Improving Access to Health Information and Services

A group of adolescent girls and young women sit on plastic chairs in the shade of a large tree in Adjumani, Uganda. Florence, a Right To Play-trained community mentor, is in the middle of the circle teaching them about menstrual health and hygiene. She passes around a guide for how to make reusable menstrual pads, an activity they’ll do together shortly, and describes the different stages of the menstrual cycle and when conception is most likely to occur.

Florence leads regular sessions on sexual and reproductive health and gender equality. Her mission is to equip young people with the information they need to make informed decisions about their health, keep themselves safe from disease, avoid early pregnancy, and become advocates for their well-being. They also discuss topics related to gender equality, addressing harmful gender norms and domestic violence.

Learn more about how young people are finding support and mentoring through SHARE in Uganda.

Equipping young people to advocate for their health and well-being

In Uganda, many young people find it difficult to access sexual and reproductive health care, information, and services. Some communities believe that exposing young people to ideas and information about sexual and reproductive health encourages them to become sexually active too soon. This, paired with social stigma and deeply rooted gender inequalities, creates environments where young people, especially adolescent girls and young women, are not able to make informed choices about how to protect themselves from disease, prevent early pregnancy, or advocate for their health. In areas of Uganda where Right To Play works, only 35% of sexually active adolescents believe they can get their partner to use contraception.

The Sexual Health and Reproductive Education (SHARE) project is supporting the realization of sexual and reproductive health and rights for young people in Ghana, Mozambique, and Uganda. The project will reach more than 325,000 adolescents and youth – 59% of which are female. Active since 2022, the program is implemented through a consortium led by Right To Play in partnership with the Forum for African Women Educationalists (FAWE), and WaterAid, with technical support from FHI 360, and financial support from Global Affairs Canada.

Through the project, adolescents and young people 15 years old and above can access mentorship groups that equip them with the skills and knowledge to advocate for their health-related rights, and promote gender equity within their personal lives and communities.

In Adjumani, 1,560 adolescents and young people are participating in 52 mentorship groups, and 50% of participants are female. The groups are split by gender to ensure participants feel comfortable speaking openly about sensitive topics. Led by volunteers like Florence, the mentorship groups address a wide range of locally relevant topics, including nutrition, parenting, menstrual hygiene management, healthy relationships, financial savings, prevention of forced marriage, and mental health. Sessions also include games and playful activities designed to improve participants’ social connection and help them develop interpersonal skills like confidence and communication.

FAWE, a project partner, also organizes community dialogue sessions in Uganda where parents, young people, community members, and leaders come together to discuss issues related to gender inequalities, adolescent health, family planning, and access to health services. If an issue is raised that requires additional advocacy or interventions, they are forwarded to key stakeholders for action.

Mariam, 20, has been an active participant in these community dialogues for almost a year. She hates to see adolescent girls and young women drop out of school because of a lack of knowledge about menstrual hygiene management, or inadequate facilities, and wants to help them stay in school. She helps to combat the belief that young people are not allowed to access sexual and reproductive health services and encourages local youth to seek out support at health centres when they need it.

“The community dialogues empowered me to take meaningful action,” says Mariam proudly. “I am actively addressing adolescent health and menstrual hygiene management issues in our community. I have learned to communicate effectively, [and to facilitate better] understanding between parents and adolescents. I've also seen a decrease in school dropouts due to increased awareness.”

Equipping health centres to provide youth-responsive services

Community volunteers like Florence and Mariam aren’t the only ones working to improve young people’s access to information and health services. Pauline is a Ugandan Health Officer who works with the SHARE project to promote referral pathways — the chain of information that helps ensure young people know where to go and what to do if they need help related to their sexual and reproductive health. She believes that when young people have access to information, they can become champions of their own health and share their knowledge with their friends.

“[We] empower health workers to pass adolescent-responsive information to the adolescents. This also build the capacity of the young people in addressing their own issues,” she says.

Accessing health centres can be a challenge for young people. In many communities, health centres have policies to provide sexual and reproductive health services regardless of gender or marital status. However, half of the health facilities have age restrictions around who they will provide sexual and reproductive health services to. In a survey at the start of the project, many young people reported feeling judged, having negative comments made about their behaviours, and even being denied services by nurses and pharmacy attendants when they sought treatment. Girls feel particularly stigmatized when seeking out these services.

As part of her work with the project, Pauline helps train community health workers on how they can make healthcare services more responsive to the needs of adolescents and young people and understand the specific concerns and challenges they face. She works to combat negative biases, ensure health workers provide confidential and non-judgmental care, as well as promote young people's right to access services without being turned away. She knows that when they’re equipped with knowledge, young people can also guide their peers.

The Sexual Health and Reproductive Education (SHARE) project aims to advance gender equality by improving access to sexual and reproductive education and gender-responsive health care for young people, especially girls and young women, in Ghana, Mozambique and Uganda. Launched in 2022, through a partnership between Right To Play, FAWE, and WaterAid, the project is made possible with the financial support of the Government of Canada provided through Global Affairs Canada, and with technical assistance provided by FHI 360. The five-year project will strengthen sexual and reproductive rights for more than 325,000 adolescents and youth (age 10-24) by 2026.