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Liapeng Raliengoane
LESOTHO, Thaba Tseka – Leaning against the hospital wall, a heavily pregnant Lineo* (not her real name) emotionally recounts how a myth about contraceptives deceived her.
The Lesotho Demographic and Health Survey (2014 LDHS) states that the contraceptive prevalence rate is 60% in Lesotho.
Lineo* is one of the many pregnant adolescents and young women who have come to stay at Bobete Health Centre to await the delivery of their newborn babies.
Dressed in a traditional pink blanket worn by expecting mothers, walking with bare feet and whole body smeared by a red clayed soil used for cosmetic applications, an 18-year-old Lineo* stands unique from other pregnant women she stays with at the health facility.
“I knew about birth control before falling pregnant but I did not opt for it because I had heard from several people that contraceptives block women’s menstrual blood and that blood comes out through their noses, so it scared me,” she sadly discloses.
She says she will opt for birth control after delivery even though she hasn’t made a final decision on which one.
According to World Health Organization (WHO), adolescent pregnancy report (April 2024) globally, the adolescent birth rate for girls 10–14 years in 2023 was estimated at 1.5 per 1000 women with higher rates in sub-Saharan Africa and Latin America and the Caribbean.
Preventing pregnancy among adolescents and pregnancy-related mortality and morbidity are foundational to achieving positive health outcomes across the life course and imperative for achieving the Sustainable Development Goals (SDGs) related to maternal and newborn health.
On the other hand, another teenager, a 17-year-old is one of the pregnant women awaiting delivery at the health facility and she says she knew nothing about contraceptives which is why she fell pregnant. She was doing grade 8 at one of the schools in the area.
Data from this health centre delivery ward shows that this year, 2024, the lowest age delivered is 15. They delivered 4 teenagers in July, 9 teenagers in June, 5 teenagers in May and 4 teenagers in April.
Orlando village health worker Mabulang Letima highlighted that as young as 13 years, the girls in her village fall pregnant.
She stated one of the challenges facing village health workers is parents who hide their children’s pregnancy until the last minute when they knock at her door seeking help because their daughters are in labour.
Bobete, Tlokoeng, and Orlando Village Chief Tiisetso Letima confirmed that child marriage and early and unintended pregnancy are a challenge in the area.
Chief Letima said these challenges are worsened and driven by alcohol abuse which is high in the area.
“To address these challenges, when we have public gatherings, we give village health workers a spot to give health education to the villagers,” he disclosed.
A pilot study by the World Health Organization in 2020, including 50 women from two health centres in Egypt (one rural and one urban) was carried out to assess the contraceptive prevalence rate and non-medical factors associated with their use. Women were asked to freely report any fears and rumours about contraceptives that they had heard or that were circulating in their communities or families.
They listed that: taking oral contraceptive pills affects fertility, Oral contraceptive pills cause weight gain, Oral contraceptive pills cause cancer, Oral contraceptive pills are only used to avoid pregnancy, Oral contraceptive pills have to be taken at the same time each day, No other contraception is needed while using oral contraceptive pills, Intra Uterine Devices can penetrate the uterus and travel up to the heart and Injectables cause permanent infertility.
The pilot study recommended reproductive health programmes to refute myths and misguided beliefs about modern contraceptives may help increase the use of modern contraceptive methods and are recommended, along with continuous provision of such contraceptives.
Suggestions have been made for mass media and family planning health campaigns to improve awareness about the benefits of modern contraceptives and to change social norms about their use.
In Lesotho, family planning is part of the Sexual and Reproductive Health Programme of the Ministry of Health and is an important part of the National Strategic Development Plan (NSDP II).
The United Nations Population Fund (UNFPA) Lesotho supports the Government of Lesotho’s efforts to increase access to quality sexual and reproductive health and rights (SRHR) services that are integrated and youth-friendly. These efforts aim to prevent maternal deaths, and early and unintended pregnancies, reduce new HIV infections and eliminate gender-based violence and harmful practices.
UNFPA Lesotho supported a field trip for journalists to conduct interviews in the highlands and get the state of child marriages, early and unintended pregnancies, family planning and gender-based violence from the communities.