A case for youth friendly health services

Author: Ahmad Mehmood

Ali was tired of dealing with his problem alone. The more he thought about it, the more he tried to resolve it and the worse it got. He kept hiding his soiled bed sheets from his mother and was exhausted by washing them early in the morning before going to school. Things got worse when he heard his maulvi sahib tell him that even bad thoughts are punishable. He interpreted his curiosity and dreams as sinful and his nocturnal emission as punishment. He wanted them to stop and had no clue what to do about it. His confidence was diminishing by the day and he was withdrawing in himself under the heavy burden of shame.

Coming back from school one day he saw an ad chalked on the wall about a miracle worker specializing in male problems. Excited at finally finding someone he could talk to and hopeful of finding a solution to his problem, he made a beeline towards the address.

This is the story of a lot of young boys growing up in this country. They go through it but when they are adults it never occurs to them to save the next generations from facing the similar issues.

Young people often have no knowledge about their body when they are growing up. They experience changes in their body, they experience attraction to the opposite sex but no one provides any help or guidance to steer them through these times.

Young Omang, a network of 10 organizations, is working on similar issues that concern the sexual reproductive health and rights of young people. The organizations that form this network include Rahnuma FPAP, Channon Development Association, Youth Advocacy Network, Idara Taleem-o-Aagahi, Indus Resource Centre, Bargad, Aware Girls, Forum for Dignity Initiative, Blue Veins and Aahung. Together they reach out to the youth of this country with information and counseling services. Rahnuma FPAP has a youth toll free helpline that provides counseling by professionals to all who call in.

However, civil society organizations can never reach out to the entire population. The government also has a few limited initiatives of their own that address these issues but the need is to make serious plans to appropriately address sexual reproductive health issues faced by young people.

A major factor contributing to the poor Sexual Reproductive Health and Rights status of young people in Pakistan is the traditional and socio-cultural set of beliefs that frown upon any discussion of sexual reproductive health issues in young people. There is resistance to introduce life skill based education in schools because there is a propaganda that it is meant to challenge our traditional way of life and introduce a more western lifestyle in our society. And obsessed with this illogical belief they are depriving our children from education that can positively affect their lives and help them grow up into productive and happy human being.

In a country where 60 percent of the population is below the age of 30 it should be our top priority. We need to design youth friendly health services in all public and private health centres to ensure that this age group can access sexual and reproductive health services without any hindrance

Ali had to go to a quack to discuss a normal body reaction during puberty and God knows how the quack dealt with his problem. It is a fact that many young boys are confused about the changes their body undergoes and they are not prepared for them by anyone. Some of them end up with quacks who misguide them for profit and give them medicines which ruin their health. Others experience serious personality changes, some lose their self confidence other withdraw from social circles. They have questions about their bodies and are in need of people who can address these concerns.

Young people are reluctant to seek help regarding  reproductive health or sexuality related issues because this is considered taboo in our society. Also health care points do not cater to the needs of the young people. According to international standards for youth friendly health services, they must be located at a convenient location, having adequate space with separate examination and counseling areas that provide privacy and comfortable surroundings. The clinic must have a private approach so young people can enter without having to worry about undue exposure.

The contraceptive prevalence rate among married females age ranges from 15-24 years is 17.6 percent which is very low considering that early age marriage are quite common in the country. Data indicates that 96 percent of 20-24 year old females now were married by age 15,  and had either had a child or were pregnant; and still we don’t have special provisions in our policies and programs to cater to this age group. In a country where 60  percent of the population is below the age of 30 it should be our top priority. We need to design youth friendly health services in all public and private health centres to ensure that this age group can access sexual and reproductive health services without any hindrance.

Young Omang has designed a number of advocacy tools to spread awareness of the need for youth friendly health services. One of the fact sheet they produced lists the following reasons for establishing youth friendly health services, firstly, sexual and reproductive health is a fundamental human right. Secondly, they have a direct relationship with the country’s development indicators and it plays an important role in reducing poverty and ensuring health. Thirdly, it is linked to basic human rights which include the right to life, freedom, choice, health, education. Moreover, denying these rights can lead to greater vulnerabilities in gender-related ill health, unintended pregnancies, maternal death, harmful cultural practices and sexual and gender based violence.

It’s time to recognize and invest in young people’s sexual and reproductive health to ensure their well-being and protection. One way of ensuring this is to include these services in Costed Implementation Plans. It’s high time to review laws that expose young girls to danger and deprive them of their basic rights such as the early age marriage law.

Published in Daily Times, January 27th 2019.

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