A boost to sexual health and rights for a new generation

Germany is ramping up its support to sexual health and rights of young people with a new three-year, 3 million EURO programme in the Eastern and Southern Africa (ESA) region.

Schoolchildren in Kasaji, Congo Democratic Republic

A regional approach fosters mutual learning

The ESA Initiative also reaches out to members of marginalised groups such as these teenage Masai mothers in Tanzania

Having participated in the entire process leading up to the ESA Commitment in December 2013, BMZ has closely followed its first months of implementation in view of expanding its support. A planning mission in September 2014 set out to answer the question “How can Germany most effectively contribute to this new and crucial phase of transforming high-level commitment into tangible results for young people?”

The ESA Initiative’s first annual report indicates progress on increasing young people’s access to youth-friendly services and appropriate sexuality education in the region. BMZ has decided to focus its support on exchange and peer-learning between the ESA member countries. Sharing of experiences, challenges and good practices aims to provide a boost for success and multiply the opportunities for improved sexual health and rights of young people throughout the region.

The new programme will draw on the expertise of the German Development Cooperation programmes in the field of health and education which exist in nine of the twenty ESA countries, and on their different practical tools for promoting young people’s sexual health and rights. These include the interactive “Join-In Circuit” for life skills development, integrated peer education approaches and capacity development courses for health and education personnel.

The new programme’s overall goal is to contribute to further improvements of the regional and national conditions to achieve the ESA targets through three main fields of action:

  1. Supporting the establishment, strengthening and interlinking of the national multi-sectoral Working Groups to ensure effective implementation at country level, with strong links to the ESA Initiative’s regional coordinating structures.
  2. Identification, adaptation/development and dissemination of good quality, gender-sensitive instruments for implementation, mainly in the area of youth-friendly services, in close cooperation with all partners including effective community participation.
  3. In view of contributing to sustainable implementation of the ESA initiative, development of a concept for a mechanism to acquire and allocate further financial and technical support for implementation.

To ensure efficient and effective use of resources, it will be vitally important to coordinate closely with the many other financial and technical partners of the ESA Initiative on regional and country level. Detailed planning of activities and methods of BMZ’s new programme will shortly be shaped in a participatory “kick-off” workshop with key stakeholders. Programme head offices will be in South Africa, to be near key ESA partners and regional structures.

The ESA Initiative: unlocking the potential of 160 million young people

Dr. Kilian Guenther

BMZ, together with UNESCO, is one of the original supporters of the ESA Initiative since 2011. Subsequently, under the leadership of UNAIDS, many more partners joined.

Dr. Kilian Guenther works for PROFILE, the GIZ Programme to Foster Innovation, Learning and Evidence in HIV and health programmes of German Development Cooperation, which has been involved with the development of the ESA Initiative from the beginning. He explains how the idea started:

“The idea was born back in 2011 when colleagues from BMZ, GIZ and UNESCO brainstormed together on how best to support the national governments' response to the very alarming situation of young people’s sexual and reproductive health and rights, for instance the very high rate of new HIV infections in Eastern and Southern Africa, which remains the region most affected by these issues. The data showed that there was a lack of knowledge among young people: about 60% did not know how to protect themselves effectively from HIV, also from unintended pregnancies. But there was also a lack of adequate health services for young people, where they could get counselling, contraceptives, testing for HIV and pregnancy, and  if need be, treatment. It was clear that a multisectoral approach was necessary, involving the education sector to address the lack of knowledge, as well as the health sector, their respective ministries but also civil society and including of course the young people themselves – and to bring them all together in one large-scale approach. German Development Cooperation had made somewhat similar experiences before in Latin American countries, where together with UNAIDS it had been possible to help improve Sexual and Reproductive Health and Rights and greatly reduce new HIV infections, for example. One question was whether approaches that had worked elsewhere were wanted and feasible in the ESA region, bearing in mind of course, that the socio-economic situation is different between and within these regions, and that there were already ongoing activities in health and education for young people. The idea was also to bring these existing activities together, more systematically, to form an ‘umbrella’ ESA commitment.”
Audio-clip-symbolListen to Dr. Kilian Guenther's account of the beginnings of the ESA Initiative and Germany’s involvement

This concept was taken up by the two regional organisations East African Community (EAC) and Southern African Development Community (SADC), while numerous UN (UNFPA, UNICEF, WHO), bilateral (SIDA, NORAD), civil society (INERELA+, Church of Sweden, IPPF), Ford Foundation and further partners  joined the promising new initiative. Dr. Guenther explains that BMZ, via GIZ, continued to accompany the process financially through grants to UNESCO and UNFPA, as well as technically. GIZ participates in the ESA Initiative’s Technical Coordinating Group, and has supported activities such as the preparation of a regional survey of youth sexual health and rights issues and other key documents of the member countries that helped to pave the way for the official launching of the ESA Ministerial Commitment.

ESA countries (blue)

Germany is ramping up its support to sexual health and rights of young people with a new three-year, 3 million EURO programme in the Eastern and Southern Africa (ESA) region. GIZ has been commissioned by the German Federal Ministry for Economic Cooperation and Development (BMZ) to support the implementation of the ambitious ESA commitment on comprehensive sexuality education and sexual and reproductive health services for adolescents and young people in Eastern and Southern Africa. In their declaration of December 2013 health and education ministers of twenty countries pledged to improve HIV prevention and sexual and reproductive health and rights of the region’s young people.

Thomas Staiger, Division for Health and Population Policy

BMZ, together with UNESCO, is one of the original supporters of the ESA Initiative. Thomas Staiger of BMZ’s Division for Health and Population Policy explains why Germany decided to expand its support of the ESA Initiative. “The ESA Initiative is perfectly in line with German Development Cooperation’s priorities and principles in the health sector: fostering sexual and reproductive health and rights, including HIV prevention, and strengthening health systems and access to services. It has young people at the centre, but also involves their social environment in a multisectoral, human-rights-based approach. In our view the initiative is making good progress at regional level and also in many of the countries. We hope to complement it in a meaningful way, further strengthening its regional character, for instance by interlinking the technical experts from different countries, fostering mutual learning and sharing of resources and instruments that have proven to be effective.”

Constancia Mgimwa

“When young people go to hospitals – in school uniform especially – they’ll be turned back, although policy says that everybody from age 13 has the right to access reproductive health services and information. Another problem is skilled staff: in most villages there are no youth-friendly services because you find only one staff taking care of your mother, and your father and the young people as well. So it’s difficult to go to the same place.

Unplanned pregnancy is a big problem, because young people don’t know whom to ask for contraception. This leads to unsafe abortion, which kills almost 4 people every day in Tanzania. We advocate condom use for young people. But there are no free condoms and students have no money to buy them.

Lack of counselling services leads to misconceptions on sexuality and gender-based violence. For instance, young people ask, ‘Is a virgin girl allowed to use condoms?’ If you are in a relationship, is forcing a girlfriend to have sex, is this gender-based violence? And does this girlfriend know, ‘I am being violated’? We no longer have these traditional coming of age ceremonies where young people were taught about growing up, about their bodies changing. Young people have all these questions and nobody to ask about these issues.”

Audio-clip-symbolListen to “Aunty Cos” talk about the problems of young Tanzanians trying to get sexual and reproductive health services

How Germany’s new programme will add value to ESA implementation

These examples from Aunty Cos show the problems faced by young people in Tanzania. Many of them are shared with young people in other ESA countries, yet the solutions to these particular problems will have to be found by Tanzanians and put into practice in Tanzania. Sharing such experiences within the ESA region could then be useful to other countries working on their own programmes to improve youth sexual health and rights.

This illustrates why Germany’s new programme will focus on ESA implementation at country level and promoting exchange between countries. The experience of the existing German country programmes will be helpful here.

Ms. Sabine Diallo, head of the new regional programme, explains, “When you thoroughly understand the local situation and needs, the most appropriate and effective solutions can be tailored to fit that individual situation.  Knowledge, experience and developments acquired by our partners on the local or country level can then be brought up to the regional level, where proposed solutions and best practices can be shared, discussed and promoted on a large scale.  Particularly in view of combining efforts with the other partners, GIZ’s implementing experiences on country level will contribute extra added value to the overall implementation of the ESA Initiative.”


See the ESA Initiative’s website for the Ministerial Commitment Affirmation, the regional survey report of 2013, the first-year progress report and much more.

The following links give more information on how German Development Cooperation has supported the development of the ESA Initiative:

Cape Town (South Africa), December 7, 2013. Health and education ministers from 20 countries have just signed the historic ESA Commitment.

Based on the survey, the health and education ministers gathered in Cape Town identified major problems concerning HIV prevention and young people’s sexual health and rights that needed to be tackled – problems that threaten the economic and social future of the entire region. Noting that many problems had already been addressed in international and regional declarations signed by their different governments, they resolved to work together more closely and increase their efforts under the motto “Young people today – time to act now!”

To ensure that their commitment would be translated into action, the ministers included in their declaration measurable, time-bound targets. They agreed that each country would establish a multisectoral Working Group and develop and execute an action plan towards the ESA targets. Coordination, monitoring and evaluation are the responsibility of the two regional secretariats, supported by the Technical Coordinating Group composed of representatives of all the ESA partners, the UNESCO regional office in Johannesburg acting as secretariat. To make sure that these commitments will not just be on paper but kept in the public eye, a High Level Group of experts and eminent persons from the region including the First Ladies of Tanzania and Malawi and chaired by Prof. Sheila Tlou, the UNAIDS regional director for ESA, is responsible for political advocacy.

As an “umbrella” structure which could integrate the many individual initiatives, projects and actors who are working to improve youth sexual health and rights within the region, the ESA Initiative has a real potential to transform the lives of over half of Africa’s young people.

Young people today – time to act now!

In order to have a broad impact on the new generation, the Commitment targets young people aged 10 -24, estimated at over 160 million in the ESA region. Comprehensive Sexuality Education conveys facts about sexualities, human-rights based values and practical life skills. It should start in primary school, so that children learn the “facts of life”, gain confidence and are well prepared before they have their first sexual experiences.

The importance of Youth-Friendly Services to give young people access to respectful, confidential counselling, contraceptives and treatment, if necessary, is explained by Constancia “Aunty Cos” Mgimwa, an experienced community organisation officer with the Tanzanian NGO Femina Hip:

Listen to Dr. Kilian Guenther's account of the beginnings of the ESA Initiative and Germany’s involvement

Listen to “Aunty Cos” talk about the problems of young Tanzanians trying to get sexual and reproductive health services

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