Taking a stand for sexual health – and our future

The renewal of the East and Southern African (ESA) Ministerial Commitment on CSE and Adolescent SRHR will take place at ICASA (December 6-11). As youth leaders we know what a critical moment this is.

The first ESA Commitment on CSE was endorsed in 2013 and led many countries to step up in securing the future of young people’s lives. Across the region, programmes and policies have been introduced to improve sexual health education and increase the uptake of youth-friendly sexual and reproductive health and rights (SRHR) services, including health information, HIV awareness and gender-based management.

Since then, new HIV infections among adolescents and young people in East and Southern Africa have fallen by around one-third. But still, there are far too many young people in the region getting HIV – around 400,000 in 2020 – or becoming pregnant when they don’t want to be.

The new commitments will set out what countries need to do to keep moving forward. And that means stepping up to strengthen efforts that will enable young people to access comprehensive sexuality education (CSE) and SRHR services. It means providing young people with the knowledge and skills we need to make informed choices about our bodies and our relationships – so we can focus on living our lives to our full potential.

Common ground

For a lot of politicians, religious leaders, parents and others, young people’s sexual and reproductive health and rights remains a controversial topic. In Uganda, the idea of CSE does not ring well in the ears of many religious and cultural leaders who equate it with promoting promiscuity.

These leaders want young people to be safe. That’s what we want too. In fact, we all dream of a future where young people have a good quality of life and are able to contribute to the development of their respective communities. We want a safe and supportive country for every young person. One where young people are able to make informed choices  – where teengers can choose books over babies, where we don’t get HIV or die from AIDS-related illness. Let us celebrate this common ground and build upon it so we can move together into a world we all want.

Taking policies off the shelf

Since 2008, Uganda’s National School Health Policy has clearly outlined the SRHR information that adolescents and young people in school need to know about – subjects like consent, sexuality and HIV – and what needs to be in place to ensure this information is provided. But the policy is unoperational. It remains on the shelf, gathering dust. So how does this help young people?

A National Sexuality Education Framework also exists but religious leaders currently see it as too controversial. This continues to limit young people’s access to CSE.

The SRHR Alliance Uganda is working with the Ministry of Education, civil society organisations and institutions like the Uganda National Teachers Association to support consultations and advocacy to drive demand to pass the National School Health Policy. Schools need to commit to offering students weekly SRHR counselling and guidance sessions. We are having success here, but often we hear head teachers ask ‘where is the national guidance?’, and there isn’t any.

Right now, the majority of schools that are providing CSE in Uganda are the ones with internal funding. This is unsustainable. We need initiatives that are owned by the schools, which are part of each school’s culture. For this we need our politicians’ commitment to domestically fund CSE.

If we work with policymakers and others to focus on the common ground, find the right words and present the evidence, we can find a way.

Challenging laws and attitudes

But young people don’t just need SRHR information. We also need services, and there are still too many barriers in the way for adolescents to access HIV prevention or contraception. In Uganda, the current age of consent is 18, but the reality is that many young people are sexually active at younger ages than that. You can get an HIV test without parental consent at the age of 12, but you cannot get HIV treatment without parental consent until you are 18. So the laws don’t match up.

Uganda now has more facilities that provide youth-friendly SRHR services than before, but many clinics do not take this approach. We need our politicians to not only commit to changing this but to provide the funding, training and infrastructure to see this promise through.

Marginalisation

Uganda’s adolescent health policy is an important milestone, but it does not include certain groups. But we all now know the reality –  some young women sell sex and some young people are LGBT. These young people face additional challenges with their sexual and reproductive health. Where do our current policies leave them?

We must agree a way to ensure these young people are not pushed to the wall and denied access to the information and services they need to live fulfilling, healthy lives.

The COVID-19 pandemic has made the marginalisation that many young people face even worse, but it has also made it more visible. Research suggests sexual violence against children and adolescents in Uganda rose during lockdown. Yet, it has made more policymakers reflect on what is happening. And it has strengthened the case for more investment to protect young people’s rights.

Engaging young people in decision-making

Whatever decisions ESA Ministers make about young people will affect the present and the future of the countries we all live in. But ultimately, policymakers and politicians cannot decide what is right for young people because they do not live our lives and they cannot carry our burdens. We must be listened to.

To the young activists, and others who are committed to seeing a society where young people have a good quality of life, please keep on pushing – the tough times do not last forever. In Uganda, our population is a young one: in the next 10 or 20 years we will be the ones making the decisions. So let us not be scared to make our leaders accountable now. Because we are the change, and we are also the future.

Find out more by reading the Our Health, Our Futures Call to Action

Written by Martha Clara Nakato,Community of Action Facilitator for the WE LEAD Programme at the SRHR Alliance in Uganda.