Empowering young people to take control of their sexual and reproductive health and rights

Empowering young people to take control of their sexual and reproductive health and rights - Menu

Key insights

<p>Link Up SRH youth group, Bangladesh</p>

This project has taught me how to talk: this has been my biggest achievement. There used to be a time when I could not talk, now I can talk about my rights.

- Moly, Link Up Project, Bangladesh      

Link Up has been hugely ambitious. At its heart is the aim of meaningfully engaging young people over their sexual and reproductive health and rights (SRHR) and the integration of SRHR and HIV services to better meet their needs.

The scope and diversity of the project has brought together many different individuals, communities, organisations and contexts. It has generated important evidence on the effectiveness of integrating HIV and SRHR services. It has also revealed rich insight into working effectively with young people, useful for anyone seeking to meaningfully engage that most crucial of groups: the next generation.

The youth know their needs better than anyone else

-        Mona, a young transgender woman who works for Humure in Burundi

Empowering young people

Accepting the ambiguity of working with young people – that their contexts, perceptions and experiences are different to that of adults, and will be hugely different from one another according to age, circumstance and context – has been a key learning point. This has been crucial to understanding the diversity of young people's needs and fostering their meaningful involvement in the project.

“When you don’t have meaningful participation then it’s more of a prescription, telling them, ‘You have to do this; this is how you do it’”, says Rodgers Ampwera, Director of Programmes at Community Health Alliance Uganda (CHAU), Link Up partner in Uganda and Alliance Linking Organisation. “But when young people are involved; they have creative minds, they are very innovative, they have their own way of doing things.”

“What I call meaningful engagement is giving young people the skills, the knowledge and the information to actively engage; giving them the platform, the opportunities and the space to speak up on these issues,” says Nicholas Niwagaba from the Uganda Network of Young People Living with HIV, and Link Up youth advocate. “If we have these young people – with a lot of energy to work with, with vision and ideas – we cannot lose this opportunity.”

Trust: a key investment

Trust is an essential ingredient for working with young people. With it, comes a sense of ownership and momentum, without it, relationships falter.

“It’s one of those intangible things – you can’t put it in a budget or really in an indicator – but in Link Up the element of trust placed in young people, to grow and to become leaders, had a huge impact,” says Luisa Orza from Link Up Consortium Partner, the ATHENA Network.

“We did not provide a strong mandate, we trusted young people to be true to themselves and do what they thought would make a difference in their communities, and they did,” says Luisa. “It’s astonishing what has been achieved by these young people, sometimes with minimal financial compensation. When trust was invested they achieved so much.”

Visit our Youth leadership and empowerment page for more information.

If we are given the space then, of course, we will speak out

-        Chan Chan, Myanmar Youth Stars

Developing advocates

One of Link Up’s resounding legacies will be the thousands of inspiring young advocates who have emerged or developed further through Link Up.

“Link Up has created important pathways and tunnels for young people to access services and information, and to access parliament and advocacy efforts,” says Andrew Miller from Link Up Consortium Partner, Marie Stopes International. “It has put young people at the centre.”

“For me, the best thing about Link Up has been the growth of the young people involved, they really have become leaders. I have seen shy young people turn into incredible advocates,” says Nienke Westerhof from Link Up Consortium Partner, STOP AIDS NOW!

“The growth and progression of the young people involved has really stood out,” agrees the Alliance's Greg Gray, Link Up's Regional Technical Advisor in Asia. “In some instances, this has created a strong sense of community. In Myanmar, for example, the camaraderie has been quite exceptional.”

Visit our Youth advocacy page for more information.

One young person said, ‘We are tired, we have always asked for things to be done and nothing happens...We are telling you to pay attention: young people MUST be engaged in the integration of SRHR and HIV services or else nothing changes.’ We heard the young people loudly and clearly.

- Jeanne d’Arc, Alliance Burundaise Contre le SIDA (Link Up partner in Burundi and Alliance Linking Organisation)

Services that work for young people

Link Up has helped develop a greater understanding of how to programme for young people: by integrating HIV and SRHR services that work for them, delivered by people who understand their needs.

Young people have reported a range of benefits stemming from integration. For many, a major advantage is that they only need to form one relationship with one provider. Over time, this builds trust, which makes asking questions easier and reduces stigma and discrimination. It also saves young people time and money as they do not have to travel to different places to access various services.

Providers have also identified a number of benefits. Similarly, they recognise the way in which integration leads to the development of stronger, trusting relationships with clients, which then improves both the quality of care on offer and client satisfaction. Many also found the opportunity to develop skills which enabled them to address young peoples' needs in a more holistic way to be extremely motivational.

“With the skills and the knowledge that the young people have got, the young sex workers, or the young girls selling sex, I see that the health workers attitudes have now changed, and that services will still continue even beyond Link Up," says Margret Elang, at CHAU.

Link Up has influenced a lot, this project is liked by several civil society organisations. Now many NGOs we know are thinking about SRHR and HIV integration.

- Rokonol Rabbi, GYCA focal point, Bangladesh

Changing the way we programme

“Because of Link Up, the participation, involvement and engagement of young people is now much more firmly embedded in the Alliance’s processes: in our governance and in our proposals and planning,” says Kate Iorpenda, Senior Advisor: Children and Adolescents, at the Alliance.

“Our aim now is to share this learning. We need to emphasise - because we have the proof - that you can’t run an effective PREP trial unless you have planned for working with a 17-year-old or you can’t run an effective adherence programme unless you’ve thought about how to work with a 12-year-old. If we achieve this it will be one of Link Up’s most important legacies.”

Visit our Integrating HIV and SRHR services page for more information.

Building evidence

Through Link Up, principal research partner the Population Council has generated important evidence about the diverse needs of young people when it comes to SRHR, especially those most affected by HIV such as sex workers, men who have sex with men (MSM) and drug users.

"We found that while age-appropriate, respectful services are critical to reaching these vulnerable young people, flexibility is also essential," says the Population Council's Brady Zieman. "Programmers and researchers alike must recognise diversity within young marginalised communities in order to address the inequities that often occur along the lines of gender, age, and wealth.

"Key populations are not homogeneous groups—for instance programmers will need different approaches to reach 'hidden' MSM compared to those who are open about their sexuality. Likewise we need to address the full spectrum of SRH needs for female key populations, like sex workers and women living with HIV. It is no longer sufficient to simply promote condoms for HIV prevention. Future programmes need to also consider their desire for children, ability to safely conceive a child, and methods to space or limit future births."

Visit our Research and evidence page for more information.

The beauty of Link Up is how all the elements came together and made up something greater than the sum of its parts.

- Luisa Orza, ATHENA Network

Embracing collaboration

On a project as multilayered and complex as Link Up, building interpersonal relationships between partners, and establishing communication channels and processes that work for everyone has been essential.

Ensuring an effective induction is planned for all partners, then collaboratively launched, and creating effective feedback loops to connect all components of the project to each other are two important ways to keep communication going during complex projects such as is.

“Link Up brought together different partners, who wouldn’t normally work together, and each of us brought something different yet immensely complimentary to the party,” says Andrew. “Granted, we have had some very heated debates, but managed carefully, these can be positive things.”

Acknowledging that some organisations will be more confident than others when it comes to trusting young people and youth-led organisations to genuinely take control of programming and planning was an important part of the Link Up start-up process.

“For some, bringing in young people, working with them, giving them space and investing in them, was something different and that could be challenging. But this really pushed us to make sure it happened,” says Greg.

Look out for certain assumptions and don't be afraid to challenge them - for instance, what does everyone mean when they speak of ‘meaningful engagement’? Does every organisation involved really feel comfortable working in their non-native language?

“If I could go back and give myself advice it would to be clear on what the expectations are in terms of consortium working, especially at a local level,” says Andrew. “Clarify values. Include non-partner organisations, who will come into contact with the programme, in planning so their fears are allayed. It’s worth taking time at the beginning to get this right.”

Visit our Link Up partners page for more information.