For a long time, health experts at the small dispensary in Fulwe village, Morogoro region were baffled by the increasing cases of gonorrhea and other sexually transmitted diseases among the youth.
They knew if something was not done, the situation could possibly escalate and become a serious problem which could affect the whole region.
With the little resources they had, the medical team employed all the effort in treating the disease, but after some time, they realized they were fighting a losing battle, because new cases were reported almost every day.
Despite considerable efforts by the team to identify simple interventions that could reduce risky sexual behaviour, behaviour change remained a complex challenge.
Mwajuma Kassim, a nurse at the dispensary, says that they realized that accessing the youths in the area was challenging, because most of them feared visiting the health facility, because reproductive health needs of young people have been largely ignored by existing reproductive health services.
“Most of the youths, not only in Fulwe but in most parts of the country, fear visiting health facilities for sexual reproductive health education because they know they will be perceived differently and labelled as immoral, especially by their elders, that is why they shied away,” she said.
Mwajuma says that the situation changed when they received training on how to deal with the youth from a program called Youth for Health (Y4H), a three-year initiative co-funded by the European Union.
The Y4H Consortium comprises Marie Stopes Tanzania (MST) and Sikika, with activities focused in the Morogoro region, working in Tanzania to support the delivery of teen-friendly services in the area of Sexual and Reproductive Health (SRH).
Ms Mwajuma says that the training program started in October 2022, and that before that the centre received about 2 to 3 youths per month who turned up for SRH services, but after the training they changed the timetable and set 3:30pm to 5pm purposely for the youths.
“We set that time every day so that the youths can be comfortable to visit and receive SRH education from a qualified trained nurse who is stationed purposely for that reason, and within a very short time we started to see changes,” she says.
She says that apart from that, the centre has set aside time once a month dubbed the ‘Weekend Clinic’ to socialize with the youths, where they conduct various sports activities and later educate them, which has increased the number of youths who turn up, where sometimes they provide education to almost 200 youth every month.
Ms Mwajuma says that after gaining the confidence of the youths, they educate them on the accurate use of contraceptive methods, including the proper use of condoms.
“Apart from offering them SRH services, we also introduced weekend clinics designed to increase access to SRH information and services for adolescents.
During these clinics, we usually integrate entertainment activities such as games, sports, health education on relevant topics and integrated services provision, especially family planning, which has turned out to be a very effective method,” she says.
Amina Ramadhan, a resident of Mikese ward in Fulwe village, Morogoro region and who is one of the youths who were trained on how to reach other youths and educate them on SRH services through the Y4H program, says that apart from Sexually Transmitted Diseases (STIs), most of the youths were also facing cases of teenage pregnancies.
She says that the Youth for Health project also trains youth champions like herself to advocate for their sexual and reproductive health and rights, and hold governments and decision-makers accountable.
Ms Ramadhan says that apart from bringing positive changes to other youths in her area, becoming a youth champion has also changed her life, because the project has empowered young people by giving them a platform to discuss and share some of their challenges openly.
Catherine Madaha, the Morogoro Region Reproductive Health Coordinator on her part says that although they work with various stakeholders in the health sector, the Youth for Health program is beneficial to them because it deals directly with the youths on issues of reproductive health.
She says that with the region boasting of 9 district councils, they decided to introduce the Y4H program in four councils of Gairo, Morogoro DC, Ulanga and Malinyi.
“We introduced them in the four councils because they had a shortage of reproductive health experts, but the councils were also facing a serious challenge of early pregnancy cases, especially in Malinyi and Ulanga because of the increasing number of pastoralists,” she said.
She said the first thing Y4H did was to conduct an assessment of all their health centres, and they discovered that most of the staff did not have enough experience, where they started by building the capacity of 52 employees from 26 centres, where they took two from each centre.
She says that in the four health centres, the youths are now confident and attend without any fear, because they know that they will meet with fellow youths who are trained on providing SRH education and services.
Ms Madaha said that apart from training the health personnel, the Y4H program also targeted Community Health Workers (CHW), who have brought a great impact because they are trusted in the communities they come from.
The Youth for Health (Y4H) project is working in Tanzania to support the delivery of teen-friendly services in the area of sexual and reproductive health.
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The project, co-funded by the European Union, seeks to increase awareness of sexual and reproductive health issues, ensure that support services are available and train staff to provide support in public sector facilities.
In its first year, Y4H Tanzania supported context-specific gender and social norm change interventions, by training 42 community health workers in family planning, awareness raising and mobilization, holding 47 dialogue sessions with local communities.
The program also supported 21 public sector health facilities to provide more adolescent-friendly, inclusive, client-centred, quality care.
The services provided in these facilities helped to avert an estimated 17,100 unintended adolescent pregnancies, including 1,500 amongst adolescents, reached the most marginalized – 28 percent of client visits were by adolescents and 11 percent of clients were living in severe multi-dimensional poverty.
It also contributed to a more enabling environment for the respect, protection and fulfilment of ASRHR, by training and supporting 30 adolescent champions to develop and deliver advocacy asks to decision makers at national and sub-national levels and carrying out a budget analysis and presenting the findings to the Parliamentary Standing Committee for Health and HIV/AIDS, which agreed to incorporate the findings into their report.
