Abstract:
The policy environment for contraceptive access by adolescents in Malawi is rated as highly supportive. However, adolescents’ reproductive health outcomes remain poor, despite that the policy environment was reinforced by the Gender Equality Act in 2013. One of the factors contributing to the situation is the negative attitude towards adolescents accessing contraceptives which the 2014 National Evaluation of the Youth Friendly Health Services found to be significantly huge.
The Act contains the first-ever explicit and relatively comprehensive sexual and reproductive health rights laws in Malawi. In section 20(1), the Act provides guidelines on how healthcare workers should provide reproductive services. In section 20(2), it penalises discriminatory healthcare providers. The legally binding guidelines introduced by the Act should ideally motivate or compel healthcare providers to exhibit a friendly attitude towards adolescents accessing contraceptives. This thesis examines the changes that have taken place since the enactment of the Act regarding provision and access of contraceptives by adolescents.
Desk-based research methodology was used to collect secondary data, which was analysed using content analysis. Interpretation of the findings used the conflict and feminist theories. There are three key interrelated findings. The first is that there is limited action by the Government of Malawi towards operationalisation of provisions in sections 19 and 20 of the Act. The second is that negative attitudes of healthcare workers remain a significant barrier for adolescents to access contraceptives. The third is that there is no indication of increase in uptake of contraceptives by adolescents since the Act was enacted.