Association of Reproductive and Family Health (ARFH) December 2014 celebrated 25 years of successful implementation of family planning programmes and improvement of Reproductive Health in Nigeria. Osinowo Kehinde its Director Programmes, told Ndidi Chukwu that the dream of the founders, Professor O.A Ladipo and Mrs. Grace E. Delano 25 years ago, to improve quality of life of individuals and families through health care information has been achieved.
Most Nigerian youths said they are not being giving the opportunity to make family planning choices as youths when they go to health facilities for that, looking at the high rate of teenage pregnancies in the country, do you think health care givers are doing it right?
As an organisation, we have made significant effort on that, already we have school programme and out of school programme. We are providing information and services. ARHF was the organisation that started the establishment of youth friendly clinics such that when young people in secondary schools get information on how to prevent pregnancies and they know how to say no to sex and they are truly aware that they cannot say no to sex because they are sexually active, and some have sexual partners that are funding their education they will not be able to say no when they ought to. To control that, ARHF provided 40 youth friendly clinics in all local governments of Oyo State as a pilot to be able to ensure that when people get the information and want the services they can access it at health facilities. The government will not allow family planning products to be distributed, there will be a lot of responses from the faith based institutions and parents and that is normal. Some parents will deny that their children are sexually active, even when they see it in their faces, parents will say even if they are sexually active, my child cannot have contraceptives, we provided such opportunity and we did it in such a way that children going into such facilities will not be black listed as those going for family planning services. We made sure that there were games, library, within the clinic so that when young people go there they will realise that they can also go to our youth friendly clinic. In terms of development and using innovative approach in family planning sexual and reproductive health information to young people we have used a thousand and one approaches to suit different environments, different groups of people and different groups of stakeholders.
How much influence do you think socio-cultural barriers have to Reproductive Health in Nigeria?
It is very fundamental, unfortunately, when we want to introduce any youth friendly programme on pregnancy prevention in a community, one of the thing we always ask in the community is, ‘in this area, have you noticed any young person getting pregnant and dropping out of school?’ before you finish they will count almost all the household yet they will tell you not to talk to their children about pregnancy prevention, don’t bring family planning methods to them. When you ask “have you seen any young girl dying as a result of abortion or unprotected pregnancy?” they will count the girls and tell you. You will find out at the end of the day that they are faced with these challenges but they keep denying it. There are many abortion related deaths especially in communities yet they will not want you to talk to young people on how to prevent pregnancy or how to use protection. That is the problem we have, those traditional values are really a great barrier to us towards achieving our goals. If you are going to implement a strategy, you will be amazed that they will give you the modalities, ask them, ‘if a girl is having sex, what are the likely results?’ they will tell you she can get pregnant, and when she does she will go and abort it and in that abortion she may die, ask them again ‘do you think people who are sexually active should be dying?’ they will say no and then ask you what can they do. With that we use the local effort and their decisions to get them involved in planning and that has been the secret for our success, in youth programming. Our strategies have been successful because we also take them to go to schools, get the principals involved and the students are taught.
Do you share in my own opinion that, inadequate parent-child relationship increases teenage pregnancies?
We share the same opinion with you again, when we found out that as a major problem, we did a programme that we were educating parents, training them on how to educate their children on sex, about prevention, about decision making. There was one of the incidences when one of the parents was just going through the pains of losing her under graduate daughter to pregnancy and unsafe abortion which led to her death. So when you bring people together they know the problems and how to go about it. That is why parental education is a component of our programme. We did it in the communities where we were taking community friendly clinics too because if you don’t do that people will make sure that programme does not work very well. In planning for young people we should always have programme that will educate none literate parents because most educated parents really make good parent-child relationship.
How wide is you youth friendly programme, have you been able to cover some other states yet?
We have done it in other North-East States, we did a West African Youth initiative in Oyo, even beyond Oyo, we did it in Ghana and Jamaica as well, were we tried to support the country to replicate what we were doing in Nigeria. We also implemented the family life and health education on HIV/AIDS in all the 36 and FCT states so we were able to bring family life education into school curriculum with support from Global Fund.