On the 26th,/September/2022, Winnie Akidi an AfNHi youth mentorship cohort member based in Uganda, hosted a twitter space that brought together four speakers i.e. The president of African Youth and Adolescents Health Network on population and development, the Executive Director of Nile girl’s forum, the BCC Programs manager at Naguru Teenage health and information center as well as a disability rights advocate and communications officer at National Union for Women with Disabilities of Uganda to a holistic round conversation reflecting on the barriers young people face in accessing SRHR services and information.

In this online conversation ,it was revealed that recent studies in Uganda and across the sub-Saharan Africa show how young pep[le are having limited access to contraception services and  how lack of trained personel to address the sexual reproductive health needs of young people and persons with disability at large in health facilities is a big challenge. In her statements she  also mentioned how persons with disabilities face magnitudes of challenges in accessing these services due to stigma and negative attitudes by service providers and medical workers who assume people living with disabilities should be asexual which deficits in perception and knowledge have greatly affected persons with disability and young people’s access to sexual reproductive health care services today.

Having invited key advocates to respond to a question dubbed “REFLECTIVE VOICES ON SRHR ACCESS”, one of the panelists, Charles mentioned how policies have greatly influenced access to SRHR services for young people especially those below 18 years in Uganda. Reflecting on different works done by different members of Civil Society .He further stated how unfriendly policy environments that inform advocates are not available for example the Adolescents Health policy which would be a key guideline for actors to advocate for Sexual Reproductive Health Rights and services isn’t available. He mentioned how these are key documents that would help guide advocates works.as well as guide the health system structures  that do not favor service delivery  in terms of functionality ie, they do not have the capacity to offer these services as most of them do not have key contraception services and the community health workers model would play an important role in relaying guidance of SRHR service access in communities.

Charles also mentioned how gender inequality and patriarchy in society today does not give the girl child an opportunity to negotiate and decide or speak for themselves, thus the growing teenage pregnancy and child marriages associated with social norms and culture that fuel patriarchy. At institutional levels most of the girls and boys do not have the information around SRHR to help them make informed choices.

As a passionate gender and disability expert, Shamim mentioned how the barriers are compounded especially with the covid pandemic, caretakers of persons with disability in reproductive age  still deny them their  SRHR rights without consent where body autonomy is involved. she further mentioned how care takers carry out drastic decisions like abortion and forced sterilization of these person in thought that they incapable of taking care of children since they are disabled. Shamim also mentioned how the physical environments are not friendly and how medical equipment are not designed for examination and labor purposes thus robbing these young women of their dignity.

She mentioned an example of how a person with albinism is discriminated against and asked inappropriate questions like “Are you also white down there”. This has often made them shy away from going to access services as well as negative language from nurses to women with disability on how they were able to climb their marital bed and fail to climb the hospital beds during antenatal checkups.

Thembo, a BCC programs advocate, shared how we can quickly appreciate the translation of knowledge into information for young people and vice versa around behavior change for SRHR information uptake. He mentioned how access to information should ultimately influence behavior of young people stating how we are supposed to translate all information on SRHR into consumable knowledge for the young people to understand and appreciate the information they get. Thembo also mentioned the need to conduct routine surveys on understanding the needs and preferences of young people’s need to consume this information.

Peace from Nile girl’s forum shared how they are using a peer pals model to disseminate age appropriate information on treatment and adherence in refugee settlements in the West Nile region. She also mentioned how they are working with cultural leaders of “Alur kingdom” to champion SRHR issues and support young people, as culture is a pivotal instrument in communities given that communities believe so much in their leaders.

Recommendations;

During this call, to address the disability segregation, it was mentioned the need for continued awareness of communities, medical workers and different institutions on disability and disability rights on how to offer services for young people with disabilities.

There’s a need to be intentional on how to package messaging around SRHR and HIV prevention and awareness. Mentioning how the media needs to be fully engaged in creating awareness.

There is a need for male involvement in promoting SRHR services especially contraception usage and access as it is stereotyped and considered a women’s thing making uptake a challenge.

From the comment section, someone mentioned the need to mend structures that need to be lobbied for and advocated such that an inclusive environment is created in health centers, in this every health center needs to have an adolescent clinic.

In conclusion, from this discussion, different challenges ranging from structural, institutional and perception challenges are key barriers to access of sexual reproductive4 health rights and service information uptake among young people today. And thus the need for tailored implementation programs that best meet the needs and preference of young people in accessing SRHR information  and service as we strengthen our advocacy today.

Compiled by 

Winie Akidi- (Uganda ) AfNHi Youth Cohort member

Heard of the phrase “human-centred design”? Human Centred Design, also known in short as HCD, is an approach to problem solving that focuses on understanding the needs, motivations, and aspirations of people to inform the design of potential solutions.  With empathy as its organising principle, HCD uses a creative and participatory process to generate ideas, develop them into prototypes for testing, and iterate on the result until a solution that best serves the needs of the target users is achieve(Rimjim, HCD Consultant at HCD Exchange). 

Prior to joining  HCD Exchange in 2022 I had some level of understanding of HCD. Notably, in 2020, I participated as an interpreter on a Y-Labs project that engaged girls on SRH, specifically  youth friendly clinics.  Although there are many  HCD methods and tools such as Journey Maps, Role play,Storyboard, card sort just to mention a few. One of the tools used by Y-Labs during the session was Card sort through a focused group discussion.

I was previously unaware that card sorting  was one of the HCD tools, but I thought it was a unique method to involve the youth,especially because it enables the facilitators to include images associated with the particular topics covered during the session. Interesting, I said to myself.

 I didn’t have the opportunity to inquire further about their decision to employ that strategy because I was so ecstatic to have witnessed something novel—that was the twist—that I missed the opportunity.

After a rigorous selection procedure, I was given the uncommon opportunity to join HCD Exchange in 2022. I’ll elaborate on that later, but for now, let’s focus on how it affected my life.

When I joined HCD Exchange, I gained a lot of knowledge about how Human Centered Design can be applied to adolescent sexual and reproductive rights.That was when I understood the different HCD  tools better including the one used by Y-Labs.

You’ll notice that HCD makes it easier and more possible to understand the needs of persons we design  programmes for as development workers and  advocates.

As a young advocate with Africa free of New HIV infections( AfNHi), I had the opportunity to give a presentation where I introduced HCD to other advocates working on SRH. I briefly discussed the definition, tools, and ways they can integrate it in their work.

As a result, my project, SRH Day out, targeted the Shai Osuduko community. Using HCD, we assessed their needs and determined that they required not only reproductive health information but also education support in the form of stationeries. Using the  AfNHi youth mentorship project support, my team and I provided a comprehensive  response to their needs during the project’s implementation;through SRHR  information sharing, provision of stationeries for students, career guidance and mentorship. This way, the people of Shai Osuduko, chiefly, the young people’s needs would be met.

With the use of HCD,advocates are well versed about the various tools available to identify the needs of their target, build solutions that are targeted, and share best practices when necessary. The next time you think of designing any program or solution for SRH, think of HCD to help you in the process.

This is my HCD usage experience; to learn more about HCD, see the HCD Exchange community or the AfNHi social media pages.

Victoria Quaynor- Ghana (AfNHi youth mentorship cohort member )