Sex education reduces sexual activity and teenage pregnancies

THE recent media coverage on teenage pregnancies is important as this issue requires a lot more attention and action. Based on data from the Health Ministry (MOH), as reported by the Women, Family and Community Development minister, between 2020 and 2024, 41,842 girls aged 19 years and below were recorded as pregnant at MOH health facilities. Of these 16,951 involved unmarried girls.

It is important to view this data in a wider context.

Note that the data is only from MOH health facilities and the problem is much larger. Most teenage pregnancies are unplanned and may end up as abortions, for which we have no data. We can probably double the numbers quoted here.

In addition, it is important to be reminded of the data from the National Health and Morbidity Survey (NHMS) 2022.

It evaluated a national, representative sample of more than 30,000 students aged 13 to 17 years old, and showed that 7.6% admitted to having had sex and 5.7% were currently having sex. The rates were higher in younger children: 11% From One students admitted to having had sex, and 33% had sex before the age of 14. Some (11%) admitted to having more than one sexual partner and the majority (88%) did not use any birth control method. The NHMS study also showed that the knowledge of Malaysian teens regarding sexual and reproductive health was poor.

Finally, while the concern is regarding teenage pregnancies in unmarried girls, we must not forget that any teenage pregnancy, even in those married, carries much higher health risks and impairs the girl’s academic and economic future, and often results in school dropout. It is extremely worrying that 24,873 children were married and had babies between 2020 and 2024.

To understand teenage pregnancies, it is vital that the government share granular data of all these children with teenage pregnancies, married or unmarried, so that we can plan appropriate measures to reduce teenage pregnancies in our society. Some key factors we need to understand include:

> Poverty: Adolescents in poorer communities are more likely to become pregnant.

> Education: School dropout due educational challenges poses a higher risk.

> Community support: Did these girls receive any sex education and contraception access or were they involved in any community youth programmes?

> Sexual abuse: Were any of those in marriage sexually abused?

> Substance use: Drug use can lead to unsafe sexual behaviour.

Preventing teenagers from engaging in sexual activity requires a combination of formal sex education, open communication in families, setting boundaries, and fostering healthy attitudes towards relationships and sexuality; also required nowadays is governmental protection to ensure online safety for children.

And we must not focus only on girls – boys must be included. 

A huge body of data and research shows that comprehensive sex education reduces sexual activity and teenage pregnancies. Our children and teenagers need age-appropriate information about their sexuality and how it relates to their bodies and relationships with others. This will help them develop a safe and positive view of sexuality, build healthy relationships, and make informed, safe, positive choices about their sexuality.

Of concern is how widespread and effective is our communication about sexual and reproductive health to our adolescents? Is it reaching high risk groups?

Government initiatives like the KafeTEEN youth centre that focus on reproductive health education and counselling are important. But has the reach been adequate?

Data from the National Population and Family Development Board showed that from 2006 to 2023, 1.1 million teenagers benefitted from sexual and reproductive health advocacy programmes. While this is a commendable effort, remember that in that same time period we would have had seven to eight million adolescents aged 12-17 years. Hence, the majority of our teens, and probably the higher risk groups, remain unreached, as shown by the NHMS 2022 data.

The only really effective reach is via the national education curriculum, both government and private, starting once children approach puberty.

It is important to remember that, with teens, we require open and honest communication, and a safe environment where they feel comfortable asking questions and discussing their concerns about sex and relationships without fear of judgment. Ideally this should be the home but, in my many assessments over years, the vast majority of parents fail to discuss sex education with their children.

Hence, we have to rely on schools. The support teens require includes how to navigate peer pressure related to sex, developing refusal skills and setting health boundaries in relationships.

I was glad to hear that the government has a Reproductive and Social Health Education Policy and Action Plan which aims to raise awareness and promote responsible, resilient behaviour among young people. But as the Women, Family and Community Development Minister Datuk Seri Nancy Shukri emphasised, it is important to realise that we need an all-of- society effort to support children and teenagers in the country. We cannot afford to do too little too late, and must ramp up our support for teenagers.

DATUK DR AMAR-SINGH HSS

Consultant paediatrician

Child-disability activist

Kuala Lumpur