to complete secondary school, and a staggering 43 per cent are already married. Of these, a significant portion has partners older than them, impacting their decision-making autonomy.?

According to the American Pregnancy Association, teenage pregnancy is pregnancy that occurs in a woman that is under the age of 20. Although technically not a teenager, a young woman 12 or under, who is pregnant, falls into this definition of teenage pregnancy as well.

On its part, the WHO defines adolescent or teenage pregnancy as pregnancy in young women between the ages of 10 and 19 who become pregnant before completing their somatic development. Often unplanned and one of the most adverse outcomes of adolescent sexual activity, adolescent pregnancy is a growing global public health and social concern that afflicts both developing and developed nations.

Considered a major cause of newborn and maternal mortality, induced unsafe abortions, and increased sexually transmitted disease, among others, adolescent pregnancy negates the realisation of universal health coverage, a critical component of Sustainable Development Goal 3, which aims to ensure healthy lives and promote well being for all people of all ages.

As preventable as teenage pregnancy is, several factors have joined forces to ensure that it flourishes in society despite the avalanche of ills that it wrought upon its victims, their families, and the larger society.

But as part of efforts to curb teenage pregnancy, the Nigerian government introduced sex education into junior secondary schools in 2003 under the Family Life and HIV Education (FLHE) Curriculum. The decision to do so was influenced by the 1994 International Conference on Population and Development (ICPD) Conference, which prioritised gender, adolescent reproductive health, and reproductive health a priority.

The Nigerian National Reproductive Health Policy and Strategy of 2001 included goals such as reducing adolescent unwanted pregnancy by 50 per cent and increasing access to reproductive health information and services by 80 per cent.

Despite several research works, including Assessing Factors Predisposing To Teenage Pregnancy And Preventive Strategies Among Secondary Schools Students In Lagos State? by Chinazaekpere Catherine Nzeocha, Joy Adeyanju, Mercy Omosefe Omozusi (PhD), and Mary Mojisola Obadimeji recommending that the teaching of sex and sexuality education should be made compulsory in all schools to help adolescents understand their physiological makeup, many were mortified when the President Muhammadu-Buhari-led government struck sex education off school?s curriculum.

In striking out the subject, the Buhari government said that Nigeria is a deeply religious country, so sex education should be left in the hands of parents and religious leaders.

But some non-governmental organisations that countered the move noted that ?a learner would have spent over 15,000 hours of their active time in school, after 12 years of education. The socialisation that takes place in school is critical because of the number of time learners in formal education must spend there, which cannot be compared with the amount of time they have with their parents after school, or before school.?

Pregnancy as smouldering public health, social challenge

The World Health Organisation (WHO) notes that every year, an estimated 21 million girls aged 15?19 years become pregnant in developing regions, and approximately 12 million of them give birth.

Globally, the adolescent birth rate (ABR) for girls 10?14 years in 2023 was estimated at 1.5 per 1000 women with higher rates in sub-Saharan Africa. And of the 400,000 unplanned births that occur yearly in Nigeria, half of them involve teenage girls, who are largely unmarried, some of which are in school, while others are not.

Data further revealed that in 2021, the rate of teenage pregnancy in Nigeria was the highest rate in Africa with 106 adolescent births per 1,000 people recorded.

Another illustration of how teenage pregnancy is a major public health issue in Nigeria is the fact that over 23 per cent of teenagers aged 15?19 have started childbearing, while 32 per cent of teenagers in rural areas kick-start their childbearing process earlier compared to 10 per cent in urban areas.

To date, the highest rates of adolescent pregnancy are recorded in the North-West, North-East, and North-Central geopolitical zones.

Contradictory laws, limited education, unsafe sexual practices as major drivers of adolescent pregnancy

While socioeconomic inequality has played a massive role in nurturing the menace of teenage pregnancy, one of the major drivers of it remains contradictory laws. In clear breach of the Child Rights Act, which in Section 277 stipulates that no one under the age of 18 is considered ?capable of contracting a valid marriage,? the menace of child marriage flourishes in the North hence the region is leading the pack in teenage pregnancy is concerned.

By the last count, less than 27 states had adopted the Child Rights Act. But beyond the non-adoption of the Act by some northern states, the endorsement by the Senate of Section 29 (4) (b) of the Constitution of the Federal Republic of Nigeria 1999, which legalises child marriage makes things rather difficult for teen brides. The amendment provides that ?any woman who is married shall be deemed to be of full age.?

Early childbearing imperils adolescent girls? future, dampens their prospects

According to UNICEF early childbearing, or pregnancy and delivery during adolescence, can derail girls? otherwise healthy development into adulthood and have negative impacts on their education, livelihoods, and health. Many girls who are pregnant are pressured or forced to drop out of school, which can impact their educational and employment prospects and opportunities.

Early pregnancy and childbearing, the United Nations? organ said can also have social consequences for girls, including stigmatisation and reduced status in the home and community. They can also lead to rejection and violence by family members, peers, and partners as well as early and forced marriage.

The Founder, of Beyond the Classroom Foundation, Raquel Kasham Daniel, agrees that the effect of teenage goes beyond the victim.

Said the social entrepreneur, educator, and author of several books including FLOW: A Girl?s Guide To Menstruation ?In my work, I?ve seen first-hand that teenage pregnancy is a huge issue that affects more than just the girl involved, it impacts her education, her future, and even her community. As a first-generation graduate in my family, I can tell you this for free. When a young girl has to leave school because of pregnancy, she loses out on opportunities for a better life, independence, and the ability to support herself in the future. It?s not just her loss; it?s a loss for all of us because educated girls grow up to become empowered women who contribute to society in countless ways.?

She continued: ?In the bigger picture, when teenage pregnancies rise, we lose a generation of educated, skilled, and empowered individuals, who could have contributed meaningfully to the workforce and society. Instead, we?re faced with a cycle of poverty and limited opportunities, which only perpetuates the challenges facing our country.

?A pregnant teenager is more likely to face health complications, drop out of school, and possibly even end up in an abusive relationship, and these are factors that contribute to high rates of maternal mortality, poverty, and economic stagnation.

Parents, clerics ill-equipped to address adolescents? sexual, reproductive health concerns

SINCE the Muhammadu Buhari-led government advised when it expunged sex education from BEC, Mrs Mowah has been doing her best to explain to her kid daughter, what constitutes appropriate touches and what does not. But she is quick to point out that as far as sex education is concerned), a groundswell needs to be done especially in schools.

Said she: ?Having fallen victim of teenage pregnancy myself, I have decided that I am going to guide my daughter to the best of my ability so that she does not make the kind of mistake that I made. As young as she is ? six, she understands me, and I talk to her as my friend, just as we discuss what constitutes appropriate and inappropriate touches. But as a parent, there is an extent to what I can tell my daughter hence the need for the government to ensure comprehensive sex education is taught in schools, where teachers, who are trained for such assignments can do the task. Contrary to what the government wants, parents and religious leaders are not fully equipped to carry out comprehensive sex education.?

Medical doctor and Chief Executive Officer (CEO) of Preggify, Ifunanya Igweze, agrees with Mowah. She said: ?Many parents lack the skills or comfort to discuss these issues openly, while some religious institutions approach the subject with silence or fear-driven messages. Growing up, we had no sexual education in school and my parents never taught me either. Everything that I learned about sexuality education was from my peers. This unreliable source of knowledge can be misleading and may contribute significantly to the rise in unwanted pregnancies among teenagers. This creates a vacuum where misinformation, peer pressure, and experimentation thrive. A more balanced approach is needed?one that equips young people with accurate, age-appropriate information to make safe and informed decisions.

She continued: A simple solution could be the creation of age-appropriate sexuality education done by professionals devoid of fear, judgment, and religious bias. As a medical student, we went to secondary schools to teach sexuality education, but we were usually met with rules by authorities not to discuss some aspect of sexuality education. Certainly, these aren?t the people we want to entrust this education into their hands. I strongly advocate that even with a school-based curriculum, only trained sexual educators should be allowed to teach it. Not ordinary teachers who are also biased by their cultural and religious beliefs, and always cherry-pick what they want to teach.

Daniel, who is Co-Founder of Bambini Africa added: ?Sex education shouldn?t be confined to just one space, it needs to be holistic. Yes, parents, churches, and mosques play a vital role, but there are many children, particularly those from disadvantaged homes, who may not get that kind of guidance. For these children, school is often their only source of comprehensive learning, and it?s in the classroom where they can access well-rounded, fact-based, and age-appropriate sex education.

?I?m not saying we should ignore the importance of moral and values-based education from parents and religious institutions. But we can?t forget the huge gap that?s created when children, especially in vulnerable communities, miss out on crucial education about their bodies, relationships, and safe practices. These are the tools they need to make informed decisions that affect their futures.

On the seeming scant attention paid by the government and society to the increase in HIV cases and unsafe abortion, which lead to deaths, Igweze said: ?While there is growing awareness, the societal response is far from adequate. Teenage pregnancy and its complications, including unsafe abortions and rising HIV cases, remain stigmatised rather than addressed head-on. Advocacy is often limited to urban areas, leaving rural communities vulnerable. We need widespread, inclusive programmes that provide access to contraceptives, counselling, and healthcare while addressing the root causes like poverty and lack of education.

Govt must protect girls? rights for a sustainable society

Both Igweze and Daniel admit that for a virile, and sustainable society to be guaranteed, the reproductive rights of girls and women must be taken seriously.

Daniel said: ?If we want to truly develop as a nation, we need to invest in educating and empowering our young people, especially girls. And that starts with ensuring they have the knowledge and tools to protect themselves and make informed choices about their bodies and futures. This isn?t just a women?s issue, it?s a national issue. Teenage pregnancy isn?t just an individual tragedy; it?s a setback for the entire country.

?As development workers, nonprofits, parents, authors, and media houses, we should have stepped up and doubled our efforts to educate children in ways that fit their realities. Yes, the government will always make decisions?some of which we may not agree with?but it?s our responsibility to find a way forward.?

On her part, Daniel said: ?Policies on adolescent sexual and reproductive health are critical in reducing early pregnancies.

They serve as a guiding framework for implementing programmes that educate, empower, and protect young girls. When girls understand their bodies and rights, they are better equipped to make decisions that safeguard their health and future. Such policies also ensure that interventions are sustainable and reach marginalised communities where the risks are highest.

There should be strong a policy that is enforced against sex with minors which is statutory rape. This law should be enforced to punish any adult who engages in sexual intercourse with minors.

?I usually read stories insinuating that a minor gives consent for sex. This shouldn?t be happening as minors do not possess such abilities. Adults who cannot guide the younger ones should face the law to serve as a deterrent for others who plan to engage in sex with minors. This policy will also strengthen the availability of free youth-friendly services in every local government to make it closer to the target population. Most importantly, this policy must see to it that only well-trained and qualified educators/providers are allowed in such a position to interact with these teenagers.

For Chief Executive Officer (CEO) and Co-Founder Child Solidarity Group, Emediong Akpabio, by removing sex education from BEC, ?the government has just abdicated one of its core responsibilities, which is protection to her citizens. Law and order shapes a country all over the world. When you move this responsibility to religious leaders or parents, then the result of it is a variation of moral standards. I have seen a parent who thinks there?s nothing wrong with her daughter who is a minor getting married if she falls in love in one of our advocacies against child marriage. We also have religion that supports this because it?s part of their culture. This is very close to the same effect that allowing families and religious leaders to decide what and how sex education should be taught. It?s a terrible mistake and what we see today is only just starting if this decision is not rescinded.

On the worsening impact of adolescent pregnancy, he said: ?The society is paying attention and we are all aware of this problem, but there is very little they can do. The issue of legalising abortion has been on for a while and it?s now a controversial topic depending on your school of thought. The government says legalising abortion will lead to more negative outcomes, but I think there is a way to go about it while maintaining sanity. Education on sex education was supposed to help people make informed decisions on issues like this, but now look at where we are. Despite several interventions by WHO and the health ministries, HIV has gone terribly high especially. Importantly, teenage pregnancy is now driven by a broader economic driver like poverty and socioeconomic challenges.?

Asked how extant policies and sexual reproductive health programmes have helped in curbing the menace, Akpabio said: ?We have policies. We need an effective implementation strategy to move from talk to action in tackling these problems. Sexual and reproductive health services are still not wholly accessible and affordable. We need to now provide subsidies for most of these items that might have cost implications for some groups of people and increase community awareness. (Text, excluding headline: The Guardian)

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