How to make sure Zimbabwean youths and youth organizations can advocate for sexual reproductive health and rights?
De Hafid Derbal
Evidence and experience implementing sexual and reproductive health and rights (SRHR) programs in Zimbabwe has shown that the policy level is neglected despite its ultimate importance in creating an enabling environment for youth to access services. terre des hommes schweiz (tdhs) has invested in building up youth representation structures and worked with youth organizations over years to make sure that practical experience from the field can help shape SRHR policies and guidelines, especially with regards to teenage pregnancy.
According to new research published by the United Nations Populations Fund (UNFPA) in June 2022, almost a third of all women in developing countries, start having children at the age of 19 or younger (UNFPA, 2022). Childbearing, pregnancy and delivery at an early age can have major health consequences for adolescent mothers and their babies. In Zimbabwe, early and teenage pregnancy contribute around 30% of maternal deaths (UNFPA Zimbabwe, 2022).Early pregnancies are also like to have negative impacts on girls’ education, their livelihoods and health. Research indicates that several factors are responsible for the high prevalence of teenage pregnancy in Zimbabwe. Among these factors are early sexual debut and child abuse as well as poor access to and utilization of contraceptives among young people. Although the Education Amendment Act of 2020 made provisions to retain pregnant girls in schools, operationalization of the law remains a challenge with key obstacles remaining in prohibitive societal attitudes.
Early engagement in sexual activity in Zimbabwe happens in contexts where youths have limited information on and access to contraceptives owing to the religious and cultural beliefs that seek to control the sexuality of unmarried young people, especially young women. While parents and schools are expected to provide information on sex and sexuality to young people, this is not happening at a level adequate enough to prevent pregnancy or other consequences of unsafe sex among young people. Early marriage is also a key driver of teenage pregnancy. At about 34%, Zimbabwe has one of the highest prevalence of child marriages in the region (ZIMSTAT, 2019). Evidence suggests that this phenomenon plays a key part in the rate of teenage pregnancy in the country with research indicating that 19% of teenage pregnancies happen as a result of early marriage.
Early engagement in sexual activity in Zimbabwe happens in contexts where youths have limited information on and access to contraceptives owing to the religious and cultural beliefs that seek to control the sexuality of unmarried young people, especially young women.
Lack of clarity and inconsistent application of policies
Additionally, lack of clarity on, and the inconsistent application of government policies with regards to access to services for young people remains problematic. Government, through public hospitals dispenses contraceptives, without prescription, to children between the ages of 16 and 18 years. Parallelly, there is a suggestion that there is no age limit for access to barrier contraceptives such as condoms for children who do not have parental consent. In the absence of a reasonable clear legal age limit which stipulates the minimum age at which young people can access contraception without parental consent, many sexually active minors will remain without the contraceptives they need to prevent teenage pregnancy.
Another key policy issue is the misalignment of positions between government ministries. While the Ministry of Health and Child Care (MoHCC) seems to be taking progressive steps to improve access to contraception by adolescents, the Ministry of Primary and Secondary Education (MoPSE) has remained adamant that condom distribution will not be allowed within school premises. The situation regarding access to services is compounded by the fact that, even to the extent that sexually active adolescents who need contraceptives face service providers who are not youth-friendly. Research indicates that a significant 67% of female adolescents between 10 and 19 cannot identify a comfortable and friendly place to access sexual and reproductive health services.
While the Ministry of Health and Child Care (MoHCC) seems to be taking progressive steps to improve access to contraception by adolescents, the Ministry of Primary and Secondary Education (MoPSE) has remained adamant that condom distribution will not be allowed within school premises.
The prevailing economic situation in the country and growing poverty, has played a significant role in driving up the rate of teenage pregnancy. Evidence indicates that adolescent young women are engaging in transactional sex across generations, with older men, for survival. In these relationships the power dynamics are skewed in disfavor of adolescent girls and young women who cannot negotiate for safer sex. The recent raising of age of consent to sex, through a court ruling, to 18 from 16 years will also play a key role in stemming much of this exploitation. However, without proper regulations to guide the enforcement of this major legal position, it may deter many young people below the age of 18 years who require services from seeking such. This policy position may also be misconstrued by service providers as the same as the age of consent for accessing services, resulting in young people being denied services. Additionally, the economic situation has taken a toll on the child and youth protection systems, including structures for reporting sexual abuse and the support of victims. Another key consequence of the harsh economic climate is a rise in rates of school dropouts against evidence suggesting that schools offer a safe environment for girls pertaining to early sexual debut whereas staying in school helps avoid three in ten teenage pregnancies.
Another key consequence of the harsh economic climate is a rise in rates of school dropouts against evidence suggesting that schools offer a safe environment for girls pertaining to early sexual debut whereas staying in school helps avoid three in ten teenage pregnancies.
The need to address health issues at various levels
These factors indicate that addressing the root causes by merely working with youths and sensitizing communities is enough to reduce the high rates of teenage pregnancies. terre des hommes schweiz and its partners have been working in Zimbabwe since 2012. Thus, the practical expertise from the field and scientific evidence have informed the strategy of tdhs to adopt a socio-ecological model of health promotion. It is a theoretical model that acknowledges the multiple determinants of health and, explicitly, highlights both the multiple levels for intervention and how these are interconnected and, therefore, best addressed in combination. The belief is that sustainable positive health-seeking behavior change is a result of conceited and concurrent interventions at the individual level of teenagers, their families, communities, key organizational and policy levels.
As a result, tdhs and its partners design interventions that seek to address obstacles at these various levels. Evidence and experience implementing sexual and reproductive health and rights (SRHR) programs in Zimbabwe has shown that the policy level is neglected despite its ultimate importance in creating an enabling environment for youth to access services. This is, partly, because the majority of community-based organizations (CBOs) are invested more at the community level due to the size of the organizations and their respective budgets. Additionally, capacity and funding for advocacy work remains low in a context where operational space for civil society is shrinking. Civil society organizations are often considered enemies of the state and are often persecuted for exposing government shortcomings.
Evidence and experience implementing sexual and reproductive health and rights (SRHR) programs in Zimbabwe has shown that the policy level is neglected despite its ultimate importance in creating an enabling environment for youth to access services.
There is a twofold gap between the implementation of policies and evidence practitioners and youths experience in their communities; first there is a need to transfer the experience to policy makers and second there is need to capacitate NGO practitioners, especially youths, to influence policies and guidelines according to their engagement in the communities. tdhs has been focusing its work around youths and their participation since the early 2000s. Such participation can only happen if youths are capacitated to use their voice and civic spaces of participation are accessible. This is why over the last 5 years tdhs has invested in national youth representation processes and methodological capacity building through local staff. The vision was and remains to include partner organizations and their youth leaders in any strategic discussion and process. As Sandra Chiomvu, a youth worker for the CBO Million Memory Project Zimbabwe (MMPZ), gets not tired to claim: “Nothing for the youths without the youths!”.
While the youth representation structure helped tdhs to build a consistent youth voice in its programme and strategy, it also saw its role in supporting a process where local actors would help bridge the gap to policy makers. In partnership with the Zimbabwean NGO Katswe Sistahood who led the process, all partners and representatives of the youth met over a 2-day meeting to develop an advocacy strategy. Since the start in August 2021, an advocacy strategy was developed with agreed key activities and products. As part of the strategy development process, partners were trained on advocacy by Katswe Sistahood.
The training included basics of advocacy from a policy brief on teenage pregnancy in Zimbabwe up to specifics like a handbook on how to engage parliament in Zimbabwe. Meetings with members of parliament were held in which young people and all the partner organizations interfaced with policy makers and a petition to parliament was started to review key laws relating to teenage pregnancy. The petition has since been acknowledged and the tdhs partners shall be summoned to give evidence before parliament. “It’s important to demystify parliament” says Talent Jumo, director of Katswe Sistahood, as most citizens usually do not see parliaments and their members as spaces they can simply interact with. In this light, visits to parliament for youth and partners are planned in order to explore opportunities for influence and to be oriented on how the system of policy making works.
There is a twofold gap between the implementation of policies and evidence practitioners and youths experience in their communities; first there is a need to transfer the experience to policy makers and second there is need to capacitate NGO practitioners, especially youths, to influence policies and guidelines according to their engagement in the communities.
Merely a year into work, this advocacy work has already shown considerable results. However, it is still work in progress with uncertain outcomes as policy changes depend very much from momentums we can rarely influence directly. There is need to think advocacy beyond sensitization of local communities. It is also vital that advocacy is driven by the local partners including youth leaders. But while it is important to include youths in this process, we seriously need to think about personal protection in the context of advocacy. Although it is highly impactful to get young people to speak for themselves, having them in such platforms speaking out in front of communities and policy makers may expose them to retribution by parties that may feel aggrieved in the process. Especially if they are minors.
Enhancing advocacy outcomes requires actors to address issues, not only from the demand-side of rights holder by capacitating young people and our partners. The process requires us to strengthen the supply-side of rights by also capacitating duty-bearers. In this process, the members of parliament themselves have shown little understanding of the issues and their role with regards to SRHR reform. In some cases, they could be potential violators of such rights. Another area of capacity strengthening would be on how to engage the youth without stigmatizing or blaming them. In the meeting with the youth, members of parliament would sometimes use language that further victimizes the youth.
Meetings with members of parliament were held in which young people and all the partner organizations interfaced with policy makers and a petition to parliament was started to review key laws relating to teenage pregnancy.
There is need for funding strategic advocacy work despite the fact that tangible results can take years to materialize. There is also need for more coordination of advocacy efforts between national and international partners. This requires time, additional resources and patience. And there is need to budget more resources for designing, printing, and packaging of advocacy material as presentation matters in policy advocacy. In civic environments that are shrinking also with regards of the human rights related SRH, strategic funding, planning and implementation of advocacy work is one of the most sustainable approaches we can adopt.
terre des hommes schweiz (tdhs) works with local youth organizations in Zimbabwe, Tanzania, Mozambique and South Africa in the field of SRHR. The prevention of teenage pregnancies and the support of young mothers are key components of the Southern African programs. Beneath the promotion and sharing of CSE and the development of key social and communication skills in youth work to empower youths to keep up healthy lifestyles and health seeking behavior, tdhs and its partner support young mothers to be reintegrated in the education system and/or build up basic income initiatives.
Another key element of tdhs in the coming years lies in advocacy work. For instance, in Zimbabwe we are aiming at lowering the age of consent to accessing contraceptives and essential SRHR to 12 years and ensuring that contraceptives are conveniently accessible and affordable for young people. We want also to make sure that laws and policies support pregnant girls to remain in school and that teachers and parents are sensitized to support them to get back to school after they gave birth. There are already laws prohibiting the marriage of children and adolescents in all countries we work. It is key to make sure these laws are applied and that all children have access to birth registration documents as s basic human right to facilitate the sentencing of offenders. tdhs is a politically and religiously neutral association founded in 1960 based in Switzerland.
Hafid Derbal (he/him) is the Desk Sexual Reproductive Health and Rights (SRHR) and program coordinator for Zimbabwe and South Africa at terre des hommes schweiz (tdhs) in Basel, Switzerland. He joined the team of terre des hommes schweiz in 2015 after having coordinated the youth programs of the European Union in Switzerland. He holds a degree in global studies with specialization in international development studies. Email
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