Hopolang Mokhopi 

LESOTHO is facing an alarming crisis of child pregnancies particularly in remote rural areas, with some health centres admitting a majority of teenagers aged between 13 and 19 in their maternity wards than older women. 

According to the sexual reproductive health (SRH) mentor at Quthing Hospital, Keneuoe Thinyane, they had 66 pregnant teenagers attending the antenatal care (ANC) in the first quarter of 2024. 

Additionally, Bobete Health Centre in Thaba Tseka had delivered 37 teenage childbirths from April to July 2024, with mothers aged between 15 and 21. 

This has been attributed to the reluctance to obtain and use contraceptives by these young girls as the practice is regarded a taboo in the rural areas. This despite the government’s increased efforts over the previous four years to improve sexual and reproductive health by offering family planning services. 

Family planning gives individuals the power to choose when and if to have children by utilizing the resources, tools, and techniques at their disposal. It includes a broad variety of contraceptives, including tablets, implants, IUDs, fertility-limiting surgeries, and barrier techniques like condoms. 

A United Nations Population Fund (UNFPA) 2020 study states that one key tactic to lower maternal mortality in Lesotho would be ensuring that women have access to and use contraceptives. 

Additionally, it backs the government’s initiatives to lessen the unmet demands for family planning. 

UNFPA supports family planning by ensuring a continuous, reliable supply of quality contraceptives, strengthening national health systems, advocating policies supportive of family planning, and gathering data to support the impact of the programs. 

This surfaced during a UNFPA week-long workshop for journalists where they were sensitised about family planning, early and unintended pregnancies, menstrual health/poverty, child marriages, gender-based violence, and maternal health. The event ran from 15 to 20 July 2024 in Quthing and Thaba Tseka. 

According to the UNFPA 2020 report, access to and use of contraception remained a crucial strategy to reduce maternal mortality in the country and support the government’s plans to address unmet needs for family planning. 

Despite some commendable progress since 2020, health workers and nurses in Quthing said family planning education needed to be strengthened to reach more people. 

Ms Thinyane said at the seminar?the absence of adolescent corners in the district made youth resistant to accessing and using contraceptives. 

“In the First quarter (Jan-March) we had 66 teenage pregnant mothers who attended ANC clinic aged 15 to 19 years; those in first trimester were 10, second trimester 37 and third trimester 19,” Ms Thinyane said. 

Ms Thinyane explained that they were collaborating with partners like UNFPA, Lesotho Planned Parenthood Association (LPPA), Protectors, and Baylor to provide services to young people through village outreach programmmes. 

She said they had trained peer educators to sensitise and encourage youths to access and use contraceptives. 

“The aim is to sensitise them about these services and their importance. Peer educators have been established to encourage youth to access and use contraceptives. Village health workers also play a pivotal role in educating youth about contraceptive methods and providing these services.” 

However, Ms Thinyane noted that areas like Mphaki and Mount Moorosi lacked access to family planning services because clinics such as St. Matthews and Villa Maria, run by churches, did not offer them. This because the churches preferred natural methods of birth control. 

“In remote areas like Sinxondo and Dili Dili, communication barriers pose a problem since different languages, like Xhosa, are spoken,” she added. 

She also attributed some of the pregnancies to sexual assaulst, saying the hospital had attended to 34 sexual assault cases of girls aged 2 to 22 in the past three months. 

She said this was fuelled by Quthing’s high food insecurity. 

“Most of the children are left alone at home while their parents are in a neighbouring country trying to find means of life. So, they have a lot of freedom while others due to hunger end up sleeping with older men to get food,” Ms Thinyane said. 

In addition, a Dili Dili nursing assistant, Mookho Molete, said most pregnant teenagers came late for antenatal care services because they were afraid to come without consulting their parents while some did not have transport to the facility, and they did not want their peers to know that they were pregnant. 

“Pregnant teenagers do not attend antenatal care due to the stigma they face. Sometimes they do not want to miss classes since they are still schooling.?? 

?She said because their bodies were not yet fully developed, pregnant adolescent girls were at greater risk of birth complications such as cephalopelvic disproportion (CPD), which complicated the delivery process.? This usually resulted in caesarean procedures. 

“Often, pregnant teenagers are not able to follow birthing instructions due to lower understanding. For example, a young mother may start pushing the baby out before their cervix is sufficiently dilated, causing a cervical tear,” she said. 

A nine-month pregnant teenager aged 16, expressed her disappointment after discovering that she was pregnant early this year which led her to drop out of school due to the fear of challenges and stigma she faced. 

She told the seminar that the shame and pain she brought to her family was unbearable as she was scared that she would ruin her future. 

She said that she was in grade 8 and she still wanted to pursue her studies after giving birth. She said her ambition was to become a nurse one day. 

She said the baby’s father was 17 years old but was not in school. 

For her part, UNFPA communications manager, Violet Maraisane, said Lesotho was in the process of developing a Prevention and Management Learner Pregnancy Policy which will focus on the prevention and management of Early and Unintended Pregnancy (EUP) for learners. 

?The process led by the Ministry of Education and Training, was financially supported by UNFPA. 

Ms Maraisane said this had been prompted by data from the Education Management Information System (EMIS) and studies which indicated that early and unintended pregnancies coupled with child marriages were among the key factors that led to girl children dropping out of school. 

“For example, the Lesotho Demographic Health Survey has shown that 19 percent of women aged 15 – 19 had begun childbearing in Lesotho and of these 15 percent had had a live birth and 4 percent were pregnant at the time of the interview. 

“It further shows that the proportion of teenagers who have begun childbearing rises rapidly with age, from 3 percent at age 15 to 40 percent at age 19 and rural teenagers and those in the lowest wealth quintile tend to start childbearing earlier than other teenagers,” Ms Maraisane said. 

She said as part of mitigation measures, the Ministry of Education and Training through UNFPA’s support, had begun the processes of developing The EUP Policy. 

UNFPA already supports the delivery of Life Skills Sexuality Education in Schools and Comprehensive Sexuality Education Programs out of School as well as accessibility and availability of modern contraceptives for adolescents and young people including comprehensive condom programming, she said.