A young woman called Uchizi Kumwenda from northern Malawi has wise words. She says: "There is nothing for the youth without the youth themselves. Young people across the world need more efforts and resources to consolidate health systems and improve access to services."
Indeed, young people in Malawi and across Africa tend to lack knowledge and skills when it comes to their sexual and reproductive health and rights including where to access services. When they do access services, it can be inappropriate. For example, in some areas young people have to queue in line with older women who ask why the young person is there, and gossip about them.
Dorothy Nyasulu, assistant representative from the United Nations Population Fund Malawi, understands young people's needs well. She says: "Young people need their own spaces where they can be free, and where people are specifically trained to address their issues." However, long distances to access services, long waiting times, poor service provider attitudes, and negative judgments from other adult clients create barriers to sexual and reproductive services for young people.
Shaping policy and programming
The Malawi National Youth Policy stipulates that 'young people have the right to access sexual and reproductive health information and services.' Yet the Ministry of Education's policies do not allow the distribution of family planning products in schools. While the ministry has now begun to incorporate sex and sexuality issues into its school-based curriculum, this inconsistency in policy means that health facilities are a critical site for youth interventions.
Southern Africa AIDS Trust (SAT-Malawi) in partnership with REAP is implementing a governance project called: 'Investing in our future: addressing the needs of youth and adolescents living with HIV and AIDS in Malawi'.
The project is popularly known as 'teenage programme' among the communities of Mzimba North and Rumphi districts in northern Malawi. It empowers young people with advocacy and governance skills in order to demand services from health providers. Gift Chinoko, 16, joined Rumphi Sunrise teen club in 2012. He became empowered when he participated in a youth camp under the 'governance project' aimed at identifying key policy and advocacy issues for young people living with HIV. He also had the chance to attend training for knowledge and skills building and a session for community level policy and programme mapping of young people's needs. Above all, he represented his fellow members of the teen club during the 'budgeting' by Rumphi District Executive Committee.
Blessings Kanyangale is the Rumphi District AIDS Coordinator who has witnessed significant changes taking place. Youth and adolescents of the Sunrise teen club are more aware, very organised and they can request services from providers while following procedures.
He says: "The youths trained in this project know where to go with the issues and challenges of their daily life. It was some months ago when these youths came to my office, demanding that they would like to see the district commissioner in the presence of district health officer for some services which they deemed were not fit."
The opportunity was granted. Some of the issues they raised were difficulties with long distances to access services, a request for policy change in order for school teens to get family planning products alongside antiretroviral treatment and a need to have Saturday as special day for teens to access services. All these issues were addressed and a resolution made that every weekend the district health officer should assign a special health worker to assist them on their needs including sexual and reproductive health services.
Kanyangale says: "These youths, as far as governance is concerned, know who is responsible for what and if they have issues they know how to channel those issues."
The teen club membership also raised worries of the governance project's sustainability and as a result, the district commissioner suggested that REAP should support the group to form and register as a non-governmental organisation so that they can access Global Fund grants and other donor funds.
Uchizi and the other young people involved in this project are setting an inspiring example of what can be achieved by empowering young people to demand improved sexual and reproductive health services. Governments and organisations across Africa should take note.