Youth and Sexual and Reproductive Health and Rights: Focus on Uganda

APPLE PODCASTS

GOOGLE PLAY

STITCHER

SPOTIFY

It is critical that young people around the world are engaged and informed on sexual and reproductive health and rights. Uganda has one of the youngest populations in the world, with over 75 percent of the population under the age of 35. Maureen Andinda with Reach a Hand Uganda chats with us about the importance of young people’s knowledge of sexual and reproductive health and young people’s role in combating SRHR challenges.

Financial, social, and cultural issues are often deeply rooted in sexual and reproductive health and rights. Young people must have the knowledge and information on SRHR that would allow them to make informed decisions regarding family planning, because deciding if, when, how, and with whom one might have a family with is a basic human right.

In 2016, Uganda’s Ministry of Gender Labor and Social Development temporarily banned sex education, in order to reshape the narrative and ways in which it would be presented to Ugandans. With already limited access to sex education, this ban prevented young people from accessing it completely. This pushed Parliament and Uganda’s Ministry of Education and Sports to launch the National Sexuality Education Framework, which provided guidelines on how sex education would be taught.

Reach a Hand Uganda is optimistic about the National Sexuality Education Framework, as the Ministry of Education and Sports is open to working with various partners on improving sex education. While Reach a Hand Uganda is not quite back in schools teaching sex education, there is a new and promising structure that will allow the organization to work closer with the Ministries that work with the new framework.

U.S. policy and politics are negatively impacting Reach a Hand Uganda’s work with youth. The expanded Trump global gag rule has cut off funding and forced sexual and reproductive health care providers to close their doors. Young people are now left unable to access the services these centers provide. Vital programs through organizations like UNFPA were also defunded, leaving young people empty-handed.

We have to make sure that young people have access to reproductive and sexual health information and services around the world. Stigmatization and shame hinder access and damage perception of SRHR. Practical limitation like access to transportation and money may also prevent young people from taking care of their sexual and reproductive health. Respecting, welcoming, and hearing the concerns of young people will break down barriers and destigmatize SRHR.

Links from this episode

Reach A Hand Uganda
Reach A Hand Uganda on Facebook
Reach A Hand Uganda on Twitter

Transcript

Jennie Wetter: Welcome to rePROs Fight Back a podcast on all things repro. I'm your host Jennie Wetter. In each episode, I'll be taking you to the front lines of the escalating fight over our sexual and reproductive health and rights at home and abroad. Each episode, I will be speaking with leaders who are fighting to protect our reproductive health and rights to ensure that no one's reproductive health depends on where they live. It's time for repros to fight back.

Read More

Jennie: Welcome to rePROs Fight Backack. I'm really looking forward to today's conversation, mostly because we have a wonderful advocate from Uganda here with us today, and partly because we're talking about the importance of young people having access to comprehensive sex education and sexual and reproductive health services. So without further ado, joining me today. We have Maureen Andinda from Reach A Hand Uganda with us today. Maureen, thank you for joining us.

Maureen Andinda:Thank you for having me, Jennie.

Jennie Wetter: So what brings you to Washington DC?

Maureen Andinda:Um, okay. So I'm part of the, uh, a global youth ambassador fellowship, uh, with Planned Parenthood global, uh, who our partners back in Uganda. And I'm here to, um, share what it is that we're doing at Reach a Hand back in Uganda, in, in line with sexual reproductive health and rights for young people, but also to learn from local affiliates what it is that they're doing here, how they're advocating and, and just see the great work that everybody's doing for young people.

Jennie Wetter: Oh, that's great. Um, so do you wanna tell me a little bit about Reach a Hand Uganda and the work you guys do?

Maureen Andinda: Sure. Um, so Reach a Hand Uganda is a youth led and youth serving organization that is premised on youth empowerment programs for young people with special focus, uh, on sexual reproductive health and rights and livelihoods. We carry out interventions in over 33 districts in Uganda and we use different intervention methods that target different stakeholders. So we do community outreach, we do, um, dialogue, we do, uh, advocacy with national stakeholders. We do, um, communication and online campaigning just to get the message out, um, for the betterment of our target audience, which is the young person.

Jennie Wetter: Oh, that's great. Yeah. So how did, uh, Reach a Hand Uganda get started?

Maureen Andinda: Our founder Humphrey at the time was raised by HIV positive guardians. And, uh, he, his experience was that of stigma because people thought that he had HIV and the way that they treated him was not, uh, okay. So he thought that it was his responsibility to educate people about HIV at the time. Um, and also help young people around him to understand that HIV is not a death sentence, that you can, um, live positively, how you can prevent stigma, how you can, um, help other people to deal with stigma and that sort of thing. So, um, together with a bunch of friends, uh, started doing outreach programs in schools to just really share information. And from that, uh, the realization came that there was a need to equip these peers who are sharing information. So they had the correct and accurate information. So, um, they started doing trainings and that is how Reach a Hand started. It's so our model is we identify young people, train them on SRHR information, and then they go out into communities in schools and talk to young people. So whereas it started with HIV, it has really moved into, uh, so many more themes on sexual reproductive health and rights.

Jennie Wetter: That's so important and so great to be reaching out to the young people to make sure that they're engaged and informed. Um, how did you get involved?

Maureen Andinda: I was in the nonprofits, um, world before, uh, but I was working on, um, leadership and governance at the time, uh, when I met Humphrey and, um, there was an opportunity to apply for work at Reach a Hand and I thought that I could take that experience that I had from my work as a program coordinator doing leadership and governance and sort of like bring that to, uh, Reach A Hand. The teamwas such a small team. Um, we were learning as we went along. So that is really how I joined. And, uh, from that time I've learned so much, uh, in terms of what it means for young people's rights, what it means, uh, for people to have access to information and really the challenges that they go through everyday. And now we continue to navigate around those challenges.

Jennie Wetter: That's how you got started. So what do you do now with Reach a Hand? Okay.

Maureen Andinda: So, uh, my title at Reach a Hand is Monitoring, Evaluation and Learning Manager. But we are a fairly small team. Uh, so you find that oftentimes I double dip.

Jennie Wetter: I can relate our office is four, so I feel you.

Maureen Andinda: Yeah. Um, so, uh, I, I, I make sure that, um, the targets for the organization, uh, in line with what our strategic goal is and that we're on track and that we are actually picking lessons from our implementation and improving on our programming. Um, I also lead in a couple of advocacy projects, uh, for the organization to really ensure that young people have a conducive environment, uh, within which they can access information and services, uh, on reproductive health.

Jennie Wetter: That leads right into why is working on sexual and reproductive health and rights and comprehensive sex education so important to young people in Uganda?

Maureen Andinda: It's important to provide context, uh, around, uh, Uganda. And, uh, one of the things that is important to note is that Uganda has one of the youngest in the world. We have over 75% of the population being young people under the age of 35.

Jennie Wetter: Wow.

Maureen Andinda: Um, and with that we see so many challenges, um, that the young person faces. And whereas on face value, they look like economic challenges, they look like a social cultural challenges, political challenges. Um, a lot of the times these issues are deeply rooted within sexual reproductive health and rights um, in as much as, uh, many people don't know that. So for us it is important to equip this big chunk of the population, uh, with information and knowledge that will enable them make informed choices. And that way, um, when they have the sexual reproductive health, uh, well taken care of, then they are able to get decent employment, they're able to, um, decide if they want to have children or not. They're able to just really have a descent life as human beings.

Jennie Wetter: So what really struck me in that is that 75% of the population is, um, 35 or younger. Um, why is the population of Uganda so young?

Maureen Andinda: Okay. So, um, I think one of the reasons why we have such a youthful population is first of all the fertility rate is really high in Uganda. I think it's dropped down to maybe 6.75 which used to be 7.5. Okay. Um, so that, that means like, 7.5 children, per woman. Um, so that's one. But also, um, between the eighties in the nineties, there was a huge HIV scourge in Uganda, uh, and a lot of, um, the older population lost their lives, uh, to HIV at that point. So you have, um, a lot of the population being young people, but also being maybe orphans of our people who passed away because of HIV.

Jennie Wetter: So some of our listeners may know, but a lot of them may not, but Uganda recently received a lot of media attention for banning sex education, but some people may not know that fairly recently there was an exciting update on the progress to advanced sex education in Uganda. Do we maybe want to take a step back and talk before we talk about the good news, talk about how the band came to, um, happen?

Maureen Andinda: Prior to the ban being, um, effected by the Ministry of Gender, Labor, & Social Development, which is, um, the ministry within which the youth docket falls in our country. There was media outrage, social media outrage, uh, over, um, explicit content that it was coming out of the schools, uh, and parents were not happy about it. So people went online and there was a uproar and there was so much, um, call for accountability for the government. And because of this, uh, pressure that came in from the public, the parliament was tasked to ask the minister to, um, sort of provide a accountability in terms of how did this come about? Who is monioriting, uh, looking out for, uh, the young people, how do we not know about it? So, uh, in an effort to sort of like put things in order, uh, the minister at the time issued a ban to sort of give, give the ministry time to go back and, uh, restructure and organize the way in which sexuality education, uh, would be taught in Uganda. Um, this was I think in October, 2016, um, and since then, uh, developments that came up, uh, there was so much frustration from civil society organization because if you put a ban on sexuality education, then how are young people going to access information? Uh, how does, um, first of all, parents are not talking to their young people, teachers are teaching, uh, the kids in school. So if you put a ban on it, then already the limited ways within which people can access information is taken away. So we had, um, some members of civil society, sue the government, because they felt that the right of their person to access information as being infringed on. Uh, and so like all of this pressure from parliament and from civil society, from the general public, uh, pushed at the time, the Ministry of Education and sports to sit down and develop a framework.

Maureen Andinda: So in May this year, um, the National Framework on Sexuality Education was launched, um, to provide guidelines for how sexuality education would be taught. And from that document, then, um, the National Curriculum Development Center could go on to develop a curriculum within which schools can use to pick up on and, uh, the environment within which civil society can operate, uh, and do its work. Since then, uh, the framework was launched, there was a bit of a backlash from some stakeholders, primarily religious stakeholders who felt like, um, a lot of the consultations, uh, were not, they weren't really consulted as much as they ought to have been. Um, and also they had quite a number of issues with the content of the framework. So for example, uh, why is there content, um, on sexuality education for three year olds and five year olds? So that kind of, um, created like a stumbling block in the rollout of, uh, the framework, but that is something that is now, um, being worked upon. They've brought the stakeholders back to, um, the round table and discussed with them and sort of like given them an understanding of why it is important to have young people discuss even three year olds to understand a certain aspects around sexuality, um, education. So that is, um, a short summary.

Jennie Wetter: It sounds veryfamiliar. I mean, we definitely go through the same things here. It's funny, I was just reading an article, uh, yesterday in a conservative publication attacking um, uh, some sex education that actually Planned Parenthood was doing surprise, surprise they're going after Planned Parenthood. Um, but they were going after, um, a video they had put together around teaching consent, which seems super important in this day and age. Yeah. Um, and they were really unhappy because it, you know, showed some, somebody's getting her boobs touched or something and they were like all in an uproar. And I'm like, yes, showing bad touch too, yes, older students is kind of important to learn what is right and what is wrong. Yes. So it all sounds very familiar to things that we have here in the US as well, unfortunately. So how did the ban impact Reach a Hand Uganda in the work you guys were doing?

Maureen Andinda: Um, so for us, the most immediate impact was that a big chunk of our target audience, which is young people in school was cut off because, um, we were not able to access schools to be able to carry out our programs. We, um, our interventions are such that we do peer learning sessions, but at that point everything had to stop. And like I told you, um, I, I hope I mentioned it before, like our target audience is young people, the ages between 12 to 24 and a big chunk of that is still in school, right. So by putting a ban on sexuality education, it means that we aren't able to access the young people where they are. So, um, that was the first major effect on our work. Um, the other thing was that we got feedback from some of our audiences in terms of, but now if you stop, who is going to support us with this information, is going to support, um, to know where they can actually get services, where they can go to a health worker, um, and speak to them. Really that time, um, between when the ban was implemented, there was really a, a gap in terms of information dissemination and of course, information dissemination translates into, um, access or, or not of services. So, uh, that was a big thing for us.

Jennie Wetter: Yeah. I mean, if they're not learning about, uh, what they need or, um, where they can access services, they're not going to be able to act on it and find, um, the services you need or find the information they need. Which is even more important. They might, you know, turn to untrustworthy sources and perpetuate some myths that are going around. Yes. The current status...what's the current status?

Maureen Andinda: Okay. So like I mentioned previously in May, the sexuality education framework was launched by the Minister of Education and Sports. And, um, we saw that as such a huge milestone in terms of, um, creating a space, um, to engage with that audience. And although we acknowledged that they needs more, there is a lot that still needs to be done, it was a start and we're optimistic because the ministry is very open to working with different partners, with different development partners, with different civil society partners to ensure that, um, we can actually implement the guidelines and they, the sexuality education framework. So right now what is happening is it's being rolled out, uh, to different stakeholders, helping schools to understand what is entailed in the framework. Uh, what are the topics that you can speak about. How do you, um, disseminate this information to young learners and the like. So that is what is happening currently.

Jennie Wetter: Good. So that means you guys are back in schools?

Maureen Andinda: Not exactly, but what it means is that now that is a structure okay. Within which, so now you can get approval from the ministry to actually go and, and, and, and, um, conduct activities that have been approved that have been signed off by the ministry.

Jennie Wetter: Um, so one of the things we like to talk about on this podcast is US policy and how it's affecting things. Um, can you talk a little bit about how US policy and politics are impacting your work?

Maureen Andinda: I think the most relevant, uh, policy for us has been the global gag rule. And although primarily it was, um, around, um, cutting funding for, um, organizations that, uh, providing abortion services, um, most recently extended as you, I'm sure you know, to family planning and, and different other components of SRHR and, um, the impact that you've seen with that is that a lot of health care providers, partner health care providers have had to close the doors, which then means that our young people are not able to access the services that they require and that they need. Um, the other impact that we saw is, um, an abrupt stop to some of the projects that we had, uh, because some of our funders were telling us that, you know, this is actually happening. We have no money. So this has to stop. And it was quite heartbreaking to get feedback from our beneficiaries feedback from young people that we work with, asking questions like, okay, so what is happening next? Because we've trained, uh, youth advocates and to train peer educators in their communities, they want to engage with districts. Uh, but they're not able to afford transportation to go to this district meetings. Um, they're not able to check in with their health centers to see how young people accessing services. We used to have a project that was championed by youth advocates who would, uh, monitor, um, the districts quality of service delivery, uh, and the input by different stakeholders. So for example, what is the police doing about, uh, gender based violence cases, how many, um, young people have access to health services, uh, in a month and all of that came to an abrupt halt, uh, as a result of the, of the gag rule. So for us, we really felt it directly, uh, in terms of the projects that we were carrying out.

Jennie Wetter: So another area that has been affected by US policy is UNFPA. Um, does Reach a Hand Uganda, work with UNFPN projects? And if so, how have, how have they, how has that work been impacted by um, getting their US funding cut off?

Maureen Andinda: Yes, we do walk with UNFPA, they are a funding partner and the project that I am speaking about was one of those.

Jennie Wetter: Oh, okay.

Maureen Andinda: Yes. That had been funded by UNFPA, so it was such a blow to us because we had to uh, put it on hold for quite a long time and in order to do the groundwork to actually get it back on its feet, it was extremely difficult. So for sure, um, we felt the pinch and I'm sure UNFPA felt the pinch well, especially locally.

Jennie Wetter: Yeah. What always strikes me with, you know, the argument in the US is that it's before abortion, they're cutting off funds to prevent abortions. And to me, when I'm hearing about what you're talking about, I'm just thinking about all of these, um, young people who are losing access to comprehensive services that have nothing to do with abortion.

Maureen Andinda: Yes.

Jennie Wetter: Or losing access to birth control, which would prevent abortion.

Maureen Andinda: Yeah. Yeah. So, um, exactly like that's a, it's such a paradox. Yeah. Because, um, cutting off other services, you know, um, for even health facilities or health service providing partners who don't necessarily carry out abortion, uh, work, but do, uh, family planning and contraceptive services. It was such a huge blow because, um, a lot of the health care providers in Uganda do not necessarily do one thing. [ So a, a facility, a desk, contraception, a facility does HIV testing and services, it does a STI screening. It does counseling. And by you cutting off funding for this one aspect of the health facility, it means you're, you're closing doors to so many other health needs that people have. Right. So, yeah, it was, um, it was very unfortunate.

Jennie Wetter: And it just makes sense, right, that facilities would cover all of these things because you don't want to have to go here to get this right?

Maureen Andinda: Yes. It has to be integrated.

Jennie Wetter: Exactly. Yeah. So as we are wrapping up, do you have any final thoughts or any message you want to, um, share with our audience?

Maureen Andinda: Sure. Um, the message that I would have is I think the onus is on each one of us. Yeah. If you think that you deserve quality health care and that you deserve quality services, then um, you should want the same for somebody else and within your capacity, whatever that capacity may be, we should try to do something to make sure that young people or even just people generally have access to the same things that we want to have access to because then everybody has an opportunity, has a chance to have a descent life.

Jennie Wetter: Okay. So in your wrap up you just mentioned, um, the importance of making sure that everybody has access to services. And I think one thing that would be great for us to dig in a little bit because it is so important, is the, um, value of making sure that youth have access to youth friendly services.

Maureen Andinda: Yes. That is an extremely important aspect of health service delivery because, um, when you interact with young people, the things that hinder them or that stop them from actually going to health facilities to access services, um, uh, things like lack of confidentiality. You know, that is already stigma around being a young person. That is, there isn't a trust there isn't respect. Um, there isn't time according to young people, all of those aspects in one way or another, um, could hinder young people from getting services. I will give you an example, um, to sort of put the conversation into context. In some of the rural areas in Uganda, people walk kilometers or miles, you know, to just access services and um, young people will go out of their way to get little, the little that they have to be able to transport themselves to this far away health facilities and for them to get there and they're being judged and they're not being listened to. Attention to their issues is not being given priority. So you'll find that a lot of the times that like I have to spend this little money that I have to go there and potentially not even get the service that I, um, I require. I might as well just figure it out or like just let it be. So the aspect of youth friendliness is extremely important because it would create that conducive environment within which young people are encouraged to actually share what their issues are.

Jennie Wetter: Absolutely. I mean, if they don't, aren't getting in, um, a respectful, welcome and like felt like they've been heard, why would they go back? And they would probably also tell their friends that they had a bad experience and not encourage them to seek help either.

Maureen Andinda: Yes. Um, and, and that has been a debate around whether we should focus on youth for any health services or try to make facilities in general, you know, to be accommodative of everybody and to give priority to everyone. But, um, initially that is what it's supposed to be. But you will find that because of so many issues, like it could be social, cultural issues in Uganda, I know that, um, young people are only seen and not hard, you know? So, for example, if you're in a line with somebody much older than you, the expectation is going to be that priority is given to this older person who probably may have a headache or may have for what ever reason priority will be given to uh, somebody else. And because the numbers are so many, you'll find that day one, you're there day two, that day three or that and still the priority is being given to other people. So whereas, that would be the ideal situation to ensure that all health facilities are friendly in general for everybody, you'll find that young, younger by not being included. So that is where we really, really push for youth friendly health services.

Jennie Wetter: Well, Maureen, thank you so much for being here and doing this. Um, I had a lot of fun talking to you.

Maureen Andinda: Thank you for having me, Jenny. This was fantastic.

Jennie Wetter: For more information including show notes from this episode and previous episodes, please visit our website reprosfightback.com. You can also find us on Facebook and Twitter at rePROs Fight Back. If you like our show, please help others find it by sharing it with your friends and subscribing, rating and reviewing us on iTunes. Thanks for listening.

Take Action