Generation Next: Nigeria is failing young people’s need for sexual health services
Editor’s Note: This week’s Thought Leadership blog comes from Precious Ereka, a Youth Service Corps Member serving at Nigeria Health Watch. She writes about the prevalence of sexually transmitted diseases in young Nigerians and the importance of sexual health education for not only young people, but also for the health workers who are meant to provide services to this important population.
It was a sunny afternoon when Mary stormed into my room soaked in tears. The sight of my friend in this situation made me scared and worried as to what might be the cause of this outburst. When I was finally able to calm her down and get the reason why she was crying, she informed me that she was experience vaginal discharge that had a foul odor, painful urination and pain in her upper right abdomen, which after diagnosis from the school clinic it was discovered that she had Pelvic Inflammatory Disease (PID). Generally the symptoms of PID include pain in the pelvis, abdomen, lower back or vagina, chills, fatigue or fever, vaginal discharge, nausea or vomiting, to name a few. We later found out that she was ill because she had come down with a common Sexually Transmitted Infection (STI), Chlamydia, which was not properly treated.
Sexual Transmitted Diseases (STDs) are a silent set of diseases that are spread through sexual contact. They can have serious repercussions because some of them take a long time before symptoms begin to show, often times only diagnosed as a result of the damage they cause. STDs can affect every sexually active adult, however the Centre for Disease Control and Prevention estimates that young people aged 15–24 years bear almost half of the burden of all new STDs. More concerning, the Centre further suggests that one in four sexually active adolescent girls have an STD. This shows that compared with adults, sexually active adolescent aged 15–19 years and young adults aged 20–24 are at higher risk of acquiring STDs, due to a combination of behavioral, biological and cultural reasons.
In Nigeria, The high prevalence of STDs among adolescents could be as a result of the many barriers to accessing quality STD prevention services, especially in tertiary hospitals. Lack of doctor-patient confidentiality from the institutions clinics is one of the major factors preventing students from discussing their sexual lives with healthcare workers, and this makes it difficult for them to request contraceptive services. Many facilities also make it compulsory for young people to get permission from their parents before they are allowed to access sexual health and reproductive services and this creates another barrier.
Cultural sensitivities also play a role, as sexual discussions amongst adolescents are often viewed as taboo conversations and the young people who engage in them seen as wayward for asking sexual health related questions. We live in a culture that still largely denies the thought of young people having sex, even though the evidence is clear that they are, and at younger ages than ever.
The most common sexually transmitted infections in Nigeria according to the Bridge Clinic are Chlamydia, Gonorrhea and Syphilis. If not detected and treated early, these diseases go on to have serious consequences for both men and women, affecting their social, mental and sometimes reproductive lives. In women particularly, some STDs if untreated can lead to pelvic inflammatory disease (PID), which affects almost every reproductive organ, posing dangers to a woman’s ability to conceive.
In our Nigerian cultural context, infertility is considered a serious problem, often causing incredible stress between couples and in extended families. Not many people are aware that infertility is one of the biggest consequences of sexually transmitted infections and protecting yourself from STDs is one sure way of preventing infertility.
Sexually transmitted diseases like many other diseases can be prevented, and they require much less effort and resources to prevent than to cure. Information abounds on the prevention of STDs, ranging from use of condoms correctly and consistently by sexually active individuals, regular annual physical checkups, to vaccination, especially against Hepatitis B and Human Papilo Virus (HPV) which causes cervical cancer in women.
But sexuality itself remains a difficult topic to broach in public arenas in most African countries, including Nigeria, especially between older and younger generations. This has led to unmet need of information, education, and services for sexual and reproductive health for adolescents, youths and adults. With the alarming incidence of STDs, including HIV/AIDS, which is more prevalent in the 15–24 year age group, it is of critical importance that young people have a voice in tackling issues that affect them.
Mary was lucky to have called for help early, received treatment and prevented complications of PID. Many young Nigerians are not as lucky. We must begin to create open dialogues where health workers are trained on how to provide youth-friendly reproductive health services. We must teach young people to understand their bodies and give them the opportunity to access care when they need it without fear of being criticized and an assurance of confidentially. We must put an emphasis on sexual and reproductive health education for communities, especially those where cultural concerns come into play. Nigeria’s young people are worth investing in today, if the country is to have a healthy future.