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Webinar Reading Time: 8 minutes

Addressing Young People’s SRH Needs in Humanitarian Settings

Recap of Connecting Conversations Theme 4, Session 3

On July 22, Knowledge SUCCESS and FP2030 hosted the third session in the fourth module of the Connecting Conversations series: “Celebrating the Diversity of Young People, Finding New Opportunities to Address Challenges, Building New Partnerships.” This particular session focused on how to ensure that young people in humanitarian settings have their SRH needs met in settings in which health systems may be strained, fractured, or non-existent.

Missed this session? Read the summary below or access the recordings (in English and French).

Featured speakers:

  • Anushka Kalyanpur, CARE Lead for Sexual and Reproductive Health in Emergencies (moderator for the discussion).
  • Dr. Alka Barua, Steering Committee Member of Common Health.
  • Viateur Muragijerurema, Executive Director of Kigali Hope Organization.
  • Erick Bernardo, RN, President of Philippine Society of SRH Nurses, Inc., and FP2030 Youth Focal Point for the Philippines.
From left, clockwise: Anushka Kalyanpur (moderator), speakers Erick Bernardo and Viateur Muragijerurema.
From left, clockwise: Anushka Kalyanpur (moderator), speakers Erick Bernardo and Viateur Muragijerurema.

When we talk about crises in humanitarian settings, what are we talking about?

Watch now: 12:01

Erick Bernardo, RN, started the session by discussing natural and human-made disasters. The Philippines lies in the Pacific “Ring of Fire,” a geographic area characterized by active volcanoes, frequent earthquakes, typhoons, and other events. Because of his context, when speaking about people living in humanitarian settings, he thinks about those affected by these natural disasters. He also thinks about conditions, like terrorism, that are created by humans.

Dr. Alka Barua spoke about internal displacement in India due to COVID-19 lockdowns. These situations have negative implications for young people and adolescents.

Viateur Muragijerurema discussed displacement due to wars in the Central Africa region. There are many refugee camps in Rwanda for those fleeing war zones in the Democratic Republic of Congo and Burundi. A high percentage of young people live in refugee camps, and there is an urgent need to address issues surrounding sexual and reproductive health.

What are the sexual and reproductive health needs and challenges of young people living in humanitarian settings?

Watch now: 15:50

Dr. Barua discussed mental health in humanitarian settings. In addition to the known challenges and health needs that young people face, the COVID-19 pandemic has imposed additional challenges due to school closures and limited social interaction. Stressed adolescents face an increase in mental health issues. At the peak of the pandemic, young people had few outlets to share their challenges and address their needs since frontline workers were focused on the pandemic. Young people also faced job loss and added family stress during that time.

…the COVID-19 pandemic has imposed additional challenges due to school closures and limited social interaction. Stressed adolescents face an increase in mental health issues.

Prior to the pandemic, the Philippines held a record for having one of the highest rates of teen pregnancy in the world. Since the March 2020 COVID-19 lockdowns began, teen pregnancy rates have risen. In a report from 2019, pregnancies among young people aged 15–24 were declining, while pregnancies among 10–14-year-olds increased. HIV is also an issue for individuals in the 15–24 age range. Because of the COVID-19 pandemic, many young people have faced challenges getting tested, and those living with HIV have had difficulty getting antiretrovirals from treatment hubs. Also, experts have noted the underreporting of gender-based violence during the pandemic. If one is in lockdown with their perpetrator, it is unlikely that they are able to report the issue due to their inability to leave the home.

Mr. Muragijerurema spoke about the lack of youth centers in refugee camps in Rwanda. Youth centers should be places for adolescents to access SRH services and get an education. While some older camp members provide lessons to those who are younger, refugee camps need designated places for youth to access a basic education so they can be empowered.

What are some barriers to the provision of SRH services to young people in crisis settings, and how do we adapt these programs to meet their needs?

Watch now: 22:43

Mr. Muragijerurema discussed the issue of lack of facilities in refugee camps. A facility is a place where young people can chat with peers, get information about sexual and reproductive health, and access HIV testing, menstrual hygiene products, and more. Many people in refugee camps are sexually active, and access to free condoms is vital to prevent unwanted pregnancies. One program in a refugee camp that Mr. Muragijerurema worked with trained young people to be peer educators. They distributed materials and implemented activities for youth in their camp. This was done for two reasons:

  1. Youth know the language spoken in their camp.
  2. Young people know more about their camp than adults living outside of it. It is important to consider the capacity of those in the camps and train them to provide SRH services.

Mr. Bernardo spoke about a reproductive health law in the Philippines that limits minors’ access to SRH services. During a humanitarian crisis, the negative effects of such policies are further exacerbated. Data on the number of boys and girls in evacuation centers who would need vital SRH information and services are nonexistent. During the COVID-19 pandemic, the government of the Philippines imposed age-based restrictions for going out. Despite historically high rates of teen pregnancies in the country, young people who may have desired access to contraceptive methods were restricted from leaving their homes to access family planning services. Minors must have written parental consent to use public health service facilities in the Philippines. In humanitarian settings, many young people are separated from their families. As a non-governmental organization, Mr. Bernardo’s organization (Philippine Society of SRH Nurses, Inc.) provides vital SRH services without parental consent, allowing young people to gain access to services in humanitarian settings.

How can we incorporate young people into the design of SRH programming given the unique challenges that exist in crisis settings?

Watch now: 31:18

Dr. Barua discussed how one shouldn’t wait until a crisis starts to involve young people in SRH programming. It is important to anticipate that a crisis situation may occur and engage young people from the early stages. From planning and implementation to monitoring and evaluation, using existing platforms is helpful. It is important to go to youth groups and forums that young people regularly use in their communities, rather than expecting them to come to institutionalized service delivery points. Additionally, leveraging the work of civil society organizations and NGOs (that often reach adolescents and youth) is important. It is also beneficial to use familiar language that young people relate to. For example, a national adolescent health program in India specializes in clinics for adolescents. They were initially called “Youth-Friendly Centers,” as young people were not consulted in the naming of these centers. On one center’s opening day, its counselor was thrilled to see 125 adolescents outside, eager to access SRH services. However, she soon learned that the youth had interpreted it as a dating center. Thus, adolescent engagement is a necessity at every level of SRH programming, including planning, naming, development of services, and the monitoring process.

Dr. Barua discussed how one shouldn’t wait until a crisis starts to involve young people in SRH programming. It is important to anticipate that a crisis situation may occur and engage young people from the early stages.

Mr. Bernardo spoke about meaningful youth engagement and treating young people as partners rather than as beneficiaries. Giving young people a platform to speak about how they envision a well-run program and giving them a space to reach out to other young people is important. Young people know the appropriate language and are experts with regard to their particular crisis setting. It is time to listen to them and provide them with a platform.

What are some examples of SRH programs that have been responsive to young people’s needs, and what are some best practices for adolescent and youth SRH programming in crisis settings?

Watch now: 36:48

Mr. Bernardo spoke about youth engagement following Tropical Storm Washi, which devastated the Philippines in late 2011. A group of young people volunteered to assist the government’s relief efforts by visiting evacuation centers and gathering data on the young people there. In 2012, when Typhoon Pablo hit the country, the government tapped this group of young people to assist with the response. They were asked to lead projects, spark conversations with other young people, lead data collection, and more. It was a great success and demonstrated the importance of acknowledging the work of youth and giving them a platform to excel and become leaders in their own fields.

Dr. Barua discussed some examples from the non-governmental sector. The programs she was involved with were flexible and quickly adapted to the needs of adolescents. A computer-assisted personal information system collected information about youth health needs, telecounseling and teleconsultation were available, health education was conducted through platforms frequently used by youth (such as Zoom, WhatsApp, Instagram, and YouTube videos), and adolescents were asked about their preferred helplines.

In crisis settings in India, there is a hierarchy of casualties. The first casualty is usually sexual and reproductive health because it is not seen as an emergency. The second is adolescents because they are seen as a healthy cohort. Within adolescents, girls are at particular risk, because India is a patriarchal society. That’s why an adaptable system that takes all of this into account is important.

In crisis settings in India, there is a hierarchy of casualties. The first casualty is usually sexual and reproductive health because it is not seen as an emergency. The second is adolescents because they are seen as a healthy cohort. Within adolescents, girls are at particular risk, because India is a patriarchal society. That’s why an adaptable system that takes all of this into account is important.

Mr. Muragijerurema discussed the importance of collaborating with partners already on the field when planning activities for young people in refugee camps or other crisis settings. In Rwanda, there is a ministry in charge of emergency issues. Speaking with them (and others who already have information about crisis situations) is important. Working with others not only facilitates the sharing of knowledge but also teaches young people in refugee camps about collaboration—once the project in a camp has ended, the program should be sustained and continued by the young people living there.

What are the unique needs of boys and men in these spaces, and how can we engage them in SRH?

Watch now: 44:28

Mr. Bernardo spoke about the misconception that since most family-planning commodities and contraceptives are female-centric, SRH only involves girls. Boys also need a space to talk about their concerns. There are boys who would likely say, “I also have the same concerns. I don’t have anyone to talk to,” when asked about SRH. Being more inclusive of traditionally male concerns in SRH spaces would help boys understand their role in SRH.

Mr. Muragijerurema also spoke about involving boys in health education within refugee camps. For example, young boys need to understand that young girls menstruate. Boys and girls grow up together, so boys should know that girls have specific needs. Boys should be engaged early so they can support their sisters.

What role do you see for the new WHO Self-Care Guidelines in addressing some of the issues around physician access?

Watch now: 49:17

Dr. Barua spoke about self-care. Self-care is not something that is unique to this pandemic; many adolescents are skeptical about the judgmental attitudes of health care providers through the lens of SRH, so they avoid health facilities. Instead, when they can afford them, they use self-care alternatives—buying medicine from drug shops, for example. Adolescents need to be informed about what they are taking, and they should also have an emergency system in place if they experience any complications. As long as the entire spectrum of care is available—medicines, services, requisite information, and facilities—in times of high-risk situations, then self-care interventions work.

Mr. Bernardo discussed how self-care interventions have become the new norm in regard to SRH services. Multi-month dispensing of commodities like pills and condoms are commonly used in health care. Young people don’t need actual contact with health care providers to access these resources, so they don’t have to worry about where to get supplies on a monthly basis.

About “Connecting Conversations”

Connecting Conversations” is a series tailored specifically for youth leaders and young people, hosted by FP2030 and Knowledge SUCCESS. Featuring 5 modules, with 4–5 conversations per module, this series presents a comprehensive look at Adolescent and Youth Reproductive Health (AYRH) topics including Adolescent and Youth Development; Measurement and Evaluation of AYRH Programs; Meaningful Youth Engagement; Advancing Integrated Care for Youth; and the 4 Ps of influential players in AYRH. If you’ve attended any of the sessions, then you know these are not your typical webinars. These interactive conversations feature key speakers and encourage open dialogue. Participants are encouraged to submit questions before and during the conversations.

Our fourth series, “Celebrating the Diversity of Young People, Finding New Opportunities to Address Challenges, Building New Partnerships,” began on June 24, 2021, and concluded on August 5, 2021. Our next theme will begin in October 2021.

Want to Get Caught Up on the Previous Conversation Series?

Our first series, which ran from July 15, 2020, through September 9, 2020, focused on a foundational understanding of adolescent development and health. Our second series, which ran from November 4, 2020, through December 18, 2020, focused on critical influencers to improve young people’s reproductive health. Our third series ran from March 4, 2021, to April 29, 2021, and focused on an adolescent-responsive approach to SRH services. You can watch recordings (available in English and French) and read conversation summaries to catch up.

Connecting Conversations
Shruti Sathish

Global Partnerships Intern, FP2030

Shruti Sathish is a rising junior at the University of Richmond studying Biochemistry. She is passionate about adolescent health and elevating the voices of young people. She is FP2030’s Global Partnerships Intern for the summer of 2021, assisting the Global Initiatives team in their work with Youth Focal Points and other tasks for the 2030 transition.

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