Marcus Swanepoel from Roots of Health began his presentation with an overview of factors affecting young people’s and indigenous people’s abilities to make healthy and desirable sexual and reproductive health (SRH) decisions in Palawan, an island in the Philippines. As the only SRH organization in Palawan for the last 11 years, Roots of Health has gained a rich understanding of issues affecting both these groups and has applied innovative solutions to meet their needs. Both young people and indigenous people in Palawan face provider discrimination, lack of access, negative perceptions, and misinformation. In addition, young people also face embarrassment, confidentiality concerns, and lack of awareness when it comes to SRH information and services.
To address these barriers, Roots of Health has employed an iterative process that continually incorporates feedback from women and adolescent girls. The organization also considers observations from program implementation to reach underserved communities with SRH information and services. Since its inception, Roots of Health has conducted significant SRH outreach to indigenous communities living in geographic isolation. The program began by training community health workers (CHWs) such as nurses to reach these communities, later incorporating trainings for government health workers as well. Roots of Health found that while these communities were isolated and myths and misconceptions surrounding SRH were common, women and adolescent girls wanted accurate knowledge and accessible services. However, a critical demographic was missing from this outreach: single young women.
To address this, Roots of Health first tried to train young CHWs to encourage young single women to attend information sessions. But when this didn’t work, Mr. Swanepoel and his team decided they needed to go to the source and talk to the women themselves. They found that many of them feared judgment and a perceived lack of confidentiality in speaking with the CHWs. To address this, Roots of Health trained even younger health workers (HWs) who had been teenage mothers themselves. This approach showed promise, and pregnancy rates initially dropped. However, providers continued to discriminate against young single women trying to access services. These findings led Roots of Health to have honest and open conversations with staff about behavior change and practices in health clinics, intentionally ensuring that providers were hired who supported the fundamental human right to contraceptives and SRH information and services. The team also opened clinic spaces specifically for young people and instituted an appointment system that minimized their chances of being seen by waiting patients.
Roots of Health didn’t reach its current operating model without learning and adapting along the way, but the services offered today are significantly more impactful and valued thanks to the journey. Mr. Swanepoel concluded his presentation by recommending that programs listen to their stakeholders and work with them to develop solutions to their challenges.