By Jasmine Ryu Won Kang
The Shai-Osudoku Teenage Pregnancy Initiative (SOTPI) is a bold step forward taken by the Yayra-Si Youth Foundation to reduce stigma surrounding adolescent pregnancy, provide resources for women who have experienced teenage pregnancy, and initiate conversations on the topic of family planning. Funded by the University of Toronto International Health Program’s Community Engagement Project, the initiative operated within the Shai-Osudoku district of Ghana. I had the chance to meet Sauliha Alli, Executive Director and Co-Founder of the Yayra-Si Youth Foundation (YSYF) Canada, and Maryam Fatima, Content Creator at YSYF Canada, to unpack some of the project’s goals and impacts.
The prevailing social attitude towards women and pregnancy in Shai-Osudoku, says Alli, can be described in a perplexing dichotomy. “The value of women is ... tied up with the ability to bear children, but at the same time, women who are pregnant out of wedlock are chastised.” While Alli states that as a foreigner to Shai-Osudoku, she may not grasp the full cultural nuance surrounding the issue, she is able to state with certainty that unmarried pregnant women in the district face tremendous stigma. Rooted in religious and cultural values, such negative stereotypes often discourage these women from seeking help or accessing health resources. In certain cases, women are cast out from their religious institutions or forced to leave their homes.
A mining community in which the workforce is predominantly male, Shai-Osudoku bears severe gender disparities that leave many women in the community economically vulnerable and financially dependent on their male counterparts. Alli adds that the region is tight-knit, and that most of the residents know each other and their families. This may result in a heightened sense of scrutiny directed towards women who experience adolescent pregnancies. There is considerable “stigma of being an unmarried woman who wants family planning,” Alli explains, as it is often looked upon as an “act of deviance.” Importantly, the district has among the highest rates of teenage pregnancy in Ghana. Furthermore, with the nearest hospital located forty minutes away and many families lacking personal cars, access to health care becomes elusive under the burden of transportation.
With these local factors in mind, the Shai-Osudoku Teenage Pregnancy Initiative sought to provide education on a wide variety of topics related to adolescent pregnancy, including family planning, sexual health, maternal and child health. Delivered through the medium of a radio program, which garnered over one thousand listeners, this educational initiative came in conjunction with presentations at local schools and the production of a video on consent, which was shared with over seven thousand viewers. Spanned over the length of 4 months, this educational program “emphasize[d] core perspectives to ensure that the overall delivery of the program was holistic and appropriate for a wide audience,” says Fatima. She acknowledges that there remains “tremendous work” needed to advance the de-stigmatization of adolescent pregnancy. However, she is confident that the radio program has provided an important initial spark to initiate important conversations on these “unspoken health topics.” Having received an “overwhelmingly positive response,” it seems this confidence is justified.
This positive outcome was only made possible through the overcoming of several challenges, compounded by the swath of complications brought on by the COVID-19 pandemic, says Alli. During a time when donations and funding have been an area of pronounced difficulty for many NGOs, the Shai-Osudoku Teenage Pregnancy Initiative was prompted to make multiple adjustments - for instance, by substituting its initially proposed conference for school visits and switching its work platform to an online setting. Alli identifies further difficulties in navigating cross-cultural barriers, differing perceptions of cultural phenomena such as patriarchy, and power differentials and privilege carried by Western volunteers. A fallback of the radio program in particular was the “one-way line of communication” that it generated, making it difficult to gauge the audience’s understanding of the concepts presented. However, to improve the accessibility of its programming, the SOTPI had ensured usage of local languages throughout the entirety of the initiative, minimizing any linguistic barriers.
A meaningful project that embodies the Community Engagement Project’s overarching goal to “promote sustainable and health-enhancing change,” the SOTPI has made a firm impact on empowering women in the Shai-Osudoku district. Nevertheless, the issue is far from resolved, as Fatima stresses. Communities, families, and even schools remain arenas in which family planning is still largely a taboo subject. The hope is that through incremental steps, the stigma surrounding teenage pregnancy can slowly be dissolved, allowing women to access the health resources to which they are fundamentally entitled.