“Young people’s participation is crucial”: ensuring a genuine commitment to sexual and reproductive health in the responses to COVID-19

Young people have the technical expertise and skills needed to be genuine partners in the decision-making and implementation processes to ensure the continued provision of essential health services, including sexual and reproductive health (SRH), during the COVID-19 pandemic; In June, the World Health Organisation (WHO) published guidelines for maintaining essential health services during the pandemic which address some of the issues related to the SRH needs of young people. Governments have begun to adapt these guidelines and develop national plans to meet the SRH needs of their populations during this crisis; They must take into account the challenges and vulnerabilities faced by young people by ensuring that young people are able to contribute in an inclusive and relevant way.

Some organisations, including youth-led civil society groups, are taking proactive steps to address the SRH needs and challenges of young people during the pandemic; They are gathering evidence on this issue, raising questions with local health departments and other stakeholders, and advocating for the participation of young people in the development of national contingency plans for COVID-19;

PAI held discussions with Aminata Badiane Thioye, a young expert in SRH advocacy in Senegal, who works for the Alliance Nationale des Jeunes pour la Santé de la Reproduction et de la Planification Familiale (ANJSRPF); At the start of the pandemic, the ANJSRPF carried out a rapid assessment involving 130 people (mainly young people as well as community health workers and midwives) with a view to understanding the impact of the pandemic on young people’s sexual and reproductive health and rights (SRHR) and determining what measures needed to be taken to guarantee their access to SRH services; The ANJSRPF found that the loss of livelihoods, particularly in the informal sector, coupled with restrictions on mobility, has plunged young people into financial insecurity. Alongside the fear aroused by COVID-19 and the restriction on access to SRH services during the pandemic, the cost of SRH services is driving young people to avoid using them;

The good news is that efforts are now being made at institutional level to ensure the continuity of health services and supplies; Senegal’s Ministry of Health has developed an emergency plan for COVID-19 to ensure the continuity of reproductive, maternal, neonatal, child and adolescent health services, based on WHO guidelines. The plan includes advice on the governance and coordination needed to maintain public and private sector SRH services, as well as an essential health services kit, a guide for providers responsible for these services, stock management, monitoring and evaluation; The bad news is that young people have not been consulted (as is all too often the case), let alone involved in the decision-making process;

Aminata told PAI that “even if the risk of contraceptive methods running out of stock is well managed, this doesn’t prevent young women and teenagers from experiencing financial difficulties in obtaining products”; SRH services are supposed to be free in Senegal, but medicines and treatments are not; “It’s the same problem with emergency contraception, which is financially inaccessible to young women, making the situation all the more critical given the increased vulnerability of girls to rape and sexual exploitation during the pandemic, which can also increase the risk of unwanted pregnancies and recourse to unsafe abortions that could be avoided if they had easier access to it;

The closure of schools has further complicated the situation for teenage girls and young women, depriving them of their usual shelter; School is often the safest place to protect yourself from sexual and gender-based violence; In addition, the reduction and, in many cases, complete interruption of formal and informal education means that SRH programmes for young people are at a standstill. In some contexts, particularly in rural areas and for girls working as domestic servants in Dakar, the capital, menstrual hygiene management and access to clean water have become even more difficult, especially due to many years of water shortages.

“This growing vulnerability is mainly due to the fact that the government’s responses to COVID-19 have been more security-related than social,” Aminata told PAI, referring to the imposition of curfews, the ban on transport and the closure of markets; “We now find ourselves in a state of social and health emergency; This situation has particular consequences in terms of health equity, which is unbalanced between different age groups and between urban and rural areas in Senegal; The ANJSRPF has heard of cases of road and health centre closures in rural areas where health services are already limited; While inequality has always played a major role in the accessibility of SRH services, the current management of the pandemic is exacerbating these disparities;

A number of initiatives, notably at ANJSRPF, are working to ensure that the voice of young people is heard; In collaboration with other partners, the Ouagadougou Partnership, a French-speaking West African initiative that aims to increase the use of modern contraception in its nine member countries, has produced 10 videos of young people advocating sexual and reproductive health. The videos look at the impact of COVID-19 on SRHR, including early and forced marriage among out-of-school girls, the need for young people to have access to contraception, including flexible and mobile services to reach the most vulnerable, and sexual and gender-based violence due to increased stress factors;

As Aminata told PAI, coordinated advocacy efforts are essential to guarantee SRHR, in particular to ensure that SRH service delivery models are adapted to local needs and to the social and economic conditions of young people in times of crisis; “The participation of young people is crucial. We can achieve much more together than on our own. We all know that these are difficult times and that the lack of collaboration and cooperation remains a major challenge to performance and resilience;

Read the PAI brief,Optimising the World Health Organisation’s provisional guidance on COVID-19.