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Can adolescents access sexual reproductive health services without parental consent?

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By Morenike Folayan

The need to reduce  the age of consent of adolescents’ access to sexual and reproductive health services, including HIV related services, in Nigeria, has been an issue of concern.

In more recent times, the barriers created by the demand by health care services providers for parental consent prior to adolescents’ access to contraception and HIV services had led to Civil Society organisations taking actions and putting pressure on authorities to reduce the age of consent.

Teenage pregnancy is a huge problem with significant implications for the growth and development of nations. Yet, parental consent is a huge hindrance for adolescents access to contraception made available through youth-friendly programmes like that implemented through the A360 project hosted by the Society for Family Health, Nigeria.

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During a session hosted by the New HIV Vaccine and Microbicide Advocacy Society at the recently concluded Maiden National Adolescents Health Conference, Mr Tunde Ogungbenro of the Society for Family Health described how the request for parental consent served as a hindrance to sexually active adolescents’ access to contraception.

For those who prioritised their health, they return to the clinics with forms signed by ‘parents’ just to get services.

For those who cannot get around the parental consent challenge, a number have reported back with unwanted pregnancies.

Joy Oboyi, a youth working with Education as a Vaccine, also reported the challenges she went through with accessing sexual and reproductive health as an adolescent. Her recall of the unfriendly services by health care workers was a reason why she works actively as a youth to push for the reduction of the age of consent for sexual and reproductive health and HIV services to 14 years. She advocates on the platform of Education as a Vaccine and work alongside with APYIN to make this demand on the National Government of Nigeria.

Prior to now, in 2014, the New HIV Vaccine and Microbicide Advocacy Society worked in collaboration with the Bioethics Society of Nigeria and Population Council Nigeria, led a process for the lowering of the age of consent for conduct of sexual and reproductive health and HIV related research with adolescents.

This was because of the challenges with accessing parents to consent to adolescents’ participation in this research was making it challenging to generate the needed evidence to inform policy and programme development for the population.

The age of consent for research participation was lowered to 16 years and this was reflected in the guidance document on sexual and reproductive health and HIV research issued by the Federal Ministry of Health in 2014.

The need for policies and programmes targeted at addressing adolescents’ sexual and reproductive and HIV needs in Nigeria is extremely high.

While the incidence of HIV infection is decreasing in other populations, it is increasing for adolescents. The drivers of HIV infection in the population remains unknown – data for adolescents are extrapolated from data from older adolescents and young persons. Uptake of HIV testing services is also very poor for adolescents: only 4 percent of females and 2 percent of male adolescents knew their HIV status by the end of 2014.

There is no evidence-derived information on the reason for this low HIV testing uptake and ways to make a difference.

In view of these needs, the members of the National Council of AIDS, at its meeting held at Kakanfo Inn  Ibadan, Oyo State approved the memorandum submitted by AYPIN on lowering of the age of consent for adolescents and young persons living with HIV  to access HIV and sexual and reproductive health services to 14 years.

This is a first route to success. With the approval for by the National AIDS Council to lower the age of consent for adolescents and young persons living with HIV to 14 years, it may now be easier to request for this reduction of age of consent for all adolescent for the same purpose.

Civil Society Organisations working on this issue hope that with support of the Federal Ministry of Health, a memorandum can be submitted to the National Council on Health for approval.

In the interim, there is the need to garnish more public support for this request to ensure policies and pronouncements by the various arms of government can be made actionable.

Prof. Morenike Oluwatoyin Folayan is  a researcher of  Infectious Diseases, Public Health and International and Humanitarian Medicine,  Obafemi Awolowo University, Ile-Ife, Nigeria. 

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