Growing rate of adolescent pregnancies raises concerns
HEALTH authorities in Guyana have expressed growing concern over the high rate of adolescent pregnancies here. Although the prime child-bearing age in this country remains among the 20-24 age group, early teenage pregnancies continue to record the highest rates, a document from the Adolescents/Youths Sexual and Reproductive Health (ASRH) Guyana component said. Documents on the subject were released to the media at a workshop on Adolescent Sexual and Reproductive Health at the Prairie International Hotel, Coverden, East Bank Demerara earlier this month. According to the documents, adolescents and young persons represent more than 50 per cent of the total population of Guyana and the English- and Dutch-speaking Caribbean countries. This group, statistics show, faces enormous sexual and reproductive health problems including the violation of their sexual reproductive rights. This, the document states, is evident in the high rates of violence and sexual abuse, and a lack, or denial of access to adequate services. In Guyana, there is an increase in teenage pregnancies, many of which are as a result of unsafe sexual activity. Concern for the high instances of sexual and physical abuse, especially among children and youths, is mounting, and it is reported that only about three out of every 10 of such cases are reported. Coupled with this is the fact that most cases of sexual abuse are seldom prosecuted, even when they are exposed. In Georgetown, about 70 sex abuse cases are reported each year, the assessments released at the ASRH workshop noted. While abortion is not a contraceptive method, it is often selected as an option by women for unwanted pregnancies. Non-use of any contraceptive method is one of the reasons women give for opting to terminate their pregnancies. Ministry of Health reports state that for the period March-December, 1997, persons within the 15-24 age group accounted for 43 per cent of abortions done, and during 1997, that group tallied 41 per cent. Youths within the 15-24 bracket accounted for 43.5 per cent, 36.9 per cent and 46.9 per cent of the total number of medical terminations done in Regions 4, 6, and 10 respectively, as compared with 43 per cent at the national level. Ministry of Health reports show that of the 36 adolescents under 15 had terminated their pregnancies; 30.5 per cent of them refused any form of contraceptive, while 27.7 per cent accepted the condom as compared with 36.1 per cent who selected oral contraception. This "risky" behaviour was addressed at the International Conference of Population Development (ICPD) in Cairo and is also a component of the final document of the 1998 Caribbean Youth Summit in Barbados. The ICPD programme of action has described reproductive health as a condition where people are able to have a "satisfying and safe sex life, be able to reproduce and have the freedom to decide if, when and how often they should be pregnant". To enjoy such freedom, there must be access to family planning and related health services. Reproductive rights means that all persons can freely determine the number and spacing of their children and to have the necessary information, education and ability to support this responsibility. In developing countries, a pregnant adolescent about 16 years old is five to seven times more likely to die from maternal causes than a woman aged 20-24 years old. From 16-19 years, the risks are twice as high. It is projected that by the beginning of the 21st century, there will be over one billion adolescents and more than 50 per cent of that population would most likely be sexually active and married. Current estimates state that one in every 20 teenagers worldwide contracts a sexually transmitted disease each year. Although there may be greater risks of complications and death, child bearing figures among the young is still on the rise. The consensus is that the existing health services in developing countries need a comprehensive approach in order to zero in on those problems and related issues. In March, 1997, as part of the follow-up for the plan of action of the Cairo conference, the Executive Board of the United Nations Family Planning Association (UNFPA)/UNDP approved a programme of assistance to the English- and Dutch-speaking Caribbean, from 1997 through 2001. Its main focus lay with the improvement of the ASRH rights. A UNFPA sub-programme on ASRH rights was elaborated on with Suriname, Guyana and Jamaica identified as the countries which will be `demonstration sites'. These sites for the ASRH-integrated pilot project have a formulated strategy for implementation. Identification and selection of countries were based on a combination of factors such as population size, poverty levels, gender inequalities, youth as the majority of the population and poor sexual and reproductive health indicators. The UNFPA/ASRH programme in Guyana has identified Port Mourant, in Berbice; St Cuthbert's Mission on the Mahaica River; Victory Valley, Linden; and Beterverwagting, East Coast Demerara, as areas to benefit directly from the pilot project. Guyana's component of the programme aims to provide direct or referral programmatic links, which will not only be among advocacy groups, family planning and related services, education and communication agencies, but will also include basic skills training agencies, STD clinics and counselling in addition to back-to-school services and after-pregnancy programmes. There are many related programmes which are provided by some government and non-governmental organisations (NGOs) in the four Guyana sites. It may me possible for some of these services to be linked up with those that will be provided through the ASRH programme. The Government offices which conduct related activities are the Ministries of Health, Education, and Culture, Youth and Sports. The Education Ministry is currently working on a Family Life Education (FLE) programme to be included in the schools' curriculum. In the meantime, the Cyril Potter College/Teachers Training College conducts courses in Family Life Education. These are specially designed for the curriculum of the teachers in training in preparation for the implementation of FLE in the schools upon graduating. The Ministry of Culture, Youth and Sports is now in the process of developing a youth policy. So far, many courses have been facilitated and financed by the Commonwealth Youth Programme. About 22 youth organisations countrywide have participated. (Sharon Lall) 
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