I REFER to the report “5,000 babies born to under 18s” (The Star, July 23) where Deputy Prime Minister and Women, Family and Community Development Minister Datuk Seri Dr Wan Azizah Wan Ismail was quoted saying that among the factors leading to cases of illegitimate children and baby dumping were incest, child abuse, domestic violence, premarital sex and pornography.
I believe it is important to take heed of the following facts when discussing this issue.
1. Sexual and reproductive health and rights of young people (adolescents and teenagers) and provision of comprehensive sexuality education: Young people aged 10 to 24 years make up more than one-quarter (27.6%) of Malaysia’s total population (32 million).
The percentage of unmarried young Malaysians aged 13 to 24 years who were engaged in sexual activity increased from 2% in 2004 to 4.8% in 2014. These figures are probably an underestimation as the Malaysian Global School-based Student Health Survey (GSHS) conducted in 2012 found that 8.1% of 25,507 students aged 13 to 15 years were sexually active (9.5% males and 6.9% females).
The 2015 Malaysian Youth Sexual and Reproductive Health Survey showed low levels of knowledge relating to sex and protection against pregnancies and sexually transmitted diseases, with 25% of respondents believing that protection is not required as long as there is mutual trust. More than half of sexually active young people said their first sexual act was unexpected or unplanned.
According to the Health Ministry’s 2015 data (Teen Pregnancy Statistics Manual), 28.8% of 13,831 teenagers aged between 10 and 19 years have conceived children out of wedlock.
These statistics are alarming, and because premarital sex is not accepted in the Malaysian cultural and religious norm, it is difficult for unmarried young people to obtain sexual and reproductive health (SRH) information or services. The disconnect is apparent with schools only providing basic SRH information on topics related to anatomy, reproduction, puberty, healthy relationships, HIV and sexually transmitted diseases, and promoting the abstinence model.
There is institutional and social denial of the fact that young people are sexually active outside of marriage. And despite the Health Ministry’s acceptance of the fact, it is yet to be addressed.
Putting the blame on lack of parental, religious and moral guidance as well as unregulated access to the Internet is a blatant denial of the realities of today’s complex challenges facing our youths.
It is time we accept and adopt the best practices in reducing unintended and teenage pregnancies.
Comprehensive sexuality education (CSE), which goes beyond just promoting abstinence, has been clearly shown to reduce risky sexual behaviours and unintended pregnancies and encourage later sexual debut. It has also been shown to increase self-esteem and promote a rights-based approach. Contrary to grossly mistaken beliefs, CSE does not increase sexual activity among the young.
2. Baby dumping and teenage maternal deaths: Police statistics show that 517 cases were reported between 2005 and January 2011. Figures up to 2016 show that on average, 100 babies were dumped every year with more than half found dead and others suffering horrifying circumstances, including being thrown from multi-storey buildings or flushed down the toilet.
The Teen Pregnancy Statistics Manual showed a spike in the number of maternal death among teens, with five cases recorded in the first three months of 2013 compared with 17 cases throughout 2012. Between 2009 and 2012, the rate of teenage maternal death almost tripled from 3.1 to 8.6 per 100,000 live births.
Most teenage pregnancies were unintended, as shown by multiple local studies. Behind every baby dumped is an unintended pregnancy. Many maternal teenage deaths were also due to unintended pregnancies.
Providing CSE and access to sexual and reproductive health information and services is critical in preventing unintended teenage pregnancies. Our laws need to be restructured for such services to be provided.
Healthcare workers, educators and parents must also be empowered to support these critical efforts.
DR JOHN TEO
Consultant obstetrician and gynaecologist
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