By Mpho Shelile

MASERU – The ability to determine if and when to become pregnant, is vital to a woman’s sovereignty and well-being, for this very reason contraception is key. It protect girls and young women from the risk of early pregnancy and older women from unintended/unplanned pregnancy. Adolescent pregnancy is a major public health concern.

Adequate access to contraception can limit multiple pregnancies, reduce the need for potentially unsafe abortion and reduce maternal and infant mortality and morbidity. Some barrier forms of contraception such as condoms, also reduce the risk of STIs and HIV infection. Access to contraception allows women to make informed choices about their reproductive and sexual health, increases empowerment, and enhances choices in education, careers and participation in public life.

The Lesotho Planned Parenthood Association (LPPA) is a non-profit making organization affiliated with International Planned Parenthood Federation (IPPF).  The Association was registered as a non-governmental organization in 1968. Since then, the Association was the sole provider of family planning services until later in the 1990s when the Government of Lesotho introduced FP services in its health centers. After 1994, following the International Conference on Population and Development, the LPPA program shifted from linear family planning to a more Integrated Sexual and Reproductive programming.

At societal level, access to contraception is a key factor in controlling population growth, with resultant impact on the economy, the environment and regional development. Consequently, the United Nations considers access to contraception a human right that is central to gender equality and women empowerment that saves lives and reduces poverty. Birth control has been considered amongst the 10 great public health achievements of the 20th century.

To optimize women’s control over pregnancy, it is essential that culturally appropriate contraceptive advice and means are widely, easily, and affordably availed to anyone who is sexually active; including adolescents. In many parts of the world access to contraception and family planning services is very difficult or non-existent. In developed countries cultural and religious traditions can create barriers to access. Reported usage of adequate contraception by women has risen only slightly between 1990 and 2022, with considerable regional variability. Although global usage is around 55%, it may be as low as 25% in Africa.

Why is it important to talk openly about contraception? It will reduce unintended pregnancies, abortions, and facilitate family planning/spacing of births.  Effective contraception provides both health and social benefits to mothers and their children. Contraception lets people have the number of children they want, when they want them and within their budget constraints. This is everybody’s right under the United Nations Declaration of Human Rights.

Delaying or spacing babies allows women and men to pursue education and career goals that may be interrupted by having children. This empowers the human capacity element in the labour force and potential to earn more. With fewer children, families are also able to invest more in each child.

Worldwide 222 million women have no or limited access to contraception Some caution is needed in interpreting available data, since contraceptive prevalence is often defined as the percentage of women currently using any method of contraception among all women of reproductive age  those aged 15 to 49 years, unless otherwise who are married or in a union. The “in-union” group includes women living with their partner in the same household and who are not married according to the marriage laws or customs of a country. This definition is more suited to the more restrictive concept of family planning, but omits the contraceptive needs of all other women and girls who are or are likely to be sexually active, are at risk of pregnancy and are not married or in-union.

There remain significant barriers to accessing contraception for many women in both developing and developed regions. These include legislative, administrative, cultural, religious and economic barriers in addition to those dealing with access to and quality of health services. Much of the attention has been focused on preventing adolescent pregnancy. studies have identified a number of key barriers, on both the supply and demand side, including internalizing socio-cultural values, pressure from family members, and cognitive barriers (lack of knowledge), which need addressing. Even in developed regions many women, particularly those who are disadvantaged, may face substantial difficulties in access that may be financial and geographic but may also face religious and political discrimination.

 Parents are the first and most influential sex educators for teens. It’s important to learn ways to guide them toward safe and healthy choices in relationships. This includes knowing how to avoid pregnancy and sexually transmitted infections (STIs). They need accurate and complete information about contraception from a trusted source–you!

Young people are especially at risk of problems in pregnancy, Contraception allows them to put off having children until their bodies are fully able to support a pregnancy. It can also prevent pregnancy for older people who face pregnancy-related risks. Contraceptive use reduces the need for abortion by preventing unwanted pregnancies. It therefore reduces cases of unsafe abortion, one of the leading causes of maternal death worldwide.

When asked whether it is about time their teenagers used contraceptives to avoid pregnancy, Mrs. Moroesi Foulo who is a mother of two girls stated that telling an adolescent to begin swallowing things like pills is an indirect way of telling them to go ahead and have sex “it encourages immorality in adolescents and I will never tell my kids to do such but to abstain” she said

“It teaches these adolescents immorality how can I tell my children to go out and sleep with men because they cannot get pregnant when they use protection? As a parent, I cannot allow that. When adolescents start having sex, they do not even respect their own parents/guardians since they perceive themselves to be mature just like their parents/guardians” another parent said.

Most parents noted that the possibility of adolescents engaging in unrestricted sexual activity would mean that they would not respect their parents. Because with Basotho, sex is seen culturally to occur in the confines of marriage, adolescents will also see themselves as equals to their own parents/guardians since they would also be doing what their parents/guardians do.

Some parents or guardians did not support the use of modern contraceptives among adolescents because it was attributed to the high incidence of HIV among adolescents. Modern contraceptives were perceived to increase the incidence of HIV by removing the fear of getting pregnant, and indirectly promoting multiple sex partners since most of them do not protect against HIV infection.

“Use of contraceptives which do not protect against HIV can also lead to spread of this disease among adolescents simply because they will only focus on protecting themselves against unwanted pregnancies yet HIV also is contracted in this same process, I always tell my daughter to abstain but I know kids this days do not pay attention to what us adults. So I think it is safer for them to just go ahead and use contraceptives if that can help them avoid teenage pregnancy” Mr. Tumelo Kabi declared

“For me as a parent, I do not support it at all. It is not good because these things have serious side effects” another parent stated

A few parents admitted that they go as far as creating awareness for their adolescents on modern contraceptives. To them, making adolescents aware of modern contraceptives is not directly telling them to go and use but empowers them with the knowledge to guide them in making informed decisions. These are of parents or guardians who believed that times have changed and the guarantee that culture and religion alone would play a role in limiting the adolescents from having sexual relationships is a total delusion. However, those who admitted to playing such a role were those who were educated.

Boitumelo Phapho a student stated that she thinks it is better for them to use contraceptives because they do not want early teenage pregnancy, “I would advise other sexually active girls to get contraceptives and avoid early pregnancy” she said