Abuse of emergency contraceptive pills: Power to Choose project leads advocacy in Sagnarigu

Abdul-Salam Salamatu (not her real name) is a 16-year-old adolescent girl at Garizegu Roman Catholic Junior High School in the Sagnarigu Municipality of the Northern Region. At the age of 13 when she first experienced her monthly flow, she was told any form of unprotected sex could result in an unintended pregnancy or sexually transmitted infections, which could hinder her dream of becoming the first female neurosurgeon in her community. Even though, there was no available sensitisation platforms to educate her on how to protect herself against such occurrence, her curiosity and resolve to finding a remedy for her fears and worries, got a better side of her when she was introduced to a project in her school, which sought to empower Adolescent Girls and Young Women (AGYW) on their Sexual and Reproductive Health and Rights (SRHR). In 2022, she expressed interest in the project, which ushered her into a limitless world of exposure and knowledge acquisition on the various misconceptions of SRHR and the need to speak up on her rights as an adolescent girl. She told the Ghana News Agency in Tamale that what immediately caught her attention during her engagements in the project was the advocacy on the abuse of emergency contraceptive pills adding it was a common phenomenon among some of her peers in the neighborhood. As part of the empowerment processes under the project, she was equipped with the needed information on SRHR, and began sharing her newly found knowledge, first with her two kid sisters at home including some of her peers, who were hitherto involved in the abuse of the pills. She said in mid 2023, she volunteered to educate some of her community friends, who were not beneficiaries of the project on family issues to enhance their knowledge on SRHR. She said even though she was initially tagged as a 'naughty girl', it had been impactful, triggering other young girls in the vicinity to ask probing questions on SRHR. Another adolescent girl, Alhassan Pumaya (not also her real name), a 20-year-old student at the Tamale Technical Institute (TTI) also recounted how she was lured into abusing family planning methods including the emergency contraceptive pills until it began affecting her health and academic performance in school. She said at one point she began experiencing irregular and painful flow of her menses because of the regular use of the pills. Prior to the introduction of the project in her school, Pumaya narrated that she could not have mustered the courage to go to a health facility to seek SRHR information for fear of intimidation. 'But now, I can confidently say that I have been equipped with the necessary information to seek answers on SRHR without being timid', she noted. The project's advocacy, awareness creation on SRHR, especially on the abuse of the emergency contraceptive pills is not only limited to the above scenarios but a total of 1,026 other AGYW in three communities and six schools in the Municipality are also receiving various forms of empowerment to be confident and vocal in defe nding themselves and others against any form of Sexual and Gender-Based Violence (SGBV). The Power to Choose (P2C) Project In the Sagnarigu Municipality, there have been widespread cases of SRHR with deep seated traditional and social norms in the use of contraceptive pills, child marriages, teenage pregnancies among others. Statistics from the Ghana Demographic Health Survey Report in 2022 showed that family planning among sexually active unmarried women stood at 63 per cent with 46% using modern methods and 17% using traditional methods. Those, who use emergency contraceptive pills, stood at 12%, implants stood at 10% and injectables 10% were the most used modern family planning methods among sexually active unmarried women in the country. The report suggested that many adolescent girls and young women were involved in the use of various family planning methods to protect themselves against teenage and unplanned pregnancies, sexually transmitted infections, among others. It is in this light that it be comes imperative for all stakeholders to demonstrate enough interest in SRHR issues to help minimise its abuse and offer AGYW the voice to express themselves on SRHR issues. Why the P2C Project? It is against this backdrop that the P2C Project, which began in 2021 and will end in 2028, is being implemented by Norsaac, a local implementing partner of the Oxfam in Ghana's project on SRHR. It is a seven-year Global Affairs Canada funded project being implemented in seven countries across Africa, Latin America, and the Middle East. In Ghana, the project is being implemented in seven Metropolitan, Municipal and District Assemblies (MMDAs) and in five administrative regions. In the Northern Region, for instance, Savelugu and Sagnarigu Municipalities are the beneficiaries of the project. The project's overall objective is to increase access to reproductive health information and services for AGYW between 10-24 years by 2028. The P2C Project so far in Sagnarigu Municipality So far, the project has benefited some 1,026 AGYW through capacity building and mentorship to enhance their advocacy skills to demand the necessary interventions that best guaranteed their SRHR. Some of the beneficiary communities and schools in the Sagnarigu Municipality include Sanga, Garizegu, Shigu, Northern Business Senior High School, Tamale Senior High School, Tamale Technical Institute, Garizegu Junior High School, Kasalgu Junior High School, and Nangbagu Yapala Junior High School. The project has also trained some 24 mentors and 22 patrons in the Sagnarigu and Savelugu Municipalities to ensure that AGYW in the communities and schools are properly guided to achieve the intended purpose of the project. Testimonies from patrons and mentors Patrons and mentors at a recent training workshop to enhance their engagement skills with the beneficiary schools and communities, shared their observations and expectations for the project going forward. The workshop brought together patrons, mentors, and School Health Education Coordinators from the Sagnarigu and Savelugu Municipalities. Madam Ruka Alhassan, School Health Education Coordinator (SHEP) for the Sagnarigu Municipality said the rate at which AGYW were exhibiting courage and confidence in finding answers to some of the most critical issues on SRHR was impressive and mind-blowing. She said all efforts must be put in place by all stakeholders to ensure that the project was maintained. Mr Stephen Ayabaa, School Patron for Garizegu Junior High School, said the project was unveiling some of the myths and misconceptions on SRHR whilst at the same time giving them the opportunity to know the consequences of their decisions regarding their growth and development. Mrs Benedicta Aovare, Savelugu Municipal SHEP Coordinator, also lauded the significance of the project saying it should be linked with other ongoing AGYW projects in the region to help build constructive collaboration and enhance sustainability. Challenges facing the project/ beneficiaries For every good intervention, there is bound to be a challenge and the P2C project is not an exception. Most of the AGYW are still being influenced by some deep-seated social norms and orientations. The project needs to strategise and widen its scope of operations to help address the challenges confronting AGYW in the Municipality. The current Domestic Violence Act 2007(Act 732) does not fully serve its intended purpose and must be reviewed to capture the very needs of AGYW. Conflicting policies and programmes on SRHR continue to weaken the efforts of NGOs and other organisations' commitments to advocate for the rights of AGYW, hence the need to address such infringements to promote inclusivity. Recommendations Government must demonstrate enough willingness towards the realisation of the Family Planning 2030 Commitments, which aim at ensuring equitable and timely access to quality family planning information, commodities, and services to all persons of reproductive age in Ghana by the end of 2030. Government must also intensify the implementation of i ts policies to ensure it meets goal three and five of the United Nations Sustainable Development Goals, which aim at ensuring healthy lives and promoting well-being for all at all ages and achieve gender equality and empower all women and girls by 2030. Traditional and religious authorities must ensure they comply with the laws of the country, especially those on SRHR to guarantee the safety of AGYW in the country. Source: Ghana News Agency

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