Zambia Takes the Lead on Preventing Early Marriage and Teenage Pregnancy
In Zambia, more than 16,000 schoolgirls are estimated to become pregnant every year, and a third of young women will give birth by the time they are 18 years old. Most will not complete their education. It is a crisis for a country where more than half of the population lives below the poverty line.
Interestingly, the problem isn’t policy. Zambia has as many as 17 policies and legal frameworks to improve the health of young people and decrease teenage pregnancy. These include an adolescent health strategy and a youth communication strategy. The “Integrated Family Planning Scale-Up Plan 2013-2020” also includes ambitious goals around reducing teenage pregnancy. The real challenge lies in lack of support to enact the strategies, confusion and miscommunication about the policies, and insufficient coordination among ministries.
Last month, the World Bank and the government of Zambia launched a new initiative to reduce child marriage and teenage pregnancy. I chatted with Amos Mwale, executive director of the Centre for Reproductive Health and Education (CRHE) in Zambia to discuss the significance of the new initiative and what happens next.
Tell us about the World Bank’s announcement. What is it about and why does it matter?
The government of Zambia asked the World Bank to conduct a desk review on adolescent pregnancy. The study documented trends in adolescent pregnancy and highlighted international best practices for interventions. This was important because, right now for girls, 47 percent of school dropouts are due to teenage pregnancy or early marriage. The World Bank initiative helped to generate high-level policy dialogue about how to address the teenage pregnancy rates we are seeing.
CRHE has been working on teenage pregnancy and adolescent sexual and reproductive health for some time. What have you been doing and what’s new about the World Bank initiative?
CRHE has been working very closely with the Ministry of Community Development, Mother and Child Health (MCDMCH) and the Vice President’s office, with support from the Opportunity Fund. One of our challenges is lack of agreement among the ministries about how best to address teenage pregnancy and youth sexual and reproductive health. Because of that, our objective was to get the Vice President to declare teenage pregnancy a national crisis and to create an inter-ministerial working group that would coordinate the activities of the ministries and create a clear and common work plan. As second-in-command, a declaration from the Vice President would demonstrate the highest level of political will. This is especially important given how many young girls we are losing from the school system due to teenage pregnancy. We want the common work plan to include expanded access to contraceptive information and services for in and out-of-school adolescents.
The World Bank initiative helped to reinforce our message. For example, this year, CRHE, Planned Parenthood Association of Zambia, UNFPA and UNESCO conducted a study on teenage pregnancy in schools in three districts in Zambia to help build the case for action. The study was commissioned by MCDMCH and the Ministry of Education who wanted to understand the extent of the challenge we are facing. The World Bank desk review echoes and validates our findings. The difference between our study and theirs is the World Bank also brought in international evidence on best practices. They also highlighted that the demographic dividend—the economic growth that can result from changes to a country’s age structure—will not happen if we do not address teenage pregnancy.
So what happens next?
The ministers of gender, MCDMCH, youth and education agreed to raise the issue of teenage pregnancy with cabinet and to develop a common agenda about what needs to be done. They will need to come up with an agreement about how things can be done since the different ministries all have their own policies. The World Bank has pledged to provide the resources and technical assistance to implement the policies that come out of this agreement.
Is there a role for civil society?
Absolutely. Ministries don’t implement — CSOs implement. So we need the outcome of the cabinet discussions to demonstrate the ministries’ political will. If they can coordinate and agree upon shared language for what needs to be done and how services should be provided, CSOs will handle the rest.