Two Can Play: A Tale of Government and Young People (ii)

‘Sola Fagorusi

Several myths have been around in Nigeria for years. Given that young people are closer to their peers; these myths are the first kind of information about SRH young people get to hear. The myths and misperceptions about contraception combined with inaccessibility to supplies harshly abate prevention habits among young people.

Young people are precocious and the feeling of invincibility; the it-can’t-happen-to-me belief makes them easy targets for STIs, which a modern contraceptive like condom can protect against. The image of sex in the media is that of something spontaneous and pleasurable.

The myth is that in real life, sex is also the same and thus should not be something that should be planned for. The everyone-is-doing-it belief also portends great danger for young people. Young people like to regale themselves with embellished stories of how ‘skin-to-skin’ is the best sexual experience and that condoms prevent the real taste of sex. The truth holds that the anxiety that comes with knowing whether one has contracted a disease or HIV is not worth it. Or in some instances, the fear of the girl getting pregnant should do damage to this myth. It’s amazing, the myth continues to spread.

A young girl in the rural community who barely has the economic capacity to feed herself getting pregnant stands risk of death during childbirth and a lifetime in poverty given the cost involved in raising a child. It’s a classic case of a child giving birth to a child! There are still variants of myths ranging from – ‘you can’t get pregnant after the first sexual intercourse, ‘to saying that a girl cannot get pregnant during her period.

There are also the hilarious ones, like saying a girl cannot get pregnant if she has sex in an upright position and that a girl who has not lost her hymen cannot get pregnant. The last one is often contentious. Some young people in the process of foreplay release sperm into the female vagina even without penetration and this can cause infection or pregnancy.

The efficacy of condoms lies in the correct and consistent use. Gold Circle condoms sold by Society for Family Health, SFH have been available since 1986, and considered the most popular due to their widespread availability and affordability. According to SFH, most young people believe that Gold Circle condoms are manufactured in Nigeria, and that as such they must be of inferior quality.

This ‘locally-made’ perception contributes to the belief that Gold Circle is the “condom for Nigerians”. Contributing to this locally-manufactured perception is that Gold Circle is inexpensive, found everywhere, is the only condom with a government approved registration number on the box, has benefitted from social marketing media advertising, and is associated with the government. The packaging for the product is sometimes thought of as ‘old-fashioned’ and ‘uninteresting’, furthering the belief that it is made in Nigeria.

The truth, according to the NGO, is that it is made in Malaysia, of very high quality, meeting all international standards, and SFH packs the sealed condoms in locally made boxes, with a locally produced instructions insert, at its warehouse in Lagos.

The belief that sex without contraception is a show of love and fidelity by young people is also misplaced. Girls are known to use traditional methods of contraception, which are at best harmful. These range from inserting of tissue paper and herbs into the vagina or even douching with disinfectants like Dettol to wash out semen and ‘clean up’.

Government is the big brother in Nigeria. The agents of socialization with massive reach are under her control. The media, religious institutions and schools are broadly regulated by the government. The resources for planning, awareness, legislations and collaborations are in the hands of the government. Financial resource is a core support government can give to the cause. According to SFH, the current prevalence rate for contraceptive use in Nigeria is approximately 11%–13%. This rate is very low in spite of the high rate of sexual activity and widespread awareness of the various contraceptive methods among Nigerian adolescence and youths.

Young people are relaxed in an environment dominated by young people. Given the energy and dominant interests of young people, it is easily predictable where to find a huge population and ones who are likely to have sex or are already sexually active. Having condoms readily available at these places at no cost is a debt the government owes the demography Israeli Prime Minister, Benyamin Netanyahu once described as ‘the trustees of posterities.’ Contraceptives, like the male and female condom and emergency pills, should be made available at these places all over the country. Clubs, hostels on campuses, common rooms, hotel rooms, eateries and conveniences/loos are some of the places where young people can readily have access to contraceptives.

The arguments are in two fold – arm young people with information and the tools or lose them to death occasioned by STIs or maternal mortality in a bid to abort unwanted pregnancies. The former seems the better option. The social media is also a tool for awareness that the government can deploy for information purposes. I have seen friends hook up with girls they met on Facebook, Badoo, Whatsapp and 2go. It’s only logical to use the same route for awareness purposes. Gone is the era of large billboards on busy roads. My finding is that people barely read them; that’s assuming they even see them. There’s also that possibility of building mobile apps that can help young people map and identify the nearest youth-friendly centre to them.

It is through massive Behaviour Change Communication (BCC) that the government can enlighten the growing population of young people to understand that it is not the cheapness of a condom that matters but how it is used. Yunus narrates his experience to me: “You don’t unpack a condom like Gold Circle in front of a girl. The last time I did, the girl complained, asking if I thought she was the cheap type. She would rather I do not use a condom at all than use an ‘inferior type.’”

Government, through its Ministry of Health, would also need to support the effort of manufacturers and encourage producers to put scent, texture, lubrication, and resilience into consideration when manufacturing condoms. This is one sure way to attract young people to use the contraceptives. Size, shape and attractiveness of the package itself are of importance in this make-up.

The provision of emergency contraception by government comes in highly recommended given susceptibility of girls to sexual violence. In cases of rape, emergency contraceptives are sure means of reducing the emotional and psychological trauma that can come with pregnancy, in additional to the emotional scar of the act itself.

Government’s approach of using adults as gatekeepers of intervention in encouraging the use of contraceptive should be changed. I propose a youth-to-youth initiative, where young people acting as peer educators are the information giver under the watch of other well-trained young people and adults. It encourages young people to ask more questions and find clarity. I once watched a condom demonstration that was so humourous that I instantly felt like using one! Such mp4 videos can be made available and circulated amongst young persons. Edutainment is one of the most effective methods of learning in today’s world.

Agreed; the only 100 percent effective way to avoid having a baby is to not have sexual intercourse. Abstinence is the most effective method of keeping STIs, HIV/AIDS inclusive, at bay. There are young people in Nigeria who stick with this option either due to moral or religious values. But then, how about the several thousands who do not? They also deserve a chance to live a healthy live and dream big. The consequences of STIs and HIV /AIDS can be far-reaching for young people. The illness, stigmatisation and sudden death it can cause are concerns. Young people are establishing patterns of sexual behaviour that may last a lifetime. There is the possibility that a young person who initiates sex without the use of a condom may continue like that in succeeding sexual encounters.

Young people are a significant population to address when considering education and services for better sexual and reproductive health options for the future. Nigeria has a relatively young population and it is estimated that over 60% of the population is under 30years. It is also estimated that approximately 1.8 million young people in Nigeria between the ages of 10-24 are infected with HIV/AIDS.

Research by the African Journal on Reproductive Health shows that the relationship between contraceptive prevalence rates and maternal mortality is evident in the fact that countries with low contraceptive prevalence rates also have very high mortality ratios. Nigeria has one of the highest maternal mortality ratios in Sub-Saharan Africa, and ranks as the country with the second highest number of maternal deaths in the world according to the World Health Organisation. The availability of contraceptives provides benefit for young people in rural areas, where cases of maternal mortality are rampant are huge.

New trends in sexual encounters with the growing Lesbians, Gays, Bisexual and Transgender, LGBT community in Nigeria makes it compulsive for young people to seek adequate protection. There is a growing population of bisexuals, which makes it necessary that young girls and men uphold the use of contraception during sexual encounters to prevent infections and teenage/unwanted pregnancies.

As I conclude, I recall an invitation to speak at a friend’s 30th birthday anniversary later this month. He’s not the regular type of young person in thinking and perception. He is lucky to be alive, even though I believe it’s more of his outlook to life than luck. He plans to celebrate his birthday with a group of about 30 young people in a workshop format and he would have me talk about a spectrum of issues ranging from reproductive health choices for adolescents and career choices especially since most of the planned audience are on the threshold of furthering their education in tertiary institutions. He battles a cancer variant and every morning for him is a gift.

He has requested that I, in addition to talking, do a condom demonstration to ensure that these young people know exactly how to use the condom and also understand why they should use it. Our effort is lean but then a life saved makes it fat. Government’s intervention in ensuring contraceptives is readily accessible where there’s a motley crowd of young people would be a plus in addressing sexual and reproductive health in Nigeria, nay Africa.

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