Addressing reproductive, sexual health needs of adolescent girls: RHESY makes impact

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Dromo, a beautiful adolescent girl with disability, is a very vocal person who resides at Asere, a community at James Town in Accra, home town to many Gas.

Like any other young ambitious girl, 18-year-old Dromo has just completed junior high school and aspires to become a medical doctor, not allowing her disability to be a barrier in achieving that goal.

Dromo has lived in Asere all her life and made friends with her age mates; both males and females, and she is noted for encouraging her friends to take their education seriously. This she does with the inscription: “Education is the Key to Success,” boldly written at the back of her mobility aid; the wheelchair, which she rides through the community, each day.

At age 18, Dromo entered into a love relationship with a boy in the community and they both consented not to indulge in any sexual act until they got married. But Dromo’s aspirations turned sour after a visit to her boyfriend’s house one Wednesday afternoon.

“I visited Adama, my boyfriend, one Wednesday afternoon, and I was with him when it started raining, so I had to wait till it stopped. I could not believe it, it all happened so fast, he held me, pulled me towards him and as I asked what he was up to, he ignored me as if he didn’t hear me speak,” she said.

Dromo realised she was in serious trouble when Adama started pulling off her blouse with force.

“After all my self-defence mechanisms failed, I pleaded with him to spare me but he turned a deaf ear and satisfied himself by penetrating me, defiantly,” she said.

“I shouted for help, I cried, but he kept to his agenda. I felt sharp pains in my vagina.
And at that very moment I realised I had lost my virginity, not only that, but my pride and dignity as a woman. It had been over three years but the painful memory is still fresh and torments me”.

For Dromo, the worse part of her predicament was the lack of support and betrayal from her parents; her parents did not believe her narrative as Adama was so defensive and managed to convince them that they had consensual sex.

Dromo got pregnant and had an unsafe abortion, which resulted in infection and bleeding. These complications worsened her plight as a disabled person because the community began to stigmatise her. She almost gave up on herself due to emotional stress as a result of stigma and the violation of her sexual right.

Thankfully, the introduction of the Reproductive Health Education and Services for Young people (RHESY) by the United Nations Population Fund (UNFPA), with funding from the Canadian Government, has saved the situation for Dromo as well as many out of school adolescent girls.

Just liked Dromo, many adolescent girls with disability face discrimination and stigma in society due to lack of education, parental and societal support and adequate information on their sexual and reproductive health rights.

A research report by the Domestic Violence and Victim Support Unit (DOVVSU) of the Ghana Police Service suggests that women and girls with disability are three times more likely to be victims of physical and sexual abuse compared to others.

A good sexual and reproductive health is said to be the state of complete physical, mental and social well-being in all matters relating to the reproductive system.

This implies that young people must have access to accurate information, safe, effective, affordable and acceptable contraception of their choice with the know-how to protecting themselves from sexually transmitted diseases.

The RHESY, which is being implemented by the Alliance for Reproductive Health Rights (ARHR) in selected districts of five regions, is gradually addressing the concerns of girls like Dromo, between ages 10 and 19, by providing them with enough information on the prevention of sexual and gender based violence and the easy ways to access reproductive health services in their communities.

Through the RHESY, the girls are more exposed to information on their human rights, how to assess family planning to prevent unwanted pregnancies, avoidance of unsafe abortion and protecting themselves from persons who try to violate their reproductive and sexual health rights.

It has so far led to the creation of adolescent peer education groups in its implementing areas; the Ashiedu Keteke Sub- Metro in the Greater Accra Region, Komenda Edina Eguafo Abrem (KEEA) Municipal Assembly in the Central Region, Nzema East Municipal Assembly in the Western Region, South Dayi District, Volta Region, and Bosome Freho District, Ashanti Region.

Nii Ankonu Annorbah-Sarpei, the Director of Programmes, Alliance for Reproductive Health Rights, said in the Ashiedu Kekete Sub-metro, for instance, the RHESY had empowered young girls to speak up and seek help at the appropriate places regarding their reproductive rights.

“Over the last three years, we have also encouraged adolescent boys to participate in our girls empowerment programme with the idea that boys will also have a sense of responsibility to protect the girls rather than violating their rights,” he said.

Nii Annorbah-Sarpei said most girls with disability knew the forms of help available to them when they were sexually abused.

“In addition to the education, we have linked them to facilities and institutions that provide legal services and have also engaged their parents to teach them ways to assist their girls with disability with the help they require”.

He said during the ARHR interactions with adolescent girls with disability, he observed that most health facilities in the country were not disability-friendly and there were no specialised health workers to attend to their needs.

Maame Esaaba, an adolescent girl from KEEA Municipal Assembly, who is visually impaired, said through the RHESY programme she had been empowered with enough information on how to seek information on her reproductive health needs.

“Your engagement today has empowered me to believe in myself again, I have learnt unsafe abortion is dangerous and know where I can access support for my reproductive health needs. Now I can confidently protect myself from pregnancy and any form of sexual violence against me,” she said.

Research, however, shows that millions of girls are forced into sex or marriage, putting them at risk of unwanted pregnancies, unsafe abortions, sexually transmitted infections (STIs) including HIV, and dangerous childbirth.

Adolescent Reproductive Health Champions say many young people face barriers to reproductive health information and care and even those able to find accurate information may be unable to access the services needed to protect their health due to financial constraints.

In committing to the realisation of the Agenda 2030 of the Sustainable Development Goals, which stress ‘Leaving No one behind’, adolescent sexual and reproductive health must be supported by government and all well-meaning Ghanaians.

This means providing services to prevent, diagnose and treat STIs, counselling on family planning, and access to comprehensive sexuality education.

It also means empowering young people to know and exercise their rights including the right to delay marriage and the right to refuse unwanted sexual advances.

The UNFPA also advocates and supports the efficient delivery of holistic and youth-friendly health-care package of services. These include universal access to accurate sexual and reproductive health information; a range of safe and affordable contraceptive methods; sensitive counseling, and quality obstetric and antenatal care for all pregnant women and girls.

Ghana must pay critical attention to the sexual and reproductive health needs of adolescent girls, especially those with disabilities, to ensure success in her endeavour to attaining Universal Health Converge for all by 2030.

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