When Chimwemwe’s parents found out she was pregnant at the age of 17, they immediately arranged for her to marry her lover. Chimwemwe dropped out of school and moved away from her home. But the married life was not what her parents had painted.
SchoolspregChimwemwe was subjected to brutal abuse by her in-laws. Food was scarce for the young, unemployed couple. When a child protection worker approached the couple to end the illicit marriage.
Even though Chimwemwe was only 17 at the time, it is widely accepted in many rural areas of Malawi that any girl who becomes pregnant is old enough to marry.
Despite Malawi’s Constitution prohibiting weddings involving boys and girls under the age of 18, the practice propels girls and boys into child marriages and out of school.
According to a 2020 issue report on teen pregnancies and child marriage, half of all adolescent girls marry before the age of 18, teenage pregnancy is at 29%, and one in every five girls experiences sexual assault before the age of 18. Adolescent and young individuals are also more vulnerable to HIV due to high incidence of premature sexual experiences and child marriage. According to 2021 HIV projections, young adults aged 15-24 accounted for almost one-third of all new HIV infections in 2020.
Limited comprehensive sexuality education, as well as prevalent myths and misconceptions about contraceptive use, undermine attempts to address adolescent fertility.
In response, the Malawian government, in collaboration with various organizations, is providing an integrated package of sexual and reproductive health services, HIV-sensitive programs, and sexual and gender-based violence prevention.
The purpose of this Sexual and Reproductive Health and Rights is to prevent unplanned pregnancies, sexually transmitted illnesses, new HIV infections, maternal mortality, and sexual and gender-based violence.
Such interventions can assist young people like Chimwemwe in making informed choices regarding relationships and sexuality, as well as care and treatment for HIV-positive adolescents.
Since the first HIV case was discovered in Malawi in 1985, it has advanced to become one of the leading causes of death, putting enormous strain on the country’s health system and economy.
At its peak, HIV prevalence in Malawi was over 20%. Malawi has achieved significant improvements, for example, lowering HIV transmission from mother to child by 84%. More HIV-exposed babies are tested for HIV before they are eight weeks old, ensuring that those who test positive receive the necessary medication on time.
However, challenges remain.
HIV affects adolescent girls and young women disproportionately.
While adult HIV prevalence is 7.8 percent, young persons aged 15 to 24 account for one-third of all new infections in 2020.
Humanitarian conditions, stigma and discrimination, negative gender norms and practices, and a lack of male engagement, among other things, limit the rights of women, adolescents, and young people in Malawi to receive sexual and reproductive health services.
According to the Global AIDS Strategy (2021-2026), in order to eradicate inequities, young people must be properly empowered and resourced to chart an alternative path in HIV response.
While the usage of contraception has increased from 42 to 58 percent among married women, the prevalence among adolescents remains low at 37.5%, resulting to Malawi having one of Africa’s highest adolescent birth rates.
Adolescents and young women are also victims of sexual and gender-based abuse, which goes mostly undetected.
The COVID-19 problem has worsened global imbalances in access to life-saving care for children, adolescents, and pregnant women. According to a recent UNICEF survey of 29 HIV priority countries, one-third claimed that service coverage for children, adolescents, and women living with and vulnerable to HIV is 10% or less than it was before the pandemic.
While acknowledging the cultural, political, and religious norms that influence policy regarding the consent age, policy improvements that allow teenagers to receive HIV testing, contraception, and other health treatments must be encouraged.
We must protect, sustain, and accelerate HIV gains for HIV-positive children, adolescents, and pregnant women.
These services are required for adolescents and young people at all youth-friendly service delivery centers on the country.
As kids grow into adults, they should have access to accurate, reliable, and age-appropriate information regarding relationships.
This can assist individuals in making educated decisions about relationships and sexuality, as well as navigating a society where gender-based violence, gender inequity, early and unwanted pregnancies, HIV, and other sexually transmitted illnesses pose major health and well-being threats.
The reproductive health sub-sector received K600 million in the national budget for 2023/24, a 20% increase over the previous year, however there are proposals for financing in the billions of Kwacha.
Maziko Matemba, a health rights campaigner, commented on the issue, saying that financing for sexual reproductive health is inadequate and that an increase is needed.
“We recommend that the government improve coordination between the government and development partners, particularly during the budget process, as consultations have not been completed.”
“The government should manage the inefficiencies in development budgets in the health sector.” In cases when development partners are committed, the government may also consider granting sub-grants to the private sector to minimize low absorption of money,” he stated.
In his statement, Ted Sitimawina, Principal Secretary in the Ministry of Finance, stated that the government is dedicated to financing the health sector, but that it may not be able to do so at the typical rate owing to Cyclone Freddy, which he claims has impacted the health budget.
He went on to say that because sexual representative health is such an important problem, the government is eager to enhance funding.
Speaking on the subject, Adrian Chikumbe, a spokesperson for the Ministry of Health, stated that Malawi is committed to providing comprehensive and integrated Sexual and Reproductive Health (SRHR) services in accordance with the recommendations of the International Conference on Population and Development (ICPD), which was held in Cairo, Egypt, in 1994.
”Malawi is also a signatory to the AU Maputo Plan of Action, which pushes for a comprehensive SRHR strategy.
Since 1997, the Ministry of Health has supervised the integration, implementation, monitoring, and evaluation of SRHR services at all levels through the Reproductive Health Unit,” he explained.
The Malawi National Reproductive Health Program acts as the basis for the Ministry of Health’s management of SRHR services.
The purpose of the National Sexual and Reproductive Health program is to promote safer reproductive health practices among men, women, and youth through informed choice, including the use of quality and accessible reproductive health services.
