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.
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.
Winie Akidi- (Uganda ) AfNHi Youth Cohort member