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Sustaining Youth Contraceptive Use in West Africa

A Policy Dialogue Between Youth Leaders and Policymakers

In many countries, youth ages 15 to 24 have higher rates of contraceptive discontinuation than older women. To explore the factors behind this challenge and identify policy solutions, PACE convened a two-hour virtual policy dialogue on youth contraceptive discontinuation in West Africa on May 26, in collaboration with the Réseau des Femmes Sénégalaises pour la Promotion de la Planification Familiale and Knowledge SUCCESS. The event aimed to increase regional policymakers’ commitment to addressing the barriers to sustained contraceptive use among youth and forge collaboration opportunities for youth-led organizations, journalists, and young researchers.

This innovative policy dialogue provided three major lessons about meaningful youth engagement in family planning policies and programs:

  • While youth-led organizations offer innovative insights about family planning decision-making, their role in enhancing youth contraceptive use tends to be limited to youth sensitization. Youth should be included in the policymaking and program design process.
  • The legal and policy environment is generally assessed based on the existence of texts and documents, and greater consideration needs to be given to how laws and policies are applied and experienced by users.
  • Contraceptive continuation must be considered alongside contraceptive access in order to optimize the return on investment of governments’ efforts to expand access to voluntary family planning information and services.

Fatou Diop (Alliance Nationale des Jeunes pour la Santé de la Reproduction et la Planification Familiale – Senegal) and Rachid Awal (African Youth and Adolescents Network – Niger), representing youth-led organizations, presented key findings about youth contraceptive discontinuation, drawing on a PACE policy brief. They highlighted that youth may be particularly sensitive to side effects and face significant barriers, including provider bias, to accessing quality family planning services. They outlined seven policy recommendations to address these obstacles, such as providing high-quality counseling, including active follow up mechanisms between appointments, and ensuring access to the full range of contraceptive methods.

Hervé Bassinga (Institut Supérieur des Sciences de la Population), alumnus of PACE’s inaugural policy fellows program in West Africa, presented results of the alumni’s analysis of the favorability of national country and program contexts for sustaining youth contraceptive use in Benin, Burkina Faso, Guinea, Mali, and Togo. His presentation revealed that many best practices for sustaining youth contraceptive use are not currently reflected in countries’ policies, and that more attention is needed at the policy level to sustain youth contraceptive use. Of the five countries, four do not have a law or policy that supports youth access to family planning care without consent from both parents and spouses.

During a moderated panel discussion featuring youth leaders, several high-level policymakers, including Honorable Assoupi Amèle Adjeh, a parliamentarian from Togo, Dr. Siré Camara, an official from the Ministry of Health of Guinea Conakry, Fatimata Sanou Toure, a magistrate from Burkina Faso, and Angelo Evariste Ahouandjinou, the mayor of the largest municipality of Benin, endorsed the policy brief recommendations. They emphasized the importance of involving young people in discussions, from the community to the national level, about how to support contraceptive continuation among youth. Fatou Diop emphasized that young people shouldn’t just be considered as recipients of services who need to be reached with information but should be seen as equals who have innovative ideas about how to enhance contraceptive continuation among young people.

Fatimata Sanou Toure and Honorable Assoupi Amèle Adjeh linked youth contraceptive discontinuation to the issue of unintended pregnancies among youth who are in school. Dr. Siré Camara mentioned that in Guinea, nurses’ offices in schools and universities are able to offer family planning services.

Fatimata Sanou Toure and Dr. Siré Camara also emphasized that even when good policies are in place, implementation issues occur. For example, while contraceptives are free in the public sector in many countries, youth often prefer to access contraceptives in the private sector. Honorable Assoupi Amèle Adjeh suggested that providers who refuse to provide services to young people should face legal consequences. Angelo Evariste Ahouandjinou noted that a budget line item for contraceptives is in place for his municipality and that information about family planning is available to youth.

This event included more than 85 participants, including several West African journalists. PACE is supporting the participation of youth-led organizations to translate recommendations into policy action, through connecting youth leaders and policy fellow alumni for a roundtable discussion about data utilization and provide a bespoke policy communication training to the youth-led organizations to support their increased involvement in ensuring accountability for implementation of policy commitments in their respective countries. PACE is also working to connect journalists who attended the webinar with participating decision-makers and youth leaders, to promote high-quality reporting on sustained contraceptive use.

This article is cross-posted from the PRB website.

Illustration: Young people of many cultures
Cathryn Streifel

Senior Policy Advisor, PRB

Cathryn Streifel is a senior policy advisor at PRB, where she works with national and global partners to enhance policy advocacy efforts related to family planning and reproductive health by conducting policy communication workshops for family planning experts and contributing to PRB’s written publications. Before joining PRB in 2019, she was associate director of the CSIS Global Health Policy Center and a business development associate at Palladium/Futures Group. Cathryn holds a master’s degree in public health from The George Washington University and bachelor’s degree in political science from McGill University. She is fluent in French. 

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