13 April 2023 – The rate of unintended pregnancy in adolescents in the country stands at 11%, and is among the highest in Europe. Moreover, the rate of adolescent births is 15.7 per 1,000, which is almost three times higher than the average of 6 per 1,000 births in the countries of the European Union. Majority of adolescent mothers are Roma, and yet they have limited access to sexual and reproductive health information and services. These are some pieces of information that we shared at this week’s debate “To What Extent Are the Young Mothers, and Especially Roma Women, Recognised and Provided with Services in the Health Care and Social Protection System”, organised by HERA – Health Education and Research Association.
According to the research into the impact of COVID-19 on the young people’s access to information about sexual and reproductive health, which was conducted by the youth group formed as part of the regional project “Youth Speak, Youth Select”, as many as 38% of the covered young Roma women have faced challenges in accessing the necessary information about sexual and reproductive health (SRH). Young people from the vulnerable communities have demonstrated a twice bigger need for information about many SRH topics than that of the general population. Young mothers and pregnant women, as one might expect, have shown greatest interest in questions concerning pregnancy, childbirth and postnatal care, whereas young Roma men were mostly interested in protection against gynaecological infections, menstruation or treatment of hormonal issues. The existing social stigma and discrimination, and the lack of healthcare documentation and insurance, have made difficult the Roma people’s access to SRH services. The feelings of fear and anxiety in young mothers due to poor information about COVID-19 have affected their health safety.
Aziza Sali from the Association “Šuto Orizari Women’s Initiative” illustrated the gravity of the problem with the two cases of deceased nursing mothers, who, since there was no gynaecologist in the municipality during the pandemic, did not have an opportunity to receive regular gynaecological examinations.
“Without access to general gynaecologist in the very municipality, girls and women could not even obtain a certificate of controlled pregnancy, which imposed additional barrier in realising their social rights”, was pointed out by Sara Sejfula from the Social Work Centre.
On the other hand, the experience of Dr. Lambe Krsteski, who has been working as the general gynaecologist in Šuto Orizari in the last 6 months, has shown that access to a gynaecologist is exceptionally important in the reproductive healthcare, and for the overall wellbeing of women. “At the moment, some 1,000 Roma women come to see me. Some 15 Roma women have given birth so far, all of whom are living and healthy”, he shared.
The list of panellists also included Nada Tofoska, a social worker from the public health facility University Clinic for Gynaecology and Obstetrics, who addressed the social consequences brought about by adolescent pregnancy and motherhood: “Because of their pregnancy, adolescent girls and younger girls drop out from the education process, which then renders them ranking low on the labour market. This brings long-term consequences not only for their economic independence, but also for their mental health. They often face depression, and even physical and sexual violence, which is then dramatically reflected in their relations with their children”.
Finally, it was concluded that both the public health and the civil sectors should work much more committedly on information dissemination among the Roma women of reproductive age about the available services and the benefits from regularly visiting a gynaecologist, including about the measures provided for vulnerable groups of women in the Preventive Programmes of the Ministry of Health. Part of the solution could undoubtedly be seen in comprehensive sexuality education, through which young Roma men and women can get educated about the importance of age in planning one’s marriage and pregnancy, contrary to the existing harmful practices stemming from tradition.
