Date: Jan 21, 2019 Source: The Daily Star Saving adolescents from having unplanned children Patricee Douglas My country is overwhelmed with teen pregnancies. In 2013, the United Nations Population Fund estimated that Guyana had the second-highest rate of adolescent pregnancy in South America and the Caribbean, with 97 of every 1,000 girls between the ages of 15 and 19 giving birth. Five years later, little has changed. Today, some 42 percent of Guyanese young people are sexually active, 29 percent do not use condoms during sex, only 15 percent say they are familiar with birth control methods and 56 percent of sexually active young people have contracted a sexually transmitted infection. Furthermore, 12 percent of Guyanese girls have sex before their 15th birthday, and 62 percent say that they have an unmet need for contraception. When adolescents cannot obtain condoms and other forms of birth control, the rate of unplanned pregnancies increases, health outcomes suffer and young people are unable to reach their full potential. To avoid these trends, and to reverse them where they exist, countries must strengthen their health care systems and ensure that every teenager has access to sexual and reproductive health services. One of the biggest obstacles to reducing the rate of unplanned pregnancies is the lack of sex education in schools. In Guyana, the government’s Health and Family Life Education program was meant to address this shortcoming. But only a handful of secondary schools offer the curriculum, and those that do typically avoid topics that would contradict the of Education Ministry’s abstinence-only policy. As a result, most teachers fail to educate students properly about safe sex. Another challenge in Guyana is the services gap between coastal regions and the country’s interior. The country’s hinterlands suffer from a lack of health facilities, which further limits adolescents’ access to information about safe sex, contraception and neonatal care. Not surprisingly, rates of teenage pregnancies and maternal mortality are highest in the interior. The shortage of rural clinics partly reflects a dearth of qualified health care workers. To maintain basic care for a country’s population, the World Health Organization recommends a minimum of 22.8 skilled health professionals for every 10,000 people; universal coverage requires at least 34.5 workers per 10,000 people. In Guyana, however, there are only 11.4 health workers per 10,000 people, a staffing shortfall that affects every aspect of the health care system. Finally, Guyana is a socially conservative country, and biases about young people’s sexual activity pervade health care and domestic life. Some nurses prefer not to provide girls with contraceptives, while many parents believe that talking about sex will only encourage sexual behavior. This, together with the lack of sex education in schools, leaves Guyanese teens with few places to turn for advice before becoming sexually active, or to find help when they become pregnant. These obstacles can be surmounted, and Guyana can lower its rate of teen pregnancy. But it will require significant changes in how Guyanese think about and address the issue of adolescent sexual activity. For starters, Guyana must implement comprehensive sex education and work to ensure that teachers have been trained to provide unbiased data and information. Adolescents must be made aware of what services are available and parents and community members must be encouraged to support the provision and expansion of these programs. Moreover, communities need to increase access to contraceptives and other sexual health services; one way to do this would be to revive or establish youth-friendly spaces and centers where information can be shared. These spaces should be open after school and on weekends, staffed by knowledgeable, sympathetic adults. Special attention must be devoted to rural regions and people with special needs, an often-overlooked segment of the youth population. These reforms are essential to improve the life prospects of Guyana’s young people. If more teenagers had access to sex education and contraception, fewer girls would have their lives interrupted by pregnancy. Only by empowering women and girls with the resources to control their reproduction will the grim statistics that have long burdened Guyana - and many other countries - begin to change for the better. Patricee Douglas is a medical doctor, a recipient of the 120 Under 40 award for leadership in family planning, and a member of Women Across Differences, a Guyanese non-profit organization that works to empower women and girls. THE DAILY STAR publishes this commentary in collaboration with Project Syndicate © (www.project-syndicate.org). A version of this article appeared in the print edition of The Daily Star on January 21, 2019, on page 6.