Soraty raha hikaroka

Webinar Fotoana Famakiana: 6 minitra

Recap: Mampifanaraka amin'ny zavatra ilain'ny tanora rehefa mitombo izy ireo

Andian-dresaka mampifandray: foto-kevitra 3, FIVORIANA 4

Tamin'ny 29 aprily, Fahalalana FAHOMBIAZANA & Fandrindrana Fianakaviana 2030 (FP2030) nampiantrano ny fivoriana fahefatra sy farany tamin'ny andiany fahatelo amin'ny resaka ao amin'ny andian-dresaka mampifandray, Tsy mety amin'ny rehetra ny habe iray: Reproductive Health Services Within the Greater Health System Must Respond to Young People’s Diverse Needs. This session focused on how health systems can adapt to meet the changing needs of young people as they grow to ensure that they remain in care. Tsy nahita ity fivoriana ity? Vakio ny famintinana etsy ambany na midira ny firaketana (in anglisy na FRANTSAY).

Featured Speakers:

  • Cathryn Streifel, Senior Policy Advisor of the Population Reference Bureau
  • Dr. Angela Muriuki, Maternal Reproductive Health Advisor of Save the Children
  • Dr. Jacqueline Fonkwo, Co-Founder/CEO of Youth 2 Youth Cameroon
Clockwise from top left: Cathryn Streifel, Brittany Goetsch (moderator), Dr. Angela Muriuki, Dr. Jacqueline Fonkwo.
Clockwise from top left: Cathryn Streifel, Brittany Goetsch (mpandamina), Dr. Angela Muriuki, Dr. Jacqueline Fonkwo.

What are we currently seeing related to retaining youth in healthcare systems?

Jereo izao: 12:30

Moderator Brittany Goetsch, Program Officer with Knowledge SUCCESS, kicked off the discussion by asking each speaker to describe the current situation regarding meeting young people’s needs and retaining youth in healthcare systems.

There are a number of issues that make it difficult for health services to retain youth. Ms. Streifel discussed the USAID-funded PACE Project’s analysis of service provision assessment data among youth in seven countries. The analysis highlights waiting times as an issue, but more qualitative research is needed to unpack this further: Is it the amount of waiting time or the stigma associated with being seen waiting for family planning services that has a bigger impact on youth retention? Youth also reported dissatisfaction with the quality of counseling, availability of medical supplies, privacy, hours and days of service, and cleanliness. Ms. Streifel also pointed out that the lack of follow-up mechanisms between appointments can be an obstacle to retaining youth in health systems. Actively following up with women who use a contraceptive method increases contraceptive continuation and facilitates switching when side effects occur. Ms. Streifel suggested several follow-up methods to increase retention, including phone calls, automated text messages, home-based visits from a health provider, or establishing a hotline.

Dr. Muriuki provided a different perspective, stating that in looking at outpatient data, the number of adolescents who make contact with the system is surprising. na izany aza, she suggests the need for integration of family planning and other health areas.

Dr. Fonkwo raised that what happens within the community (where adolescents spend most of their time, what they know about the health system, Sns) contributes to retaining adolescents. What happens at the international level guides the national level, which then translates to what health care providers are providing to different communities.

What are programs doing to ensure a health system remains responsive?

Jereo izao: 23:28

Ms. Streifel expressed that a key challenge to health system responsiveness is insufficient customization in service delivery. Family planning programs must respond to young people’s needs, and not assume that they are a homogenous group. Family planning needs also vary by geographical contexts. She suggested that a way to provide client centered care is through high quality supportive contraceptive counseling. This should include a case history (a discussion of prior contraceptive use and current contraceptive needs), proactively addressing the management of side effects, and providing information that dispels myths about contraceptive methods. Ms. Streifel also noted the importance of ensuring that young people have the resources, knowledge, and opportunities to directly engage with decision makers to obtain what they want.

“In order to retain them, we really need to be responsive to the feedback they’re providing,” she said.

Dr. Fonkwo explained that the private sector has only recently begun having conversations about adolescents within the global context. She suggested that best practices have to be holistic. Within her own academic studies, Dr. Fonkwo has realized that data about adolescents can be extremely limited.

Dr. Muriuki added that when it comes to the health system, we need to have young people at the table and actually listen to their needs. Murikui posed the question, “If health systems came up with their own way of doing things, would adolescents agree with what we are saying are their priorities and needs?”

How can we ensure providers are responsive to both their current and future patients?

Jereo izao: 33:12

Given Dr. Fonkwo’s medical background, she stressed that this question must be raised and raised again. She stated that if a doctor doesn’t receive sufficient medical training to provide health services to adolescents, they will not be equipped to deliver the services. Medical training must to be structured to address the needs of adolescents. Farany, Dr. Fonkwo suggested several elements that can contribute to better outcomes: system-level approaches, attention to training and coursework, continuous medical education, feedback mechanisms, and national indicators.

Dr. Muriuki, who also has a clinical background, remarked that when the provider fails, the client will remember. Various issues—such as long workdays—can influence how they treat their patients. Dr. Muriuki noted that providers are members of a community, and have their own values and issues. The health system expects that, in walking into a clinic, providers will set aside their own beliefs and biases—but the system does little to support providers in navigating the potential conflict between who they are and what they do, to ensure that clients are provided with unbiased services. Provider bias has to be addressed within the system so that we are not just targeting the end result of a system failure.

Ms. Streifel added that provider bias can lead to women using contraceptive methods other than their own choice (non-preferred methods), which can result in them abandoning that method (contraceptive discontinuation). Ms. Streifel noted that, according to a PRB analysis on policies in 22 firenena, ihany 4 countries out of 22 support youth access to family planning services without consent from both parents and spouses; ihany 10 support a full range of family planning options to meet young people’s needs. dalana ara-politika that remove requirements for third party consent and restrictions are necessary to promote contraceptive use among youth. She expressed that provider training should include values clarification and knowledge of youth cognitive development. Ms. Streifel emphasized that providers need to take a case history, provide information on how to manage side effects, and dispel myths about contraceptive methods. She also stated that training should be given to all who work in the health system, as anybody can have an impact on an adolescent’s visit. Ms. Streifel closed this section with a comment that since unmarried youth have a preference for obtaining contraception from the private and informal sector, pharmacy and drug shop staff should also receive training to better serve youth.

Youth in decision-making roles

Jereo izao: 46:38

Dr. Muriuki brought up the work of the Child Rights Team at Save the Children in Kenya. The organization brings together groups of children in various parts of the country to debate issues related to reproductive health; at the end they meet with senior leadership (councils of government, members of parliament, Sns) to provide this information and hold them accountable. Dr. Muiruki admires this work because of the importance of preparing young leaders so that when they get a seat at the table, they have a clear, well-delivered message. This builds young people’s capacity for leadership positions and allows older leaders to be intentional about listening to youth.

Dr. Fonkwo added that FP2030 has youth focal points for each participating country. These focal points are individuals who effectively engage and capture the voices of young people. She emphasized the importance of being culturally sensitive. When adolescents try to make their voices heard, we want to be aware of their context.

Ms. Streifel mentioned the importance of training researchers and advocates on how to translate data and research into language that resonates with decision-makers. Developing advocacy tools with youth is extremely important, so they can directly engage with decision-makers on issues affecting them and their future.

Collaborative efforts between the private and public sectors

Jereo izao: 55:53

According to Dr. Muriuki, data-sharing is a major challenge in collaboration between the public and private sectors. Dr. Fonkwo agreed, and emphasized the strong divide between what happens in the private sector versus the public sector. Dr. Fonkwo shared an example from Cameroon, where the proportion of health care providers trained in the private sector is high compared to the proportion trained in the public sector, but there are challenges with collaboration. In working with FP2030 as her country’s focal point, she has identified many opportunities for private and public sector organizations to collaborate—including identifying how decisions are translated into community practice, highlighting good practices for interacting with adolescents, establishing feedback mechanisms for improvement, and working with governmental focal points. Dr. Fonkwo recognized the need for spaces for private and public sectors to learn from each other.

Key Takeaways from the Speakers

Moderator Brittany Goetsch asked each speaker to share one sentence to close out the webinar:

Dr. Muriuki: We could do better with building systems for adolescents and this is beyond the service delivery point—this is involving issues around other issues that adolescents face.

Dr. Fonkwo: I think that to make it more responsive to young people’s needs—for example, if the pharmaceutical companies can factor in how adolescents want their contraceptives, how they should be designed—we will need their voices more and more. They are not in a box, they are different.

Ms. Streifel: Retaining youth in health systems requires meaningfully engaging them and a systems approach.

Momba ny "Connecting Resadresaka"

Resadresaka mampifandray” dia andian-dahatsoratra namboarina manokana ho an'ny mpitarika tanora sy tanora, nampiantranoin'ny FP2030 ary FAHAMARINANA ny fahalalana. mampiseho 5 lohahevitra, amin'ny 4-5 resaka isaky ny lohahevitra, Ity andiany ity dia manolotra fijery feno momba ny Fahasalamana ara-pananahana ho an'ny tanora sy ny tanora (AYRH) lohahevitra anisan'izany ny fampandrosoana ny tanora sy ny tanora; Fandrefesana sy fanombanana ny fandaharan'asa AYRH; Fandraisana anjaran'ny Tanora misy dikany; Fampandrosoana ny fikarakarana mitambatra ho an'ny tanora; ary ny 4 Ps an'ny mpilalao manan-danja ao amin'ny AYRH. Raha nanatrika ny iray amin'ireo fivoriana ianao, dia fantatrao fa tsy webinars mahazatra anao ireo. Ireo resadresaka ifandrimbonana ireo dia ahitana mpandahateny fototra ary mandrisika ny fifanakalozan-kevitra misokatra. Entanina ny mpandray anjara hametraka fanontaniana mialoha sy mandritra ny resaka.

Our third series, Tsy mety amin'ny rehetra ny habe iray: Reproductive Health Services Within the Greater Health System Must Respond to Young People’s Diverse Needs, ran from March 18 through April 29, 2021. Our fourth series will begin in July 2021. Manantena izahay fa hiaraka aminay ianao!

Want to Get Caught Up on the First Two Conversation Series?

Ny andiany voalohany, izay nanomboka tamin'ny Jolay 15 hatramin'ny Septambra 9, 2020, nifantoka tamin'ny fahatakarana fototra momba ny fivoaran'ny tanora sy ny fahasalamana. Ny andiany faharoa, izay nanomboka tamin'ny Novambra 4 hatramin'ny Desambra 18, 2020, nifantoka tamin'ireo mpikatroka mitsikera mba hanatsarana ny fahasalaman'ny fananahana ny tanora. Afaka mijery ianao noraisim-peo (misy amin'ny teny anglisy sy frantsay) ary mamaky famintinana ny resaka hanatratra.

Resadresaka mampifandray
Emily Young

Intern, Fandrindrana Fianakaviana 2030

Emily Young is a current senior at the University of Massachusetts Amherst studying Public Health. Her interests include maternal and child health, black maternal mortality, and the racialization of reproductive justice. She has previous experience in maternal health from her internship at Black Mamas Matter Alliance and hopes to open her own health care facility for mothers of color. She is Family Planning 2030’s Spring 2021 intern, and is currently working alongside the team doing social media content creation and assisting with the 2030 transition process.

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