As Practitioner and Mother, Empowerment is the Goal
By Willow Gerber
As the mother of a 17-year-old son, I worry about a lot of things, from school safety to gender norms that support "boys being boys" and everything in between. One thing I don't worry about is my son's capacity to advocate for his health. He knows his right to high-quality care that respects his level of development, or underdevelopment as the case may be. He wasn't born with this capacity; it came about because after working in health and gender for decades, I've had a little influence over his world view. At the same time, what I've learned from parenting also shapes what I bring to my work.
This overlap was especially clear this year as I worked on an activity in Malawi, as part of the USAID-supported Health Policy Plus project, to make the government's National Youth Friendly Health Services policy relevant to communities, to people. We took a relatively abstract policy document and distilled its key points into language that youth—the people it's meant to benefit—could understand. Two key lessons I learned through this experience were that (1) we mustn't underestimate young people and (2) getting results out of policies is hard work.
Malawi's youth have a lot of potential, but face challenges
Malawi is an interesting place. It has almost 19 million people, 44 percent of whom are under the age of 15, and another 20 percent of whom are between the ages of 15 and 24 (PRB, 2017). That's a lot of young people! And a whole lot of potential. While Malawi has an advanced adolescent health policy, unfortunately, it falls short of achieving its policy goals. When we began our work in Malawi, hardly anyone knew the policy existed, and many of Malawi's young people lacked the capacity—and confidence—to access the health services the policy addresses.
Youth-friendly health services need to be accessible at the local level
A key aspect of making the policy relevant to young people was to shore up the demand side of the policy equation—giving youth the right information, at the right time, in a way they could understand. In doing so, young people felt a sense of agency to act on behalf of the policy. Equipped with knowledge and confidence, they were able to demand services and to advocate for themselves and their peers.
To make that happen, we undertook a three-pronged approach. First, we partnered with the Developing Media Partners media group to work with three community radio stations based in rural areas, which is where 84 percent of Malawi's population lives. We briefed the station staff on the policy and trained them on how to work with youth journalists who'd also been trained on how best to cover the topic.
Second, we worked with young people to learn about how the youth-friendly policy articulates their right to high-quality, relevant, accessible, attractive, affordable, appropriate, and acceptable health services. One way we did that was through setting up radio listening clubs in each of the three communities where we were working. Youth involved in the clubs had the chance to contribute to the radio programs by suggesting what topics and content they wanted to hear about and inviting speakers.
Third, to reinforce young people's learning, we developed infographics that communicate key facts and make the case for supporting young people's right to health services.
While our first idea was to focus on young women, we knew that sustainable results required interest and action from both young women and men for their respective care. So we brought them both along, knowing that when men are involved in family planning they're more engaged with their partner's and children's well-being (Barker, 2014).
Did we get it right? The results so far seem to show we did:
- The number of radio clubs has grown from 9 to 19—10 of which were formed by youth under their own initiative—and the young people contribute to the content of the radio programs.
- Health facilities in the three communities reported seeing five and six times the number of young clients coming in for services.
- Teachers have now begun to provide time and space in schools to discuss youth-friendly health services as part of their existing life skills classes.
- Tribal chiefs, church leaders, and parents are also involved in the discussion. They make appearances at youth-friendly health services awareness events and appear on the weekly radio programs to advocate for these services.
Don't underestimate young people
I imagine many parents in Malawi share the same fears I have in raising a son in a turbulent world. I've done what I can and trust that he'll make good choices and treat others as he has been treated. I know he'll be able to speak more confidently to doctors and nurses, ultimately contributing to a virtuous cycle of respectful care.
In the end, young people should be able to go out in the world being safer, healthier, and more confident. Thanks to this type of activity, policy-makers, program staff, and the young people themselves begin to understand why this type of policy matters and the importance of investing resources to help youth achieve their potential.
Willow Gerber is a senior policy analyst and gender specialist with over 20 years experience in family planning and reproductive health.