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MOKHOTLONG – AT just 12-years-old, Tšepiso is pregnant with her first child and has been forced to drop out of school. She was doing Grade Six.

Tšepiso is not her real name, thepost will not mention to protect her identity as a matter of policy. The incident has shocked many in her village.

Mokhotlong district has one of the highest rates of unmet need for family planning in the country at 24 percent, compared to 18 percent nationally.

The high Teenage child bearing cases put Mokhotlong in the second place in the country at 24 percent, with Butha-Buthe topping the list with 25 percent. Mokhotlong has the highest fertility rate at 4.4 percent.

It also has the lowest contraceptive prevalence rate (CPR) at 48 percent according to the Lesotho office of the United Nations Population Fund (UNFPA Lesotho).

This scenario leads to high rates of unplanned pregnancies, school drop-outs, child marriages, teenage pregnancies, unsafe abortions and maternal deaths.

The acting principal at the school that Tšepiso attended said primary students are already engaging in sexual activities from an early age.

“Almost every year we have dropouts due to pregnancy,” the principal said.

“This year is even worse as we have a 12-year-old,” she said, revealing that most are below the age of 15.

She said their policy allows pregnant children to continue with their education at the school but many leave once they fall pregnant.

She said Tšepiso’s mother requested her to leave school until she gives birth.

“Her fears were that she might give birth at school. She wanted to fully monitor her child’s pregnancy until the end,” the principal said.

She said schools offer Life Skills Based Sexuality Education (LSBSE) subject from Grade Four to Grade Seven.

This is the kind of education Basotho in general rejected when the Ministry of Education introduced it in primary schools three years ago. Many argued that such a subject would corrode children’s morals.

“We collaborate with nurses to talk to them but children are children, they will just laugh during the lesson and this being (a Roman Catholic Church) school doesn’t help,” she said.

The church, as a matter of religious policy, does not promote the use of contraceptives, let alone by children who are expected to remain celibate until they are grown up and married.

“Children in this era don’t care about education and don’t relate the lessons taught to real life situations. They think they are taught for grades. They don’t understand,” the principal said.

She said the school encourages children to protect themselves but “it’s difficult to control them as once they leave school, they don’t care”.

She said some parents do not have interest in education but “we still encourage them to talk openly about Sexual Reproductive Health (SRH) with their children and know their children’s movements”.

The principal said children engage in sex because they do not know about the changes in their bodies.

“Sex education is still a challenge but they should try it.”

’Maitumeleng Lenepa, the Mapholaneng area village health workers supervisor, said teenage pregnancy among students is high and some conceal pregnancies, although she does not have the exact figures.

“Students strangle their newborns or abort while others self-deliver and dump babies,” Lenepa said.

“I encourage them to use contraceptives and they prefer “biscuits”. They boldly ask for them and I distribute them,” she said, referring to condoms as biscuits.

Lenepa says she also warns children on the dangers of being pregnant at a young age.

“We approach parents as well but it seems our messages are ignored because cases of teenage pregnancy are still rampant, some children are even sex workers,” she said.

She narrated the pain she endured when her own daughter became pregnant at 12.

“She was already menstruating but I never thought she was already engaging in sexual activities. If I knew, I would have given her contraceptives,” said Lenepa, adding that her daughter dropped out of school and went to work in Durban.

She said her daughter’s then boyfriend denied responsibility and “although it was painful, it was a blessing in disguise because she was still too young to get married”.

“Pregnancy doesn’t mean marriage.”

Lenepa said she started pushing for the use of contraceptives by teenagers after she felt the pain of having a pregnant child at such a tender age.

“I don’t wish for any mother to experience the pain I went through. It was unbearable because I have contraceptives.”

She said she encourages other parents to introduce their children to family planning once they start menstruating.

“And if they are too shy to take them to the clinic, I accompany them, I don’t have any stress. The pain I experienced I don’t want any mother to feel it as well.”

Tlokoeng village health worker, ’Mabonang Sethathi, described her work as “easy”. She says the village chief often give her a platform to sensitise villagers about contraception during community gatherings.

“The uptake is positive,” Sethathi said.

The Ministry of Education’s CEO for Secondary Education, ’Mabakubung Seutloali, said early pregnancy has resulted in many children dropping out of school.

“We lose a lot of pupils to teenage pregnancy,” Seutloali said.

“Preventing early and unplanned pregnancies is therefore an important component of a wider response to ensure the right to education for all,” she said.

According to a 2017 United Nations Education Scientific and Cultural Organization (UNESCO) report, Lesotho is among countries with high rates of early and unintended pregnancies.

In 2013, Eastern and Southern African Ministers of Health and Education committed to teaching Comprehensive Sexuality Education (CSE) to adolescents and young girls in schools and making it compulsory from Grade Four to 12.

“However, we learnt recently that it wasn’t taught in all schools, although teachers were capacitated,” Seutloali said.

“Their explanation was that they were afraid to talk to the children about the subject. We are currently doing follow ups to capacitate teachers again, inclusive of providing psychosocial support,” she said.

What makes teachers feel embarrassed to teach the subject is that they have to teach children about sexual body parts and their functions in sex using Sesotho language.

Many consider it as vulgar to mention private parts in Sesotho, even if it is for educational purposes. This came to the fore when sex education was supposed to be included in the school curriculum a few years ago, and the proposal was met with fierce resistance from parents and churches. About 90 percent of schools in Lesotho are owned by churches.

In 2017, UNESCO conducted an assessment that revealed that 12-14 year olds are initiating sexual activities.

In 2021, the Ministry of Education collaborated with the UNFPA to commission a consultant to develop a policy to manage students’ pregnancies at school and protect them from all forms of abuse.

Data from School Report Cards collected from schools participating in the School Improvement Project indicates that pregnancy and early marriage were the number one reason for girls dropping out of secondary school (46.7 percent in 2018 and 45.7 percent in 2019).

The Ministry of Health’s Family Planning Manager, ’Mankosi Sithole-Tšotetsi, said the goal of family planning is to protect the health of women and adolescent girls by reducing high risk pregnancies.

Sithole-Tšotetsi said it also aims to protect the health of children by allowing sufficient time between pregnancies, reducing abortions, supporting women’s and adolescent’s rights and opportunities.

“Family planning saves the lives of women, newborns, children and teenage girls,” Sithole-Tšotetsi said.

She said many pregnancies pose serious health risks for mothers and their children, specifically pregnancies characterised as too early, too many, too late and too soon.

“Girls under 18 face a higher than normal risk of death or disability from pregnancy and their babies have more health risks,” she said.

She said the most commonly used methods of contraception are injections at 60 percent, followed by pills at 31 percent.

The United Nations Population Fund (UNFPA) and the Ministry of Health have introduced a self-administered contraceptive injection in some rural districts of the country.

The move is expected to result in more rural women taking up contraceptives and avoid unwanted pregnancies as they will be able to self-inject after every three months than constantly travelling long distances to health centres.

The new contraceptive is called Subcutaneous DMPA (DMPA-SC), under the brand name Sayana Press.

It comes in a pre-filled, all-in-one injection system and is delivered every three months to rural women and girls who have the greatest need for contraceptives but have to travel long distances, often on foot, to access contraceptives.

It is offered for free in public hospitals. This contraceptive is safe, according to officials.

Officials from the Ministry of Health, with assistance from the UNFPA, trained health practitioners on the use and administration of the injection.

The health practitioners passed on the knowledge to village health workers who work with women and girls in rural communities.

The injection has come in handy for those who have to take contraceptives secretly to avoid detection by their husbands or parents.

‘Mapule Motsopa

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