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Empowering Young People to Live the Lives They Choose

Stories from around the world

By UN Foundation

June 6^th, 2016

The largest generation of young people the world has ever seen – 1.8 billion – are in or entering their reproductive years. This unprecedented group of youth presents us with a choice: to either provide them with the health information and services they need to live healthy, empowered lives, or continue to put their needs on the back burner.

Today the picture is grim. Complications from pregnancy and childbirth are a leading cause of death among 15-19-year-old women in developing regions, where one-third of girls are married before 18. Young women are also often forced to drop out of school when they become pregnant, limiting their ability to earn an income.

Sixty percent of sexually active young women have an unmet need for modern contraception, meaning they don’t want to become pregnant, but face barriers accessing contraceptive information and services. These barriers range from social stigma associated with sex outside of marriage, to a lack of accurate information and youth-friendly services, to partner opposition, and many other challenges.

But how do these challenges impact the lives of real young people around the world who are simply striving to build a better life for themselves? The Universal Access Project traveled around the globe speaking to young people from Haiti to Indonesia to Tanzania to find out.

For the young people we interviewed, access to reproductive health was about so much more than a pill, a shot, or a check-up; access to contraceptive information and services was the key to unlocking their entire lives – from surviving adolescence, to earning a degree, to pursuing a career, to living with dignity.

Maureen, Nong, Indah, David, and Alexandrine show us what can be achieved when young people are empowered with reproductive health care to live the lives they choose - and what can be lost when they aren’t.

Maureen - Planning a Family, Planning a Life

Maureen Oduor grew up in a small village in rural Kenya where she and her six siblings lived with her mother in a mud-walled, thatched-roof hut. Without electricity, Maureen struggled to study at night by candle light. Her father had a job over 200 miles away with the Nairobi railroad, leaving her mother, who worked as a farmer, to “struggle to gather basics like food” for all seven children. According to Maureen, “I qualified to go to better schools, but they cost a lot of money, so I couldn’t go there.”

Empowering Young People to Live the Lives They Choose

Her mother had never heard of family planning, but Maureen, who at age 30 is now college-educated and a senior staff member at a Tanzanian health NGO, says that without access to contraceptives and comprehensive sexual education, “I wouldn’t be here. I could not have gone to school, I could not have gotten my degree, and I would not be working. I would be in the village, maybe married to a very old man who gave my family two or three cows. All this happened because I’m able to plan my reproduction; I’m able to plan my life.”

Today, Maureen is a sexual and reproductive health advocate fighting for expanded voluntary contraceptive information and services for adolescents in Tanzania. The country has one of the youngest populations in the world, with almost half of all citizens under the age of 15. Maureen became motivated to advocate for reproductive rights after her best friend at boarding school bled to death due to complications from an unsafe abortion. “A group of 10 students …we tried carrying this girl to reach the health facilities. … Unfortunately, on reaching the facility we lost this life in the hands of our students.” The loss of her best friend spurred her to action and sparked her to ask, “‘Why did this girl have to go for an unsafe abortion?’ It is because we never had access to family planning. Pregnancy was equal to girls being chased out of school. She wanted to remain and study, and then she paid for it with her life.” “From that time,” she added, “I decided to break the silence.”

Now Maureen spreads her knowledge of reproductive health throughout sub-Saharan Africa to help adolescent women understand their options and take control of their lives. “People look at contraception as planning families, but me, I look at it as planning a future. It has helped me have a future that is constructed.”

Nong – Embracing Who You Are in Indonesia

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Nong is 21 years old and studying international relations in Yogyakarta, Indonesia. He hopes to become a diplomat for the Indonesian Ministry of Foreign affairs, and in his free time Nong serves as a peer volunteer at the UNALA clinic, a UN Population Fund (UNFPA)-supported program that offers youth-friendly services. Services geared toward youth are particularly important in Indonesia, where the adolescent birth rate stands at 48 births per 1,000 women aged 14-18. According to Nong, contraception for young people, particularly those who are unmarried, still remains controversial: “When we kids want to access some condoms or pills, people have this stigma that we‘re bad young people… because we‘re having sex before marriage.”

Young women in Indonesia often face even more barriers accessing contraceptives than young men. According to Nong: “It’s harder for girls to access [contraceptive pills] but it’s easy to get condoms.” Yet even when accessing condoms, young women still face discrimination. “When you see a boy buying condoms you don‘t think he is a bad boy. If a girl buys condoms people will say a lot,” explains Nong. Such stigmas leave many young people in Indonesia with few contraceptive choices, leading to unplanned pregnancies and unsafe abortions.

Through UNALA, Nong is now working to fight these stigmas and increase education among his peers. “I‘m part of the young people, and I want to do more with my abilities to help other young people… to make them more concerned about the issues that are about them,” he adds. Sharing information on reproductive health is one of the tangible ways Nong has been able to make a difference. “I don‘t think a lot of high schools in Yogyakarta promote safe sex,” he says, “Unala is giving more specific information.” In Nong’s view, tolerance and acceptance are the keys to changing the social fabric of Indonesia, and this acceptance begins with yourself. “I say be proud of what you are, and about who you are. Embrace it and go with it.”

Indah – Overcoming Stigma as a Young Woman in Indonesia

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At 23, Indah is attending college and dreams of working in public relations. Like Nong, she is also part of the UNFPA-supported UNALA clinic association and advocates for increasing contraception access among her peers. As young women in Indonesia, Indah and her friends face many barriers when accessing contraceptive education and services. Throughout the country, less than 14% of women report receiving family planning information from their health provider and limited family planning method options are available to them. As Indah explains, “When [my friends] want access to contraceptives they have to buy it in the 24-hour convenience store… with the risk that they will get a negative stigma from the seller…. You don’t dare to go to the clinic to get access to contraception, because everyone knows they are likely to refuse you.”

Due to the taboos surrounding reproductive health for young people, Indah describes the hesitation she used to feel before seeking medical treatment or advice, saying, “Every time I would go to the doctor, my heart would start beating fast because I was afraid.” She recalls a time one of her close friends sought emergency contraception, and they struggled to find a clinic that would provide it. “We had no idea where we could access the morning-after pill. Almost all the health services in Indonesia do not provide contraception access to young people, especially those who are not in a legal relationship,” Indah explained. Unable to find a clinic willing to give them the pill, Indah and her friend were left without options. “We could only depend on [luck]. We were counting the days anxiously.” Eventually, her friend learned she was not pregnant and Indah discovered the UNALA clinic, where she learned that reproductive health services were available to young people.

Another time Indah and her friend were denied cervical cancer screenings because they were unmarried: “My friend and I were visiting a laboratory in Yogyakarta to do a Pap smear. At that time, we were rejected by the lab because we were not married.”

Indah stresses the importance of contraception as one of the keys to education and a career, explaining, “A lot of my friends have been expelled because of getting pregnant at school.” She adds that her life would be very different without access to contraception: “Maybe I will be forced to get married, although I am not mentally ready to get married, and then I would be forced to take care of the children while I’m also still a child myself.” Instead, Indah is able to dream of a future and plan for a career. “I want to work in public relations, perhaps an NGO… I want to learn more about gender and sexuality, and also about the NGO management,” she says.

In order to change the status quo in Indonesia, Indah is working to educate her peers and advocate for a more inclusive reproductive health system. “It is not only the government but also the community that needs to be friendlier to support the youth to get more access and information,” she explains. In Indah’s view, marital status and age should not affect the availability of contraceptives: “Everyone has the same rights. If everyone in Indonesia could make peace with the differences that happen here, maybe I could say that Indonesia is heaven on Earth.”

DAVID – “EVERYONE IS HAVING SEX” – SEXUAL EDUCATION IS KEY

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David –“Everyone is having sex” – Sexual Education is Key

David lives outside of Port-au-Prince, Haiti, and volunteers at the Profamil clinic, a local clinic providing services including gynecological exams, contraception distribution, prenatal services, post-abortion care, breast cancer screening, and STI testing and treatment. Access to contraceptive information and services is critical in Haiti where, according to the UN Population Fund, 52 percent of 15- to 19-year-old young women who are married or in a union have an unmet need for contraception.

Through his work, David attempts to combat myths surrounding contraception, particularly when talking to other young men. According to David, “Some men think if they have a wife or partner who wants to use family planning it’s because they don’t respect the men that they’re with… it’s because the girl wants to cheat on them.” When faced with this response, David emphasizes the responsibility of men to support their significant others: “I’m trying to tell the man that the term ‘family planning’ does not concern only the girl but the boy as well. It’s family planning. It concerns them both because they are together.”

According to David, many of the misconceptions surrounding contraception in Haiti stem from a lack of sexual education, which is not required to be provided in schools by the Ministry of Education. Few schools offer programs for students regarding reproductive health, yet he has seen a desire for information among the young people he works with, explaining, “Some of the schools in this community accept us to go inside the school, to the class, to talk about these things, but that is not regular. We cannot bring the condoms inside the school, but when the school is done, we see a lot of students coming out to look for us to [get] condoms.” Comprehensive sexuality education is “important for everyone,” according to David, because “everyone is having sex.”

Today, David seeks change: “Sex education should be one of the classes that everyone should have, it should be mandatory. We have to start with the ministry of education, we have to introduce and make this class available for everyone.”

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Alexandrine – Gaining a Second Chance

Alexandrine lives in Port-au-Prince, Haiti with her husband and three children. She became pregnant with her first child at age 15 when she was raped by her school principal. “I was alone, living with my father, and the person who got me pregnant was the principal of my school … he forced me,” she said. Alexandrine did not initially report her principal to the authorities because, as she explains, “I was really scared of my dad.” She finally summoned the courage to tell the authorities, but the man had fled, and her father forced her to drop out of school, refusing to pay her school fees. Alexandrine dropped out of school to take care of the baby.

It was not until after her third child that Alexandrine learned about reproductive health and rights through the Profamil clinic. Unfortunately, this is not unique. In Haiti, over a third of married women wish to delay or prevent pregnancy but are not using any form of family planning. Through Profamil, Alexandrine now has a three-year contraceptive implant and does not plan to have more children, explaining, “Only my husband is working, so providing a lot of things to my children is a big deal …. Sometimes it’s hard to find money to buy their lunches. I would like their lives to be different, especially the way in which I had my first child.” Family planning is “very important because it gives you the power to control when to have children. When you continue to have children, it’s not advantageous to you or the children because you will not be able to provide for so many children,” she adds.

To hear Alexandrine’s story in her own words, you can view her video here.

Take Action. Learn More.

Each of these young people from around the world shares a strong desire to change the status quo and ensure voluntary access to sexual and reproductive health and rights for themselves and their peers.

Join the movement to spread voluntary reproductive health information and access to young people everywhere.