Involve The Young!

For Dr Pramilla Senanayake, assistant director-general of the International Planned Parenthood Federation [*], young people hold the keys to improving the record on reproductive health

Pregnancy related problems are a leading cause of death among adolescents. Are most of these unwanted pregnancies?

You have to distinguish between pregnancies within and outside marriage. In countries like Bangladesh, Nepal and some parts of Africa, the number of girls married by 15 or 16 is exceedingly high--up to 70 or, 80 per cent. In those situations, pregnancy within marriage may be wanted but we know that it is hazardous, in terms of its consequences on health, education and economic opportunity. Outside of marriage, the vast majority of pregnancies are unwanted. The "sugar-daddy" phenomenon is common, while a more recent trend is the false belief by some men that by sleeping with a virgin, they will not get AIDS.

Does pregnancy generally mean an end to education?

Yes, or else girls often end up having botched-up backstreet abortions because they are afraid of being expelled. You could argue that schools should be encouraged to keep pregnant students but in reality, this doesn't really work. These women have special needs. In countries as far afield as Jamaica and Tanzania, we have set up special schools for pregnant mothers allowing them to complete their education. Once the child is born, they often continue into vocational education as long as childcare facilities exist.

What impact did the 1994 International Conference on Population and Development have?

The United Nations Population Fund took a leadership role by spearheading the need to look at adolescents as a group whose sexuality had to be recognised and whose needs had to be met in terms of education, information and services. This has to be done in a holistic way. The conference made the world aware that this was not a problem that you could just sweep under the carpet. But at a country level, progress in taking care of teenagers' needs has been slow. NGOs are setting the example inmost cases, notably with peer education projects that are giving promising results.

To what extent has sex education improved, particularly in developing countries?

In some countries including my own (Sri Lanka) sex education exists, but in reality teachers are not trained to handle these issues. Sex education is not just about having sex, it's about relationships and making choices. Girls need empowerment to say "no" to a relationship and this is difficult for them. This kind of sex education is still rare in schools and often starts too late. Primary school is the important starting point. But you also have to look at what is happening outside the school, because very often girls drop out at the secondary level, and there are some 125 million children who never go to school at all. The potential of distance learning, media and other communication forms has to be more broadly harnessed.

What do we know about the impact of sex education programmes?

Study after study has pointed out that sex education delays childbearing and does not lead to promiscuity or to early sexual experimention. It is usually the reverse: if you are forearmed with that knowledge, you are more cautious. In every walk of life, we train young people to cope, we give them skills and knowledge, but when it comes to sex education, there seems to be a myth that the less you tell them the better off they are. It makes no sense. It is control of power by an older generation.

How can access to contraception be improved, notably in Africa?

There is a crying need for information on contraception. Information has to be made available through a variety of sources: in clinics, in pharmacies, through peer groups, the media, etc. Services have to be made more youth-friendly and accessible to all young people regardless of their marital status. Young people themselves should play an active role in defining how health services should be run. The press can play a pivotal role: we are running a particularly successful operation with the BBC World Service known as Sexwise. It is a 12-part series on sex education, family life education, contraception and parenting. In South Asia, where it was first launched in eight languages, we received some 75,000 queries from listeners. After being extended in 1999 to Europe and Eurasia, the series will go global in July 2000 and is expected to reach over 60 million listeners in Africa, the Arab world, Latin America, South East Asia and China by the end of the year.

In 1999, the U.S. introduced a rule that aims to defund organizations outside the U.S. which provide any abortion-related information and assistance to women in need. Are you concerned about this?

This rule is hurting women. It is depriving funds for NGOs like ours. This means we are unable to provide reproductive health services, including contraception and family planning to women who are in need. This results in more unwanted pregnancies because services are not available and women who could have gone to have services ended up having botched-up abortions. It is very shortsighted.