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“Youth—My Past and Their Future” is a revealing series of interviews with luminaries in the field of adolescent sexual and reproductive health. The series will provide a candid glimpse into the adolescence of our interviewees and focus on their current work with this population. We will be posting these interviews over the next few weeks on Half the World. This week’s installment is an interview with Ward Cates Jr., MD, MPH, president of research at FHI 360.
Willard (Ward) Cates, Jr., MD, MPH, is president of research at FHI 360, one of the nonprofit organizations in international public health and development, with field activities in more than 50 countries. He has worked to improve youth sexual and reproductive health throughout his nearly four-decade career.
WC: Well I’ve never stopped being a teenager…so just like I am now. My priorities then were girls, sports, and grades – and in what order depended on the time of day. Now they’re family, sports and work…ditto.
IYWG: What were you told about sex when you were a young person? Who gave you this information? What else do you wish you had been told?
WC: The first time I heard about sex was when someone told me that my father put his thing in my mother to create me. I think I was about 7. I didn’t believe them, so I asked my mother. She gave me a book that she had ready for the occasion. My father came by that night and uncomfortably asked if I had any questions; when I said I didn’t, he was relieved. But I keep reading voraciously (for a teen!) and became the age appropriate sex education source for my social network.
IYWG: We have a few questions for you about the state of the world’s youth today. First, what is the biggest issue currently faced by youth?
WC: Establishing their self-esteem and developing a sense of security in a rapidly changing, increasingly transparent world.
IYWG: What is the most important thing that could be done to improve the health and well-being of today’s youth?
WC: Providing a supportive environment in which youth feel they can control their own destiny. It’s important to avoid a sense of fatalism where they feel that their future is in the hands of others – from criminal forces to supernatural beings. Hopefully we can empower youth to feel that they can control where they will end up in life. This sense of control is a necessary foundation for all of us, not only youth, to move forward and be accountable for our actions.
IYWG: Finally, please share a little about your work with youth. Why is the health and well-being of young people especially important to you?
WC: Because youth are the future. Each generation builds upon itself, and today’s youth are tomorrow’s adults. We (the slightly older than teenage generation) need to understand and value that our future is in their hands.
IYWG: What is one thing about youth that you wish you better understood?
WC: How to better manage their normal impulses so that youth can make better decisions for their future.
IYWG: How will the growing interest in treatment as prevention impact youth sexual and reproductive health?
WC: Treatment as prevention affects all ages. It’s as important for youth as it is for older persons to be aware of their HIV status. If infected, they can obtain treatment which will not only improve their personal HIV prognosis but will also reduce their capacity to transmit the virus to others.
During the International Conference on Family Planning, there was an exhibit of photos taken by young people around the world. The photos were taken as a part of the Well-Being of Adolescents in Vulnerable Environments (WAVE) study, Young Health Program. The program is designed to help young people around the world deal with the health problems they face and improve their chances of living a better life. The program is a partnership among AstraZeneca the Johns Hopkins Bloomberg School of Public Health, and Plan International.
We are launching a global movement to bring more attention to youth sexual and reproductive health! During the International Conference on Family Planning, we hosted an interactive session during which participants developed a new campaign titled, “Answer the Call.” The goal of “Answer the Call” is to increase international attention on youth sexual and reproductive health (SRH) through the dissemination of Twitter and Facebook messages.
In 2008, 550 people from around the world participated in a conference on youth health and development in Abuja, Nigeria. One of the outcomes of the meeting was the “Abuja Call to Action,” which calls for governments, donors, and civil society to increase investment in young people. Through “Answer the Call,” we hope to generate renewed energy and commitment to meeting the goals outlined in the Call to Action. During our interactive session young people, professionals, youth advocates and practioners working in the field of youth SRH worked together to develop the social media messages that will move the Abuja Call into action. These messages are available on the campaign website. Help us to spread the word about this ground-breaking campaign! Please visit the “Answer the Call” website, post the messages you find there (or some of your own) on Facebook and Twitter, and encourage others to get involved. Together as one collective voice, we can better ensure that the world begins to pay more attention the needs of young people.
FHI 360’s m4RH team presented their preliminary research findings at the International Confrence on Family Planning. Their presentation explored the potential of mobile-phone-based programs to overcome barriers that young people face in accessing contraceptives. Below is an interview with the principle investigator Kelly L’Engle and co principle-investigator, Heather Vadhat.
1. IYWG: Can you provide a brief overview of the m4RH program for our readers? What exactly is m4RH?
Kelly: m4RH is a family planning information service. Information about a range of short and long acting methods is provided via text message. There is also a searchable database of clinic locations where family planning services can be obtained. M4RH is opt-in, free to the user, an interactive or “ping-pong” system, and available across mobile phone provider inKenya and Tanzania.
2. IYWG: How popular are mobile phones among young people globally?
Heather: Very popular, it is estimated that 27% of the 5.9 billion mobile phone subscriptions world-wide are people under the age of 30.
3. IYWG: m4RH was designed to reach mobile phone users of all ages, but according to your presentation, it is quite popular among young people. What percentage of your users are youth?
Kelly: We only have data from Tanzania, so far. 15% of m4RH users inTanzaniawere 19 or younger during the pilot period. An additional 44% were 29 or younger. So that’s about 60% of all m4RH users who are youth and young adults.
4. IYWG: How are youth using m4RH?
Kelly: We know that young people are looking at a range of different contraceptive methods using m4RH. In fact, younger users access information about more methods in comparison to older m4RH users. Young people tend to be active and frequent information seekers about sexual and reproductive health, and m4RH seems to be supporting young people’s desires to learn about reproductive health by providing a high-quality and comprehensive range of information about contraception.
5. IYWG: Why are mobile phones a good platform for providing contraceptive information to young people?
Kelly: Mobile phones are private and confidential. Young people may stay away from clinics or conversations with health care providers or other adults, for fear of being stigmatized for seeking out information about reproductive health. m4RH provides an alternative method for learning about contraception that is private and confidential, and therefore m4RH may be especially helpful to young people who are thinking about their relationships and planning for the future.
6. IYWG: What are the barriers that young people face in accessing contraceptives?
Heather: Limited knowledge about contraceptive methods is a major barrier for young people; the next challenge is overcoming the common myths and misconceptions about contraception. Often young people are reluctant to seek information or clarification about contraception from a clinic setting because of concerns around privacy and confidentiality, cost of services, and provider biases. Convenience of clinic locations and hours of operation is another challenge for many young people.
7. IYWG: Based on your research with users, how does m4RH seem to be addressing these barriers?
Heather: m4RH allows young people to learn basic information about many different contraception options and where to go to learn more. The service is free and available 24 hours a day, which addresses the convenience factor and the privacy afforded by using a mobile phone has been noted by many of our users as a key benefit of the system.
8. IYWG: m4RH is an informational service, yet your research shows that m4RH is not only increasing knowledge of contraceptive methods among young people but may also be leading to behavior change.
Kelly: That’s correct. When we asked m4RH users to report changes in family planning use after accessing m4RH, numerous changes in contraceptive behavior were reported. In most cases, accessing m4RH messages alone will not cause behavior change, but accessing m4RH messages in conjunction with exposure to other family planning information and health programming can result in positively impacting family planning behavior.
Young people reported many changes in condom use, which shows that mobile phones may be an effective platform for reaching youth with condom information, and m4RH provides an innovative method of reaching out to young people to complement usual ways of reaching youth with family planning and HIV prevention messages. Young m4RH users also reported changes in use of other contraceptive methods, suggesting that there is room for the adoption of a variety of coitally-dependent, short, and long acting contraceptive methods.
9. IYWG: What are the implications of this research on the field of youth sexual and reproductive health?
Kelly: We need to embrace using new technologies such as mobile phones to reach young people with SRH information, support, and services. A number of organizations in developing and developed countries are creatively reaching out to youth via the Internet, smartphones, and through SMS-based programs. Given the large numbers of young people in the world today, these technologies only offer the tremendous opportunity to empower millions of young people with essential information about their bodies and relationships and health.
Last night the Interagency Youth Working Group (IYWG) hosted its annual
meeting as an auxiliary event at the International Family Planning Conference. Hosting the meeting at the conference was an amazing opportunity. Attendees included youth, government officials, donors, and a wide range of professionals. It was truly inspiring to be surrounded by so many people who share a common goal of improving the sexual and reproductive health (SRH) outcomes of young people.
At the meeting, participants shared their incredible insights and experiences. There were some outstanding discussions about approaches to meeting youth SRH needs among a range of populations and through a diversity of interventions. The topics discussed included the SRH needs of married adolescents, addressing cross generational relationships, the SRH needs of young people living with HIV, and many more.
Commitment to improving young people’s sexual and reproductive health has been a common thread throughout the entire conference. One goal of this year’s IYWG meeting was to explore how we, as a community of youth sexual and reproductive health champions, can ensure that the conference’s focus on youth is maintained after the meeting closes. By joining together to share lessons learned from the conference, participants were able to discuss how to translate these lessons into action in the field.
“I will share the information I learned tonight with our networks to help lives” –Participant Senegal
The IYWG will develop a set of strategy recommendations based on the discussions that were held at this meeting. These recommendations will be available on our website. We will also be hosting a follow-up e-forum to continue the meeting dialogue. The e-forum will be held from January 25 to January 27 2011; if you were not able to attend this meeting, we invite you to participate in the e-forum. Check our website for more details.