EPWORTH, Zimbabwe (AP) – Becoming a mother at such a young age was never something Kelly Nhedega had planned. At 18, the Zimbabwean teenager had pictured a very different life for herself. She wanted to finish school, become a nurse and think about starting a family later.
But when she became sexually active, getting contraception wasn’t easy. She worried about standing in line for condoms, birth control pills or an implant at a busy local clinic. Someone she knew might see her, judge her or tell her parents. Even the possibility of being questioned by healthcare workers made her uncomfortable. She stayed away from the clinic, became pregnant at 16 and eventually left school.
Now looking after her 18-month-old child, Nhedega has found a more private way to access contraception. She hopes this will give her the chance to return to school.
For Nhedega, finishing her education remains a priority. She knows that having another baby now would make it much harder to find the time to study and work towards becoming a nurse.
As aid cuts and disruptions to international shipping threaten access to contraception for girls in Africa, her experience shows that the problem isn’t simply about whether contraceptives are available. Many girls are afraid of being seen at a clinic. Others face opposition from their parents, restrictive rules or judgement from their communities. These difficulties continue even as governments struggle to make up for shrinking foreign aid.
Health experts say contraception is especially important for teenage girls because it can help prevent unintended pregnancies and reduce the risks associated with childbirth. Those risks are particularly concerning in Africa, where maternal deaths remain a major health problem.
The situation is part of a wider maternal mortality crisis in sub-Saharan Africa. The region has the world’s fastest-growing population and accounts for about 70% of maternal deaths globally. Across Africa, approximately 180,000 pregnancy-related deaths are recorded each year.
The United Nations Population Fund (UNFPA) estimates that cuts to international assistance will create a $185 million gap in global contraceptive funding this year. According to the International Planned Parenthood Federation, nearly 1,400 reproductive healthcare facilities had closed worldwide by December. Of those, 1,175 were in Africa, leaving an estimated 5.9 million women without access to services.
For girls like Nhedega, smaller and more private healthcare facilities can make a real difference. She found one such place in Epworth, a crowded settlement outside Zimbabwe’s capital, Harare. In a quiet corner of a hospital stood an old blue-and-white caravan that had been converted into a mobile clinic. It offered young people a place to seek contraception without worrying about being recognised by neighbours, relatives, church members or other patients.
Nhedega said the privacy made her feel more comfortable seeking contraception. Although she and her husband had agreed to use birth control, she still worried about what people in her community might say if they saw her visiting a clinic.
Foreign aid support is drying up
Since 2021, the caravan has provided services to more than 100,000 adolescents from Epworth and surrounding farming communities and informal settlements. These services include contraception, treatment for sexually transmitted infections, counselling and information about sexual and reproductive health, according to Pester Siraha, director of Population Services Zimbabwe, the organisation responsible for operating the caravan and other mobile clinics.
