Module 6 – RH

This module is an introductory module, aiming to define the key components of sexual health and rights and why this is a critical subject for young people in Zimbabwe.

Topic objectives

• Define and discuss how sexual health, reproductive health, sexual rights, and reproductive rights intertwin for young people in Zimbabwe.
• Explore drivers of poor sexual and reproductive health & rights.
• Identify the responsibilities of both young people and tertiary institutions in achieving sexual and reproductive health and rights for young people.

DEFINITION OF TERMS

The terms below may appear in this module and other previous modules. Please always refer to this section if you meet a new word or a word that you are not sure of its meaning.

Menstrual Health & Hygiene refers to access to menstrual hygiene products to absorb or collect the flow of blood during menstruation, privacy to change the materials, and access to facilities to dispose of used menstrual management materials.

Maternal Health refers to the health of women during pregnancy, childbirth, and the postnatal period.

Comprehensive sexuality education A curriculum-based process of teaching and learning about the cognitive, emotional, physical, and social aspects of sexuality. It aims to equip children and young people with knowledge, skills, attitudes, and values that will empower them to realize their health, well-being, and dignity; develop respectful social and sexual relationships; consider how their choices affect their own well-being and that of others; and understand and ensure the protection of their rights throughout their lives.

Gender and sexual diversity refer to all the diversities of sex characteristics, sexual orientations, and gender identities, without the need to specify each of the identities, behaviors, or characteristics that form this plurality.

Gender norms describe how people of a particular gender and age are expected to behave in each social context.

Harmful gender norms result in many types of inequalities between girls, boys, women, and men. However, while gender norms can affect all people, they are proven to disproportionately affect women and girls.

Autonomy Someone’s prerogative to determine when, with whom, and under what circumstances they engage in sexual activity; to only engage in sexual activity to which they consent.

Dignity Respectability e.g., respect for sexual identity and private choices

Self-worth The internal sense of being good enough and worthy of love and belonging from others.

Integrity Acting in accordance with your own values, beliefs, and morals. Sexual integrity involves being honest about your sexual preferences.

WHAT IS SEXUAL AND REPRODUCTIVE HEALTH AND RIGHTS?

Sexual Health is a state of physical, emotional, mental, and social well-being related to sexuality; it is not merely the absence of disease, dysfunction, or infirmity.” The ability of young people to achieve sexual health and well-being depends on their access to comprehensive, good-quality information about sex and sexuality, knowledge about the risks they may face and their vulnerability to adverse consequences of unprotected sexual activity and ability to access sexual health care and living in an environment that affirms and promotes sexual health.

A young person enjoys sexual health when:

• They can understand and weigh the risks, responsibilities, outcomes and impacts of sexual actions and to the practice abstinence when appropriate.
• They feel good in relation to the area of their sexual life.
• They feel good in body, mind, and spirit.
• They feel comfortable within their society about the way they are conducting this part of their life.
• They are free from sexual abuse and discrimination.
• They are confident and able to make decisions about their own bodies and how they will express their sexuality without anyone forcing or pressurizing them.
• They are confident to say “no” to sex until they are in a loving relationship and are happy to say “yes.”
• When they have sex, they can protect themselves from unwanted pregnancy and diseases that are passed during sexual intercourse.
• They can enjoy pleasure from sex without harming others.
• They can enjoy their sexuality free from shame, guilt, and fear.
• They can visit the health center if they have a problem.

Sexual Rights ‘are human rights related to sexuality.’ They are part of existing human rights and fundamental freedoms, including:

• the right to life,
• the right to privacy,
• the right to freedom of thought and expression,
• the right to freedom from violence,
• the right to education and information,
• the right to equality,
• the right to freedom from all forms of discrimination and
• the right to the highest attainable standard of health.

A young person enjoys sexual rights when:

Sexual rights come with responsibilities, the realization of sexual rights is possible only if all persons respect the autonomy, dignity, and equal rights of others — especially of their sexual partners — as well as their own integrity and self-worth.

Reproductive Health refers to the health condition of male and female reproductive systems during all life stages. It implies that people can have a satisfying and safe sexual life and have the capability to reproduce and the freedom to decide if, when and how often to do so.

Reproductive Rights – are the basic right of an individual to decide freely and responsibly when, with who and how to have children. It also includes the right to have the information and means to do so, and the right to attain the highest standard of sexual and reproductive health and to make decisions concerning reproduction free of discrimination, coercion, and violence.

A human rights-based approach identifies who has rights (rights holders) and what freedoms and entitlements they have under international and national laws, as well as the obligations of those responsible for making sure rights-holders are enjoying their rights (duty-bearers). This approach empowers rights-holders to claim their rights and supports duty-bearers to meet their obligations and promotes accountability for meeting SRHR obligations.

A rights holder is entitled to claim his/her rights, to hold duty bearers to account and to respect the rights of other rights holders.

A duty bearer is responsible for promoting, respecting, and fulfilling human rights. The main duty bearer to human rights is the State often represented by ministry e.g., the ministry of higher and tertiary education. Other duty bearers including health-care personnel, teachers, community leaders, parents, and all those have a duty to ensure that young people have access to SRHR information and services.

How do sexual health problems arise?

Many sexual health problems arise when young people (both male and females), do not have control over their sexual lives, are ill-informed or ill-equipped to deal with the consequences of sexual activity that they have entered or are coerced into sexual activity by one or more people who are more powerful than they are. These issues are exacerbated by social cultural norms that deny sexual health needs to young people especially the needs of young girls and women.

Every tertiary institution must ensure that young people have access to accurate information and the safe, effective, affordable, and acceptable contraception method of their choice. The institutions must have policies that protect SRHR of young people e.g., HIV & AIDS Policy, Sexual Harassment policy, and gender policy.

Young people must be informed and empowered to protect themselves from sexually transmitted infections. And when they decide to have children, women must have access to services that can help them have a fit pregnancy, safe delivery, and healthy baby.

Services must be provided in a friendly atmosphere that encourages all students to access. Health staff must be competent to provide quality care in a stigma free manner that does not discourage some sections of the student populations from accessing e.g., students with disability, those living with HIV etc.

What can young people in tertiary institutions do to maintain Sexual Reproductive Health and rights?

Knowledge – Young people as rights holders have a responsibility to seek out knowledge about SRHR. They should be active agents in understanding their bodies, their values, their aspirations, and those of others. Young people should actively seek information about sex and sexuality and how they can improve their sexual health and reproductive health. Some of the sources of information are:

1. Trained peer educators
2. Health facilities especially the health facilities on campus
3. Community-based organizations and non-governmental organizations like SAYWHAT
4. Books, videos, fliers, posters, and other IEC materials on SRHR
5. The internet – however if using the internet for information one should be able to sift and get accurate information from trusted websites.

Action – Young people are responsible for taking protective actions after learning about SRHR, these include respecting their values and the values of others, correctly and consistently taking protective measures to ensure sexual and reproductive health for themselves and others. Young people should get sexual health services and products from trusted service providers. e.g.,

• Peer educators e.g., condoms
• Health facilities especially the health facilities at campus e.g., contraceptives, condoms, STI treatment, counseling services, HIV testing, HIV medicines (PrEP, PEP, ARVs), circumcision, mental health support, etc.
• Community-based organizations and non-governmental organizations like SAYWHAT

Advocacy – Young people should know and claim their rights as rights holders. To claim their rights young people must know the obligations of institutions and the policy documents that institutions have developed and assess if indeed the institutions are implementing these policies. Young people should stand up and speak out for their sexual reproductive health and rights. They should demand SRHR services and should use these services responsibly. They should also speak up and speak out for other young people who might fail to speak for themselves e.g., those who are disadvantaged (sexual minorities, disabled, or just not knowledgeable or confident), those who are poor, and those who are victims or survivors of abuse.