Sexual and Reproductive Health Care for Women & Girls: September 28 in the DRC

On October 1, 2015, Pathfinder together with the National Program of Youth and Adolescents (PNSA) organized an event in Kinshasa, DRC to celebrate September 28, the Global Day of Action for Access to Safe and Legal Abortion. The event centered on the issue of unwanted pregnancy, and aimed to generate fresh ideas to create suitable policy, community and service delivery environments for better access to sexual and reproductive health and rights for young girls and women.

There were more than 70 attendees at the event, including members of the Congolese Government, civil society, Pathfinder’s partner advocacy and community organizations, university and college representatives, plus media from TV and radio covered the event.

Worldwide, 46 million pregnancies each year end in abortion; 36 million of these occur in developing countries. In the DRC—a country whose penal code criminalizes abortion in all its forms—unsafe abortion is common.

At the October 1st event, reports from two studies were presented: one conducted by PNSA and Pathfinder; the other by Medecins du Monde. Both focused on the issue of sexual and reproductive health for young people.

Beatrice Mbayo presented on Pathfinder’s work to address youth’s sexual and reproductive health and rights, including sexual- and gender-based violence, unsafe abortion, and safe abortion advocacy.

“We are working to get a sense of the health priorities of young women ages 15-24,” said Mbayo. “Things like where do they go for health services, perceptions about various health providers’ negative attitudes and the quality of care youth might receive, and then gaps in youth-friendly services.”

Together with PNSA, Pathfinder’s team conducted a survey among more than 500 young women to address these questions. Of those who were sexually active, nearly one in three (30.2%) had already had at least one abortion. In 25.9% of cases, respondents were in favor of abortion when sex was forced.

These results were used to craft a program that will build the capacity of health providers to deliver clinical gender-based violence services that include youth-friendly post-abortion care and harm reduction strategies.

“This survey allowed us to see the true needs of youth in Kinshasa,” Mbayo explained, “so our programming could be well informed by what these young women really need.”

Mbadu Muanda, Director of PNSA, joined Mbayo in presenting the results of the study at the event.

AN ISSUE CLOSE TO HOME

Due to decades of war and poverty, sexual- and gender-based violence is a poignant reality in the DRC, driving women, adolescents, and children to increased vulnerability, poverty, morbidity, and mortality. It also increases unintended pregnancies.

Often, violence starts during girlhood and spans a woman’s life. A 2013 report claims that 71% of women in the DRC have experienced some form of intimate partner violence.

In addition, sexual violence, including forced sex within marriage, is common: 64 percent of adolescent girls aged 15-19 reported a non-consensual sexual initiation (DR Congo DHS 2007 and MICS 2010), and 33 percent of married adolescents and young women aged 15-24 reported sexual violence from their husband (Democratic Republic of Congo: Summary of Data on Girls, DFID 2013).

The reality of the situation is shown in the DRC’s poor progress towards achieving Millennium Development Goals 3 and 5.

STANDING FOR WOMEN’S RIGHTS

Gaëlle Fonteyne of Medecins du Monde presented a picture of the situation for youth and adolescents now. She used data from two studies around unwanted pregnancy conducted in Kinshasa by PNSA on negative norms that create barriers for youth trying to access services.

Professor Nguma Monganza, a gynecologist and researcher at Les Cliniques Universitaires de Kinshasa, presented clinical experience of the management of unwanted pregnancies in DRC hospitals, focusing especially on youth and adolescents. Monganza—well-known in the DRC for his work promoting access to family planning and post abortion care—believes the clinical care offered to this group contributes significantly to the overall mortality of pregnant adolescents.

And finally Ebeka Pelagie, a lawyer and staunch defender of women’s human rights, reviewed the legal status of abortion in the DRC. She introduced opportunities for advocacy around women’s and girls’ rights to comprehensive sexual and reproductive health services including abortion, recommending beginning with special circumstances such as rape or incest (citing Article 14 of the Maputo Protocol, which was signed and ratified by the DRC government).

“Particular attention must be paid to the health of adolescents, as they are the future leaders of tomorrow,” Pelagie insisted.

Participants then took part in a reflective debate on abortion in the DRC context.

At the close of the event, participants agreed that more work is needed to understand the problems young people face; but all could agree that young people deserve information to allow them the freedom of choice regarding their sexual and reproductive health.

Participants also agreed to do their part in developing an enabling environment where family members and communities are involved and committed to developing communication strategies so they can pass on accurate information to young people regarding safe sex behaviors.