By Reach A Hand Uganda

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East African youth face stigma and misconceptions when it comes to their sexual and reproductive rights, according to a new research paper. This finding puts serious gaps in the race to meet the UN's sustainable development goals.

Five Canadian health researchers published a scoping review titled Exploring Adolescent Engagement in Sexual and Reproductive Health Research (SRH) in Kenya, Rwanda, Tanzania and Uganda.

They found that, as a result of information from parents and communities, as well as anxiety about the potential side effects of biomedical treatment, adolescents in the region are plagued by misconceptions about aspects of SRH, including family planning, abortion, HIV/Aids and contraceptive use, due to fear of infertility and cancer.

“The fear of infertility is connected to the high value placed on having children in East Africa. Literature noted that adolescents are constrained by cultural and gender norms which equate having children with status and value, creating pressure to prove their fertility, especially among young women,” it noted.

It was observed that rather than focusing only on sexual and reproductive health, teenagers are more interested in learning about the variety of sexual behaviours, such as sex curiosity.

Furthermore, there was a stigma associated with using contraceptives because of the belief that the different methods were only for married or child-bearing women and that using them for other purposes would lead to infertility or more dangerous sexual activity.

The United Nations reports that nine million teenagers in Uganda are prone to poverty, HIV/Aids, early marriage, teenage pregnancy, gender-based violence and low secondary school enrollment, all of which hinder young people from reaching their full potential.

This prompted Reach A Hand Uganda (RAHU), a nonprofit organisation, to lead youth-centred campaigns in addressing this issue in its capacity by reaching out to young people, typically between the ages of 10 and 30, through their cultural ikons, peer education, male engagement, and edutainment models.

RAHU CEO Humphrey Nabimanya (C) talks to educators during the Peer Educators Academy program. PHOTO | COURTESY

Through these approaches, programs and campaigns young people are empowered to make informed decisions about their sexual and reproductive health, preventing them from becoming vulnerable to gender-based violence, AIDS, STIs, child marriages, mental health issues, menstrual health and hygiene, access to family planning, and teenage pregnancy.

These advocacy and social behavioural change communication strategies are typically conducted both in and out of schools for the impoverished in urban and rural areas, as well as for refugees, internally displaced people, hard-to-reach groups, and marginalized communities.

According to RAHU, gender norms prevent young women from participating in safe sexual practices like condom use or obtaining sexual and reproductive health care, information and limit their choices regarding bodily autonomy and participation in decision-making in communities. 

This is because patriarchal gender norms give preference to men over women and older people over young people which leads to power disparities and a reduction in women's and young people's ability to make their own decisions.

Additionally, these norms perpetuate the idea that young women are promiscuous. Ensuring universal access to sexual reproductive health services and rights is the goal of Sustainable Development Goals (SDG) 3.7 and 5.6.

Slow progress toward reaching SDG targets in Sub-Saharan Africa, which includes East African nations, has left adolescents in need of subpar SRH care and a persistent burden of STIs. The aforementioned research paper shows that this slow progress has been attributed to the difficulty of defining SRH priorities as well as a lack of research evidence to support relevant policy and program decisions.

“Young people’s participation can contribute to defining SRH services, policies, and programs that better reflect their needs,” the health researchers noted. Every January, RAHU hosts the Peer Educators Academy program for young people 18 to 24 years old who have recently graduated from high school, are in universities or who live in the community.

These young people are trained and equipped with information about sexual and reproductive health rights to become educators and advocates in society, pushing for policy and mindset change, facilitated through a year-long fellowship of volunteering and mentorship.

“After graduation, they get 11 months fellowship with RAHU conducting peer learning sessions. They grow and get professional mentorship so that they penetrate different policy-making and awareness-creation spaces to influence change,” says Lynn Tasha Akullu, the communications officer of RAHU.

“And with this, they are also attached to schools, health centres and leadership offices in communities where they can carry out peer learning sessions, community outreaches and dialogues empowering fellow young people.”

In addition, RAHU works with other organisations, cultural institutions and line government ministries; through the yearly intergenerational dialogues, the girl's festival as well as film and television, RAHU has brought together a variety of voices to foster powerful dialogue, innovation towards gender equality and improved sexual and reproductive health and rights for youths.

The annual multi-actor and intergenerational gatherings have been used as platforms to garner political and young people’s commitment towards the empowerment of adolescents and youth in all aspects of life, beginning with Sexual and Reproductive Health and Rights.

“Over the years, the IGD has made tremendous strides including increasing the participation of young people in matters that impact their lives, increasing access to decision-makers in the sector and documenting commitments from key leaders of our time especially the RAHU Patron King Oyo Nyimba Kabamba Iguru Rukidi IV of Tooro Kingdom to support the achievement of Sexual Reproductive Health and Rights for young people in Uganda,” Ms Akullu elaborates.

Additionally, RAHU has been working to expand access to HIV/AIDS services and information through an annual campaign called “I know Kati," which translates to "I now know" literary, calling on individuals to know their HIV status so they can better protect themselves and their community.

There are 1.4 million HIV-positive individuals living in Uganda, 860,000 of whom are women and 80,000 of whom are children, according to World Health Organisation data.

In line with the World Aids Day celebrations of 2023, to address the HIV/AIDS burden, RAHU collaborated with 5 public health facilities in areas where the disease is prevalent, such as Mbarara, Rwampara, and Isingiro districts; the Reach a Hand Uganda Clinic in Mbarara; and partners including the Global Livingstone Institute, Reproductive Health Uganda, Uganda People's Defence Forces (UPDF), The Aids Support Organisation (Taso), and the Mbarara City and District Local governments.

A matching procession during the IknowKati HIV/Aids Awareness Campaign in Mbarara District, Uganda in 2023. PHOTO | COURTESY

“We reached over 1,670 registered people directly with information and SRHR services including family planning, HIV tests and counselling, cervical cancer screening, and voluntary safe male circumcision and contributed a total of 114 units of blood donated to save lives,” Ms Akullu says.