Are youth friendly services friendly?

Turn up the love, condomise! Love yourself, condomise! Live, love, condomise!

These are just some of the messages displayed during a Ministry of Youth and Sports on-going Condomise Campaign, whose aim is to encourage condom use among the youth. Currently, the use of condoms among the youth in Malawi is low, according to the studies by the ministry.

But it is not only condoms that are being shunned by the youth; almost all forms of modern contraception are not popular among this population group, leading to not only unplanned pregnancies, but also the spread of sexually transmitted infections (STIs) including HIV.

The Condomise Campaign, which is taking place in Mzuzu with funding from UNFPA, has coincided with the World Contraception Day today, whose mission is to improve awareness of contraception among young people, so that they can make informed decisions about their sexual reproductive health (SRH).

Coupled with government’s efforts to ensure youth friendly services (YFS) in its health facilities, this campaign would ideally have a notable impact in improving the uptake of contraceptives among youths. However, experts believe the stigma that surrounds sex in general, and the youth and sex in particular, is a major hitch in this process.

The Engender Health website, which describes YFS as a service that provides young people, quality health care services, notes that providers are often biased and do not feel comfortable serving youth who are sexually active.

“As a result, the youth don’t feel comfortable accessing the services because they aren’t youth friendly and may not meet their needs and often community members don’t feel the youth should have access to SRH services,” indicates Engender Health.

Thus, while YFS requires health workers to reflect upon and assess their own beliefs about adolescent sexuality while ensuring that those values and attitudes do not compromise the youths’ sexual and reproductive health rights, Engender Health says this right is not a reality.

“Many youths in need of SRH services may either decline or be denied access to health services for variety of reasons,” reads the website information.

This should not be strange in Malawi, a country where family planning is rarely discussed among parents and children, is not a part of the education curriculum, and where young people often feel shy when the topic is brought up.

Project officer for Pakachere Health and Development Institute, Basimenye Nhlema, told The Nation that while youth friendly services (YFS) are a preventive strategy to early pregnancies and STIs, it is unfortunate that the country does not have the capacity to meet its demand.

“One of the things holding back the progress of YFS is the fact that hospital personnel who are trained may get transferred to another district. As a result, the remaining staff don’t know anything about YFS,” she noted.

She said there is a need for civic education to improve attitudes towards the youth and contraception and also to include YFS into the training curriculum of health workers so that every medical personnel is familiar with YFS by the time they start working.

“There is a lot of resistance from elders and parents regarding sexual and reproductive health, especially the use of family planning methods among the youth,” she said.

The result of this status quo is that in the country, 45 percent of girls get pregnant before the age of 18, according to the 2010 Malawi Demographic Health Survey (DHS), which further indicates that 41 percent of women have an unmet need for contraception, keeping them from planning the number of children they want to have and when.

According to the International Planned Parenthood Foundation (IPPF), fulfilling the unmet need for modern family planning would reduce the number of pregnancy-related deaths by 48 000 in sub-Saharan Africa and 79 000 globally.

During the World Population Day commemoration in July, UNFPA resident representative Athanase Nzokirishaka noted that the high maternal mortality rate and occurrences of obstetric fistula in Malawi are aggravated by early child bearing.

“This is exacerbated by poor access to sexual and reproductive health information and services by girls. In addition, coverage of youth programmes appears to be disproportionately focused on late adolescent girls (15-19 year olds), with early adolescent girls not adequately covered,” said Nzokirishaka..

Around the world, about 16 million girls under age 18 give birth each year.

United Nations Secretary General Ban Ki-moon said in his World Population Day message that young people and women who have the power and means to make own decisions about how many children to have and when to have them are better able to contribute to the development of their societies.

“Teenage pregnancies are still common in most parts of the world, often driven by poverty and lack of education…I call for urgent, concerted action by member States to bridge the gap between the demand and supply for reproductive health care,” he said.

Ki-Moon further noted that the highest rates of STIs are among young people aged 15 to 24.

“The needs and human rights of these young people must be urgently addressed,” he said.