People at the Centre (PeaCe) health program in Zambia makes strides in reducing adolescent pregnancy rates in Eastern and Southern provinces – Clinton Health Access Initiative

Addressing Adolescent Pregnancies in Zambia: A Report on the People at the Centre (PeaCe) Health Program

Kazungula district adolescent health focal point person providing health information to adolescents at Kazungula district hospital

Problem

Sub-Saharan Africa has one of the highest burdens of adolescent pregnancies in the world, with the rate twice the global average at 98 births per 1,000 girls[1][2]. As of 2020, Zambia ranked twelfth in Africa at 115 births per 1,000 girls[3]. Nearly 30 percent of Zambian adolescent girls get pregnant by the age of 18,[4] with the Eastern and Southern Provinces being some of the most affected. Limited access to family planning and information services, supported by social-cultural and structural drivers, are key drivers to the scourge of adolescent pregnancies. In addition, poverty also drives some girls to offer sexual favors in exchange for money, goods, and other services, contributing to teenage pregnancy. Even though there are family planning options available, most adolescents are unaware of these services.

Solution

The Government of Sweden, through the People at the Centre (PeaCe) health program in Eastern and Southern Provinces of Zambia, with technical support from the Clinton Health Access Initiative (CHAI), has been supporting the Ministry of Health (MoH), Zambia, to address this issue. A key strategy of the program to reduce adolescent pregnancies has been increasing access to quality adolescent health (ADH) information and behavior change communication using outreach and facility-based engagement models. The MOH, with CHAI support, has trained healthcare workers (HCWs) and peer educators (PEs) in providing people-centered adolescent, including sexual and reproductive health (SRH) and information services, at community and facility levels.

Results

Since the program started in 2021, the program has trained 420 HCWs and 1,163 PEs across the two provinces in adolescent health programming. At present, every facility in the provinces has at least one healthcare worker trained in ADH, from 38 percent in March 2021 to 66 percent by the end of June 2023. Facilities with at least two peer educators trained in ADH have increased from 0 to 37 percent during the same period. The number of adolescents who have been reached by the HCWs and PEs since the program started has increased by over 34,600 in 2022 against an estimated adolescent population of 80,471. With continuous training and outreach efforts, the program aims to reach more adolescents to help reduce the rate of teenage pregnancies in the Eastern and Southern Provinces.

SDGs, Targets, and Indicators

1. SDG 3: Good Health and Well-being

   • Target 3.7: By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information, and education, and the integration of reproductive health into national strategies and programs.
   • Indicator 3.7.1: Proportion of women of reproductive age (aged 15-49 years) who have their need for family planning satisfied with modern methods.

2. SDG 5: Gender Equality

   • Target 5.6: Ensure universal access to sexual and reproductive health and reproductive rights as agreed in accordance with the Programme of Action of the International Conference on Population and Development and the Beijing Platform for Action and the outcome documents of their review conferences.
   • Indicator 5.6.1: Proportion of women aged 15-49 years who make their own informed decisions regarding sexual relations, contraceptive use, and reproductive health care.

3. SDG 10: Reduced Inequalities

   • Target 10.2: By 2030, empower and promote the social, economic, and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion or economic or other status.
   • Indicator 10.2.1: Proportion of people living below 50 percent of median income, by age, sex, and persons with disabilities.

Table: SDGs, Targets, and Indicators

Analysis

1. Which SDGs are addressed or connected to the issues highlighted in the article?

The issues highlighted in the article are connected to SDG 3: Good Health and Well-being, SDG 5: Gender Equality, and SDG 10: Reduced Inequalities.

2. What specific targets under those SDGs can be identified based on the article’s content?

• Under SDG 3, the specific target is Target 3.7: By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information, and education, and the integration of reproductive health into national strategies and programs.
• Under SDG 5, the specific target is Target 5.6: Ensure universal access to sexual and reproductive health and reproductive rights as agreed in accordance with the Programme of Action of the International Conference on Population and Development and the Beijing Platform for Action and the outcome documents of their review conferences.
• Under SDG 10, the specific target is Target 10.2: By 2030, empower and promote the social, economic, and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion or economic or other status.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

• For Target 3.7 under SDG 3, the article mentions the indicator 3.7.1: Proportion of women of reproductive age (aged 15-49 years) who have their need for family planning satisfied with modern methods.
• For Target 5.6 under SDG 5, the article mentions the indicator 5.6.1: Proportion of women aged 15-49 years who make their own informed decisions regarding sexual relations, contraceptive use, and reproductive health care.
• No specific indicator is mentioned in the article for Target 10.2 under SDG 10.

These indicators can be used to measure progress towards the identified targets by collecting data on the proportion of women who have access to family planning services, their informed decision-making regarding sexual and reproductive health, and the social, economic, and political inclusion of all individuals.

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Source: clintonhealthaccess.org

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