Sexual and reproductive health in Malta : trends, discourses

Abstract

This research aims to provide an overview of the sexual and reproductive health situation in Malta. The study took the form of a desk research and reviewed various local and international literature on various topics, namely sex education, access to contraception and sexual health policies and services. The literature reviewed indicates that the changes in the attitudes and behaviours of the Maltese population with regards to sexuality are indicative of a shift towards secularisation. The teachings of Sexuality and Relationships Education are not consistent across Maltese secondary schools and students still leave compulsory education with many misconceptions. Sex education has simply not been effective and the trends in sexuality and reproductive health knowledge and behaviour amongst students is evidence of this. Malta ranks poorly in most categories of the Contraception Atlas and this is indicative of the low levels of access to contraception in the country. Following a judicial protest, parliamentary sessions and a civil protest, different types of the emergency contraceptive pill were made available in 2016. Access to emergency contraception still remains hindered and despite various promises, such contraception has not been made available to victims of rape who seek immediate health care at Mater Dei Hospital. Laws and policies are vital in the promotion of sexual and reproductive health and the protection of human rights. The National Sexual Health Policy has not been updated in a decade and not much has been implemented when it comes to sexual and reproductive health and rights. Patient admission to the GU clinic has more than doubled within the last 10 years, and as a result the clinic has been understaffed. Promises to increase the clinic’s staff were made years ago but still not yet been fulfilled. NGOs have recently been stepping up and offering sexual and reproductive health services in order to fill the gaps in services not provided by the State. The following recommendations were made based on the extensive literature review. Mechanisms and frameworks to monitor sex education need to be created and implemented through policy in order to ensure that lessons are delivered in a consistent manner across all schools. Access to contraception needs to be given more importance and the oral contraceptive pill should be deemed as essential medicine in Malta. Contraception subsidisation and reimbursement schemes should be implemented in order to increase accessibility levels of contraception and to allow for better autonomy over family planning. The national sexual health policy is in dire need of an upgrade through the publishing and implementation of a new comprehensive policy document. The introduction of family-planning clinics should also be considered. It is time for Malta to start taking sexual and reproductive health and rights seriously by addressing long-term issues which have been existent for a very long time.