I never knew how to use contraceptives. I thought that family planning was only meant for married couples. I also feared that I would not give birth if I used family planning at that age.Sharon Ayebale, 17, Kyenjojo District, western Uganda
At age 14, Sharon Ayebale became pregnant. Sharon had never learned about contraceptives and thought that family planning was only for married couples.
But, today, with the help of the USAID/Uganda Family Planning Activity (FPA), Sharon is now a youth champion, teaching adolescents in her community about reproductive health, contraception, and supporting them to make decisions about their reproductive futures.
FPA began last year, as COVID-19 exacerbated reproductive health challenges in Uganda. Forced lockdowns closed schools, created travel bans, and prevented many from accessing local health centers. Meanwhile, young Ugandans continue to face stigma and social and cultural challenges that prevent them from using contraception. FPA is addressing these challenges by empowering adolescents aged 10 to19 and young people between the ages of 20 to 24 to take the lead in improving access, knowledge, and uptake of reproductive health services.
- 25% of teenage girls in Uganda, ages 15-19, have a child or are pregnant.
- There are 9 million adolescents, ages 15-19, in Uganda.
Nakato Joyce, an FPA youth champion, discusses condom use. Photo: Pathfinder Uganda
Through FPA’s ‘youth champion’ model, the Activity engages adolescents and young people to mentor their peers and share information about reproductive health. During the first year of FPA, 461 young people have become peer educators and, ultimately, agents of change in their communities.
The Activity trains each champion, who then educates and refers other young people to nearby health centers for reproductive health services. To ensure that care is accessible for young people, FPA also mentors health workers, enabling them to provide quality, youth-friendly services. So far, FPA has trained more than 500 community health workers to administer short-term family planning options, often going door-to-door and conducting home visits which creates demand and reaches young people at home.
FPA has also explored new ways of reaching adolescents and young people, including through their mobile phones, online, and radio talk shows. Many adolescents are now using radio talk shows to speak up about sexual and reproductive health issues they face. In addition, alongside USAID’s Social Behavior Change Activity (SBCA), FPA has created a toll-free number and mobile SMS code that youth can use to get information, counseling, and answers to their reproductive health questions. To date, over 1,200 have been reached with the majority of callers being young people between the ages of 15 to 24. In the last year, FPA developed three WhatsApp groups for youth champions to promote knowledge sharing and engagement. These WhatsApp groups allowed champions to ask questions, share information, and create a ripple effect on social media to spread messages.
In addition to this targeted outreach, FPA is building connections throughout communities and generations, reaching ‘gatekeepers’ like cultural, religious, and local leaders, who help develop action plans to address social and cultural norms that may be harmful to reproductive health. Dialogues with community members go over issues like child marriage, preferences for male children, and inheritance for widows. By engaging community members, men and boys, and local leaders, FPA contributes to a supportive environment for adolescent and youth reproductive health.
For Sauda Nakato and her partner Peter, FPA’s work has reached home. The couple had their first child in September 2020, and they wanted to delay their next pregnancy, but they feared the side effects associated with using contraceptives.
Growing up, Sauda had heard about family planning from people in her community, but they mostly spoke of side effects, and not benefits. She developed a negative attitude towards contraceptives and often thought that she would not have children after using them. “I heard about family planning from my friends. But they always talked about bad side effects. This discouraged me,” said Sauda.
When their daughter was seven months old, Sauda decided to face her fears and went to her local health center to find out more about family planning. She was linked with a health worker who had been mentored by FPA on how to share information about family planning, in addition to how to address side effects.
“I found a health worker who informed me about the availability of family planning services, including how to handle any side effects, and this motivated me to go for the service,” recalls Sauda. Before Sauda could take on any method, she went back home and shared what she learned with her partner. “After talking to Sauda, I became very positive about family planning,” said her partner, Peter. “I encouraged her to go back and pick a method…I accompanied her to the health center.”
The duo voluntarily chose the Intra Uterine Device (IUD), a long-term contraceptive method. They can care for their daughter now, while planning in advance when they might want to have another child.
Eron Nakitende, a 19-year-old youth champion, puts it simply. “I want to ensure that young women in my community do not get pregnant when young so that they can achieve their dreams.” she says. With the help of FPA, Eron and the other champions are helping to create an environment where more adolescents and women can choose if, when and how to have children.