Supporting teen moms and building community in Mbare

“It is not discussed openly”

Mbare and Epworth are two densely populated townships in Zimbabwe. During the COVID-19 pandemic, families in both communities struggled to make ends meet and many teenage girls became increasingly vulnerable to sexual and gender-based violence, child marriages, and reduced access to health care.

These pandemic-era challenges came on top of the barriers girls were already facing in the community due to cultural beliefs, taboos, and myths around sexual health.

“Issues to do with sexual and reproductive health (SRH) or sexuality are not discussed openly in the community space, especially when we look at the relationships of parents and their children,” said Relative Chitungo, an MSF social worker in Mbare. “The moment an adolescent tries to approach a parent and ask [about these issues], they are pointed fingers at, or blamed for being, say, mischievous. The fear of being judged also limits most adolescents from seeking or accessing appropriate information that is very crucial in terms of them making health choices.”

Since adolescents typically rely on their parents for financial support, and most SRH services are relatively expensive, it can be incredibly difficult for them to keep a trip to an SRH clinic private.

“There are reasons why many girls are not going to health centers to collect protection (condoms) or contraceptives,” said Marvellous. “This is because our communities, and even our own parents, would demand the reason you were at a health clinic.”

“Those who discuss condom use or the benefits of using it are labeled as having loose morals or being prostitutes. There are [also] myths that if one uses contraceptives before having babies, they will never conceive.”

The Teen Moms’ Club

For Marvellous, her first contact with an SRH service came in the form of a leaflet from the MSF Mbare clinic.

“MSF held an outreach program in our community, and they handed me a flyer as they told me how MSF could assist young girls in my situation. They referred me to the Edith clinic, in Mbare. I was welcomed by aunt Relative from MSF.

“It was here that I narrated my story, before she took me through counseling. The following day I went back and joined the Teen Moms’ Club. Realizing there were more girls in my situation gave me a sense of relief.”

The Teen Moms’ Club was set up in 2020 as part of MSF’s existing project in Mbare, developed by a team of midwives, counselors, social workers, and health promoters. Their aim was to support pregnant teenagers to mitigate risks associated with early pregnancy, and to empower young mothers with knowledge about contraception and safe sex, pregnancy, safe delivery, parenthood, mental health, and school and career prospects.

The project also seeks to break down the societal barriers—including attitudes, taboos, and costly health care services—which make access to SRH care difficult for young mothers.

“[Marvellous] explained to me what the Teen Moms’ Club is, how good it is for her, how well she was welcomed, and that she was going to attend that club,” said Jacqueline. “She told me that MSF was going to register her pregnancy at a hospital, buy baby clothes, and monitor her health during pregnancy. I was happy to hear that.”

Another of the participants, Miriam, was four months pregnant when she attended a prenatal care consultation at the Edith clinic and was referred to the club. “They educated us on how to protect ourselves from unwanted pregnancies…they said falling pregnant does not mean one is a failure in life,” she said.

“When I was about to give birth, I was encouraged to come for pregnancy reviews at no cost. MSF would provide us with free counseling and testing. In the event that one is found to be HIV positive, they would provide counseling sessions. Those who test HIV negative would be told the effects of being HIV positive.”

The program also recognizes that the young women and their families need to be able manage financially into the future, which has led to training on income-generating skills such as nail technician work and soap making.

Marvellous chose to be trained on how to make dishwashing liquid, and her mum supported her with the production and selling. “We would mix the ingredients together, advising each other on the correct measurements,” said Jacqueline. “The dishwash project uplifted my family and we sold a lot during [Marvellous’s] pregnancy. We did a lot with the proceeds.”

Listening to the voices of young people

Key to the project’s success is its “teen mom champions”: girls who have participated in the club themselves and are interested in becoming peer educators. They are trained in health promotion, to reach other girls facing similar challenges, and to lead their peers.

Marvellous was employed by MSF as a peer educator after she began voluntarily visiting girls in her community to pass on the information she had learned. “The assistance I got from MSF inspired me to give back to my community, realizing that I was not the only one with the same problem.”

“[Now as a peer educator], I am encouraging teen mothers in my community to register their pregnancies in order to deliver in safe spaces.” Marvellous also helps provide sexual health education, information about contraceptives and referrals to the clinic for post-natal care.The formation of this club brought a huge change in reducing maternal deaths within our communities. Those who received help are now spreading the message.”

Chitungo said that as health workers, it is vital they create the space for the young mothers to speak for themselves. “We have been really strategic to say, OK, we want to empower the adolescents…to raise their voices, to just be themselves. For us to have effective programs, we need to hear their voices.”

MSF also runs sexual health education sessions with the caregivers of the participants. The project has had success in engaging fathers of the teen mothers, and encourages the girls to bring their partners along, too. Parents have come on board with the Teen Moms’ Club to spread the message to the community, to say, “let’s be there for our children.”

Jacqueline is among them. “I would like to encourage parents to embrace their daughters when faced with such challenges. I accepted this predicament, and I am grateful to MSF because I could see that my daughter’s spirit had been uplifted after a long time,” she said. “I am incredibly happy that she is proud of what she is doing to help others. She is now completely able to look after and raise her baby without any challenges.”