AFRICAN YOUTH ALLIANCE Reaching Vulnerable Youth with Sexual and Reproductive Health Services in Uganda

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1 Reaching Vulnerable Youth with Sexual and Reproductive Health Services in Uganda Rhobbinah Ssempebwa, SWSA, MA Lorna Tumwebaze, MD, MPH Tayla Colton, SM Global Health Council s 31 st annual conference Washington DC June 3rd 2004

2 Project Goal Improved adolescent sexual and reproductive health among young people aged years in Botswana, Ghana, Tanzania, and Uganda.

3 Partners and Key Component Areas PATHFINDER INTERNATIONAL Youth-friendly services (YFS) Institutional capacity-building (ICB) PATH Behavior change communication (BCC) Integration of ASRH into livelihood skills development programs (LSD) UNFPA Coordination and dissemination Policy and advocacy

4 UYDEL Background The Uganda Youth Development Link Founded in 1993 Primarily serves disadvantaged children in semi-urban areas in and around Kampala: street children adolescent commercial sex workers (CSWs) Major activities include rehabilitation of drug users, vocational and life-skills training and IEC/BCC

5 Background Poverty has forced many adolescents onto the streets or into urban slums, increasing their vulnerability to sexual exploitation, violence and drug abuse. Urbanization is increasing and urban slums are expanding. Need to scale-up and improve the quality of SRH services for vulnerable young people.

6 Specific Objectives Increase access to youth-friendly services for street children and commercial sex workers through high quality outreach services and drop in centers in and around Kampala city. Strengthen selected UYDEL management systems as they relate to provision of high quality youth-friendly services.

7 Major Activities Mobilized community leaders, bar and brothel owners to support the program. Conducted in-depth focus group discussions with young people to identify priority needs. Established and upgrade drop-in centers to offer youth-friendly services including VCT, STI treatment, counseling, FP and referrals. Established barefoot mobile services or outposts at bars, restaurants and other places where young people congregate.

8 Major Activities (cont d) Trained 10 service providers, 15 counselors and 40 peer educators in YFS. Strengthened referral networks between out reach and drop-in centers and between UYDEL and other service delivery points. Supported provision of livelihood skills, such as hair dressing, tailoring and mechanics, to offer alternative means of income generation.

9 UYDEL Clinic Staff

10 Results An increasing number of young people have sought services from both drop-in centers and outposts, significantly surpassing original estimates.

11 Total Number of Visits in ,000 70,000 60,000 50,000 40,000 30,000 20,000 10, st Qtr 2nd Qtr 3rd Qtr 4th Qtr New Visits Revisits Total visits

12 Success Stories 60 young people have discontinued sex work and found other sources of income (58 girls and two boys). 46 young people are no longer living on streets. 24 youth have been trained in hair dressing. Eight youth have been trained in tailoring. Five youth have been trained in motor mechanics.

13 Classes at a UYDEL Drop-in Center

14 Success Stories (cont d) VCT service provision attracted funding from the University of California for the SUUBI (Hope) project. SUUBI is currently supporting 25 HIV positive young people between the ages of 13 and 21, by providing guidance on positive living and linkages with ARV programs.

15 Results Selected Services (provided in 2003) STI treatment Voluntary counseling & testing Condoms distributed Pill cycles distributed Drug abuse Drop-in center 3, ,635 2,870 1,977 Outreach 5,910 Refer to dropin center 46,890 4,723 2,070

16 Major Challenges Commodity and supply stock outs, such as for STI drugs. Shortage of VCT kits discourages and disappoints large numbers of young people turning up for VCT. Stigma against young people on the street, and especially young sex workers.

17 Observations and Lessons Learned Sites that also offer livelihood skills development have more youth visits for ASRH information and services Outreach services contribute significantly to increased numbers of youth visits Institutionalization of this strategy requires: Meaningful involvement of community leaders and bar/restaurant owners. Sensitization of community members. Training of service providers on the special needs and rights of vulnerable youth.

18 Conclusion (cont d) God gave us UYDEL health workers as a blessing. They have cured us from gonorrhea and have given us condoms to prevent it. All these services, they provide to us at no cost." Male client at an outreach post

19 Thank You!