Speaking To Zambian Youth About Sexual And Reproductive Health And Rights

Last week, I was in Lusaka hosting user feedback workshops for Praekelt’s TuneMe service. TuneMe is a mobi-site targeted at youths and not only provides sexual and reproductive health and rights (SRHR) information, but speaks to them in a relatable and personal way, moving beyond the clinical and avoiding any patronising 'do this, don't do that’ tones. The service was inspired by the success of Young Africa Live which ran in South Africa from 2009 - 2015. Young Africa Live was an initiative by Praekelt dedicated to educating young people about sex, HIV/AIDS, rape and gender issues via mobile-web. It's positive effect on not only helping to increase youth's’ knowledge of key sexual health topics, but to help develop a healthy mindset towards sex was ground-breaking and with it reaching a community of 1.8m, made it one of the largest private social networks in South Africa. It was a no brainer to try and replicate its success in other countries facing similar challenges.

Zambia is rife with challenges for youth regarding sex and their SRHR. In the 2012 State of the Nation report released by Restless Development, it was found that 7% of youth aged 15-24 tested positive for HIV. Prevalence among young women was higher than that of young men at 9% and 4%respectively. It was also found that HIV prevalence increased with age, from 4% among youth age 15-17 through 6% among those aged 18-22 to 13% among youth aged 23-24. The State of the Nation report also cited that there were 13,634 pregnancies in basic (primary) schools and 5,517 re-admissions in 2009, meaning 8,117 dropped out of school. In secondary schools in the same year, there were 1,863 pregnancies and 1,162 re-admissions. A lack of knowledge on sexual health was the second-most cited cause of teenage pregnancy at 77% and poverty being cited as the greatest issue. Interestingly, awareness of Sexually Transmitted Infections was generally high across youth age groups despite the fact that SRHR education has only just been implemented as core curriculum in schools this past year. This perhaps highlights the gap between information gathered by youth from various sources and how it can practically relate to the youths themselves, their lives and their actions.

Evidence of this was noted during our feedback sessions where we heard thoughts from the youths themselves saying that they felt intimidated when visiting health clinics, even when it was just to obtain condoms. Most of the youths who had tried to get condoms from clinics said that their experience had been a negative one with the health worker questioning them and their intentions. As one young male put it: “It's obvious. Why do they need to ask?!” Even when trying to obtain condoms from pharmacies or shops where they were purchasing the items, many still felt ostracised. Several youths explained that oftentimes the worker at the shop could be a family friend or neighbour and therefore they would avoid buying condoms in case word got back to their parents or guardians. Additionally we heard that previous information sources were not adequate in relating the topics to the daily lives of the youths. One young girl highlighted the disparity between the biology textbooks she had previously used as her sole point of reference for sexual health information compared to the real life stories she was reading on TuneMe. She explained how the stories had helped to build her knowledge and confidence in the area of relationships - something not covered by a textbook.

For many years, the ABC approach has been the core strategy in the plight to reduce the incidence of HIV and AIDS in much of Africa including Zambia. ABC is the acronym for Abstinence, Be faithful, Contraception or similar variations depending on the organisation. The ABC approach is generally promoted in a way that places the core focus on Abstinence with Contraception being pushed if you cannot adhere to the A or B.Whilst this has been credited with helping to reduce the incidence of HIV and AIDS, ss Dr Mary Otieno of UNFPA Zambia acknowledges, it is not always the only approach for youth. This because they are at that age where they want to experiment and you just can't stop human nature. Since 2013 she has strongly been advocating a more balanced approach to SRHR for youths that promotes safe sexual behaviour as much as abstinence - as the large bowl of various prophylactics in her office attests to! 

Panoply Digital is due to have their evaluation of TuneMe complete by the end of this year, but despite being able to draw any strong conclusions, the feedback gathered so far, especially from the mouths of the youths themselves has been very positive. We hope to be able to share more of our findings in the coming months so please check back for updates and feel free to contact me or Ronda Zelezny-Green for further information.