Why the focus on Adolescent Reproductive Health?

Growing up is wild. One minute you’re a kid, worried about cartoons and snacks, and the next; your body is changing, your feelings are all over the place, and suddenly, there are big questions about sex, relationships, and the future.

In developing countries, this stage of life between 10 and 19, sometimes stretching up to 24 is called adolescence. It’s akin to standing on a bridge between childhood and adulthood. What you do while crossing that bridge shapes the rest of your life. If you miss a step, you may find yourself drowning in the water. However, if you have skills to swim then you will survive and make it to the bank.

Fun fact: almost a third of Uganda’s population are adolescents. That’s millions of young people figuring themselves out, and yet; many of them don’t have the right information or services to guide them through it.

A little more context; the average adolescent has their first sex encounter at approximately 16-17 years. Sadly, around this age, most teenagers haven’t had any honest conversation about safe sex or family planning with anyone they trust. All they have heard are myths and whispers.

The consequences of such a trend are heavy. Too many girls end up pregnant before they’re ready, many before turning 18. Some then opt for unsafe abortions because, again, they know no safe options. Young women under 25 make up about 60% of unsafe abortions in sub-Saharan Africa. That’s not just numbers that’s real people, real lives. Others drop out of school losing the chance to build the future they once dreamed of. These pregnancies may come with maternal health risks like fistula, and babies born to very young mothers also face more health problems compared to those born to older moms.

The scarcity of critical information doesn’t affect girls only. Boys bear the brunt too. They’re figuring out masculinity, relationships, consent, peer pressure and unceasing online pressure to get sexually active. Clearly, reproductive health isn’t a “girl thing” / “boy thing”, Rather, it’s an “us” thing.

Why is Reproductive Health such a big deal for adolescents?

Because it is about more than avoiding diseases or teenage/early pregnancies. It’s about rights. The right to say yes or no. The right to decide if or when one wants children. The right to access safe health services without being judged or shamed. It’s about knowing one’s body, making proper choices, and feeling confident about one’s future.

Unfortunately, the system as it is now doesn’t work for young people. Walk into many clinics, and the vibe is awkward. Even adults may feel judged the moment they ask about condoms or family planning. Faith based schools may avoid teaching real sex education, and parents? Most wont even bring up the subject. So young people end up learning from social media sites like Facebook and Tik Tok, gossip, or friends who also don’t know better. Unprogressive cultural traditions like female genital mutilation and harmful practices like early marriage or make things worse.

The following are some of the specific reasons for the focus on adolescents and young people’s reproductive health:

• Adolescents start having sex at an early age with a         median age of 16-17 years
• High rate of pregnancies among adolescent girls with most of the pregnancies being unwanted.
• Majority of criminal abortions are among the adolescents since the pregnancies are unwanted.
• High risk of pregnancy-related complications (obstructed labour, fistulae)
• High infant mortality to children born to mothers below 19 years.
• Adolescent female account for a significant proportion of maternal deaths
• Most adolescents are still economically dependent and have no power over their sexual rights
• RH services are not youth/adolescent friendly since most services target married people.
• Young people face greater reproductive health risks than adults, yet they are less willing and able to access reproductive health services
• Lack of positive guidance
• Inadequate and inappropriate reproductive health information on sex, sexuality, family planning, Antenatal etc.
• Due to Gender discrimination in some societies
• About 20% of female adolescents are married compared to their male counterparts
• To encourage responsible sexual behavior
• To help adolescents protect and focus on their sexual and reproductive health
• In order to revisit policies that leave out the adolescents

The good news is CHANGE IS POSSIBLE. Around the world; policies, programs, and campaigns designed to protect young people are on a rise. Some schools are beginning to teach sexuality education, communities are being empowered to fight against child marriage, and more health workers are being trained to provide youth-friendly services. It’s not perfect yet, but it’s a great start.

Key factors and issues that affecting adolescent Reproductive Health

The adolescent sexual reproductive health has remained to be a very contentious topic across different societies. There have been challenges on building consensus on what kind of information should be given to them and who should deliver the information. These differences and challenges are cause by the following factors;

• Harmful cultural practices perpetuated by cultural norms
• Lack of knowledge and awareness among the adolescents and their parents/caretakers
• Exposure to adult media like pornography
• Impact of globalization (moral decadence, cultural dilution) causing the adolescents to lack appropriate guidance and support on their reproductive health.
• High cases of sexual abuse and violence against the adolescents
• Limited access to reproductive health services
• Economic dependence creating vulnerability to sexual exploitation
• Weak legal and structural systems to protect the adolescents and ensure access to justice.

What does adolescents or youth-friendly mean?

It means spaces whether in clinics, schools, or online where young people can get accurate information and support without fear or shame. It means, services are affordable and confidential and the health worker is warm and welcoming. They don’t raise eyebrows when a teenager asks for information.

Imagine a world; where a 15-year-old girl doesn’t drop out of school because she got pregnant, where a teenage boy understands consent and treats women with respect and one where young people actually have a say in decisions about their bodies and futures. That’s the vision of adolescent sexual and reproductive health.

When young people are healthy and empowered, entire societies win. They finish school and build careers, start families when they’re ready, and they contribute more to their communities. Investing in adolescent health is like planting seeds for a stronger, more equal future.

So, here’s the takeaway: adolescent reproductive health is not just some abstract policy issue. It’s about young people world over.  You, your friends, your classmates, your siblings etc It’s about making sure every young person can walk across that bridge from childhood to adulthood with knowledge, dignity, and power over their own choices.

The following some of the characteristics of adolescent friendly reproductive health Services:

1. Accessible: Adolescents are able to access and obtain reproductive health services
2. Acceptability: Adolescents are enabled to have the feeling and willingness to seek the health services
3. Equitable: All adolescents including marginalized groups of adolescents are enabled to obtain health services
4. Appropriate: The health services that adolescent users need should be provided on spot or through referral linkages and should be suitable.
5. Effective: The health services provided should help adolescent users stay well and healthy, and          the ill adolescent should be given treatment in order to get back to good health

Although adolescents face risk for a range of reproductive health issues, little attention has been paid to them. Yet the years of adolescence could offer chance for them to acquire broad knowledge including that for optimal health practices. This knowledge could then help influence their choices at their adolescent stage of life and later on in their lives. There is therefore an essential need for reproductive health interventions for adolescents and it is most ideal to start reproductive health education before puberty is attained.

Factors affecting adolescent RH

• Harmful cultural practices perpetuated by cultural norms
• Lack of knowledge and awareness among the adolescents and their parents/caretakers
• Exposure to adult media like pornography
• Impact of globalization (moral decadence, cultural dilution) causing the adolescents to lack appropriate guidance and support on their reproductive health.
• High cases of sexual abuse and violence against the adolescents
• Limited access to reproductive health services
• Economic dependence creating vulnerability to sexual exploitation
• Weak legal and structural systems to protect the adolescents and ensure access to justice.