Lancet CAH: Sexual and reproductive health and rights in Mozambique

13 December, 2022

Citation, extracts and a comment from me below. Full text:

CITATION: Sexual and reproductive health and rights in Mozambique

Sophie Cousins

Lancet Child and Adolescent Health, Published:December 07, 2022


'At a bar outside the major northern port city of Beira in Mozambique, a group of young men gather around to watch a play on HIV. The play tells the story of a man who is in denial of his HIV diagnosis, who refuses to take his pills and now has bad diarrhoea. “This is witchery,” he exclaims to the roaring laughter of the crowd. “A neighbour put a spell on me. I feel fine.” The nurse insists he takes his drugs; that if he does, he can live a normal life. At the end of the play, a peer educator from Médecins Sans Frontières (MSF, or Doctors Without Borders) asks the crowd if they understood the message. “You need to take your medicines—you can't let HIV get to an advanced stage. You can live as a normal person and have a normal life,” one young man answered. Another said: “The play showed me it's not the end of the world if I get HIV.”...

Francisca Noronha is an African Youth Charter Hustler at the African Union who is passionate about gender equality and ensuring youth realise their sexual health and reproductive rights. While she welcomed Mozambique's decision to ban child marriage, and cited cases of adults being punished, she said there was tension between old belief systems and the modern law. “We have so many girls who don't know about the law; they have limited access to information. Many adolescents don't know their sexual rights, they don't know about contraception either,” she said. “We have conflict between the law and society. We have a lot of work to do with local leaders and parents and to ensure perpetrators are held accountable. Until 2019, we didn't have a real instrument to punish people who commit child marriage. Civil society have a real tool now [but] the challenge is implementing it.”...

COMMENT (NPW): This feature article underlines the continued lack of basic information about HIV, sexual and reproductive rights, and contraception. It also emphasises the importance of direct health education such as drama, and bringing local leaders on side. Yet despite all these efforts, the availability, understanding and use of reliable healthcare information remains poor, in Mozambique as in other countries. The role of governments is critical to provide an enabling environment for school teachers and civil society organisations to address these issues.

And yet I have just discovered that earlier this year the Mozambique Ministry of Education *withdrew* a set of Grade 7 textbooks including sexual health material from its education curriculum, denying young Mozambicans comprehensive sexuality education (CSE) in schools.

The Centre for Reproductive Rights (USA) notes: 'Comprehensive sexuality education (CSE) is critical in ensuring the health and well-being of school-going Mozambicans. It equips adolescents with age-appropriate information on sexuality, reproduction, opposite sex relations and risks associated with irresponsible sexual behaviors. In a world where there is widespread misinformation including on sexuality, it is best to equip learners with accurate information in schools with textbooks being a key source.

'According to United Nations Educational, Scientific and Cultural Organization (UNESCO), “Sexuality education has positive effects, including increasing young people’s knowledge and improving their attitudes related to sexual and reproductive health and behaviors. Sexuality education – in or out of schools – does not increase sexual activity, sexual risk-taking behavior or sexually transmitted infections.”

'The Republic of Mozambique ought to ignore in toto, the misinformation aimed at discrediting the objectives of comprehensive sexuality education (CSE) and unconditionally reinstate the Grade 7 textbooks in the education curriculum. Adolescents ought to enjoy the right to information, freedom from non-discrimination and right to health which includes access to sexuality education.

'We appeal to the Government of Mozambique not to go back on the progress that it has made on providing much needed information for the protection of the right to health of adolescents particularly without any evidence that this information has been harmful to them in the years that this curriculum has been in use. The Republic of Mozambique has ratified the African Charter on the Rights and Welfare of the Child (ACRWC) and the Maputo Protocol-progressive human rights legal instruments-which obligate Mozambique to among other things, recognize adolescent’s rights to sexuality education.'

Every person needs access to reliable healthcare information on sexual and reproductive health. Governments must be part of the solution and not part of the problem.

Best wishes, Neil

Dr Neil Pakenham-Walsh, HIFA Global Coordinator

Healthcare Information For All

Global Healthcare Information Network

Working in official relations with WHO