Scaling up Sexual and Reproductive Health for youths in the ESA region

Partners from ESA countries discuss next steps

Impressions from the 2nd Transnational Learning Conference in South Africa

From 25 to 27 October 2017 high-level political decision-makers and implementers from health, education, youth and gender sectors, including the UN family, gathered in Pretoria for a transnational learning exchange conference, hosted by the ESA (Eastern and Southern Africa) Regional Programme for Implementation of the ESA Commitment, commissioned by the Federal Ministry for Economic Cooperation and Development (BMZ).

For young people, the sexual and reproductive health situation in the ESA region is in an alarming state: about 50 young people get infected with HIV every single hour, and the prevalence rates of Sexually Transmitted Infections (STI), early and unintended pregnancies and gender-based violence are markedly higher than in the rest of the world. In Namibia for example, 43% of all new HIV infections are found among young people between the ages of 14 and 24, and the large majority of them affect young women. In South Africa, every week 2300 young women and girls are infected with HIV.

This situation has persisted although it is well-known that comprehensive information about their sexual and reproductive health enables young people to adopt healthy lifestyles and to protect themselves against sexually transmitted infections and early pregnancies.

Against this background, the conference provided a forum for exchange about recent implementations of Comprehensive Sexuality Education (CSE) and Adolescent and Youth-friendly Health Services (AYFHS) by the countries supporting the ESA commitment. In addition, opportunities and challenges for the scaling-up of successful interventions and key actions for effective advocacy on these topics by high-level decision-makers were also discussed.

ESA Commitment and HIV Prevention Coalition

Mr. Bechir N'Daw, Senior Adviser for Political Partnerships and Social Justice representing the Regional Director of UNAIDS, pointed out that the ESA Commitment represents an integral part of the Global HIV Prevention Coalition. He stressed the importance of ensuring access to combination prevention options, including condoms, PrEP, harm reduction and VMMC to at least 90% of people at risk by 2020, and especially to young women and girls in high prevalence countries and to key populations. To achieve this, stronger political commitment and adequate investments were needed and sensitive issues related to young people’s sexual and reproductive health and the lack of systematic prevention would have to be addressed. According to Mr. Bechir N’Daw, the ESA Commitment constitutes an important cornerstone in approaching these bottlenecks effectively.

Misconceptions about comprehensive sexuality education

In partnership with the UN, the German-supported ESA Regional Programme organised online training for teachers in comprehensive sexuality education in four ESA countries in 2017. Participants’ feedback was overwhelmingly positive, however, many of them reported that they encountered considerable challenges when they began to deliver CSE at their schools. Government representatives are well aware of the reasons behind these difficulties:

‘False beliefs and perceptions around CSE remain, as guardians and community members continue to believe that CSE sexualises young people even though the opposite is the case. CSE needs to start early as it sensitises young people about how to protect themselves when engaging in sexual activity’, explained Julius Nghifikwa of Namibia’s Ministry of Education. Fortune Chibamba, Acting Director General and Programmes Director of Zambia’s National AIDS Council, agreed with him: ‘It is immoral not to provide children with the right information and tools to protect themselves against HIV, other sexually transmitted infections and unintended pregnancies’.

Comprehensive sexuality education raises demand for youth-friendly health services

Another aspect which the conference highlighted was the need to combine the provision of CSE with youth-friendly health services. In several regions where schools introduced CSE this had created an increased demand for sexual and reproductive health services that the countries’ health systems were not able to meet. To address this problem, the ESA Regional Programme in cooperation with the German-supported Zambian HIV Programme, the Ministry of Education and health service providers helped to strengthen linkages between CSE provision at schools and the provision of youth-friendly health services in the surrounding health facilities.

Young people call for government action

Many of the young delegates at the conference spoke, for example, about the discrimination they faced in health care settings and about the lack of communication between parents and young people about their HIV status. Where this issue was kept taboo, young people were unable to access the health services and the antiretroviral treatment which they needed on a regular basis.

In her video ‘This is it’ Koketso Mokhetoa gives voice to the real-life stories of young people living with HIV.

In a joint call for action, the young delegates reminded their countries’ representatives that only 36 months remain for the achievement of the ESA Commitment. They highlighted their willingness to support the implementation and called for strong involvement of youth in ESA coordination and progress monitoring. Also, they proposed the establishment of social contracts between youth, community-led organisations and government officials to ensure full accountability.

As they closed the conference, Ms Sabine J. Diallo, GIZ ESA programme manager, and Mr. Bechir N’Daw, UNAIDS Director for the ESA region, thanked all delegates for their contributions to the fruitful exchange and encouraged them to continue and scale up their joint efforts: “We need to take our commitment outside this room and bring it to other governments in the region”.

November 2017

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