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Highlight of the 2nd National Adolescent Health Conference held on 26th September 2016 held under the theme; “One Agenda for Health Transition and Zero Deaths for Every Adolescent”.
The National Adolescents Health Conference
Date: Wednesday 26th September 2016 - Venue: Grand Global Hotel
The ministry of health in partnership with Restless Development, AfriYAN Uganda and the Uganda Youth and Adolescents Health Forum on the 26th September 2016 held the 2nd National Adolescent Health Conference under the theme; “One Agenda for Health Transition and Zero Deaths for Every Adolescent”.
The conference organized and supported by My Voice My Rights Project a partnership SRHR advocacy project implemented between Restless Development Uganda and AfriYAN Uganda with support from Amplify Change brought together more than 150 young people in Uganda, from diverse groups and categories including; adolescents living with HIV, adolescent mothers, young women who are victims of gender based violence, young LGTBI youths, sex workers, young people with disabilities, school going adolescents as well as observers like teachers and other key officials from government and CSOs working young people; including Ministry of Health, Ministry of Education, UN agencies like UNAIDS, UNESCO, UNFPA and other CSO’s like Restless Development, Straights Talk Uganda, Reproductive Health Uganda as well as many other youth led SRHR organizations among others.
The National adolescent’s health conference was organised with an aim of providing a free space for adolescents and young people in Uganda to;
- Assess and discuss progress and challenges since the 2015 national stakeholders meeting commitments on partnerships for sustainable adolescent responsive programming.
- Sharing experiences, discussing challenges as well as identifying, reviewing and harmonization of key priority adolescent and youth health issues for advocacy to improve adolescent health outcomes.
- Update adolescent and youth participants on the key emerging adolescent health issues in relation to the school health policy and adolescent health policy, guidelines and service standards.
- Recognition of young people’s contribution to the National adolescent health issues through presentations of their respective interventions and sharing best practices.
- Amplified involvement of adolescents and young people in the national adolescent health issues through learning, networking and experience sharing with key actors attending the conference and to chart a way forward for enhancing meaningful participation and involvement of young people in the monitoring and accountability framework of the National Adolescent health policy and guidelines, and decision making.
Adolescent health situation in Uganda
Deliberations at the National Adolescent Health Conference were informed by the current situation and status of adolescent health and well being in Uganda and young and contribution of young people as a key driving force for improving health outcomes and achieving the 203O Sustainable Development Agenda.
Globally, there are 1.2 billion adolescents and an estimated 196.5 million are in Africa. Uganda has one of the youngest populations in the world with 70 per cent of the population less than 25 years of age. This population structure presents a high dependency ratio, undermining social transformation and sustainable development of the Country. Nevertheless, this can be turned into an opportunity if appropriate policies, programs and investments are made for young people (10-24 years) to ensure that they are socially and economically stable, healthy and independent.
Young people face challenges as a result of the physiological, emotional and psychological changes that take place in adolescence. Though largely healthy, if not well guided, they can indulge in behaviours that may put their lives in danger. Such behaviours include substance and alcohol abuse, risky sexual behaviours and early sexual debuts, sexual and gender based violence, early and forced child marriages, limited access to correct life skills information and education including comprehensive sexuality education, lack of access and utilization of quality youth friendly services including access to contraceptive services, STI and HIV services, poor sanitation and hygiene including; menstrual hygiene and management, limited opportunities to meaningfully participate in decisions making among other challenges.
This is catalysed by negative gender stereotypes, negative cultural and religious practices, insecurity, peer pressure, poverty, a none responsive health care system for responding to the SRHR and HIV/AIDS needs of adolescents.
In addition, the lack of enforcement of some laws aggravates the violation of rights of adolescents.
The outcome of the above scenario includes; forced and early child marriages, teenage pregnancies, school drop outs, unsafe abortion, maternal mortality and morbidity, abandoned/ street children and adolescents, injuries as a result of sexual and gender based violence. Negative social behaviours like substance abuse, make young people prone to trauma and injuries as well as negative mental outcomes such as anxiety, depression and suicide.
Although information on modern contraception is high among adolescents aged 15-19 at 92% for girls and 96% for boys, access to and use of appropriate Sexual and reproductive Health services is usually limited. The contraceptive prevalence rate among the married young women 15-24 years of age is only at 11.4% with a high Family Planning (FP) unmet need of 31.3% for the15-19 years and 35.4% for the 20-24 years (UDHS 2011).
HIV infection is also a big burden among young people. According to the 2011 HIV Indicator Survey, HIV prevalence among young people 15-24 years is at 5.1 per cent reaching the peak of 9.1 per cent among young women 20-24 years of age. The latter was higher than the national average of 7.3 per cent among the reproductive age group (15-49 years). This indicates a very high risk and vulnerability to HIV infection among young people. For every HIV positive male, there are 4 to 6 girls while it is 1:1 in adults
According to the UDHS 2011, 23 % of girls 15-19 years indicated that their first sexual encounter was forced. In Uganda dating violence is on the increase and this involves young people using drugs. 21.3% of females aged 15-19 and 40.9% of those between 20-24 years had experienced some form of sexual violence in their lifetime according to the UDHS 2011.
Some traditional practices such as female genital mutilation and rituals surrounding male circumcision commonly performed in adolescence, together with spouse sharing and inheritance infringe on adolescents’ rights and result into poor health especially exposure to STIs and HIV.
Regarding sexuality education and SRH information, young people are not adequately prepared at home and in schools early enough for them to use it in preventing, managing and mitigating the SRH disease burden, negative masculinities and gender stereotypes. Furthermore, the gender stereotypes, cultural as well as religious biases restrict access to sexuality information for young people.
Uganda also experiences high Teenage pregnancies (24%) contributing to 17% on average of the overall maternal deaths but this can go up to 40% in referral units (Mulago Hospital). The prevalence of obstetric fistula among adolescents is 1.3 %.
Key issues raised by young people at the conference
- Drug abuse; including smoking, alcohol and other illicit drugs
- Teenage pregnancy
- Limited access to youth friendly services and information;
- Menstrual hygiene management, costly leading to school dropouts
- Teenage pregnancy – early marriages, poverty, peer pressure
- Unemployment – lack of technical schools; ignorance of available jobs
- Limited parental guidance and involvement
- Poor health care service delivery; inadequate staffing and limited access to adequate medication
- Sexual harassment in some schools and at home; not reported to police
- Unfriendly (rude) health workers
Key Recommendations from Young people
- Program to train youth as peer educators and serve as role models
- Continuous sensitisation programs for teenagers on dangers of early pregnancy
- Program the public and health professions with sign language skills
- Utilise social media platforms for health communities
- Improve access to adolescent health services in rural areas with youth friendly corners
- Training girls on how to use re-usable pads and information on how to manage menstrual periods
- Awareness creation on consequences of teenage pregnancy
- Peer to peer education
- Equipping young people with technical and life skills – income generation
- sensitisation of parents on parenting adolescents
- Training for CHWs (Village Health Teams)in adolescent health issues
- Involve young people in monitoring and evaluation of AHS
- Recruit counsellor to help girls in school with menstrual hygiene
- School provide time to train students on SRH
- Train health workers to provide youth friendly services
- Push for the School Health Policy to be implemented
- -Work with Young people groups to disseminate RH information
- -Train Health workers and social workers on RH issues
- -Work with ministry of Gender, labour and Social development to create mass awareness through cultural institutions and local structures
- -Work with teacher training institutions to have SE included in curriculum
Commitment from Ministry for Health and Ministry of Education
- Ensure provision of quality of adolescent health services
- Adolescent to be at the forefront of addressing AHS
- Include the youth recommendations in the National adolescent policy
- Ministry of Education and Sports to do health education; providing health information, sexuality education (reproductive health information) for disease prevention; STIs, early sex, abortion,
- Ministry of Education to lobby for professional counsellors in schools
- Curriculum for learners in low secondary education being reformed and will include health education to address sexuality education and life skills education
- Menstrual hygiene management taking place in schools and the ministry shall continue to tranin teachers