75th World Health Assembly
Objectives: Through this side event, we had to mobilize support for policy actions for equitable and resilient health systems, identify specific policy measures which are effectively contributing to gender-responsive UHC and strengthened health systems to make connections between stakeholders working across different levels and contexts to support exchange of views and experiences on the pandemic’s impacts on implementing gender-responsive UHC.
Talking points by Dr. Kughong Reuben Chia
Q1. You lead a youth-led and focused NGO to ensure adolescence SRHR, GBV and UHC. Youth often face challenges to meaningfully influence policy and decision-makers. And in the case of health systems and UHC, youth and adolescents have specific needs, experiences and knowledge. Given that OHISD collaborates actively with policy makers and other stakeholders to promote health-care for all, what are the gaps you have encountered in terms of gender and youth-responsive health systems?
- Challenge with time Scheduling: living in this challenging world of today especially with in the COVID 19 era, many youths turn to have tight schedules with school, extracurricular activities, work, and home chose. With this tight schedule, many youths turn not to want to involve in policy making because they usually feel that their inputs won’t be respected and valued. If youth have to sacrifice their time to take part in policy design meetings, they need to be re-assured that their inputs will equally matter and be taken into consideration among all suggested points.
- The experience barrier. It is often assumed in my country that more experience is always better and this led to a local saying that goes “experience is acquired with age so the older you are, the more experienced you will likely be” as perceived by the community and most policy makers. This has impacted even in my practice as a Medical Doctor. I remember hearing patients talking in the corridors like will this young guy be able to solve my problems? Is he still on internship here or is he a Doctor already? And many others. In addition, certain types of experiences like attending certain schools or working in a particular profession tend to be valued more than others in our country. These values and assumptions privilege only certain class of people and don’t leave room for diverse representation. Paying too much emphasis on years of experience also affect youth participation in meetings or decision-making bodies. I remember one time we had a coordination meeting at the Regional Hospital and one young Doctor brought-up and idea on how to better improve patient care through digitalizing patients information in the hospital and one of our very highly respected professor in public health just bold told him that the idea won’t work and he said “with his over 25 years in the field”, he was best placed to develop a means to address patients care not him that just started practicing and having limited experience with patients. This attitude turns to scare youths away from policy design meetings, which has led to the design of health policies and programs which are not gender nor youth responsive or friendly.
- limited number of youth voices in meetings: young people in Cameroon usually face challenges in health system programming since they are always outnumbered in meeting. Bringing up new ideas in the presence of these so-called healthcare experts involved in decision-making who almost always intimidate the younger generation by referring to their years of experience before giving any suggestions make it extremely difficult for a young person to propose a different idea or counteract their propositions.
- Poor youth diversity representation in meetings: Most at times in high level meetings, the same youths are called to sit at the table each time to represent youth voices. Those invited are mostly youths with high-level connections with political leaders not necessarily experts in youth needs or people with lived experience or those who have demonstrated their experience through their community engagement. This poor representation of youth voices usually lead to poor health system programing which are not inclusive of adolescent and youth needs. At times, with the political affiliation of these youths, they are coerced into proposing youth strategies that are aligned with what their mentors/god-fathers want and not necessarily the true reflection of the challenges youths face.
Several other gaps exist that limit youth participation in health policy design and most of them are contextualized with respect to different countries laws or regional biases and perspectives.
Q2. Youth constitutes 1.2 billion in the global population and Africa specifically has the youngest population in the world with 70% of the Sub Saharan Africa population being under 30 years old. What policy successes or recommendations can you share with us that support gender-responsive UHC and more equitable health systems?
UHC can contribute to improving adolescent and youth health, provided it is made to be gender responsive and equitable. The WHO introduced the Youth friendly Healthcare services decades ago with five pillars of youth healthcare friendliness: accessibility, acceptability, equity, appropriateness and effectiveness.
To make UHC more gender responsive, youth friendly and equitable, we need to focus on creating adolescent friendly health services (Youth Clinics) which will act as a safe space for young people and this should be built on the principles of confidentiality and prioritized responding to youth health needs.
This model is implemented by providing “youth-friendly” training to a health care provider and creating separate rooms (Safe Space) in health facilities or organizations where adolescents either wait or receive health services.
In our organization, we adopted this model about a year ago and created a youth friendly SRHR One-stop-shop where young people have access to All RH services such as; Contraceptives (Condoms, pills, implants, IUD, and injectable FP), screening for STIs including HIV, counselling and trauma healing services for survivors of GBV, FGM and follow-up of teenage pregnancy.
Although this model worked well, the ever-growing adolescent and youth population in LMICs including Cameroon, and the limited number of this safe spaces, this model leave many young people behind not knowing where they are welcome and in some cases, what services are available to them.
Hence the need to shift to an adolescent responsive health system approach as instituted by WHO that integrate;
- service delivery (which promote adolescents to have access to an integrated package of health care, including FP/RH, MNCH, GBV and other curative and preventative care paying more attention to last distribution),
- health workforce (which demand that healthcare staff who interact with adolescents including CHWs should be adolescents capacitated through training and mentorship in order to ease communication),
- health information (which group data collected by age, sex and gender and provides space for adolescent feedback),
- medical products (health commodities made available without restriction of age, sex or gender),
- financing (where services for adolescents are included in insurance schemes and other financing initiatives).
- Leadership and governance (which institute that Policies, standards, guidelines, and budget allocations uphold adolescent rights to healthcare),
- community health care systems intentionally reaching out to adolescents.
To view webinar recording: https://youtu.be/Du9IK4hPbtg