By Carol Gatura
Carol Gatura is Communications Officer at African Population and Health Research Center (APHRC). This article originally appeared on the APHRC blog, and is an update to the post Meeting the sexual and reproductive health needs of youth living in urban poverty.
Youth living in urban informal settlements face numerous challenges when it comes to accessing sexual and reproductive health (SRH) information and services. Comprehensive sexuality education is hardly taught in schools, and parents are not quite sure how to talk about sex with their children.
As part of our work on the USAID-funded African Strategies for Health project – a multi-year initiative in collaboration with Management Sciences for Health that examined barriers to access to reproductive health services in urban and peri-urban contexts across the continent – the African Population and Health Research Center produced a short film based in the Nairobi, Kenya slums of Viwandani and Korogocho.
Shiko, 23, raises her five-year-old son in a slum outside Nairobi, Kenya. When she went to her first antenatal visit after noticing changes in her body, the nurse denied her services because she thought Shiko was too young to have a baby. Now, Shiko is a mentor of girls in her community. She wants to make sure they have access to sexual and reproductive health information and youth-friendly services, so they can make healthy choices that are right for them.
Hannah, a health worker, provides non-judgmental sexual and reproductive health services to the young people who come to her clinic. Many of the youth she sees are pregnant, have sexually transmitted infections or want contraception.
How can we meet the sexual and reproductive health needs of youth living in urban poverty?
Experts highlight opportunities to improve the health of youth living in impoverished conditions and call for stronger, integrated health services to meet the needs of young people in an increasingly urban Africa.
Featuring FCI Program’s Melissa Wanda (Kenya), the video was funded by USAID and produced by African Strategies for Health (ASH) partners, the African Population and Health Research Center (APHRC) and Management Sciences for Health (MSH).
By Ariadna Capasso and Maria Faget
Ariadna Capasso is senior program officer for the Latin America and Caribbean (LAC) program, and Maria Faget is LAC regional adviser on youth and adolescents.
The rights and needs of persons with disabilities are too often neglected, violated or ignored. This is manifested in acts of discrimination, emotional abuse, and physical and sexual violence, especially among adolescent women. Fifteen percent of people—close to 1 billion–around the world live with a disability, and 80% of them live in developing countries. Many women with disabilities, including adolescents, face unacceptable discrimination. Around 68% of women with a psychosocial disability will suffer sexual abuse before they turn 18. Women with disabilities often see their right to make decisions in regards to their fertility and motherhood curtailed, through practices such as forced sterilization and limited access to family planning methods. These practices are often the result of generalized stereotypes and lack of cultural sensitivity towards disabilities.
Sékou Traoré, 26, became one of FCI Mali’s youth peer educators, or un educateur-leadeur, two years ago. He works as a mechanic at a garage in Bamako, making him one of many Malian youths who work in the economy’s informal sector. Youth in the informal sector have been, and remain, difficult to reach with health awareness and advocacy messages, because they take jobs rather than attend school where these youth health messages are concentrated.
While Sékou maintains his job, he works for FCI as a peer educator as often as time allows, sometimes once a week for a few hours, and sometimes two or three times a week. Sékou dedicates most of his free time to FCI.
By Kigen Korir, National Programme Coordinator, SRHR Alliance in Kenya; Hellen Owino, Advocacy Officer, Centre for the Study of Adolescents in Kenya; and Lara van Kouterik, Senior Programme Officer SRHR, Simavi in The Netherlands
We have the largest generation of young people ever.
The world must listen to young people’s voices. It must ensure that we have the opportunity to influence policies that affect us, especially in setting the new development agenda for the era beyond 2015. It must understand that young people know what they want and need, and are committed to safeguarding their sexual and reproductive health and rights (SRHR).
Too often, the voices of young people are drowned out by those of adult policymakers who think they know what young people need and assume young people are “too young” to articulate their issues effectively. For many years, these assumptions have limited the opportunities and constricted the space for young people to participate meaningfully in the creation of the development programs and policies that will have a direct impact on their lives.
At a recent side event during the Commission on Population and Development, young people voiced their concerns, shared best practices, and discussed key issues with other stakeholders. The event was hosted by Simavi (an NGO based in the Netherlands), the permanent mission of Ghana to the UN, and SRHR Alliances from Ghana, Kenya, Uganda, and Malawi, and was attended by representatives, including youth, from country delegations; SRHR advocates; policy makers; and young people.
“Involving young people in SRHR is a basic right enshrined in the laws of many countries, and it is therefore incumbent for countries to observe the same,” explained Edith Asamani, a youth representative from Curious Minds Ghana.
Aisha Twalibu, a youth representative from YECE in Malawi, explained to the group that young people are a diverse group with different needs, and that listening to their voices will help governments, CSOs and development agencies tailor SRHR programs to their needs.
Three other young Africans shared case studies on youth SRHR programs. First, Chris Kyewe from Family Life Education Programme described his peer education program in Uganda, in which youth peer educators (YPEs) are trained to give SRHR information and education to their peers and refer young people to local health centers where trained healthcare providers offer youth-friendly services. In addition to education, YPEs also provide their peers with condoms and oral contraceptive pills, together with instructions on how to use them. This example showed how young people are meaningfully engaged in the implementation of the program.
Then Hellen Owino from the Centre for the Study of Adolescents in Kenya shared that comprehensive sexuality education programs in Kenya empower young people to make informed choices about their health and sexuality. CSA and the Kenya SRHR Alliance have been engaged in advocacy to include comprehensive sexuality education in the national curriculum of Kenya. She also shared that CSE programs should be appealing and interactive, for example by using ICT and social media, to capture the attention of young people. Justine Saidi, the Principal Secretary for Youth in Malawi also called for the active involvement of parents in demanding that young people have access to sexuality information.
Charles Banda from YONECO shared the last case study that focused on preventing child marriage in Malawi. He shared his experience in working with youth-led organizations to build awareness on the negative impact of child marriages on girls and communities, creating a more enabling environment for young girls to exercise their rights. He also described how civil society organizations in Malawi have advocated successfully to raise the legal age of marriage to 18 years, which was recently made into law by the President of Malawi.
Highlighting lessons from the women’s movement, the side event concluded with a discussion of key strategies for youth advocates, including:
- Mobilizing a critical mass of young people
- Holding governments accountable for fulfilling their national and international commitments
- Investing in ensuring that health data can be disaggregated by age group, especially for young people aged 10 to 14
- Identifying champions at all levels to advance the youth and SRHR agenda
It is time that young people’s views and concerns are incorporated into the new development agenda. Without listening to young people, no country will be able to realize the potential of the demographic dividend that comes with this generation.
Amy Boldosser-Boesch is the Interim President and CEO at Family Care International. This article originally appeared on the MDG456Live Hub, curated coverage of women and children during the UN General Assembly.
As we move into the intergovernmental negotiations for defining the post-2015 development agenda, continued advocacy will be needed to link sexual and reproductive health and rights (SRHR) to sustainable development. Do you have the talking points you need to make the case that governments must ensure the comprehensive inclusion of sexual and reproductive health and rights within the post-2015 development framework?
A new tool Briefing Cards: Sexual and Reproductive Health and Rights (SRHR) and the Post-2015 Development Agenda can help. The briefing cards detail the linkages between SRHR and other key development issues including environmental sustainability, gender equality, economic growth, educational attainment, and broader health goals. Produced by FCI, with support from the UN Foundation, and co-authored by partners in the Universal Access Project, each one page card provides advocates with succinct arguments and key Facts at a Glance about the impact of SRHR on the broader development agenda. Each card also includes recommendations for inclusion of SRHR in the post-2015 development framework in a cross-cutting way, for example, by encouraging targets and indicators that address and measure the strong connections between girls’ education and their sexual and reproductive health and rights. All of the partners involved in developing the Briefing Cards hope that they will be a useful tool for advocates worldwide working to shape the social, economic and environmental aspects of the post-2015 sustainable development agenda. The cards are available for free download; please share them with your partners and help us make the case with governments and other stakeholders in the post-2015 process that sexual and reproductive health and rights are integral to the achievement of all shared development goals.
This year’s Women Deliver conference made a strong call for investing in the health and development of adolescents and young people: they were at center-stage, and their health and development needs were discussed in dozens of sessions on different topics. And they were a notable physical presence. In addition to a youth pre-conference that brought together one hundred young leaders from around the world, adolescents and young people spoke on panels, moderated discussions, and chaired a youth networking zone. The conference highlighted the unique problems faced by adolescent girls and young women–some of the most vulnerable and neglected individuals in the world–and stressed the importance of addressing their needs and rights, not only for their individual benefit, but also to achieve global goals such as reducing maternal mortality and HIV infection.
In response to an invitation from the editors of the peer-reviewed journal Reproductive Health, 16 experts from WHO and other UN agencies, academic institutions, and a range of NGOs — including FCI’s global advocacy director Amy Boldosser-Boesch — coauthored a commentary that lays out the key themes that reverberated throughout the conference, on the health and development needs of adolescents and young people, and promising solutions to meet them.
“The time to act,” the authors write, “is now.” With increasing recognition that meeting the needs of young people is essential to achievement of the Millennium Development Goals, and a growing understanding of the challenges faced by adolescents and the interventions that are effective in addressing them, “the real imperative is to apply the knowledge and understanding that we already have.” They conclude:
There is widespread acceptance of the need to address the sexual and reproductive health of adolescents and young people. There is a groundswell of support from national and international bodies to translate words into action. We need to leverage this collective commitment and expertise. For the world’s 1.2 billion adolescents to survive, grow and develop to their full potential, the small scale, time limited, piecemeal projects of yesterday must be transformed into the strong, large scale and sustained programmes of today.
To read the full article, click here.
Ann Starrs is FCI’s president.
Yesterday at the United Nations, FCI joined with the UN Missions of Bangladesh, Canada, and Malawi, and a dozen partner organizations, to sponsor a moving, inspiring, and often infuriating discussion on child marriage. Too Young to Wed, a side event to this week’s annual meeting of the UN’s Commission on the Status of Women, shed light on an issue that affects tens of millions of young women — 39,000 women under 18 are married every single day — but is too seldom discussed.
For FCI, this issue hits right to the heart of our mission. When a girl is married off too early, she begins sexual activity without giving any meaningful consent, and is soon faced with a pregnancy for which she is not prepared either physically or emotionally. The risk that a pregnant teenager will experience complications that threaten her life or health is much higher than for an adult woman. Adolescent girls account for about 10% of all marriages but nearly a third of all maternal deaths. Complications of pregnancy and childbirth are the leading cause of death for young women between 15 and 19 in the developing world.
Speakers at the UN event included Dr. Babatunde Osotimehin, the Executive Director of UNFPA, and Michelle Bachelet, Executive Director of UN Women and former president of Chile; senior representatives of the governments of Namibia and Malawi; and a number of advocates. One moving highlight was an appearance by video link (because she was unable to procure a US visa) by Mereso Kiluso, a young Tanzanian who was married off at the age of 14 to a man in his 70s.
A number of panelists emphasized that child marriage is often a form of sexual violence. Nyaradzayi Gumbonzvanda, General Secretary of World YWCA, moderated the discussion, noting that it is rape when a young girl has to sleep with a man she doesn’t know, even if it is on her wedding night. And Michelle Bachelet pointed out the vast power inequality that exists between a young bride, with no legal or social support to rely on, and her older husband, who often paid for her and views her as a piece of property.
“The problem of child marriage,” according to Lakshmi Sundaram of Girls Not Brides, “is underlaid by the fundamental belief that girls and boys are not equal.” A world in which women are second-class citizens is a world that will continue to tolerate sexual violence, genital mutilation, and early marriage. When parents see national and community leaders who are women, said Bachelet, they will begin viewing their own daughters differently.
Several speakers highlighted the need not only for stronger government policies – notably an increase in the age of marriage – but also for implementation and enforcement of the policies that are in place. Girls – and boys – must have access to information about their sexual and reproductive health and rights, and to health services, including family planning. Religious leaders should be engaged on this issue: for example, before presiding at a marriage ceremony, they should take the bride aside privately to ascertain her consent, and ask to see her birth certificate to ensure she is of age.
As Catherine Gotani Hara, Malawi’s Minister of Health, pointed out, policies must be put in place not only to discourage or prevent child marriage, but also to mitigate its effects: for instance, Malawi now allows girls to stay in school even if they are married and/or pregnant.
The discussion came back, again and again, to the vast challenges that still exist in our efforts to protect girls and young women from being forced to marry too soon. But there was also reason to hope. “It’s possible to prevent child marriage,” said Nyaradzayi Gumbonzvanda. “It’s possible to protect against child marriage, and it’s possible to end child marriage.”
- Watch a video of the event
- Read the press release
- Read a blog by Carole Presern of the Partnership of Maternal, Newborn & Child Health
María Faget is Family Care International’s Regional Advisor in the Latin America and Caribbean region.
Last month, 21 young people from five Andean countries spent four days together learning radio production skills, recording professional-quality radio shows, and developing strategies for fighting teen pregnancy. The engine driving their work was the passion of these young people for their communities, and their outrage at the difficult realities they see around them every day. Motivated by their commitment to sexual and reproductive rights, and fascinated by radio’s potential to communicate positive messages to their peers, these young people parted at the end of the workshop with pride, satisfaction, and many new friendships.
All of this occurred at an innovative workshop, organized by FCI, that was held in Tenjo, near Bogotá, Colombia, as part of youth-participation component of the Andean Plan for the Prevention of Adolescent Pregnancy Prevention (PLANEA). The workshop was conducted with financial support from UNFPA and the International Foundation,
Participants learned to use familiar stories, interviews, commentaries, and musical effects to illustrate various facets of teen pregnancy. Working with two professional audio editors and facilitators from Caracola Consultants, they ultimately succeeded in writing, producing, and recording seven complete radio programs.
One young participant summed up the experience like this:
I am so motivated, excited, pleased, and happy with all that we achieved in this workshop, the quality of speakers we met, and the friends from different countries whom we lived with. There is no way to say thank you … Now it is up to us to show, in the work we do back in our countries, how much this has empowered us.
Taller de producción radial: Pasión y orgullo
María Faget es Acesora Regional de Family Care International en América Latina y el Caribe.
Estos dos conceptos pueden resumir lo que ocurrió durante los 3 1/2 días del taller de producción radial liderado por Caracola Consultores en las afueras de Bogotá. En el marco de las actividades en participación juvenil del PLANEA, FCI, con apoyo financiero del UNFPA y de The International Foundation organizó este encuentro-taller para fortalecer la articulación de las redes juveniles y su capacidad de comunicación e incidencia política.
En esta oportunidad, veintiún jóvenes de 5 países del área andina trabajaron de sol a sol orientados por las facilitadoras, y con apoyo adicional de dos editores de audio lograron su meta: completar 7 programas radiales pregrabados.
El reto estuvo claro desde el inicio: a través de una historia conocida, mediante entrevistas, comentarios, musicalización y otros recursos de la crónica o el reportaje, cada uno de los 7 grupos debía mostrar una faceta del embarazo en la adolescencia y dejar un mensaje. La realización paso a paso de los programas fue un proceso muy rico de creatividad, análisis y crítica participativa que además fortaleció el aprendizaje individual.
El esfuerzo durante el taller tuvo como motor la pasión de estos jóvenes por su trabajo en las comunidades. Movilizados por los temas de derechos sexuales y reproductivos, indignados por las realidades que ven en su entorno, conmovidos por los casos particulares, fascinados por las posibilidades de la comunicación y en particular de la radio, pusieron todo su espíritu y todo su empeño en la tarea creativa. Los resultados fueron inmediatos, y el orgullo y la satisfacción de los y las jóvenes, manifestados claramente en sus evaluaciones sobre el taller están plenamente justificados.
Los productos, las fotografías y los testimonios son – más que ningún informe – prueba de lo ocurrido y de lo logrado durante el encuentro. Véanlos a continuación.