Men's Role in Adolescent Reproductive Health

Paul Kimumwe

On Wednesday July the 11th, the world commemorated the World Population day, with this year’s theme focusing on men’s involvement and participation in making a difference in women’s lives, with emphasis on the young people.

In her statement the UNFPA Executive Director, Thoraya Obaid, remarks that, "All over the world, young people want to be heard and involved. They possess the ideas, determination and energy to accelerate effective action to reduce poverty and inequality....

"It is clear that the Millennium Development Goals will not be met unless young people are actively involved in policymaking and programming, their voices are heard, their needs are met and their human rights are respected".

One area however that has been lacking in support to the young has been in their sexual and reproductive health. Many young people engage in risky sexual behaviours with little or no knowledge about how to protect themselves against the risks of infection or unwanted pregnancies.

A 2004 national survey of adolescents in Uganda by the Makerere Institute of Social Research and Guttmacher Institute revealed that in Ugandan, many adolescents are sexually active and are aware of the risks of unprotected intercourse.

The report further says that while many are interested in obtaining sexual and reproductive health information and services related to family planning, HIV and AIDS and other STIs, pregnancies, etc. from reliable sources such as the formal health care system, they express a number of problems with doing so under the existing health care system.

These include; fear, embarrassment, confidentiality of information shared, distance/ease of access to the facility, client handling, and affordability of services.

This year’s theme couldn’t have any timely. While the gender equality and equity crusade has come of age now, its effects are yet to take root, mostly because men, to the larger extent, have not yet been embraced as partners in this noble cause.

To borrow Obaid’s words, "We (need to) see men and women as partners in a relationship built on mutual respect, trust and commitment.

Partnering with men promotes the right of every woman, man and child to enjoy a life of health and equal opportunity."

Fathers (men) often decide whether a daughter will marry young or have a chance to complete an education.

They have the financial power to take their pregnant wives to health centres; often make the decisions on how many children they should have, the list goes on.

Addressing adolescents’ sexual and reproductive health needs is an important and urgent policy and programmatic concern in Uganda.

But to address young peoples’ needs effectively, it is imperative to have a better understanding of the various aspects or adolescent sexual and reproductive health and needs.

As family heads, fathers need to appreciate that adolescents face many huddles in the course of juggling with unfamiliar body changes, temptations, inaccurate or complete lack of information relating to sexual reproductive health, and the challenge of living in an era of HIV and AIDS, on top of other STIs.

It is therefore important for a countrywide campaign that promotes parental participation, especially fathers (or father figures), in ASRH issues and equips them with information to effectively deal with their children’s concerns.

This is because, while the mothers are making attempts to fill the gaps, in light of the new ASRH challenges, particularly those posed by HIV and AIDS, they need to be equipped with accurate information and appropriate skills to establish an effective dialogue with their children.

And of course, sensitise and persuade fathers to appreciate their roles and responsibilities so that they can become more proactive in the lives of their children.

Talking AIDS to the young: What works?

Paul Kimumwe

For all the achievements that there have been in the fight against AIDS, none has been more effective that communication. Simple as it is, it has been responsible for massive strides in the reduction of HIV prevalence.

At its basic, AIDS communication has been about telling people how AIDS can be spread, the symptoms, prevention methods, and where to seek treatment from. This is the stage of creating awareness.

The end result has to be behaviour change. Period! Any thing less of this, the efforts would be deemed wasted.

By its nature, AIDS was a myth to the world. Its emergence has been a challenge to all aspects of life. Responding to it required immediate and drastic actions, which the world was not prepared for at the time, even up to now. For some, the realities were too harsh to bear.

You could not talk about AIDS without talking sex. Yet talking sex at the time represented the highest level of immorality. It was taboo. More so, admission to having AIDS in your country meant losing out on revenues from the tourism industry.

Unfortunately, the rate at which it was obliterating communities demanded that it was time to face the music. There was little else left to do.

As researchers, clinicians, and herbalists grappled to find a cure, it was important that preventive measures are given priority. Up to until now, the AIDS cure is still elusive, infection rates are still high and prevalence levels have stagnated.

AIDS and young people
But one of the biggest victims of AIDS have been the children. Not only has it redefined the very meaning of childhood for millions, it has gone ahead to deprive many of their human rights; the care, love and affection of their parents; of their teachers and other role models; of education and options for the future; and of protection against exploitation and abuse.

According to a stocktaking report, “Children and AIDS” released by United for Children, United against AIDS early this year (2007), it is estimated that 2.3 million children under 15 years old are infected with HIV, 15.2 million children under 18 have lost on or both parents to AIDS, and millions more have been vulnerable.

The report notes that the risks inherent in these statistics are many, as children affected by AIDS may experience poverty, homelessness, school drop-out, discrimination, loss of life opportunities and early death.

The report further notes that “the Millennium Development Goals (MDGs) especially MDG 6, which is to halt and reverse the spread of HIV/AIDS by 2015 will not be reached without integrating approaches to children and AIDS with approaches to child health and survival”.

Talking to them about AIDS
For this to happen, it means that young people will, by themselves, have to make critical decisions regarding their sexual lives. Society can only do so much.

However, many young people still engage in risky sexual behaviours with little or no knowledge, skills and resources to have health sexual relationships and protect themselves against the risks of HIV and AIDS and unwanted pregnancies.

Studies done by the Guttmacher Institute in four African countries of Ghana, Uganda, Burkina Faso and Malawi show that young people are not getting the information they need to protect themselves against HIV.

Traditionally, aunties, uncles or grandparents, depending on the cultural area, played the role of providing sexuality education to adolescents within the family setting. However, this practice has been eroded by modernisation, leaving an information vacuum.

Adolescents particularly those who are out of school, now have no one to turn to – except perhaps their peers and siblings – to address their information needs and concerns on AIDS, sexual and reproductive health issues.

The Guttmachers studies show that some mothers are making attempts to fill the gap, but in light of the new adolescent sexual and reproductive challenges, particularly those posed by HIV and AIDS, they need to be equipped with accurate information and appropriate skills to establish an effective dialogue with their children.

Of importance also is the need to sensitise and persuade the fathers to appreciate their roles and responsibilities so that they can become more proactive in the lives of their children.

This is because, in the era of HIV and AIDS, where behaviour change is plays a key role, awareness creation is just a step in the process. For messages to take root and be acted upon, they must be simple, repeated and provide answers to the so what questions, which is always asked in any behaviour change communications. Why should I behave in a certain way? Why should I use a condom? Why should I abstain? The list goes continues…

Make Every Day A Day of the African Child

Paul Kimumwe

As the world marked the Day of the African Child on June the 16th my heart sank deep. Just a few days before that, there had been several Ugandan media reports about that really bothered me: child-headed homes were on the increase (The New Vision, Monday, June 11, 27), the worst districts being Kampala, Masindi, Iganda, Busia and Kabarole.

One the same page, there was a story of two children who were being looked after by the police after they had been abandoned by their parents, just on the next page, there was a story of a man who had just been sentenced for defiling a 15-year old girl. And this was just in one media outlet.

Since 1991, the world has been observing this day, which was created to honour the memory of innocent children in Soweto, South Africa when hundreds of them were wounded and killed during a match to protest the inferior quality of their education and to demand their right to be taught in their own language.

Looking at the situation now, I think these poor souls will never rest in peace. For all their courage and sacrifices of life, these children seem to have died for nothing.

The number of child soldiers in all African civil wars is simply unbearable. The number of street children is always on the increase; defilement and rape cases are heart breaking; and if poverty or AIDS had a human face, it is highly likely to be that of an African Child!

The day of the African Child is supposed to be a day for celebrating and acknowledging our children as Africa's most valuable asset. A day on which nations, families and communities should reflect on the challenges and threats that compromise the healthy growth and development of children, and their health and well being of their children.

It is also a day on which all of us, as adults, should assess opportunities for enhancing children's lives, individually and collectively, in the home, in schools, communities and other institutions that potentially make a positive difference in the life of a child.

This year’s them could not have been any better. “Stop Child Trafficking.” The rate at which children are being trafficked within and across the boarders is heart breaking.

In many a posh home, there are multitudes of children enslaving away as maids. Their only crime is being orphans, coming from poor families and dropping out of school, with rich relations in need of cheap labour.

According to a Rapid assessment report in trafficking of children into worst forms of child labour, including child soldiers in Uganda, conducted in the districts of Busia, Kalangala, Masaka, Pader and Kampala, as part of the International Programme on the Elimination of Child Labour Time Bound Programme by the ILO, child traffickers mainly target children who have lost their parents, mainly out of school and at the brink of poverty.

The report further says that most of the children are promised employment opportunities, a better life, making quick money and school fees. And in addition to the promises made to children, guardians are also enticed with sugar, alcohol and monthly remittances of income earned by the children.

With all these gruelling scenarios, it defeats thinking that we have to wait for June the 16th to think about our children.

On Wednesday the 13th June 2007, the African Network on Prevention and Protection against Child Abuse and Neglect (ANPPCAN –Uganda) organised quite a successful dialogue, during which the above report was launched. But while these efforts are commendable, the situation demands that there is still a lot to be done.

The driving factors of children into vulnerabilities are quite overwhelming. These cannot wait for June the 16th or thereabout to manifest. They are daily occurrences. Unfortunately, they seem to have become part of us.

Sparing at the bare minimum a minute each day to think about the African Child will do miracles, and brighten up the future of our children. You do not have to wait for June the 16th to make a contribution. All you need is a heart that cares for the children – all children!