This week, the horrors of Boko Haram’s coordinated campaign of violence against women were underscored by a new report that many of the girls and women who have been abducted by the extremist group were repeatedly raped with the goal of impregnation. Latanya Mapp Frett, who first spent time in Nigeria in her roles with the United Nations Children’s Fund and the United States Agency for International Development, spoke to Women in the World about violence against women and girls and her new mission as executive director of Planned Parenthood Global. Acute crises like the kidnappings and the use of rape as a weapon of terrorism focus the world’s attention, but sexual and reproductive health in Nigeria is precarious to begin with. Frett describes the collaborative efforts to change that.
Women in the World: The world began to focus on Nigeria with the Boko Haram kidnappings, but it seems to be the tip of the iceberg. What is the most underreported story about Boko Haram?
Latanya Mapp Frett: Many of the rescued Boko Haram hostages are reportedly pregnant as a result of rape. They deserve access to a comprehensive package of sexual and reproductive health services including safe abortion.
WITW: Can you talk about the reproductive health problem in Nigeria?
LMF: Women in Nigeria face many challenges today: not only are they vulnerable to abductions and sexual violence, but they are often under immense pressure to marry and start a family, share in the financial upkeep of their family, and continue their education in a society that doesn’t always support it. Those living in rural areas often face additional barriers to information and services. For these women — and for many women and girls around the world — access to comprehensive sexual and reproductive health care can literally be a question of life and death.
WITW: There are 1.3 million unintended pregnancies yearly in Nigeria. How can women and girls get access to contraceptive methods in Nigeria?
LMF: This is a global problem. Around the world, more than 200 million women and girls in developing countries who wish to delay or plan childbirth still lack access to modern contraceptives, information, and services. There’s a special need among young people to have access to these services.
In Nigeria, we work with partners like [a Christian Reformed church] NKST, a faith-based group that runs health centers and community education campaigns, to address this unmet need. NKST trains young people as Youth Peer Providers, to serve peers in their own communities — increasing knowledge, dispelling myths, and providing basic reproductive health counseling and contraceptive access to their peers, classmates, and friends.
WITW: In Nigeria, 54 percent of women give birth before the age of 20. Why do you think these statistics are still so high 2015?
LMF: Northern Nigeria also has some of the highest rates of child marriage in the world. Many of them are forced or pressured into these arrangements against their will. Across the country, less than half of all female adolescents receive sexuality education of any kind. This is a deadly reality: the WHO has shown that the risk of maternal mortality is highest for adolescent girls under 15 years old and complications in pregnancy and childbirth are the leading cause of death among adolescent girls in developing countries. We need to invest more in women and girls, and make their education and rights a top priority in international development to change this reality.
WITW: What have you seen in Nigeria when it comes to speaking about abortion?
LMF: In Nigeria, abortion is legal to save the life of the woman. In addition, in the southern states, abortion can also performed for physical and mental health reasons. In recent decades, as more and more girls have been attending school in Nigeria, the number of women dying from unsafe abortions has dropped. But it is still an issue of grave concern.
There is also the challenge of opposition and religious fundamentalism coming in from the West, which denies Nigerians not only access to lifesaving health services but also the agency to determine their own laws and futures. In this, NKST has been a pioneering partner, mobilizing the faith-based community to vocalize their own support for sexual and reproductive health and rights.
WITW: Nigeria has the second largest number of people infected with HIV. How can we combat this epidemic?
LMF: Nigeria is very large, and is the most populous country in Africa. The rate of HIV infection there is actually about the same as the rate among African Americans in the South of the U.S. That is to say, it’s an epidemic. In both areas, women and girls are particularly affected. As of 2009, HIV was twice as prevalent among young women as among young men in Nigeria. Young people are a key group if we want to fight and defeat this epidemic. Education is a big part of staying healthy and empowering young people to prevent the spread of HIV/AIDS. Looking to the future, we need strong health systems, committed political leadership, and sound policies to achieve our vision for the world we want: a world with zero new HIV infections, zero AIDS-related deaths, and zero discrimination — and a world in which those living with HIV are able to make their own decisions about their health and lives.
WITW: Can you share any stories about your travels in Nigeria?
LMF: A teenage Muslim girl living in Northern Nigeria named Zahra left a strong impression with me. She spoke about a transformation her father had undergone — he was now supportive of her contraceptive use, and furthermore, supported her counseling and providing condoms and other contraceptive methods to her peers as a Youth Peer Provider. Zahra’s father’s position is unique in her conservative community, but I hope to hear more and more stories like these as attitudes shift.
WITW: What are you most hopeful about with the change in Nigeria?
LMF: One effort I’m particularly excited about is Global Mobile, which is a joint effort by Planned Parenthood and UNFPA, the United Nations Population Fund to make sexual and reproductive health information and services available to young people around the world via mobile technology.
I’m very excited for this unique new program, and for all the efforts of our partners and other groups to make this one the healthiest generation ever.
WITW: Planned Parenthood has regional offices in Africa and Latin America. What work are you doing to spread knowledge about reproductive health?
LMF: Planned Parenthood Global works in partnership with local agencies. In Africa, we have partnered with girls soccer programs, churches, hair salons, health centers, legal groups, and more to advance sexual and reproductive health and rights in the area.
Planned Parenthood Global’s work in Nigeria focuses on regions where access to reproductive health services and education are extremely limited due to a variety of factors including a lack of skilled health providers, strong cultural and religious taboos around sexuality, widespread poverty, and unreliable infrastructure. Despite these obstacles, last year Planned Parenthood Global achieved a major win when, in collaboration with the Nigerian Federal Ministry of Health and National Primary Health Care Development Agency, we launched new guidelines calling for the inclusion of youth-friendly services in government-run primary health facilities.
Currently, most services designed specifically to meet young people’s needs are operated by private, nongovernmental health facilities. But the new guidelines aim to change that.