Adolescents longing for friendly health services

MALAWI: The adolescents’ are excited to hear the bodily anatomy issues in detail, it’s a moment of truth here at Bangwe Health Centre.

The Youth Friendly Health Services (YFHS) focal people from this facility and Blantyre District Health office are interacting with Adolescent Girls and Young Women (AGYW) on Sexual Reproductive Health Rights (SRHR) issues and the operations of their department.

“I’m glad to be part of this session. There are lots of teenage pregnancies and Sexually Transmitted infections in this area. This problem is here largely because the adolescents don’t have information on their sexuality,” says 18-year-old Chisomo Makina of Ntenje in Bangwe Township.

Bangwe, a densely populated peri-urban slum district of Blantyre, suffers from high levels of urban poverty. Teenage pregnancies, early marriages, rape, defilement, and child maltreatment are all common in the area. Female-headed and child-headed households predominate. According to the AGYW assembled here, the region is never short of scandals involving sex, particularly young females having sexual encounters with older guys.

The AGYWs admit that they frequently discuss their reproductive health and occasionally provide advice on how to avoid unwanted pregnancies. However, the high prevalence of adolescent pregnancies speaks eloquently about the quantity of misinformation that circulates among this age group.

“We lack the right information. What I’m learning today is totally different from what I know and have been believing for a long time. Lack of information has done lots of damage to AGWY of my area,” admits Chisomo, adding, “Many girls from my area have failed to make informed reproductive health choices due to lack of knowledge. They have ended up in bigger problems. I know of girls who had unsafe abortions due to bad choices.”

According to the Malawi Demographic and Health Survey (MDHS) 2015/16, 15% of young women and 18% of young males aged 15-24 had had a sexual experience before the age of 15.

The Health Policy Project, (Futures Group) Health brief document of March 2015, titled: YFHS Malawi, how does the YFHS program performance match up to national standards? says in 2007, the Ministry of Health through its Reproductive Health Directorate launched the YFHS program, aiming at providing high-quality services to young people in a friendly manner that is acceptable, accessible, appropriate, affordable, and attractive.

“Managing the performance of the YFHS program is one aspect of safeguarding young people’s transition into adulthood and improving health indicators…,” reads the document in part.

HIV Testing Services Officer and YFHS provider at Bangwe Health Centre, James Matembo says YFHS are an important aspect for the youths’ reproductive growth.

“Most youths are experiencing bodily changes, at the same time they are under pressure from peers to experiment with their sexuality. This mostly results in the youths contracting STIs or falling pregnant because they share false information. But when they regularly come here, they have the right information,” he notes.

Every Friday, youths at the Bangwe health center gather for youth corner sessions to discuss SRHR topics, share challenges, reflect on solutions, and gain access to different health services including as HIV testing, contraception, and antiretroviral treatment (ART). The department serves 80 young people per week and 320 young people per month.

“I believe we would have had a lot of youths in attendance but they are discouraged. We have no YFHS designated building here. We currently use the ART building. Many of them are afraid of speculation that they come here for ART and not for their services,” Matembo observes.

He reveals that it has been difficult to have comprehensive data on youth STIs and unsafe abortions because most youths prefer to go to private clinics as it is believed to have more ‘privacy’ than our clinic.

Matembo elaborates: “Although with very critical cases, at least AGYW would come to the clinic to seek post-abortion care cases. But the not boys with STIs. On normal days, we still attend to youths’ health needs through our red carpet program. We check on the queues and if there’s a youth we take them to one of the consultation rooms to hear their medical issues.”

The interactive session with AGYW and YFHS employees was conducted by the Young Women Christian Association (YWCA) Malawi.

YWCA Malawi is a Christian organization devoted to empowering young women, women, and girls in order to build and sustain a progressive community. With funding from the Her Voice Fund, the organization has been implementing advocacy programs and services to develop the leadership and collective power of women and girls; to support individuals, their families, and communities during difficult times; and to promote gender equality and community strengthening.

The organization recognized through its AGYW active citizenship initiative that AGYW also had issues in the SRHR area, therefore facilitating their meeting with YFHS officials at Bangwe health clinic on this day.

YWCA Projects Coordinator, Irene Ntonga, notes that AGYW has SRHR issues but they rarely speak out because sexuality issues are regarded as social taboos.

“There is an increase in teenage pregnancies and STIs amongst AGYW because there is a lot of false information sharing amongst the youth. We noted the gap that’s why we connected them with YFHS personnel,” she says.

Ntonga further says through this project, YWCA aims at amplifying the voice of AGYW through the engagement of local leaders.

“If they are part of development committees, it becomes easier for them to advocate for their needs such as vibrant abuse reporting mechanisms and inclusion of pad changing rooms when constructing girls’ toilets. We have so far seen the inclusion of some AGYW, this is a good sign,” she says.

If Bangwe AGYW are aware of their SRHR and participate in the development process, the area's present narratives will shift, paving the way for improved lifestyles.