East Africa Toolkit: AYSRH Advocacy
AYSRH: Youth Engagement
The Global Consensus on Meaningful Youth Engagement defines meaningful youth engagement as: “Meaningful adolescent and youth engagement is an inclusive, intentional, mutually-respectful partnership between adolescents, youth, and adults whereby power is shared, respective contributions are valued, and young people’s ideas, perspectives, skills, and strengths are integrated into the design and delivery of programs, strategies, policies, funding mechanisms, and organizations that affect their lives and their communities, countries, and world.”
The Challenge Initiative (TCI), widely known as Tupange Pamoja in East Africa, works with local governments to identify and strengthen the capacity of adolescents and youth to support implementation of TCI’s high-impact interventions. Identified as ‘youth champions’, these young people are often already involved in local youth groups, community activities and organizations or may even be associated with the health system. A key strategy for Tupange Pamoja is to institutionalize the participation of these youth in regular government meetings on reproductive health programs. In addition, TCI supports governments to cultivate and strengthen the visibility of health care providers that are actually young people themselves.
This approach will provide information related to how to engage youth to participate in, and sometimes lead, various adolescent and youth sexual and reproductive health (AYSRH) programming activities, including:
- Participating in advocacy and governance meetings, including Program Implementation Team (PIT) meetings and Health Centre/Dispensary Health Management Team (HHMT/DHMT) to provide counsel on how to conduct AYSRH activities and engaging young people as well as reaching youth in that community
- Providing referrals to other young people and community members to health facilities
- Participating in radio shows and AYSRH messaging
- Coordinating and mobilizing AYSRH-related project activities
- Conducting youth dialogue days, SRH sessions and community/intergenerational dialogues
- Organizing youth clubs in communities or at institutions of higher learning, e.g., Tuma Club
- Participating in community advocacy forums to advocate for increased resources towards SRH
Why is This Approach Important?
- By engaging youth, their perspectives are incorporated into program. Their participation in AYSRH programming helps to ensure that appropriate attention is given to problems that might otherwise go unnoticed by adults working independently of these key stakeholders.
- Young people “speak the same language” therefore they are able to tailor programming to meet their needs.
- Young people are able to take the lead in identifying and building the capacity of adolescent- and youth-friendly service providers.
- It encourages the buy-in of adolescents and youth into the outcomes of the program as well as providing opportunities for their professional and personal development.
“I always had fear to speak before the public. But, after undergoing training as a champion by Buikwe district with support from The Challenge Initiative, I developed self-esteem, confidence and a belief in myself that I can do it. I have been able to advocate and support many of my peers to access SRH and family planning information and services.” – Nampanga Rachael, youth champion, Buikwe District, Uganda
- Youth Advisory Councils (YACs) helped with advocating for increased funding for AYSRH in Kenya. Three YACs were formed – one in Kilifi, Mombasa and Nairobi. Their involvement with Ministry of Health led to an increase in funding in Kilifi for AYSRH for FY 2019/20.
- Champions raise awareness, advocacy, mobilization of young people: 493 active youth champions engaged in program implementation (246 in Kenya, 165 in Tanzania and 82 in Uganda).
- Participation in PIT meetings leading to representation of their needs to advocate for their reproductive health needs. Youthful health providers have also been recruited to support service delivery at facility level.
- 73.5% completed referrals made by youth champions and Community Health Workers/Village Health Teams
Guidance on Youth Engagement
- In collaboration with the local geography, identify youth already supporting reproductive health activities within your community or health facilities. The youth could be persons already engaged with the health system, such as participants of social youth clubs and community dialogues and/or members of local governance structures, such as Members of the County Assembly (MCAs) in Kenya.
- Build and strengthen the capacity of the youth related to AYSRH knowledge, communication skills & capabilities using existing training curricula and guidelines from the Ministry of Health. The training should focus on empowering young people with life skills and communication skills to allow them gain confidence to engage influencers in their lives and leaders and voice their health and social challenges.
- When building the capacity of adolescent and youth champions, ensure activities build their self-esteem, self-confidence and resilience to be able to participate more meaningfully.
- Position youth within their communities to support the various roles within the health system using existing guidelines from the Ministry of Health. This may include linking them with older CHVs as mentors, positioning young people to participate in technical working groups, PITs, planning and budgeting committees, etc.
- Review participation of youth at all levels and provide opportunities for continuous learning.
- Share and orient youth with simple tool for reporting to the facility or city.
Specific guidance related to demand generation interventions:
- Youth can serve as mobilizers for community dialogues and guest speakers on radio. This allows youth with the opportunity to raise awareness about their unique reproductive health needs and concerns among their peers.
- Youth can provide information directly to other youth, through SMS/text, WhatsApp groups or posts on social media to their network as they know where to find youth-friendly services.
- Provide advice and direct referral for reproductive health services.
Specific guidance related to service delivery interventions:
- Involve youth in whole site orientation and skilled provider and on-the-job trainings to bring in the youth perspective in an effort to address provider bias.
- Recruit and deploy youth-focused providers that have been trained to serve adolescents and youth.
- Adapt service delivery interventions to accommodate adolescent and youth schedules, keeping in mind school times, career and so forth. As a result, it may be necessary to have clinic hours on the weekend.
Specific guidance related to advocacy interventions:
- Embed youth in governance- and facility-level bodies:
- Adolescents and youth should participate in the preparation of local government annual working plan meetings including budgetary committees
- Adolescents and youth should form part of the PIT structure at the geography level and participate in the monthly progress review and planning meetings.
- Create opportunities for adolescents and youth to participate in high level national & sub-national conferences.
- Adolescents and youth should serve be invited to serve in quality improvement teams and other facility-level forums to ensure accountability and feedback related to the quality of health services.
- Develop and manage partnerships with youth-led organizations
- Participate in youth clubs in schools or at universities and offer the following services:
- Sensitize other students on reproductive health using TCI-U resources
- Offer psychosocial support to other students
- Refer students to youth-friendly facilities for health services
- Distribute short-term methods within their campuses
- Solicit and implement feedback from youth.
- Ensure that youth engagement activities are directly linked to health facilities and that young people are informed about where to access contraceptive counseling from health providers.
- Involve those who youth admire and influence in the community.
- Develop mechanisms that will help young people who age out to transition to other available opportunities in their communities as new ones are recruited.
- Increased participation by adolescents and youth in youth-friendly service delivery and AYSRH programming decision-making
- Increased access to AYSRH services, including quality contraception services, by adolescents and youth
- Increased uptake of contraceptives at the facility by adolescents and youth
- Number of active TCI youth champions, between ages 15-24
- Proportion of cities with youth in their management/coordination fora
- Documented achievements of TCI youth champions
- Number of adolescents and youth reached, referred, and % referral completion
- Number of youth representatives within local government ministries
- Increased resource allocation and utilization of funds towards AYSRH programming
- Documented institutionalization of youth participation in governance meetings or bodies
- Intentional inclusion of adolescents and youth in programming
- Capacity building costs for adolescents and youth on effective program management
- Participation costs in various fora
- Working within existing structures to increase representation of adolescents and youth in reproductive health programming and the health system increases ownership
Overcoming Barriers to Access: Meeting the Challenges of COVID-19
Effective youth engagement is an approach that is being leveraged by EA hub, to address emerging crises that create barriers to access of sexual and reproductive health (SRH) information and services among young people, such as has occurred in the COVID- 19 pandemic.
Youth champions have been coached and enabled to engage in activities that reduce the spread of COVID-19 while generating demand and promoting the access of SRH for adolescents and young people. They have also contributed to the AYSRH advocacy efforts which are focused on keeping the AYSRH agenda at the forefront across the community, health facility and leadership levels.
With TCI support, young people in Nairobi City, Kenya, through the Youth Advisory Council (YAC) – a council of youth that advocate for the rights and concerns of adolescents – have been involved in. Also, these activities have kept the AYSRH agenda at the forefront across community, facility and leadership levels. In addition, the YAC is supporting the distribution of pills and condoms in the community and providing referrals to nearby health facilities and pharmacies during the COVID pandemic. Between March 2020 and May 2020, these efforts have resulted in service continuity and in:
- 5,713 adolescents and youth effectively referred to SRH services at nearby facilities
- 3,386 adolescents and youth received pills from youth champions in the community
- 18,570 condoms distributed to adolescents and youth in the community
Through TCI’s youth engagement approach, youth are:
- Providing access to accurate SRH information as well as information on where services are available through a variety of digital channels, such as Twitter Chats on SRH, Facebook pages on information on contraceptives and AYSRH service location and reaching young people through WhatsApp.
- Organizing virtual meetings and webinars on the impact of COVID-19 on SRH.
- Using community radio to disseminate information on SRH and COVID-19.
- Safely providing sensitization their peers on available contraceptive services.
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