Sexual and reproductive health rights in Togo
In Togolese society, as in Africa, young girls and boys are generally excluded from the debate on sexuality in any form. This is due to parents’ apprehensions about leading their children into deviance. This so-called preservation prevails in a context where even parents are under-informed about sexual and reproductive health issues. At every stage of their lives, women and couples must have access to health services to help them live and understand their sexuality. From adolescence onwards, young people need to be informed about their rights, contraception methods, sexually transmitted diseases and the health services available.
Unfortunately, in the absence of a response technique and quality care for young people on issues relating to their sexuality, the precocity of sexual relations exposes many young people to the risks of unwanted pregnancies, sexually transmitted infections including HIV, and clandestine abortions. In most African countries, particularly Togo and Niger, early sexual relations have been the subject of much ink and discussion, and several partners have measured the impact of this by changing their programmatic approaches and strategies, with the aim of advancing the sexual and reproductive health of young people in their action programs. This change in Togo supports the momentum generated by a number of governments, but which have proved unproductive.
What then are the opportunities and challenges for pursuing and accelerating the changes initiated in favor of young people?
The answers to these questions will lead to a number of recommendations for sustainable improvement in the sexual and reproductive health rights of adolescent girls in Togo and Niger.
Current situation in Togo
In West Africa, and more specifically in Togo, more than half the population is under the age of 25. This young population suffers from a crying lack of access to reliable information and adapted, easily accessible care services. These shortcomings are closely linked to the persistence of taboos, religious beliefs and certain cultural practices that have been outdated for many years. The fight against sexually transmitted infections (including HIV), unsafe abortion, early pregnancy and gender-based violence: risks to which young girls and women are particularly exposed. Adolescents and young girls need proper care. Although countries have ratified international treaties on sexual and reproductive health and rights, their application in Togo poses enormous problems. The governments in charge of policy do not take sufficient ownership of these issues.
Although the law recognizes that the human right to reproductive health is an inviolable, universal, inalienable and imprescriptible human right, and that every individual has the right to the enjoyment of the highest attainable standard of health (see articles 6, 7 and 8), the Togolese authorities tend to shirk their responsibilities. Sexual abuse in Togo is one of the evils undermining the country’s stability. For several years now, the economic and socio-political context has led to the destruction of basic social indicators: a drop in school enrolment, a rise in infant mortality, an increase in insecurity and a rise in the number of child workers. In many cases, adolescents find themselves in the hands of ill-intentioned people and suffer all kinds of psychological and physical sexual violence.
The challenges
The consequences of the COVID19 pandemic are disastrous for young people, whose rights and choices are severely curtailed by lack of access to education, employment and essential services, including sexual and reproductive health services. Girls and young women are particularly vulnerable.
Sexual health and the future of young people: what’s the relationship?
They must be free to choose their partner, to marry or not, and to have children or not. Unfortunately, today, one in three under-age girls marries without her consent, and hundreds of thousands of teenagers become mothers every year. A woman should be able to choose whether to terminate a pregnancy if she doesn’t want to, or to bring it to term in good conditions for her and her baby. But nearly a million women in Togo have no access to effective contraception. As a result, one pregnancy in ten ends in unsafe abortion, resulting in the deaths of 47,000 women every year.
An effective continuum of care must promote the right and equitable access to quality health services, but millions of women are deprived of them because certain governments forbid it, or because they cannot afford it, or simply because health centers are too far away or unsuitable. Universal access to contraception would reduce the number of unwanted pregnancies and unsafe abortions by more than 2/3. If women’s rights were respected, they would be less exposed to the risks of HIV transmission, since their infection rate is twice as high as that of men. Empowered women and adolescents are able to exercise their rights and influence their lives, are more likely to continue their studies, pursue a professional career and participate in public life, but also to invest in the health and education of their own daughters, thus helping to reduce gender inequalities.
Legal and institutional framework:
In Togo, sexual and reproductive health rights indicators continue to give cause for concern. The prevalence of health challenges linked to sexual and reproductive health is a major issue. For young people and adolescent girls in particular, improving access to sexual and reproductive health services is a strategic challenge. In order to reinforce the actions of development actors in Togo in the field of sexual and reproductive health law, and to bring about behavioral change in communities in this area, Togo has had laws and sanctions in place since 2007, to which all offenders are exposed. This is the Togo Children’s Code. This code defines a child as any human being under the age of 18. It severely punishes anyone guilty of incest, pedophilia or sexual abuse of an adolescent. The first thing that catches the eye under the Children’s Code is sexual abuse. According to article 396, sexual abuse of an adolescent or a minor is the act of subjecting the child to sexual contact by any individual in a position of power or trust, or by any person towards whom the child is in a position of weakness or dependence. In Togo, sexual abuse of a child is punishable by one to five years’ imprisonment.
Policies and laws on sexual and reproductive health rights in Niger:
Socio-cultural barriers and the fact that the sexual health of young people is considered a highly taboo subject in Niger make it difficult to discuss and debate sexuality, and therefore create obstacles to its eradication, even though there are laws condemning this state of affairs. That said, the existence of laws and treaties in favor of girls and women does not mean that they are enforced. But even if there are shortcomings, the legislative and political landscape is full of important elements on which to build in order to influence the consideration of young people’s sexual and reproductive health. However, the level of knowledge of the laws and legislative framework by the bodies required to enforce them, or even by the populations expected to respect them, remains very low. One example of this low level of applicability and legislative incoherence in Niger is that victims of sexual abuse are required to pay a relatively large sum of money before they can obtain a medical certificate, which is the key to initiating the complaint process.
Recommendations
At a time when communities are seeking to better rebuild themselves, we owe it to ourselves to ensure that young people have priority access to the education and services they need to realize their full potential. It is essential that all generations work together, hand in hand. Together, the challenges will be met to truly help young people build a more inclusive and sustainable future for all. And for this, comprehensive sexuality education is a sure-fire weapon. Indeed, sexuality education will enable us to teach sexuality without discrimination or taboos, according to age, without value judgments and on a scientific basis.
It’s a very important subject, both in and out of school: all young people really need it. In fact, it responds to concerns linked to the health of adolescents and young people, the fight against gender-based violence and the prevention of unwanted pregnancies.
The Togolese and Nigerian governments should take these issues into account in their school curricula, and recognize the community dimension as extremely important. More broadly speaking, it is important to pool efforts on all fronts and over the long term, in particular to move away from the project approach and put stakeholders at the heart of the change processes we are aiming for.
The first thing to do would be to give young people a voice, so that they can better express their views on the challenges they face on a daily basis, and thus participate in shaping the measures that concern them. Most of the expected results will be achieved or even surpassed.
Young people themselves, religious leaders, parents and local authorities will feel that they have become more aware of the importance of certain values, such as mutual respect between men and women.
Accentuate the “cascading” training schemes relating to the Gender Violence in Schools module, while at the same time facilitating the training of education inspectors, so as to enable the proper integration of other players who were not necessarily present at the start of the process. This will enable the concept of non-violence to be extended to both teaching and non-teaching staff.
Support the adaptation of existing health centers to the needs of young adolescents, i.e. by taking into account dedicated staff, adapted hours and reserved space.
Work with young people to ensure that the laws in force concerning their sexual and reproductive health are applied in the field and effectively meet their needs.
