Family planning

The earlier we educate young teenagers on sexual health, the better!

Interview with David Kafambe

David Kafambe and his team visit the participating schools located in Uganda with the “Youth Truck”

The Young Adolescents Project (YAP) in Uganda started in 2009 as a joint initiative between DSW (Deutsche Stiftung Weltbevoelkerung) and Bayer. The goal is to educate young teenagers between 10 and 14 in sexual and reproductive health, aiming for sustainable changes by involving the young adolescents as well as their parents, teachers and the community leaders. Project-coordinator David Kafambe talks about goals and perspectives and shares some first-hand experience working with young adolescents in ten communities in Uganda.

The boys and girls the YAP addresses are 10 to 14 years old. Isn’t this very young to learn about sex and sexually transmitted diseases?

The approach the YAP takes is: The earlier we educate young teenagers on sexual health, the better. Firstly, for cultural reasons: Most of our traditional cultures in Uganda perceive a girl ready for marriage and childbearing as soon as she starts developing breasts, i.e. at the age of around ten or eleven. 13-year-olds – girls and boys – are married off because they are seen as someone who is ready to take on responsibility, earn an income and start a family. If they’re not yet informed about their sexuality, this puts quite a burden on young teens, especially on the girls. So we talk to them about how the body changes in puberty but also about topics like gender equality, about responsibility and free decision-making in sexual matters. After all, the attitudes people develop in their teens will greatly affect their later lives. Secondly, there’s a practical reason: if you don’t educate kids before they become sexually active, sexual initiation will likely occur without protection. Young people need to know the basics about their body changing in puberty, about menstruation and pregnancy, about the risk of HIV/AIDS and how to protect themselves, and also about their right to a self-determined sexuality.

Trying to educate teenagers on sexuality can easily result in giggling fits. How do you set up your lessons so the kids can take these serious topics seriously?

It’s true – most of the topics are really sensitive. If you just go to the kids and start talking, they will feel embarrassed and probably start laughing. In my experience, the important thing is to help teenagers talk about sexuality in a way that doesn’t embarrass them. I often start with a simple story, for example I tell them about a twelve year-old girl who started to have her menstruation and the other kids laugh at her. Then I ask the kids what they think, and if they like that the other teenagers ridicule the girl. Mostly this will trigger a discussion; the kids will start to bring in their ideas and – sometimes very passionate – feelings. Once you have established trust and a constructive working atmosphere, the talk can develop more freely from there.

Provide timely health information to young adolescents – this is the aim of the joint initiative between DSW and Bayer. The project has reached more than 7.000 boys and girls.

Before you could talk to the teenagers, you had to convince the adults.

Absolutely – we had to bring them all on board. In a very traditional society that can be quite a challenge. Many teachers and parents are not well informed about sexual and reproductive health themselves, and it is a taboo for them to address these topics with the kids. The idea of the YAP is to involve the entire communities and create an environment where all adults – the school administration, community leaders, teachers and parents – support the values we teach.

How did you approach the communities?

Most of the kids between 10 and 14 go to school, so first of all, we made contact with the authorities, explained very clearly what we wanted to achieve and ask for the permission to talk to the children in school. They liked the idea so we could start the project in ten schools in the Masindi, Tororo and Wakiso districts of Uganda. The next step was the community leaders. In Uganda these leaders are really powerful; you cannot organize an educational event without having them on your side. But if you convince them, they will allow you to enter their community and proceed with your project. So we had to plan well ahead and talk to these authorities. And then, of course, when you work with such young adolescents, it is very, very important to have the parents’ consent and support.

Were the parents easily convinced or did they have concerns?

At first they came up with lots of concerns. Many were really reluctant because they felt talking about sexual health wasn’t appropriate and didn’t do their children any good. Some even said, “I’m going to take my child from that school, because you are going to spoil the child, and I won’t have it.” For most of the first year, we spent a lot of time talking to the parents, explaining why it was important to start sexual health education at such an early age. We gave them lots of background information – for example that we have a teenage pregnancy rate of 24 per cent in Uganda, which is really high, or that many girls drop out of school because for this reason. Over time, they changed their minds. It has been a process, really.

So eventually you did get everybody on board.

Yes, I’m very glad to say that at the end of the day, it worked out really well. Our idea was to build a sustainable support network, so the kids will not only know about their right to self-determined decisions about their sexual life, but will be empowered to actually live by these values. So when they come home from school and tell their parents about the lessons, it’s important that the parents support the same values. What we see now, four years after the project started, is that the communities are truly adopting the YAP – they own the project, the parents own it, the schools, the children themselves.

Did you expect the YAP to work out so well?

We hoped for the support of the communities and the parents, but what we see right now is going much further than what we had initially planned for. People actually call us and say, listen, we have a community meeting and there are still lots of questions – can you join us and talk about this? And then we go and work on these questions together. The project revealed a high demand for information on sexual health, and people are really willing to engage in a dialog. I think there’s an obvious need to expand the initiative and make the same offer to other communities in Uganda. We developed a best-practice toolkit based on our experience to help others start similar initiatives – lots of copies have already been distributed to partner organizations.

Is a program like YAP to some extent revolutionizing the culture in Uganda?

Yes, I believe in the long run, you will see things change completely in my country! This is why I’m personally really proud of the work we do. I also would like to thank Bayer for giving us this opportunity – without this support we could not run the project, which is really helping our country.

The earlier young teenagers are educated on sexual health, the better. The education strategy included not only a classroom teaching style, but in particular interactive methods. The picture shows young adolescents participating in a game during peer Education Training.

Four Objectives

YAP aims to increase the knowledge of sexual and reproductive health topics among young adolescents aged 10 to 14. For a holistic and sustainable approach, parents, teachers and community leaders are closely involved. A third goal is to ensure young adolescents have access to correct information and services related to sexual and reproductive health. To support others to implement similar projects, a toolkit based on the experience with YAP has been developed and distributed.

Project team

Project coordinator David Kafambe heads a team of six. With the ‘Youth Truck’ they visit the 10 participating schools located in Uganda’s Masindi, Tororo and Wakiso districts. Their activities range from negotiating with district officials to holding workshops with parents and teachers to educating young adolescents in sexual health topics as well as skills such as setting up Youth Clubs and educating their peers.

Results

Wide reach: The project has reached 7,100 pupils, 1,900 parents and 340 teachers
Youth Clubs were established in 10 primary schools; teenagers have been trained in skills to run the clubs and educate their peers in sexual health topics.
Increased knowledge: In 2011, 90 per cent of young adolescents reached by the program had comprehensive knowledge of HIV / AIDS (2008: 25 per cent)
Social improvements: Schools report a significant decrease in female dropout rates
Improved role of teachers: Teachers are seen as a source of information on HIV / AIDS by the majority of students and confirm that their own knowledge and teaching skills have increased significantly
Improved family communication: More parents are talking to their children about topics of sexual and reproductive health
Youth-friendly health services: 17 health workers were trained to provide youth-friendly services to young teenagers
Official acceptance: In 2011, district officials defined sexual health education as a priority for education departments and part of the “District Development Plans” in 2012.
Tookit: 850 copies of the project toolkit, including best practices and recommendations, have been shared with partner organizations.