Strides Made in Family Planning, but Reaching Youth Remains a Critical Challenge
A vast, diverse and populous country, the Democratic Republic of the Congo (DRC) faces many development challenges. With maternal and infant mortality rates among the highest in the world, combined with high fertility rates, a rapidly growing population and low contraceptive use, reproductive health is arguably one of the country’s most pressing and complex issues.
In the past few years, DRC’s government has taken important steps to improve reproductive health policy. By signing on to Family Planning 2020 (FP2020) in 2013, DRC committed to increasing contraceptive coverage by more than 13 percent and growing usage of modern contraception by over 2 million people by 2020. In 2014, parliament adopted a comprehensive National Strategic Plan for Family Planning. And in 2015, for the first time ever, the government included a line in its annual budget for contraceptives, disbursing USD 300,000 to buy over 250,000 contraceptives and pledging a further USD 1.5 million.
Despite this momentum, it is the country’s youth—a third of DRC’s population—who are in most urgent need of information and services about sexual and reproductive health.
“There’s a taboo around sexuality of young people. They are seen to be asexual until they are married,” says Francoise Mukuku, director of youth advocacy nonprofit and PAI partner, Si Jeunesse Savait. “And there are not enough resources to respond to their health needs.”
Many young Congolese don’t have access to accurate information about their sexual health, yet one in four adolescents is already sexually active. For the majority, contraceptives are out of reach—shrouded in myth and taboo or forbidden by family, religion, cultural norms or even health workers themselves.
Legally, people below the age of consent (18 years old) can only get contraceptives or family planning methods with permission from their parents. Mukuku believes this is a significant barrier and that young people should have unrestricted access to family planning methods.
“The method recommended for youth is abstinence, but we cannot stop here. They need all the options. Abstinence is not realistic as the only method of protection for youth,” she says.
As a result, very few sexually active young people use family planning methods. Only 8 percent of women aged 15 to 19 years old use a modern contraceptive. Most youth can name at least one method of contraception, but knowledge levels are particularly low among younger women.
The consequences for Congolese youth, particularly girls and young women, are dire. High levels of teenage and unwanted pregnancy, contribute to unsafe abortions and the phenomenon of “street babies,” where overwhelmed mothers leave their newborns in the street or at someone’s door. According to the National Program for Adolescent Health (PNSA), one in five women giving birth in DRC is adolescent and over 80 percent of adolescent births are unwanted.
In addition, DRC is are dealing with pervasive sexual violence, rooted both in a decades-long conflict and in domestic violence. This in turn affects women and girls disproportionately. Over a quarter of Congolese women ages 20 to 24 years old have been sexually assaulted.
The government is working with social marketing organizations like DKT International to target young people with information and services on sexual health and offer contraceptives at subsidized prices. Posters showing a strong young woman with the Lingala phrase “Batela lobi na yo!” or “Protect your future!” encourage young Congolese to take control of their reproductive health, and in so doing, the healthy development of the country.
In order to do so, young people in DRC need the support of their government, religious and cultural leaders, health workers, families and peers to push for youth-friendly reproductive health care, including contraception.
In 2015, DRC’s parliament received a draft reproductive health law that includes language providing for access to contraception for all Congolese of childbearing age, without an age minimum.
For many Congolese youth, this draft bill may well be lifesaving.