TEEN girls still face some challenges when it comes to accessing affordable and effective contraceptives, this leads them to opt for abortion.
Hawa (not her real name) aged 16 years is one of many teens whose studies and dreams have been shattered. She, at her tender age opted to procure her four-month-old pregnancy after her middle-aged-married boyfriend forced her to undergo abortion.
"I could not join Form One as I had already a four-month-old pregnancy...I was terrified as I apparently saw myself going to die. Yes, I could have died. My mind was racing as I remembered that one of my peers also cheated death by a whisker after terminating her seven-month-old pregnancy," she testified.
She further said that just after she discovered that she was pregnant she informed her boyfriend about it.
"The man turned violent and pressurised me to abort. I refused, but he kept on insisting and finally I gave in to his pressure. I had no choice, but to do it...I felt I could not be able to go through such terrible pains...After I had aborted I fell ill for nearly a month," she recounted.
Hawa still lives with her parents along the Lake Rukwa Rift Valley Basin in Sumbawanga District Council in Rukwa Region.
When asked whether by that time she was using any family planning method, she said she was having unprotected premarital sex with her married boyfriend.
"A friend of mine, almost my age, who had terminated her seven-month-old pregnancy, volunteered to help me procure abortion. So, to make it possible I had to lie to my parents that I was travelling to Laela, a small town to visit a relative. But in the actual sense, I was going to my friend's home. When I arrived I was given two tablets to swallow and I inserted two more inside my private parts...To date, I don't know what kind of the tablets were," she explained.
She further narrated that it came to her knowledge that the tablets she was given were brought by her boyfriend who was responsible for her pregnancy. He was a married man with three children.
"I'm telling the truth... The reason why I gave in to my boyfriend’s pressure was because I wanted to keep our intimate relationship although he was a married man aged 20 years older than I was," she noted.
This grim incident confirms that many women and particularly teen girls are powerless when it comes to sexual health reproductive rights (SRHR), something that may subject them to health risks in case of an unwanted pregnancy or abortion.
Reports show that despite family planning being touted as one of the most life-saving, empowering and poverty reduction strategies, the prevalence rate of contraceptives in the country remains low, with latest statistics showing that only 38 per cent of married women are using them.
According to Tanzania Demographic and Health Survey (TDHS) 2010, less than 10 per cent of sexually active young people who want to either avoid or delay pregnancy use contraceptives. Appallingly, 22.8 per cent of teen girls aged between 15 and 19 years are either pregnant or are living as young mothers.
Ms Jacqueline Twendekazi (19) shared similar views, when she testified that she conceived when she was in Form Two and she was also helped to terminate her three-month-old pregnancy by her boyfriend who was her schoolmate.
"Although it is disheartening, I had no choice, but terminate my three-month-old pregnancy because I wanted to pursue secondary school education... I fell sick with frequent fever and worse still I was bleeding profusely...I saw myself approaching death," she narrated.
Another young woman aged 22 years from Kaswepepe suburb of Sumbawanga Town confided that she had an abortion three years ago when her pregnancy was four months old. By then she said she was in Form IV.
In the case of Hawa and other girls who may become parents at early age, what matters to them is to have access to affordable and sustainable health services provided at effective support health facilities.
Latest statistics show that every year in Tanzania at least one million women and girls get unwanted pregnancies, out of which 39 per cent of them end in abortions.
Equally 405,000 Tanzanian women and girls have induced abortions and 40 per cent of them experience complications that require post-abortion care and 60 per cent of those requiring medical treatment do not get the attention they need.
Rukwa Regional Medical Officer (RMO), Dr Boniface Kasululu, says abortion complications can be prevented when a patient can be treated where there is appropriate PAC services.
"We received a case of post-abortion care (PAC) of a lady who procured abortion at home, but claimed she had rather spontaneous abortion...So, we admitted her...she had already had infections and ended up removing her uterus. She, however, survived,” explained Sumbawanga District Medical Officer (DMO) based in the small town of Laela, Dr Nicodemus Masesota.
"When we asked her for the second time, she confessed to have procured abortion at home after being rejected by her boyfriend who was responsible for it," added the DMO.
In Nkasi District, the teen pregnancy prevalence rate is also high. When asked, District Medical Officer DMO, Dr Hashim Mvogogo about PAC admission cases, admitted that some adolescent girls had been hospitalised.
According to statistics from Guttmacher Institute’s fact sheet based in the USA, the law and policy on abortion in Tanzania are ambiguous and often confusing.
The Penal Code authorises abortion to save a woman's life, but is unclear about whether the procedure is legal to preserve the woman's physical or mental health.
In that context the fear for prosecution prevalent among women and healthcare providers alike, drives women to seek clandestine abortions that are often unsafe.
It further shows that in Tanzania in 2013, nearly 67,000 women were treated in health facilities for complications resulting from unsafe abortions.
However, about 100,000 other women who experienced complications requiring treatment at a health facility did not receive the medical attention they needed. Referral and regional health facilities treat the majority of Tanzanian's post-abortion care cases.
Medical literature shows that post abortion care should work in tandem with contraceptive services because post-abortion patients are highly receptive to contraceptive counselling.
The fact sheet was made possible by grants from the Dutch Ministry of Foreign Affairs, the UK Government and Norwegian Agency Development.
In efforts to address the challenges of teen pregnancy, Rukwa Region has launched the 2020- 2025 Region Action Plan on eliminating early child pregnancy.
Plan International Tanzania partnered with four organisations, Youth through Sports Tanzania - Yes Tanzania, Rukwa Sustainable Organisation (Rusudeco), People's Development Forums PDF and Rafiki SDO to implement a four- year project from 2020- 2024 on the integrated approach to prevent or end child, early and forced marriage (CEFM) in Rukwa Region.
The Norwegian Agency for Development Cooperation Framework (Norad) is funding the project.
Yes Tanzania Director Kenneth Simbaya noted that the project, among other things, aimed at keeping girls at school until they attained the age of 18 years, increase SRHR knowledge, change norms of inequality that lead to early child pregnancy and forced marriage.
Rukwa is among the nine out of 25 regions in the country with the high rates of child marriage of the rate of 40 per cent which is above the national rate of 37 per cent.
Statistics show that in 2018, 269 child marriage cases were reported to community -based child protection committees in Rukwa Region out of them 115 cases were reported in Nkasi, 54 Kalambo and 83 in Sumbawanga District and 17 in Sumbawanga Municipal Council.