Adolescents and youth Voices count in the 2030 SDGs Agenda

Patrick Mwesigye

May 18th 2017

Kampala Uganda

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As the world community continues to devise strategies for successful implementation of the SDGs agenda, its paramount that intensive investment is done in  adolescent girls and young women’s health, education, social and economic development as this is key for improving their survival and well-being and critical for the success of the  sustainable development goals agenda.

Meeting the SDGs’s significant commitment of ‘leave no one behind’, will require us as countries to pay attention to the marginalization and challenges that women, children and adolescents face at households and public decision-making and devise strategies to address these challenges as well as meet and address their needs and interests, and ensure that they are better represented in national development plans and programmes.

In the implementation of Agenda 2030, it is time to act and eliminate established power dynamics, structural inequalities and social norms that keep adolescent girls and women, in particular, from realizing their rights and accessing the critical services they need.  There is clear and increasing evidence that meaningful engagement of citizens, including women, girls and adolescents in policy design contributes to improving quality of services and to increasing the uptake of services which in turn leads to improved citizen’s quality of life and wellbeing. Adolescents must participate and be heard in decision making and the development of policies and programmes that affect them. Their needs and rights cannot be overlooked any longer.

With over 200 young people in attendance the Pre – 2017 World Health Assembly, National Adolescents and Youth Symposium on SDGs was held today on 18th May 2017 in Kampala organised by Uganda Youth and Adolescents Health Forum and World Vision Uganda, with growing momentum around citizen-led accountability across the world, to feed into discussions at the May 2017 World Health Assembly.  The symposium sought to share best practices from citizen participation in Agenda 2030 implementation, particularly highlighting the role and contribution of adolescents and young people, and to provide a platform for dialogue between young people and high level policy makers. The symposium feature discussions and dialogue on the multiple obstacles that underpin young people’s opportunities to realize their full potential, ranging from human rights violations, health, social and cultural harmful practices among others.

Young people at the symposium listen in to the discussions and contribute to the discussions.

Additionally, the event highlighted lessons and recommendations coming out of grassroots citizens’ hearings and citizen participation initiatives that we have been conducting with young people across the country as part of a local-to – national/global feedback approach.

Throughout the discussions, young people noted the need to have their unique health needs dominating centre stage of all discussions at the 2017 World Health Assembly discussions on Progress in the implementation of the 2030 Agenda for Sustainable Development and on Global Strategy for Women’s, Children’s and Adolescents’ Health.

Key highlights of the discussions;

  • Health investments need to focus on the fundamental rights of women and girls to decide freely and for themselves about their sexual lives, including whether, when, with whom and how many children they have.
  • Ensure adolescents have access to comprehensive sexuality education so that they are knowledgeable about their own health, develop life skills, and know when and where to obtain health services.
  • Develop/provide a package of information, counselling, diagnostic, treatment and care services that fulfils the needs of all adolescents, through facilities, referral, outreach and other innovative mechanisms
  • Train healthcare providers in technical competencies for adolescent health, and to respect, protect, and fulfil adolescent’s rights to information, privacy, confidentiality, non-discrimination, respect and choice.
  • Invest in health facilities to ensure a clean, welcoming, private and confidential environment with the right equipment, medicines, supplies and technology.
  • Ensure that adolescents can access a full range of contraceptive methods by ensuring that providers have been trained, commodities are available, and demand generation activities address myths and misconceptions around certain methods.
  • Eliminate legal, legislative, financial, and third-party consent barriers to adolescents receiving information, counselling and services, irrespective of age, marital status, parity etc.
  • Engage adolescents in the planning, monitoring and evaluation of programmes, and in certain aspects of health information and service provision.
  • Collect and analyze new and existing data on adolescent health, disaggregating by sex, age (10-14,15-19), marital and rural/peri-urban/urban location.
  • Map and evaluate existing adolescent SRHR programmes, assessing their coverage, costs and effectiveness.
  • Use data to inform adolescent SRHR policy and programming, and to ensure that information and services are reaching the most marginalized and vulnerable adolescents.
  • Invest in strategies beyond health that protect and empower adolescents, such as keeping girls in school particularly into and through secondary, ensure adolescents have the necessary life skills and social support to make safe, voluntary transitions to adulthood and help bring an end to harmful practices such as child marriage and FGM.
  • Build support for adolescent SRHR among parents, community members, community organizations, religious leaders, and teachers; and challenge social norms and beliefs that undermine both girls’ and boys’ SRHR.

A move towards Youth led evidence-based advocacy on contraceptives.

Compiled by: Trasias Mukama Deputy Team Leader – Uganda Youth and Adolescents Health Forum and Patrick Mwesigye – Team Leader Uganda Youth and Adolescents Health Forum

10th January 2017 – Jinja Uganda

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Picture 1: AfriYAN members and Advocates for action during training on youth-led research in Jinja

There is increasing realization of the need to conduct evidence-based advocacy for high impact adolescent health interventions. The SRHR challenges facing today’s young people though widely known, require evidenced interventions if impact is to be realized.

In generating this evidence, its crucial to have young people meaningfully involved as they know best the challenges that they face and the interventions required to address them.

Thus, Uganda Youth and Adolescents Health Forum (UYAHF) a youth led and youth serving None profit organization in partnership with AfriYAN – Uganda Chapter, a network work of SRHR based youth led organizations and Restless development Uganda have conducted youth-led research to further understand the need, availability, and accessibility and utilization of contraceptive services to young people living in the areas of Jinja and Mayuge districts in Eastern Uganda. The research is being conducted under the My Voice My Rights Project implemented between Restless Development, AfriYAN Uganda and Uganda Youth and Adolescents Health Forum with and aim of building the advocacy capacity of young people to advocate and advance for  scale of quality SRHR services and comprehensive sexuality education through engaging law makers and policy maker.

The youth-led research involved two components; the quantitative and qualitative components. The qualitative component explored, the challenges faced by young people in accessing contraceptive services, and recommendations for improving utilization of the services. This involved key informant interviews with duty bearers such as; health workers, district health officers, community development officers and parents. Further, focus group discussions were held with young people to facilitate a deeper understanding of the issues affecting young people’s access to contraceptive services. The quantitative component involved interviews with out-of-school young people.

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Photo 2: AfriYAN and Advocates for Action members during a Focus group discussion in Busaala village, Mayuge district

It is intended that the results of the youth-led research will inform and provide evidence to the advocacy efforts of the My Voice My Rights Project  in the districts of Jinja and Mayuge as well as at the national level to advance scale up of quality youth friendly SRHR services with focus on  access and use of contraception. In the long run, this would contribute to reduction of teenage pregnancy and improve adolescent health outcomes.

 

USING CONDOMS IS FANCY, COOL AND ROMANTIC

Mbarara Uganda, 5th Dcember 2016

Patrick Mwesigye Sewa

img_7264Our Team Lead Patrick Mwesigye Sewa making opening remarks at the Condom Party Youth Dialogue on World AIDS 2016

Yesterday, as the world came together to commemorate the 2016 World AIDS Day, at Uganda Youth and Adolescents Health Forum, (UYAHF), we could not hold back. We took it upon ourselves to show our continued support and commitment to wiping out the HIV epidemic through demonstrating innovative HIV prevention interventions that were aimed to encourage and attract young people to live responsible sexual lives that are less risky to HIV infection and spread.

Some of the young people who attended the event hold pluck cards with messages in support of condom use and breaking the stigma and barriers surrounding condom use.

We went on ground to Mbarara Municipality, in Mbarara District, western Uganda where we engaged locals in interactive and fun filled activities conducted under the #CondomParty brand a project under our #Pulaniki Campaign.

Young people at the dialogue enjoying an ice breaker while others listen to the deliberations and discussions during the dialogue.

The condom party was an idea that we sat and thought through as a very practical intervention strategy that we could use to speak to the language and tune that many young people listen to and hence communicate a message of breakin the condom stigma and barriers that affect young people from using condoms correctly and consistently to prevent HIV and STI infection as well as unwanted pregnancies.

So, we were set to break the condom stigma and demonstrate to the public that using condoms is #Cool, #fancy and #romantic especially, when you are not sure of the HIV status of the person you’re having sex with and when you’re not ready for pregnancy and child birth.

The day started with a dialogue at Reproductive Health Uganda which attracted about 100 young people. The dialogue held in a live wire format was an open and free space for young people to share experiences and challenges, learn and make sincere honest and sincere arguments, reflections and recommendations that they can champion in a bid to support the UNAIDS target of 90 90 90 by 2030. The topical discussion of the dialogue was; “Young People Living Responsible Lives free from HIV infection, stigma and discrimination”

Dennis a youth worker from Reproductive Health Uganda Clinic facilitating the dialogue as young people watched on and contributed to the discussions.

Young people were kind enough and freely opened up, by sharing their experience, asking questions, commenting on issues being discussed among other things. Speaker after speaker they noted that; poverty, peer pressure, alcohol and substance abuse, cross-generational sex, multiple sexual partners, school dropouts, sexual violence and other human rights violations are some of the major causes that have fueled the HIV infection especially among the young generation.

Other young people were quoted saying that the health seeking environment is very poor and characterized by unfriendly health service providers, and over congestion. Access to HIV services and information was also highlighted to be a challenges as sometimes they have to trek long distances seeking services like HIV testing, counseling, treatment and care and sometimes health facilities lack adequate supply of condoms.

Participants at the dialogue sharing their views, perspectives and asking questions about the topical discussion.

Young people living with HIV sighted HIV related stigma and discrimination as a major barrier for positive living and throughout the dialogue, it was clear that the public lacks adequate knowledge on key interventions that can scale down the HIV infections and related deaths.

“The government should pass a law to tattoo on the forehead of every person diagnosed with HIV”, noted one of the participants. “We should stop giving treatment to HIV positive people so they can all die and we pave way for an HIV free world”, noted another participant.

Another participant was also quoted saying; “Condoms cause cancer, they have been brought to succumb the African to cancer, while another participant noted that the condom lubricants in a long run cause infertility. “Women living with HIV should be sterilized so they don’t engage in child bearing and that way we shall reduce mother to child transmission”, noted another participant. “Women who wear miniskirts, should be punished by the public because they entice men and draw our minds into sexual feelings hence increasing our risk to HIV “also quoted another male participants.

This wrong information kept us thinking how misinformed the public is and how such wrong information is fueling stigma and discrimination, human rights violations, increased HIV infection, HIV related deaths among other challenges.

The dialogue was very timely and it’s for reasons of breaking such stigma, barriers and misinformation that the dialogue was organized. A team of well informed uyahf peer educators and health services providers and as well as counselors from Reproductive Health Uganda Mbarara responded to some of the above issues and made sure that correct information was given to the participants to demystify all the myths that the participants had. Some of the key recommendations that emanated from the dialogue was, the commitment by young people to test and know their HIV status, the sexually active young people committed to using condoms correctly and consistently and all participants committed to fighting cross generational sex, reducing HIV related stigma and discrimination as well as reducing multiple sexual partners and sticking to one partner.

Participants participating and show casing knowledge in condom demonstration to demonstrate correct use

After the dialogue, we took the #CondomParty vibez to the #Mbarara streets through a #CondomPart Street Flash Mob where we used edutainment and infotainment to educate the Mbarara Municipality street dwellers with information on HIV prevention through correct and consistent condom use. Our peer educators entertained the street dwellers through music and dance and distributed over 100,000 pieces of condoms to over 3000 people that we met directly and indirectly.  We broke the stigma, demystified myths and demonstrated how a fancy, cool and simple using condom is, and we emphasized the fact that young people should not only use condoms correctly and consistently but also they must stock and have enough condom on them all the time.

UYAHF peer educators entertaining street dwellers in a hot steps dance moves while others distributed condoms

We matched, danced and distributed condoms along 5 streets within the town and we were able to reach out to different categories of people including market vendors, boda boda riders, builders/foremen on site and on road contraction spots, carpenters, mechanics, taxi, bus and truck drivers, gamblers from spots betting kiosks, hotel  and shop operators, sex workers among other people.

img_7703The CondomParty Street Flash mob where our peer educators pulled down hot dance moved while others distributed condoms in a move to break the stigma on condom use.

In the night as we wand up our day, we flocked one of the biggest and most happening night club in town, known as the Nicoz Club. We rocked this clubs also famous for attracting the biggest number of sex workers in town. We were warmly welcomed by the club management and our peer educators entertained the socialites with music, dance and comedy, and also educated them on restocking condoms and using them correctly and consistently as well as demystifying myths and misconceptions and the stigma and barriers that affect condom use. In the night club, an extra 20,000 pieces of condoms were distributed and we made sure that everyone who was in club during then got his or her at least a minimum of a box of condoms free of charge.

NICOZ Pub a happening night club in Mbarara where we wond up day with our young people entertaining the clients with music dance and educative messages on HIV prevention

One after one, Mbarara’s night socialites welcomed the #CondomParty move and thanked Uganda Youth and Adolescents Health Forum team for coming up with such an innovative strategy of bringing these life saving gadgets closer to those most in need. The club management also invited us again and promised more support and much more massive mobilizationthe next time we go there. Mr. Nelson the club manager was quoted saying that, this has been a great opportunity for our company to give back to our clients and to sensitize them on the need to prevent them from HIV by using condoms correctly and consistently.

 

 

Healthy and Empowered communities can survive thrive and transform.

Compiled by: Patrick Mwesigy Team Leader – Uganda Youth ad Adolescents Health Forum

10th October 201614914954_1405510322795382_354977175_nResidents from Kibuku line up at the Kibuku Health Center III waiting to see a specialist during the Kibuku medical camp on 9th October 2016. 

As Uganda celebrated and commemorated its 54th National Independence Day on Sunday 9th October 2016, hundreds of Kibuku district residents and nearby districts of Budakar, Palisa and Butalejja could not miss out on the offer of free medical services and health education and promotion information that had been brought closer to the community through the Bagwere Batakangane medical outreach camp.

The camp organized by the Bagwere youths residing in Kampala Uganda’s capital in partnership with Uganda Youth and Adolescents Health Forum, Youth Equality Center Uganda and Public Heath Ambassadors saw over 800 people turn up to receive a range of health services and information ranging from HIV counseling and testing, family planning services, cervical and breast cancer screening, dental and optical services, malaria screening, deworming for children,  free condoms distribution for both male and female, Menstruation hygiene and management education, sexuality education on making rights choices, dialogue, information sharing and learning on breaking myths, stigma and barriers that hinder adequate utilization of contraceptive services among others.

14907761_1405510056128742_852512821_oWomen who had turned up for free medical services line up to register for cervical and breast cancer screening as well as other reproductive and maternal health services. 

Kibuku district located is in Eastern region of Uganda approximately 200 Km from the capital Kampala and was cut from Palisa District through the decentralization policy. The district has a population of approximately 100,000 people with over three sub-counties. The district neighbors: Namutumba district to the west; Budaka to the east, Butaleja to the south and Pallisa to the North.

Patients seeking treatment at Kibukus’ health facilities have to endure sleeping on beds without mattresses or buy papyrus mats to spread on the floor.

Buseta Health Centre III in Kibuku District has only three beds besides having challenges such as drug stock-out and overwhelming numbers of patients. It is estimated that more than 23,000 people depend on this facility and other facilities like Kibuku HC IV for medical treatment.

Conditions at night are said to be worse with patients and their caretakers fighting for space on the ward floors and corridors.

14881288_1405510052795409_736343703_oIn the picture above is the outpatient department of KIBUKU HC IV and resting down under th tree are some of the women that had come for the medical camp who were waiting to see a medical specialist for screening. 

The number of inpatients in the various health centres is overwhelming and yet the facilities are constrained.  There are limited spaces, shortage of drugs, supplies and medical workers.  The district also faces high maternal and child mortality rates, malaria illnesses commonly among pregnant women and children. The under five mortality rates are also still high in Kibuku with many children succumbing to malnutrition, malarial, phenomena, diarrhea, chorela among other preventable illnesses.

It was against this background that as young people we decided to take action and run to the rescue of residents of Kibuku district through mobilizing a mass medical outreach camp that would bring a variety of general health care and medical services nearer to the residents and at a free cost.

14858791_1405509986128749_1301861190_oOur teams worked tireless, to make sure over 800 people that turned up received the various services that ranged from antenatal care, postnatal care, family planning services and information, dental and optical care services, basic surgeries like herniorphy, cervical and breast cancer screening, STI screening and management, safe male circumcision, malaria prophylaxis, health education and promotion on evidence based practices like nutrition, malarial prevention, breast feeding, immunization, sanitation and hygiene, menstrual hygiene and management among others.

Our team also took it to the streets of Kibuku town where we staged a street flash mob using music, dance and art to communicate various health promotional messages to the street dwellers and residents. We distributed over 10,000 male condoms and IEC materials along the streets and engaged residents in dialogues and discussions on various issues but majorly issues related to promoting maternal and child health, increasing male involvement in maternal health, increasing uptake of antenatal care and health facility deliveries, use of family planning services to prevent unplanned pregnancies proper spacing for child birth by couples among others.

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UYAHF, PHAU and YEC peer educators and community health ambassadors spreading the health promotion and education messages on the streets of Kibuku through dance and street based based dialogue. 

UYAHF team leader Patrick Mwesigye, the PHAU program manager Segawa and Sr. Taliba Christine the in charge Maternal and Child Health at Kibuku HC III facilitated a community dialogue on family planning and contraceptive use. The participatory discussions saw participants and mainly young men and women engaged in discussion that addressed barriers to access and utilization of contraceptive services. Some of the major barriers raised were, stalk outs, legal barriers with age constraints especially for sexually active adolescent girls and boys, gaps in confidentiality, severe side effects like abdominal pain, abdominal cramps, headache, negative perceptions and violence from male partners, negative religious and cultural beliefs  among others.

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Patrick Mwesigy Team Leader UYAHF facilitating a session on contraceptive access for young people at the community dialogue as one of the medical camp activities. 

The facilitators took members through lessons on correct and consistent use of male and female condoms. Sr. Christine also sharedwith young people about the different methods of contraceptives services available at the health facilities and how they are used. Sr. Christine encouraged men to come with their wives to health facilities to seek services and make decisions together on which contraceptive methods they prefer to use.

14875230_1405510199462061_369230427_nSr. Christine the In-charge Maternal and Child health department at Kibuku HC IV speaking at the community dialogue session on contraceptive access for young people.

14937111_1405510342795380_554337381_nPatrick Segawa from PHAU taking participants through a session on correct and consistent condom use.  

UYAHF and PAHU teams through their ENSONGA campaign a camping aimed at breaking the menstruation stigma could not miss to educate the public on issues of menstruation hygiene and management. Gorrettie, the SRHR officer from UYAHF, called on communities and men to support women and girls during menstruation by creating a favorable environment that promotes menstruation with dignity especially school going girls. She called on parents to support their daughters and provide them sanitary materials as well as engage the school management to make sure that schools provide favorable menstrual hygiene facilities like washing rooms, changing and disposable facilities.

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Gorrettie from UYAHF manning the Menstrual hygiene stall where she hard 250 people  visit her stall to learn about Menstruation hygiene and management 

The outreach also saw close to 100 people, donate blood with support of the Uganda Blood Bank services which sent they team to camp with us. Information on the relevancy of blood donation was passed on to the community by the Uganda Blood Bank services and the community appreciated the need for donating blood to save lives. 

This camp was organized under the theme; healthy communities can survive and thrive.

 

Menstruation Matters: Keeping More Girls In School!!!

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20th August 2016 – Kampala Uganda

Compiled by;

Patrick Segawa: Team Leader – Public Health Ambassadors Uganda Patrick Mwesigye: Team Leader – Uganda Youth and Adolescents Health Forum

Menstruation  is  an  integral  and  normal  part  of  human  life,  indeed  of  human  existence.  Menstrual hygiene  is  fundamental  to  the  dignity  and  wellbeing  of  women  and  girls  and  an  important  part  of  the basic  hygiene,  sanitation  and  reproductive  health  services  to  which  every  woman  and  girl  has  a  right. Globally,  approximately  52%  of  the  female  population  (26%  of  the  total  population)  is  of  reproductive age. Most of these women and girls will menstruate each month for between two and seven days.

Menstruation is a natural part of the reproductive cycle, however, in most parts of the world, it remains taboo and is rarely talked about. As a result, the practical challenges of menstrual hygiene are made even more difficult by various socio-cultural factors.

According to Data from the 2015 National Population Census the proportion of females to males as per the national population remains high with about 18,124,684 people being women. 24.5% of these were women adolescents between 10-19 years (4,440,547).

According to the research study in 2014 by SNV entitled “Mapping the Menstrual Hygiene Market in Uganda”, At least 84% of these women are from  rural areas and majority poor and assumed to be unable to (sufficiently) access and/or afford sanitary materials including sanitary towel. According to a study done by UNICEF in 2013, 1 in 10 school girls in Africa miss school or drop out completely due to lack of access to menstrual materials and other sanitary products.

This critical unavailability of sanitary products is a major barrier to education for girls of school-going age. The inability to effectively manage menstruation contributes to absences of up to 4-5 school days each month, equating to as much as 20% of the academic year intentionally skipped, simply due to menstruation. Eventually many of these girls drop out of school entirely, increasing their risk to the likelihood of early initiation to sex with associated risks of HIV, early pregnancy, teenage pregnancy with its associated maternal health complications, and further limiting their future career and economic opportunities.

Other young women mainly from poor backgrounds suffer from virginal and urinary infections as a result of using unhygienic sanitary materials since they are unable to afford or access proper menstrual products. Many women and girls from such poor backgrounds rely on crude, improvised materials like scraps of old clothing, pieces of foam mattress, toilet paper, leaves, and banana fibers to manage their menstruation – all of which are unhygienic, ineffective, and uncomfortable. Such circumstances have continued to deprived young girls and women of their potential to exercise their right to health, education and dignity.

Most schools lack sanitary facilities that have access to washing facilities including clean water points and soap, changing rooms, disposal facilities to Because of  this  inconvenience,  many  girls  opt  to  stay  at  home  during  menses  and  this  has  implications  on  their general academic performance and achievement levels in the different grades/classes.(Crofts 2012).

However, menstruation is also still seen as taboo in many African societies. Cultural practices and taboos around menstruation impact negatively on the lives of women and girls, and reinforce gender inequities and exclusion.

But menstrual hygiene cannot be left to women and girls to discuss in secrecy and isolation. It must be acknowledged as a subject for public discussion. Education regarding menstrual health should be promoted. Furthermore, it’s noted in the same research study by SNV, at least 20% of the teachers interviewed said that there were still restrictive cultural beliefs surrounding menstruation. 28% of girls reported that people around them expect them to restrict their movement during menstruation.

In the Central Region of Uganda, menstruation is referred as “Ensonga” or “the issue”’; but this does not reduce the cultural practices and social myths which make it difficult for both men and women to talk about menstruation.

It’s against this background that Public Health Ambassadors Uganda (PHAU)and Uganda Youth and Adolescents Health Forum (UYAHF) with support from Virginia Gildersleeve International Fund and Wakiso District Education Department is running a Menstrual Hygiene and Health Management Project dubbed “Ensonga Campaign”  aimed at breaking the silence, stigma and building awareness among boys girls, parents, teachers and communities about the fundamental role that good menstrual hygiene management (MHM) plays in enabling women and girls to reach their full potential.

The “Ensonga Campaign” is  contributing to improved Menstrual Hygiene and Health Management (MHHM) among school going adolescent girls through sensitization and creating awareness on how to manage menstruation hygienically and with dignity, highlighting the role of boy, men and parents in ensuring girls enjoy menstruation with dignity by reducing the stigma and discrimination that surrounds menstruation and   improving access to Water, Sanitation and Hygiene (WASH) facilities within primary and secondary schools in Wakiso District.

The campaign has empowered Adolescent girls with MHM information including use of reusable sanitary pads through formation of Sanitation health clubs and installation of sustainable WASH facilities. The project slogan is #MenstruationMatters

The pictures above show PHAU and UYAHF peer educators conducting a school outreach on Menstrual Hygiene at Nansana Church of Uganda Primary School in Wakiso District.

On 4th August 2016, the “Ensonga Campaign” was launched in two selected schools in Wakiso District.  PHAU with partners from UYAHF conducted school outreaches at Nansana Church of Uganda Primary School and Wakiso Secondary School. The entire school was taken through the introductory session about menstruation and puberty before being grouped into Focused Group Discussions (FGDs). The focused group discussions provide a conducive environment for girls to speak and share freely about their views, experiences, opinions and challenges on menstruation; this is followed by Question and Answers session.

“If I skip my periods this month or have them for 3 days then I have them for 5 days next month, am I normal?” asked during FGD

20160810_124946In the pictures above, Girls at Nansana Church of Uganda Primary School demonstrate to fellow pupils on how to dress up a reusable sanitary pad at  one of #Ensonga’s School Out reaches on Menstrual Hygiene.

“Sometimes when I am about to have my periods, I grow pimples then the next cycle I do not have them, I instead have stomach pain, is it normal?” asked during FGD.

13920700_1122224911158192_706276015827172551_n (1)In the pictures above, PHAU and UYAHF Peer educators conducting another school outreach session on menstrual hygiene and management at Wakiso Secondary School.

The students were also sensitized on how to manage cramps, monitoring their cycles using the calendar and the different methods of menstruation management such as the disposable and reusable sanitary pads, towels, tampons, the menstrual cup, cotton and gauze for both boys and girls.

 

In the pictures above, students engage in participatory learning session at one of the outreach sessions on menstrual hygiene and management at Wakiso secondary school.

“I missed classes for four days when I came back to school I found out that I had missed two topics and I don’t have any one to take me through” Flora –Student, Wakiso Secondary School

Through Pad Demonstration sessions, students received practical sessions on the correct and consistent use of sanitary pads. The boys were encouraged to support girls before, during and after menstruation. The boys were also counseled to stop mocking, insulting, abusing, isolating and laughing at girls during periods, but to support and comfort them through these tough times. The boys were also called on to support #Ensonga Campaign by lobbying parents and school authorities to create and ensure a supportive environment for girls during menstruation.

In the pictures above, Boys at Wakiso secondary school demonstrate to fellow students on how to dress up a sanitary towel during the boys focused group discussion.

“We had never heard anything openly like this about menstruation, but from today we will also tell our fellow girls who are not in the health club about how to be in school during their menstrual period. Scovia – Student, Nansana C/U Primary School

Sanitation health clubs were formed in the respective schools comprising of representatives from the different classes. The clubs members will act as change agents towards adoption of good menstrual hygiene and sanitation practices and advocate for a favorable environment for girls during menstruation . The Senior Women or Senior Men are the patrons for the established school clubs hence they will provide support, guidance and mentorship to the members, while PHAU and UYAHF will continue to provide technical guidance to the clubs.

20160810_134453Sanitation Health Club members from Nansana Church of Uganda Primary School  pause for a group picture with PHAU and UYAHF team.

“Menstruation education should not be left to teachers only. It’s an initiative of mothers to educate their daughters about menstruation hence we need to involve and educate mothers too” – Jackie, Deputy Head Teacher – Nansana C/U Primary School.

A total of 386 students were sensitized on accurate information on Menstrual Hygiene Management with emphasis on reusable pads.

To manage menstruation hygienically, it is essential that women and girls have access to correct and accurate information on menstruation issues as well as access to sanitary wear and proper disposal facilities.

They need somewhere private to change sanitary cloths or pads; clean water for washing their hands and used clothes; and facilities for safely disposing off used materials or a place to dry them if reusable. There is also a need for both men and women, teachers, parents and communities to have greater awareness and information on menstrual hygiene management.

PHAU and UYAHF will continue to conduct routine follow up activities in respective schools to install talking compounds with Menstrual Hygiene Messages to provide an enabling environment for students to discuss more on issues related to menstruation.

To follow the project activities, check out our facebook; UYAHF PHAU Twitter: UYAHF PHAU YouTube: PHAU UYAHF and follow the Hashtags #Ensonga #MenstruationMatters

 

School Girls Confess, they Avoid School During their Periods. We don’t want to stain our uniforms and get embarrassed before the boys.

Compiled by Patrick Mwesigye

Founder and Team Leader – Uganda Youth and Adolescents Health Forum

patsewa@gmail.com/ info@uyahf.com 

“When I am in my periods, I avoid going to school, because of fear to stain my uniform and get embarassed before the boys” noted Faridah 15 years a Senior 3 student of Kawala College School in Lubaga Division, Kampala Uganda’s Capital.

This was at one of the regular school health outreach conducted by Uganda Youth and Adolescents Health www.uyahf.com on the 21st of June 2015 at the school.

The school outreach was held under the Girls Health Empowerment and Promotion project whose overall goal is to empower and equip adolescent boys and girls or 12 -24 years with knowledge and skills that effect change in their lives and that of their peers and communities by making informed choices and advocating for promotion and respect of the rights of young people like; the right to health, education, access to quality sexual reproductive health information and services, prevention of gender and sexual based violence, end to all forms of stigma and discrimination, end to teenage pregnancy and child marriages, and increased access to sanitary materials and integrating these in Uganda’s development priorities.

Students and teachers listen in to Paul Webs the UYAHF Program Officer as he makes introductory remarks during the during the session.

The highly interactive outreach session facilitated by the UYAHF project officers brought together over 300 students and their teachers. The focus of the session was on promoting menstrual hygiene and management and breaking the barriers that impend adolescent girls during their periods.

During the session, participants were split into two groups according to their gender to promote privacy and confidentiality and encourage dialogue, participation and opening up by all participants.

Our staff Annah and Paul facilitated the focused group discussions for girls and boys respectively.

The discussions featured core knowledge on menstrual hygiene and management, touching on key issues that ranged from;

  • Puberty and the key changes that happen during this stage for both girls and boys. In an interactive way the participants themselves contributed to the discussions by noting some of these signs below as key signs of puberty, namely; “growth of breasts, growth of pubic hair, getting attracted to the opposite sex , gals starting to menstruate, growing hips, deep voice for men, developing funny smell among other changes.
  • Anatomy; external and internal body part especially the sexual reproductive organs and the description of their functions,
  • Menstrual cycle including the 4 key stages where key events take place i.e; the steps that define menstruation as a continuous process with slow progressions and overlap between stages.

Annah, the UYAHF project officer for the Girls Health Empowerment and Promotion program informed the girls that; there are no “safe days”. It is possible to get pregnant if a woman has sex without contraception at any point during the menstrual cycle because; “The egg may still be inside the womb and does not break, another egg may have already been released as part of the next cycle or Sperms can remain in the womb for 2-3 days.”

She also went ahead to note that; Menstrual blood is the lining of the womb being shed out because fertilization has not taken place. It is not harmful or dangerous, and if the egg is fertilized it implants in the womb lining and this becomes the placenta. It contains proteins and nutrients which help a baby to grow, she added.

Anna also taught the girls about the irregularity in their periods and she noted that; in most cases girls worry about being different from their friends. This is normal she noted, and everybody is different. Some women may start their periods at 8 years while other at 16 but both are healthy.

Ann also went ahead to teach the girls how to I wash their virginal, how often to change a pad and  through a role play by the girls themselves, pad demonstration was done especially for benefit of who have not yet started their periods. These had not only never seen a pad but also didn’t know how it’s used.

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Prefects of our Kawala Secondary School pause for a group picture with Paul Webs the UYAHF program Officer after the session. 

The girls in the feedback were inquisitive to know;

Why at times they miss their period or have longer periods than others. Christina 13 years and a Senior 2 student was quoted asking; “ I sometimes miss my periods and my friends have told me that I may be infertile and will never give birth.”.  Mercy 25 years also inquired about the major caused that lead to irregular periods

In her response, Annah noted that; some women and girls have short cycles so it’s possible for them to have more than one period in a given month.

She added that irregular cycles and missed periods are not related to infertility. Women with irregular cycles can conceive and have a baby.

On the Common Causes of Missed Periods/Irregular Cycles she gave the following causes; Emotional stress, Malnutrition, strong physical exercises, Age (the first 5 years from starting her periods and nearing menopause), Pregnancy, Contraceptives which contain hormones (e.g. contraceptive pill, depot injection) among others.

The girls also mentioned and discussed the major challenges they face during menstruation and according to them, these ranged from;

Lack of access sanitary towels. “I don’t have enough money to buy pads and when I ask my mother to buy for me pads she says she doesn’t have money, while I fear to talk to my father about my periods noted Brenda 14 years Senior three students.

Faridah 15 years and a student of Senior 3 also noted that when we go into our periods most of us who can’t afford sanitary pads chose to stay home to avoid staining our uniforms as this embarrasses before the boys who make fun of us all the time.

The girls also noted that the school key facilities for proper sanitation and hygiene. For example,  the school has no private places like bathrooms where the girls can change pads during their periods and freshen up just in case they need to.

The school also lucks proper disposal facilities for these used pads. We throw our used pads in open buckets with no covers  are scantily placed in our toilets which are sometimes used by boys or teachers, noted Magie 16 years, the Health prefect. One of the teachers was also qouted saying that quite often; the school experiences water shortages whic makes life hard for these girls to clean up themselves so generally girls in this school don’t enjoy menstruation at all.

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On the side of the boys, Paul the program Manger at UYAHF and Joshua a Volunteer at UYAHF took the boys trough a series of leanings about what periods mean for girls the stress, pain and trauma they go through.

The seemingly excited boys could not hide their vibrancy in the discussions, despite some being shy and wanting to go around the bush. They boys were concerned about the common cases of girls staining their uniforms and wondered why the girls cannot control this. “It’s shameful for those girls to start bleeding in class and my dad told me it’s taboo,” noted Ashraf 16 years a student of Senior 4.

Henry 16 years a student of Senior 4 noted that girls who stain their uniforms in class, embarrass themselves and we can’t stop to laugh and make fun of them.

Kavuma Allan 19 a senior 6 student was also noted saying that while at home when her sister goes in her periods, their father and mother do not allow ther to cook or serve food since they she is unclean.

Right from the discussions, it was clear that so many myths and misconceptions surround menstruation and render girls stigmatized leaving them in the face of gross discrimination and inequlity during their periods.

Paul told the boys that menstruation is a normal process for all women and girls in the reproductive age and it’s a proper sign of showing that the girl is healthy. He added on that when girls are in their periods or about to start their periods, they undergo pain and emotions; Such pain and emotions could at times include; abdominal and back pain, back and leg pain, headache and breast pain, feeling sad, lonely and angry among others.

With such pain and emotions, Paul noted that girls need to be loved, cared for and comforted to under such hard times. Girls under go this process every month and there is no scientific evidence that has proved that periods make women unclean or less of being human. In actual sense periods make women normal, healthy and active just like the way boys have wet dream and an erection every morning. Paul called on the boys to be brand ambassadors for improved menstrual hygiene and management to support girls go through menstruation with dignity.

In conclusion boys committed to being brand ambassadors for promoting menstruation with dignity while the girls committed to doing all within their means improve hygiene while in their periods and to continue to advocate for access to menstrual hygiene materials and facilities since menstruation with dignity is their right.

Patrick Mwesigye the founder and Team Leader at UYAF in his closing remarks delivered by Paul, noted that UYAHF, a youth led and youth serving organization working in Uganda is committed to working with young people to address their health gender and livelihood needs through; empowerment, advocacy and capacity building with a goal supporting them to fulfill their potential and achieve their drams and feature aspirations. Young

Patrick also noted that it’s the responsibility of all of us to work together and develop interventions that increase efforts to ensure that all adolescents and youth have the knowledge, skills, and opportunities for a healthy and productive life, and enjoyment of all human rights.  Adolescents and youth are diverse and not all face the same risks, constraints, and deprivations. Ensuring their healthy development requires making the health services and system work for adolescents – but also addressing risk factors in the social environment and focusing on factors that are protective across various health outcomes including the enabling legal and policy environment.

Sign now to petition the Prime Minister of Uganda to end teenage pregnancy in Uganda

Compiled By: Patrick Mwesigye

C.E.O Uganda Youth and Adolescents Health Forum

@patsewa / patsewa@gmail.com
Did you know Uganda’s Productivity would be $15 billion higher if teenage girls delayed pregnancy until their early twenties, got a skill and worked?
Did you know that 3 out of 10 girls in Uganda drop out of school due to teenage pregnancy related issues?

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Did you know that 49% of Ugandan Women are married before their 18th birthday and that teenage pregnancy is highest where child marriages is prevalent?
Did you know that still birth and newborn deaths are 50% higher among infants of teenage mothers than among infants of mothers between the ages of 20 and 29 years?
Having worked with adolescent girls and young women for the last four years, there is no doubt that one of the major obstacle that has for so long deprived adolescent girls of their ability to achieve their potential and realize their dreams is teenage pregnancy. Today, pregnancy and child birth is the leading cause of death among adolescent girls.


In Uganda of all pregnancies that occur annually, 24.6% are teenage pregnancies. Teenage pregnancy has far devastating reproductive, social and economic effects on the lives of communities and families of adolescent girls.
Because of my humanitarian heart and the feel for every adolescent girl, i am signing this petition, calling on the Prime Minister of the Republic of Uganda Rt. Hon. Dr. Ruhakana Rugunda to develop, adopt and commit to financing a Comprehensive Mult- Stakeholder Plan to End Teenage Pregnancies in Uganda.
You too can show us your support by signing the petition here. https://www.change.org/p/sign-now-for-a-plan-to-end-teenage-pregnancy-in-uganda

 

Thank you for your support