Nothing for us without us
Adolescents group discussion during a breakout session hosted by LVCT Health at the Adolescent Health Symposium.
The second adolescent symposium was held between the 22nd and 24th of November at the Safari Park Hotel in Nairobi. It brought together over 300 adolescents from different geographical locations, backgrounds, religions and without a question, a myriad and great mix of experiences. It was necessitated by the fact that there are approximately 9.1 million adolescents between the ages of 10-19 years in Kenya which constitutes about 24% of Kenya’s total population.
Despite the window of opportunity that adolescence presents, many adolescents face considerable high risk of adverse immediate and chronic health consequences. Social contexts exert the most powerful effects at this stage and include economic and educational status as well as peer influence to engage in habits such as use of alcohol, cigarettes, recreational drugs, poor eating habits and early initiation to sexual relationships. It is imperative to note that often, these habits progress to abuse. Evidence suggests that adolescents experience a higher rate of violence and injuries, self-esteem, depression and other mental health problems than any other age groups. Moreover, it is also the stage at which vulnerabilities to harmful practices such as female genital mutilation, early marriages and sexual and gender based violence is at a soaring level for adolescent girls.
The ultimate goal of the symposium was to find ways to improve the holistic multisector approach to adolescent health at all levels of service delivery whilst ensuring that adolescents fully participate in developing themselves, their families, communities and the nation, towards harnessing the demographic dividend. Other objectives for the symposium included:
- To stimulate debate around a multi-sector approach to improving Adolescent Health through coordination and interaction of the health, education and financial sectors
- Promote scale up/replication of evidence based interventions that are demonstrated to have worked in various settings including country implementation of the Global Accelerated Action for the Health of Adolescents (AA-HA!) guidelines
- Identify new approaches to adolescent health interventions/ investments
- Build partnerships and synergies across different disciplines together with adolescents
One of the breakout sessions hosted by LVCT Health during the symposium, sought to set a friendly and conducive environment where adolescents could have candid discussions about certain aspects of their health and what influences the choices they make when it comes to their health, particularly around Gender Based Violence – GBV and HIV issues.
Adolescents cited ignorance, peer pressure, lack of early disclosure, drug and substance abuse, poverty and presence of sugar mummies and daddies as some stage as some of the main factors that increase new HIV infections among adolescents. As a follow up to this discussion, LVCT staff were interested in finding out the acceptability of self-testing amongst adolescents and the responses were shocking. Self-testing is thought to be a safe space for many but for this population, going by the sample that was present at the symposium, many think of it as unsafe because of the high probability of committing suicide should the test turn out positive. Most said that they appreciated the counselling done before the test in health centers saying that it gave them hope should the test turn out to be positive.
The adolescents expressed that the formation of post-test clubs for both those who test HIV positive and negative would be a good idea for raising awareness about HIV prevention. These clubs would be a great forum to educate and inform the youth on various issues around HIV prevention. Adolescents also appreciate the use of champions as a form of motivation for them to seek HIV services.
The adolescents were engaged on what the most appealing platforms for delivering adolescents’ health information was and social media sites topped the list. It was clear that young people spend a lot of time on social media and it excites them and is convenient for them. The use of toll free numbers like the LVCT Health’s toll free number – 1190 where they make calls and send text messages in a confidential space and ask/talk about health issues that they deal with without fear of judgement is also very popular. Conferences and workshops, specifically organized to engage them came out as a good platform as well as outreaches and roadshows. The young people feel that if these platforms are used correctly and efficiently, they are a great opportunity to reach out to them and offer them correct information on Sexual and Reproductive Health – SRH/HIV issues that empower them to make informed and correct health choices for themselves. They are also good platforms to take on advocacy issues and for the youth to reach the government and other partners.
Gender Based Violence continues to be a fight that needs to be won in order to win the fight against HIV. This is because, those that experience GBV are at higher risk and even more vulnerable to HIV infection. Unfortunately, many young people are not aware of GBV services that are available to them and sadly, many are abused by the very people they trust which makes it hard for them to speak out and get help.
Young girls especially continue to be disproportionately affected when it comes to GBV. At LVCT Health, DREAMS sites https://www.pepfar.gov/partnerships/ppp/dreams/ and the county health facilities which act as linkage sites are managed by service providers who are sensitized in responding to Violence against Children / adolescents. The caregivers, who accompany children to the sites are also sensitized on handling VAC and referral mechanisms guided by the National curriculum on management of Sexual Violence (2014) together with the Violence against Children Standard Operating Procedure (2017).
95% of the adolescents in the room said that they loved their parents and were interested in having a relationship with them but there are many things especially around their sexuality that they prefer to discuss with other people. The peer approach seemed to be most popular among this age group. Nearly all of them preferred to talk and confide in their partners especially as far as their personal sexual lives are concerned. This is the case because they feel safe, secure and judgement-free in their circles because they feel that they understand each other and are experiencing the same things. The adolescents also said that counsellors play a key role in creating a friendly and conducive environment where the two can have the tough conversation and have it driven by the adolescent. The counsellors also help remove parents from their comfort zone by addressing tough issues with them and giving them tips on how to engage their adolescent children.
The session gave the adolescents a voice and gave them a seat at the table to air their issues and come up with their own solutions. This inclusion of stakeholders should be the practice to ensure holistic approach to problems facing them.
By, Lynda Keeru