Thursday, April 25, 2024

Botswana records over 800 cases of teenage pregnancy per annum

Statistics have revealed an alarming trend, showing how hundreds of underage girls in Botswana fell pregnant every year for the past nine years. The numbers indicate that 7,512 teenage pregnancies were recorded over the period between 2013 and 2023, indicating an average of 835 cases per year. Data for 2014 was, however, excluded as it had “gaps”. The figures underscored a significant and persistent challenge facing young girls in Botswana.

The revelations were made by the Ministry of Health this past week following a parliamentary question by David Tshere, Member of Parliament for Mahalapye West. Tshere raised concerns about the rising number of early and unintended pregnancies among girls under the age of eighteen (18) in Botswana. The Minister of Health, Edwin Dikoloti, provided detailed responses, shedding light on the severity of the issue and outlining interventions to address it.

Tshere also raised concerns about the circumstances surrounding terminations of pregnancy, with particular attention to cases involving girls aged 12-18. The Minister clarified that terminations for medical reasons, including instances of incest, rape, and defilement, were performed under controlled conditions by medical professionals. However, the distinction between medical terminations and unsafe abortions remained a point of contention.

“We do not separate terminations of pregnancy on whether they were terminated for medical reasons, terminated for any other reasons or just spontaneous. I have, however, gotten some information from Nyangabgwe and Princess Marina Hospitals. There were a total of 150 terminations of pregnancy that were performed for medical reasons among ages 12-18 years from 2013 -2023 in these two hospitals. Most of the reasons for termination were incest, rape, and defilement.”

To combat the underlying causes of teenage pregnancies, the Minister of Health outlined a multifaceted approach. “Health education and promotion efforts aim to empower young people with knowledge about reproductive health and encourage abstinence. Dialogue sessions and youth-friendly centers provide platforms for discussing issues of teenage pregnancy, HIV prevention, and gender-based violence (GBV).”

Furthermore, he said the government is committed to providing accessible contraceptive services to prevent early and unintended pregnancies. Dikoloti said integrated sexual and reproductive health services offer a range of contraceptive methods, with a focus on long-term solutions such as implants and intrauterine devices (IUDs).

“Collaborative activities with development partners and ongoing research efforts aim to strengthen service delivery and address gaps in care. Advocacy for policy changes, including a review of the penal code to destigmatize medical terminations of pregnancy, is also underway.”

He said in Botswana, termination of pregnancy is legally permitted up to 16 weeks, including cases of incest, rape, defilement, and when the woman’s health is at risk. However, he said, abortions must be performed by registered medical practitioners within approved healthcare facilities. The Minister had started his response by offering a definition of the term miscarriage: It is the medical term for a pregnancy loss of a fetus or embryo weighing less than 500g. This happens before 20 weeks of gestational age. Any other pregnancy loss above 500g body and/or above 20 weeks of gestation is a birth. The medical word for miscarriage is abortion. Miscarriage may be Spontaneous or Induced. Spontaneous miscarriage is caused by one or a combination of the various causes which I will describe shortly. Induced miscarriage is the intentional medical or surgical termination of pregnancy for any reason. Genetic anomalies within the embryo such as chromosomal abnormalities are the most common causes of spontaneous abortion and account for 50-65% of all miscarriages globally. 

Other causes include infection, hormonal imbalances, implantation anomalies, age, uterine anomalies, incompetent cervix, lifestyle factors such as smoking, drinking alcohol or using recreational drugs, disorders of the immune system (eg lupus), kidney disease, congenital heart disease, diabetes, thyroid disease, exposure to ionizing radiation, exposure to some teratogenic medicines, and severe malnutrition.

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