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Rapariga Biz prevents Obstetric Fistula in Mozambique

“In my community, it is difficult not to see adolescent girls between 15-16 years pregnant or as young mothers”, says Lucia Aiuba Amade (18), Quelimane, Zambezia.

Childbirth at an early age is associated with greater health risks for the young mother. In fact, complications of pregnancy and childbirth are the leading cause of death in young women aged 15 to 19 years.

Teenage pregnancy often forces girls to drop out of school and puts them at risk of obstetric fistula.

Lucia is one of the 783 mentors trained under the program “Rapariga Biz”. Rapariga Biz is the first joint UN programme on adolescent girls' sexual and reproductive health and rights in Mozambique led by Government with technical assistance from UNESCO, UNFPA (lead agency), UNICEF and UN WOMEN and funding from the Swedish International Development Assistance (SIDA).

In Mozambique, it is estimated that approximately 2300 new cases of obstetric fistula occur each year. This is largely due to the high rates of teenage pregnancy and early marriage. According to the 2015 IMASIDA Survey by Ministry of Health, 46% of girls between 15 and 19 years are pregnant or mothers and 48% of girls are married before 18 years (DHS 2011).

Rapariga Biz thus aims to reach 1 million girls and young women of 10-24 years between 2016-20 to address the particular pressing situation of girls and young women in the provinces of Nampula and Zambezia.

Mentors Prevent Obstetric Fistula
“Our communities lack information about obstetric fistula, and the girls and young women are the ones to bear the consequences. Those living with obstetric fistula are isolated and discriminated against. We can help prevent this childbirth complication under Rapariga Biz” says Lucia Aiuba Amade.

Each mentor is leading a session with approximately 30 adolescent girls between 10-14 years or 15-19 years each week for 6 months in a so-called Safe Space in the community identified by the girls and young women.

Rapariga Biz has reached a total of 23518 girls in its first year of implementation.

In the safe space, they learn and discuss life skills, solidarity, human rights - including the right to live free of violence and child marriage. Sexual reproductive health, the consequences of early pregnancy and how to prevent it is another core focus.

Obstetric fistula has its own session: “We need to ensure that the girls and young women understand the causes and consequences of obstetric fistula to empower them to make informed choices and delay the first pregnancy” says Amina Carlos Antonio (22), Quelimane, Zambezia.

Promoting the Rights of Adolescent Girls
“The key to eliminating obstetric fistula is prevention, specifically through prevention of child marriage and teenage pregnancy which sits at the heart of our efforts as UNFPA targeting the most vulnerable girls and young women. It is essentially about their rights to health and life”, says Bettina Maas, UNFPA Representative.

The ability of girls and women to control their own fertility is fundamental to their empowerment and equality.

Apart from the preventive efforts, UNFPA is supporting the Government in ensuring the availability of treatment and social reintegration services for girls and women living with obstetric fistula.

The International Day to End Obstetric Fistula is commemorated across Rapariga Biz’s Safe Spaces in Nampula and Zambezia by the mentors through sensitization, discussion, and theatre with a focus on prevention.

Some mentors are also on the radio and television today to advocate for the elimination of this human rights violation through prevention of child marriage and teenage pregnancy - with an appeal to families and communities to allow the girls and young women to make informed choices about their lives.