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Sustaining Access to Voluntary Reproductive Health Care in East Africa

Insights from the COVID-19 Youth Task Force

This piece provides insights from the COVID-19 Youth Task Force on sustaining access to voluntary contraception and reproductive health information and care by youth in East Africa during the pandemic. Youth and adolescents need special consideration—while they are sometimes neglected, they increasingly make up a bulk of the population. This article articulates the important role of decision makers and technical advisors in enhancing access to voluntary reproductive health care by youth during COVID-19.

COVID-19 has brought new norms: social distancing, staying at home, and constantly sanitizing. It has been decades since such a pandemic happened globally. This is not only being felt by the health sector but also across the social, economic, and education sectors. COVID-19 is now a common term to many, including children and youth who are missing outdoor games and vibrant engagement with peers.

Youth is increasingly one of the largest cohorts in the current and projected demographic dividend. There are 1.2 billion young people globally, and it’s an opportune time to invest in them and let their voices be heard in order to realize health, economic, and social progress.

This COVID-19 era has affected seen many investments in health, including reproductive health (RH). As young people transition from adolescence to adulthood, their voluntary reproductive health care needs don’t diminish. Young people are cognizant that if COVID-19 isn’t addressed, we risk being affected by a second wave of the pandemic. This second wave will be due to the impact of COVID-19 on voluntary reproductive health care, including rising cases of unintended teenage pregnancies and early marriages among young people. In the last two months (April and May 2020), we have also witnessed increased cases of sexual and gender-based violence among all age cohorts as a result of reduced reproductive health priorities.

According to an opinion piece by DKT International, manufacturing companies across Asia and Europe where most contraceptives are produced have closed, and others are not operating at full capacity. This has not only affected their production, but shipping also, which has had a ripple in the supply chain system. The majority of youth-friendly centers are also closed in-country, and young people have had their reproductive health options limited.

In Uganda, public transport is restricted and most young people are locked in their homes, unable to access contraceptives. Tonny, a young family champion in Uganda, mentioned that voluntary reproductive health information and care are given less attention because all the focus is on COVID-19.

Tonny Muziira, Youth Chairperson for Universal Health Care Africa: “Governments should make SRH information and services essential services for young people, or else we may have a baby boom post COVID-19.”

Tonny Muziira, Youth Chairperson for Universal Health Care Africa

The Role of Youth

Young people stand to be counted during this crisis, and their meaningful engagement is key in addressing their reproductive health needs. As agents of change, they are taking their own initiative to respond to this pandemic.

Through the leadership of the International Youth Alliance for Family Planning (IYAFP), young people convened for a common of goal of responding to the COVID-19 pandemic by establishing a global COVID-19 Youth Task Force. Being leaders and problem-solvers in their own way, youth have put in place mechanisms to ensure that access to and use of contraceptives and voluntary reproductive health care are sustained.

Insights from the IYAFP task force include the following:

Partnering with like-minded organizations offers peer support

In March 2020, IYAFP organized a digital Peer Support and Coffee Chat series to nurture a sense of community and peer-based mental health support across the organization’s networks. The first session was attended by over 40 youth who opened up about the issues they are personally facing related to the pandemic and the problems they’ve witnessed in their communities. The session resulted in the participants organizing the global COVID-19 Youth Task Force and a continued Peer Support and Coffee Chat series, which IYAFP now hosts on a bi-weekly basis to provide youth-centered support and community for youth across the world.

“Task force members are working with Jhpiego’s youth team to inform and co-design COVID-19 response materials that address the various needs young people are experiencing at this time. With Jhpiego’s support, IYAFP ambassadors’ experiences, insights, and ideas for solutions will be shared with the Nursing Now Campaign to explore ways that practical solutions could be implemented through partnerships between nurses and youth advocates.” — Victoria Watson, former IYAFP Executive Director

Use of social media and other digital platforms can help engage youth

Young people from the East African Community are utilizing social media and SMS platforms to reach other youth with voluntary reproductive health information and care. For instance, youth in Uganda who work under the Population Reference Bureau- and IYAFP-led Empowering Evidence Driven Advocacy (EEDA) project created the Contraceptive Google Map Uganda Facebook page to help share information on family planning and COVID-19.

Bridget Kezaabu, one of EEDA’s advocacy associates, says, “We have also used our social media pages to send out reminders to people not to forget their contraceptive needs and to walk to the nearest open facility at least for services. We have also been sharing messages that can build mental strength and build hope in this time of COVID-19.” She also shared a personal family planning story.

Generation Guiders, a youth-led community-based organization in Western Kenya, has taken the lead in attending to the needs of rural adolescent girls by partnering with five other local organizations to develop an SMS platform for engaging girls and reaching them with contraceptive counselling and short-acting methods (pills and injectables). The girls that have subscribed to the Generation Guiders database and that of its partners engage in SMS conversations, after which the commodities are delivered to them.

Erick Omondi, the founder of Generation Guiders and a 120 Under 40 Winner, notes that COVID-19 does not only impact girls’ reproductive health, but also their social and economic well-being. To address this, he partnered with a charitable organization, Visa Oshwal, under the initiative We Rise by Lifting Others to receive donations on behalf of his vulnerable community. He distributed the donations to community members to help them overcome the economic strains they are facing due to COVID-19.

Currently, Generation Guiders is collaborating with the local county (sub-national level) referral hospital to provide long-acting and reversible contraceptives. However, this has been challenging due to stockouts and limited movement.

Erick Omondi, Founder of Generation Guiders: “We received food donations from the Visa Oshwal Community in Nairobi and we did distribute it to the vulnerable girls in the rural setting.”

Erick Omondi, Founder of Generation Guiders: “We received food donations from the Visa Oshwal Community in Nairobi and we did distribute it to the vulnerable girls in the rural setting.”

Social media not only enables young people to communicate and interact with their peers—it also serves as an information center for young people in Kenya. Alvin Mwangi, a renowned youth reproductive health advocate in Kenya, collected hotlines and contacts from all organizations serving voluntary reproductive health care for youth in Kenya, then shared this information in a Facebook post that has had a lot of impact over the past two months. Young people in Kenya are now accessing the services online through peer-to-peer referrals, and the post has been a contact database for youth in Kenya in this COVID-19 pandemic era.

“All learning institutions have been closed up due to COVID-19. Most adolescents and young people are at home and have so much free time. Online interaction is one of the best ways to interact and get immediate feedback. I decided to create a one-stop post with all the contact information that would be useful in this pandemic.” Alvin Mwangi, Youth RH Advocate, Kenya

In Tanzania, the Young & Alive Initiative, a non-governmental organization, has taken the digital space by storm and has been hosting Instagram Live sessions every Thursday and Friday since March 2020 to raise awareness about COVID-19. They co-host the sessions with experts from different sectors to unpack issues and address misinformation around COVID-19. According to Innocent Grant, a Program Officer at the organization, so far they have facilitated sessions on cross-cutting topics including youth journalism, violence against children, social and behavior change, female genital mutilation, mental health, gender-based violence, unplanned pregnancy, and voluntary contraception for youth. These engagements are essential for young people during lockdown.

Promo for a Young & Alive Instagram Live session

Promo for a Young & Alive Instagram Live session

SafeBoda can help distribute condoms

Young people in Uganda are distributing condoms donated by UNFPA and delivering them door-to-door by use of motorcycles (commonly known as boda bodas) through an app called SafeBoda. UNFPA partners with the app owner and works with the youth leaders who link the SafeBoda motorists to the peer educators. The young people have also developed short messages and animated them into videos to make them more interactive. As they say, “Sex has no lockdown.”

SafeBoda Co-Founder Ricky Rapa Thompson (R) and UNFPA Uganda Representative Alain Sibenaler. Photo: UNFPA/Rakiya Abby-Farrah

SafeBoda Co-Founder Ricky Rapa Thompson (R) and UNFPA Uganda Representative Alain Sibenaler. Photo: UNFPA/Rakiya Abby-Farrah

Our world has never had so many young people before. How we respond to their voluntary reproductive health care needs today will greatly determine how we achieve health, economic, and social progress. Young people have untapped potential and are the drivers of the change we would all like to see. Invest in them: Let them participate meaningfully in governance and policymaking processes to sustain global development.

Young people are not only great thinkers and innovators, but also reliable partners; hearing and listening to them can go a long way towards securing the next generation of great leaders. As the global COVID-19 Youth Task Force demonstrates, youth are ready to step into this leadership.

Alex Omari

Country Engagement Lead, East & Southern Africa Regional Hub, FP2030

Alex is the Country Engagement Lead (Eastern Africa) at FP2030's East and Southern Africa Regional Hub. He oversees and manages the engagement of focal points, regional partners and other stakeholders to advance the FP2030 goals within the East and Southern Africa Regional Hub. Alex has over 10 years’ experience in family planning, adolescent and youth sexual and reproductive health (AYSRH) and he has previously served as a task force and technical working group member for the AYSRH program at the Ministry of Health in Kenya. Prior to joining FP2030, Alex worked as the Technical Family Planning/ Reproductive Health (FP/RH) Officer at Amref Health Africa and doubled in as the East Africa regional Knowledge Management (KM) Officer for the Knowledge SUCCESS global flagship USAID KM project collaborating with regional bodies, FP/RH technical working groups and Ministries of Health in Kenya, Rwanda, Tanzania and Uganda. Alex , previously worked at Amref's Health System Strengthening program and was seconded to the former First Lady of Kenya’s Maternal Health Program (Beyond Zero) to provide strategic and technical support . He served as the Country Coordinator for the International Youth Alliance for Family Planning (IYAFP) in Kenya . His other previous roles were while at Marie Stopes International, International Centre for Reproductive Health in Kenya (ICRHK), Center for Reproductive Rights (CRR) , Kenya Medical Association- Reproductive Health and Rights Alliance (KMA/RHRA) and Family Health Options Kenya (FHOK). Alex is an elected Fellow of the Royal Society for Public Health (FRSPH), he holds a Bachelor of Science degree in Population Health and a Master of Public Health (Reproductive Health) from Kenyatta University, Kenya and a Master of Public Policy from the School of Government and Public Policy (SGPP) in Indonesia where he is also a public health and health policy writer and website contributor for the Strategic Review Journal.

Sarah Kosgei

Networks and Partnerships Manager, Amref Health Africa

Sarah is the Networks and Partnerships Manager at the Institute of Capacity Development. She has over 10 years’ experience providing leadership to multi-country programs geared towards strengthening the capacity of the health system for sustainable health in Eastern, Central, and Southern Africa. She also part of the Women in Global Health – Africa Hub secretariat domiciled at Amref Health Africa, a Regional Chapter that provides a platform for discussions and a collaborative space for gender-transformative leadership within Africa. Sarah is also a member of the Universal Health Coverage (UHC) Human Resources for Health (HRH) sub-committee in Kenya. She has degrees in Public Health and an Executive Masters in Business Administration (Global Health, Leadership and Management). Sarah is a passionate advocate for primary health care and gender equality in sub-Saharan Africa.

Diana Mukami

Digital Learning Director and Head of Programmes, Amref Health Africa

Diana is the Digital Learning Director and Head of Programmes at Amref Health Africa’s Institute of Capacity Development. She has experience in project planning, design, development, implementation, management, and evaluation. Since 2005, Diana has been involved in distance education programmes in the public and private health sectors. These have included the implementation of in-service and pre-service training programmes for health workers in countries such as Kenya, Uganda, Tanzania, Zambia, Malawi, Senegal, and Lesotho, in partnership with Ministries of Health, regulatory bodies, health worker training institutions, and funding organisations. Diana believes that technology, used the right way, contributes significantly towards the development of responsive human resources for health in Africa. Diana holds a degree in social sciences, a post-graduate degree in international relations, and a post-baccalaureate certificate in instructional design from Athabasca University. Outside of work, Diana is a voracious reader and has lived many lives through books. She also enjoys traveling to new places.