In Malaysia, there is a de-emphasis on sexual education, and discussing the topic in the home or in schools. This comes from conservative cultural beliefs that finds discussion of these types of things would only lead to curiosity and experimentation of the subject. This fear of sex and talking about it leads to uniformed young people making poor decisions in regards to safe sex practices, and a health crisis of teenage unwed pregnant girls in the country. This post will address the lack of social support and education that young women face in Malaysia. Hopefully it will also suggest some viable improvements to programs in the country, like current sexual education programs and women’s shelters, using a feminist perspective. These recommendations would regard improving young women’s social agency in Malaysia, and reducing the number of unwanted pregnancies.
When looking at teenage pregnancy and pregnancy out of wedlock in Malaysia, one of the first things that should be examined is the social determinants that helped to create this situation. A social determinant of health can be defined as the distribution and social conditions among a population that influences differences in health status for individuals and groups (Braveman 2014). When looking further into the social determinants of health in regards to underage pregnancy in Malaysia, it seemed two factors stood out as possible determinants of this health issue. Young girls in Malaysia are lacking the social support and education to prevent unwanted pregnancies.
Defined by Michael Marmot, social support is the good social relations, strong support systems, and emotional and practical resources available to a group or individual. For Malaysian youths there is a lack of accessibility to youth friendly sexual and reproductive health services, and skills in negotiating sexual relationships (Low 2009). In addition, in a Youth Sexuality Survey, for those females who had had sexual intercourse before, 90% of them admitted that they had not taken any “precautions to prevent pregnancy”. This number lowered to 60% for females that were out of school. Even with some education on contraceptives, students were not practicing contraception as a rule. Why might this be? One reason for this low use of contraceptives can be explained by the poor availability of these types of services. By policy, contraception is not offered by the public sector to any persons that are not married (Low 2009). However, some of these services are available by using private and non-government sector services, but the social and religious sensitivities surrounding sex outside of marriage may inhibit many young people from seeking out these services.
This low rate of contraception use also reflects some of the cultural beliefs surrounding childbirth. In Malaysia, there is a common assumption that most births can only occur within marriage (Low 2009). Unfortunately, for some women their first experience learning about contraceptive methods are while in the hospital after having their first child (Kamaluddin 1998). There is a significant proportion or young people in the country who just do not have the sufficient knowledge of contraception and other safe sex practices. Cultural values, as well as an underwhelming sexual education system may be the culprit.
In 1995, a National Population and Family Development Board study discovered that adolescents were not discussing reproductive and sexuality with anybody. Kids would generally only discuss things like puberty changes, and when they did rarely discuss things like sexuality and reproductive health, it was only with friends or media. These types of conversations were not discussed with parents or teachers (Low 2009). Another study from Universiti Kebangsann in 2011 found that for adolescents the majority of sexual education came from friends, TV, and pornographic material. Additionally, the study found that 85% of respondents reported that any sexuality education that was held in schools was not clear enough and was only held on a limited basis (Talib 2012). The Reproductive and Social Health Education is the current program held in schools around Malaysia, but is perhaps not a successful as it would hope to be, because students are still lacking proper sexual and reproductive education.
These sexual education courses tend to focus on the biological aspects of the reproductive system and the sanctity of marriage, but does not go into detail of how adolescents might prevent unwanted pregnancies, or help on how to face the real world. Teachers in Malaysia are generally uncomfortable with discussing topics like STIs, sexual intimacy, and sex because these topics are considered taboo to discuss in the wider culture. This can lead to classes that are unclear to students, too general, or too casual for students to learn the necessary information. A study in Malaysia found that only 5% of student respondents reported that their teachers instructed them on sexual education clearly (Talib 2012). Unfortunately, the educational programs found in schools are sometimes the only exposure of sex education that a student receives. The lack of proper information that a child receives from schools could impact the supportive network surrounding themselves, and could be another cause to the issue of unwanted teen pregnancies in Malaysia.
What does teenage pregnancy look like in Malaysia? Well, 13 in every 1,000 girls between the ages of 15-19 become pregnant every year (Talib 2012). Some local Malaysian reports found that the mean age of first sexual intercourse for women was under 15 years old (Zain 2016). In spite of this, in Malaysia, pregnancy before marriage is considered a violation of a cultural norm. These pregnancies are often seen as immoral and lead to social problems for women. Parents are often blamed for failing in their responsibilities as parents to prevent their daughter from participating in premarital sex. Children resulting from these pregnancies can even be labeled as forbidden or illegitimate (Zain 2016). When faced with teenage pregnancies, families often are three options, sending the women to a maternity home, marriage, or abortion (Saim 2013). There are five of these types of homes in Malaysia that accept unwed mothers for a time period between two weeks up to two years depending on the women’s need. Under the Child Act of 2006, unwed teenage mothers are considered to have been exposed to sexual abuse and in need of urgent protection. The centers serve as residential correctional facilities to prevent further unwed pregnancies as well as protective homes (Saim 2013).
Girls that reside in these types of homes lack social support from their outside families. Most of these shelters do not allow family visitations during the first month, and some only allow one hour visits once a month after this (Saim 2013). This could make many young women, some as young as 12, feel isolated from their families and outside communities. Services like counseling, one of reasons families send their daughters to these shelters, are not available, and girls are not able to get the emotional support that they need from caring adults. Some instances of discriminatory language used by shelter workers has also been reported by girls living in these types of homes (Saim 2013). It appears that the way that some of these homes are treating young unwed mothers only adds to the lack of social support that these girls are receiving.
Young unwed mothers in Malaysia are often seen as a reason for shame for their family. Their children do not carry the name of their father and are treated differently from other children from the moment of their conception. However, what happens to the fathers of these children? They are just responsible for the creation of the child, but do not seem to receive the same treatment as their female counterparts. There are no shelters homes for families of teenage fathers to send their sons to rehabilitate them and hopefully help them not to get anyone else pregnant before marriage. In general, the majority of reviewed research on the subject has only been conducted on female teenagers (Suan 2015). How does teenage pregnancies affect these fathers? How do they cope with raising a family, and what kind of rates of paternal depression exists for this population? Many of these questions cannot be reasonably answered, because there is a lack of information available (Suan 2015). It appears that young pregnant women carry much of the social burden of having children out of wedlock.
Young women experience the most negative outcomes if they become pregnant at a young age and are not married. A feminist perspective might be useful when searching for solutions to this issue. Young women need access to better education, so they can make better informed discussions regarding safe sex and family planning. In addition, services need to be improved to allow for women to have more options if they do happen to become pregnant. Finally, if unwed women’s shelters are to continue, proper services need to be accessible at all times and nondiscriminatory training need to be mandatory or some other means to reduce employees treating the young women at shelters in a prejudice manner. These recommendations are made in the hopes of giving young women in Malaysia more agency regarding their sexual and reproductive well beings.
There are a range of opinions regarding introducing more thorough sexual education classes in schools in Malaysia. Some cultural beliefs reflect the idea that information on sex will lead to young people’s desire to start experimenting sexually. However, studies have found that quite the opposite is true. Proper sexual education often encourages abstinence and provides young people with the knowledge and skills needed for responsible sexual behavior (Mutalip 2012). A study that came out of Selangor, Malaysia revealed that 49.3% of people believed that sexual education might help to, “overcome the social illness among school teenagers.” (Mutalip 2012). In addition, almost 90% of respondents from a study through the Centre for General Studies, Universiti Kebangsaan Malaysia agreed that sex education should be implemented in schools with meticulous planning (Talib 2012). These type of classes could be interwoven within already established subjects in school like biology and health, as a separate course might be harder for teachers and communities that are still working against the social taboos of discussing subjects like these. From the study referenced above in Selangor, 77.6% of respondents agreed that this sort of education could be incorporated within other subjects. It would be ideal to see more thorough sexual education programs throughout schools in Malaysia. Education is one of the keys to helping young women make informed decisions about their own sexual health.
Adolescents pregnant girls are also in need of social support from the community and preferably their families as well. In 1994 the first One-Stop Crisis Center was created in Malaysia. These centers were originally created as a integrated health sector model for women and children who experienced emotional, physical, and sexual abuse. These centers include medical care, counseling police aid, and social support to those people that are in need (Colombini 2012). Young girls that are the victim of rape can use these services already, but it could be beneficial to expand some of these services to teenage girls that have become pregnant from other means. Services like counseling could be especially helpful to young girls in this situation. These crisis centers are currently on all state run hospitals and would give access to health care to more teenagers around Malaysia. Some girls and their families still might choose to utilize shelter homes, and these systems as well could be enhanced as well.
Shelter home staff could benefit from being introduced to social work ethical codes to counteract bias and prejudice towards unwed teenage mothers (Saim 2013). More professionals within these homes would help the girls receive more one-on-one counseling as well as implement group counseling. Staff could also function as positive role models for girls that do not have these types of relationship within their homes. When these girls are treated positively and respectively they can begin to build back their self image. Courses that focus on job training, social and health education, and social-emotional skills could help girls reenter the world after their stay in the shelter (Saim 2013). Hopefully, these types of homes would not be needed as much in Malaysia if young girls are getting proper sexual education to make informed decisions for themselves. However, it is still important to make sure these programs are creating a safe were girls can get the social support that they deserve.
In conclusion, Malaysia has a long way to go before it can say that it truly has solved teenage pregnancies. The first line of defense should always be education, and improving the sexual education programs in schools across the country is one of the best ways to confront this issue. However, cultural norms and public opinion does not change overnight, and some might fight against this type of approach. It might take some time before classes like these would be more widely accepted, but it would be a worthy effort. Secondary efforts like centers and shelters should also go through some restructuring to produce the most social support for girls. The most important thing regarding this issue is helping to elevate young women. They experience the brunt of this issue instead of the fathers of their children, and should be the focus for the solution.
Braveman, P. and Gottlieb, L.
The social determinants of health: it’s time to consider the causes of the causes. Public health reports, 129(1_suppl2), pp.19-31.
Colombini, Manuela, Susannah H Mayhew, Siti Hawa Ali, Rashidah Shuib, and Charlotte
An Integrated Health Sector Response to Violence against Women in Malaysia: Lessons for Supporting Scale Up. BMC Public Health 12(1)
Kamaluddin, Siti Fathilah
Urban Malaysian Women’s Experiences of Abortion: Some Implications for Policy. Reproductive Rights Advocacy Alliance Malaysia. Kajian Malaysia. http://www.rraam.org/resources/journal-articles/urban-malaysian-womens-experiences-of-abortion-some-implications-for-policy/
Malaysian Youth Sexuality: Issues And Challenges. Journal of Health and Translational
Medicine 12(1): 3–14
Social Determinants of Health Inequalities. The Lancet 365(9464): 1099–1104
Mutalip, Siti Syairah Mohd, and Mohamed Ruzianisra
Sexual Education In Malaysia: Accepted Or Rejected? . Iranian J Publ Health 41(7)
Saim, Nor Jana, Mona Dufåker, Malin Eriksson, and Mehdi Ghazinour
Listen to the Voices of Unwed Teenage Mothers in Malaysian Shelter Homes: An
Explorative Study. Global Journal of Health Science 5(5)
Suan, Mohd, and Adibah Ismail
A Review of Teenage Pregnancy Research in Malaysia. Med J Malaysia 70(4)
Talib J, Mamat M, Ibrahim M, Mohamad Z
Analysis on Sex Education in Schools Across Malaysia. Procedia – Social and Behavioral Sciences 59:340–348. doi: 10.1016/j.sbspro.2012.09.284
Zain, Norhasmah Binti Mohd
Outcomes of Pregnancy Among Unmarried Mothers in Malaysia. http://studentsrepo.um.edu.my/6911/1/OUTCOMES_OF_PREGNANCY_AMONG_UNMARRIED_MOTHERS.pdf