Increasing Youth Access to Sexual and Reproductive Health Information
DREAMS Innovation Challenge | Success Story
Connecting adolescents with resources is nothing new for Tinnah Onions — it is Tinnah’s first time, however, linking adolescents to sexual and reproductive health information via Chipatala cha pa Foni (CCPF), or Health Center by Phone, a toll-free mobile health hotline in Malawi. CCPF utilizes trained healthcare workers to provide health information and referrals over the phone, providing a critical link to the health system, especially for remote and underserved communities. Tinnah and her colleague Justin Mpalabwazi are some of the most recent additions to the VillageReach team through CCPF for Adolescents, an initiative of the DREAMS Innovation Challenge. As adolescent advisers, Tinnah and Justin focus on promoting the CCPF service to their adolescent peers and improving the quality of customer service that the hotline offers. In their roles, Tinnah and Justin play a critical role to help address the sexual and reproductive health information needs of adolescents in Malawi.
Malawi sees high rates of pregnancy, HIV and sexually transmitted infections (STI) among adolescents, which contribute to school dropouts among the country’s youth. In addition, unintended pregnancies among adolescent girls can have far-reaching consequences and can lead to unsafe abortions, dangerous childbirths and even death.
One of the factors giving rise to these high rates of pregnancy and STIs among Malawian adolescents is their inability or hesitancy to seek information or care for sexual reproductive health (SRH) issues. Distance to the nearest healthcare provider can be great and costs of seeking health information or care are often prohibitively high. Embarrassment, a perceived lack of privacy and an unwelcoming attitude on the part of health facility staff can further prevent adolescents from seeking the information or care that they need to meet their SRH needs.
In 2017, CCPF for Adolescents was developed to extend CCPF services specifically for youth to improve access to age-appropriate sexual and reproductive health (SRH) information, services and commodities.
Originally developed by VillageReach and its partners as a maternal and child health hotline in 2011, CCPF has grown significantly in scope and scale to become a vital health resource for people of all ages. Through a unique partnership with the Malawi Ministry of Health and Airtel, Africa’s largest mobile carrier, CCPF is working toward national expansion, with the goal of reaching all 28 districts in 2018. When scale-up is complete, CCPF will be the first government-run national mobile health hotline in Africa, accessible to more than 16 million people.
The DREAMS Innovation Challenge provided VillageReach with the opportunity to capitalize on CCPF’s tremendous success and growth to offer tailored, youth-friendly services that address the unmet needs of adolescents in Malawi with the goal to significantly increase secondary school retention and reduce HIV prevalence.
In order to achieve these goals, adolescents must be made aware of CCPF and feel comfortable using the service, and hotline staff must receive adequate training in youth-friendly service provision. This is where Tinnah and Justin come in.
As adolescent advisors, Tinnah and Justin make sure that the youth perspective is considered and incorporated at all levels of project development and implementation.
During program development, Tinnah and Justin began working to uncover any gaps demonstrated by hotline staff in providing youth friendly services. They called the hotline presenting as adolescent callers, using common youth-centric scenarios as a means to assess the quality of service provision. Tinnah and Justin took note of their interactions with hotline workers, paying attention to a variety of aspects, such as tone of voice, helpfulness of the hotline worker, etc. The observations from their calls informed and shaped the curriculum for the youth friendly health services training that all hotline workers undergo. Tinnah and Justin also play a role in strategizing about best ways to promote this free, youth-friendly hotline service to adolescents in Machinga and Zomba, an aspect of their job that both find exciting. The work done by Tinnah and Justin has been instrumental in ensuring that hotline staff are equipped with the skills to provide high quality service to adolescent callers.
Tinnah and Justin believe they are learning from the program just as much as they are contributing to it. Justin has been struck by how apprehensive youth tend to be about seeking sexual and reproductive health care. Tinnah had similar observations, and has found that adolescents are also hesitant to approach their guardians with sexual and reproductive health questions. Both Tinnah and Justin have also noticed that not many adolescents are active members in youth clubs. Both view this as a missed opportunity for youths to engage with other adolescents and receive information on sexual and reproductive health. Tinnah and Justin also express that they value the opportunity to work with and advocate for youth through their roles as adolescent advisors to CCPF.
“This project has given me a chance to use my talents, develop new skills and experience the pleasure that comes from making a real difference in adolescents’ lives,” says Justin.
Looking forward, Tinnah is excited about continuing to spread the word about CCPF to adolescents. She hopes more adolescents are able to access the information they need. In the conversations she has already had with adolescents, she has heard that many are very excited that for free, they can talk openly about issues concerning sexual and reproductive health without being face-to-face with the health provider. Justin hopes to emphasize the privacy that CCPF offers and draw more adolescent callers to the service, who will not only receive the SRH information that they need, but will also receive guidance to communicate about their SRH needs to their partners, parents and friends.
Ultimately, both Tinnah and Justin look forward to continuing their work to link adolescent girls and young women with CCPF so that they are empowered with knowledge on how to avoid early pregnancy and prevent STIs. In doing so, they hope to enable adolescent girls to stay in school and complete their education.