CFYDDI at the Second Clinical and Scientific Meeting organised by Society of Adolescent Health in Uganda (SAHU)

From the Second Clinical and Scientific Meeting in Uganda on the Theme: Engaging the Hard to Reach Adolescent into Care. we bring you a summary write up of some discussions.

Prossy Babirye CFYDDI Behaviour Change and communications Manager in stripped black and white with other participants at the Meeting

Prossy Babirye CFYDDI Behaviour Change and communications Manager in stripped black and white with other participants at the Meeting

on the round table Professor Susan Rosenthal, Dr Betsy Preffer, MD, Professor Lawrence Stanberry and Professor Philip Larussa MD all from Columbia University Medical Center, New York, USA presented various importnat topics on the theme.

on the round table Professor Susan Rosenthal, Dr Betsy Preffer, MD, Professor Lawrence Stanberry and Professor Philip Larussa MD all from Columbia University Medical Center, New York, USA presented various importnat topics on the theme.

A quick Spot on statistics

Prevalence

  • In 2012, about 110,000 adolescents were living with HIV (7% of PLWH in Uganda) (MoH, 2013)
  • Only 21,641(20%) of the estimated 110,000 adolescents are in Pre-ART and ART
  • Adolescents receive care from Hospitals, Specialized Clinics and HCII, III & IV (Ministry of Health, 2013

Global Statistics:

  • Worldwide, about 2.1 million adolescents aged 10-19 years are living with HIV (UNAIDS 2013).
  • Global statistics indicate that 41% of newly acquired HIV cases have occurred among the youth aged 15 to 24
  • And over 6,000 young people acquire HIV every day. (UNAIDS 2011 report)

How about Uganda? :

  • In Uganda, 37.4% of population account for young people.
  • HIV prevalence is higher ( 19%) among 15-24 year.
  • Comprehensive knowledge about HIV prevention is low ( 2.3%).
  • Un met need for family planning among women of reproductive age is high ( 33%)
  • Only 5% public facilities provide youth friendly SRH/HIV services.

Did you know that HIV has a ‘young face….often female’

  • Every day, an estimated 5,000-6,000 young people aged 15-24 become infected with HIV.
  • Globally almost one fourth of those living
  • With HIV are under the age of 25.
  • Of the 15-24 year old young people living with HIV, 63% live in sub-Saharan Africa.

Some facts for developing nations:

  • 1 in 5 babies will be born low birth weight
  • 1 in 3 infants will be stunted
  • 1 in 4 adolescent girls will be overweight
  • 1 in 3 adult women will be obese
  • 1 in 3 adults will have hypertension
  • 1 in 7 adults will have type 2 diabetes

The Director General of Health services Dr Jane Ruth Aceng , in 2014 said  “Adolescents constitute the highest demographic segment in Uganda yet sexual and reproductive information and health services to meet their needs are still limited,”

Picking from this statement,

The Second Clinical and Scientific Meeting was opened with a key note address from  Dr. Sabrina Bakeera Kitaka who gave updated statics on the state of affair with. Adolescents

IN SEXUAL AND REPRODUCTIVE HEALTH

  • According to the Ministry of Health, presently, 25% of the Ugandan teenagers become pregnant by the age of 19.
  • About 49% are married before their 18th birthday and they start getting babies until their mid 40s.
  • Adolescents face a host of other sexual and reproductive health challenges.
  • Complicated child births and abortions often requiring Emergency Obstetric Care are widespread.
  • Sexually Transmitted Infections (STIs) including HIV infection are also common.
  • Large families with poorly spaced children define a typical Ugandan rural community.

What you need to know generally about Children in Uganda

  • Young population 56.7% below 18:(Census 2014)
  • 2 million are orphaned children
  • 5000 children are estimated to be living on streets (Uganda bureau fro Labour affairs-US )
  • 75 million children are engaged in economic activities and 51% of these are considered to be in hazardous child Labour (UNHS 2009/10)
  • 18,000 children affected by trafficking and bonded Labour. UYDEL Report 2011
  • Total number of adolescent girls and young women between 15-24 are almost 3.4 million. (Census 2014)

SOME STATISTICS ON ADOLESCENTS

  • 90% of Ugandan adolescents aged 12–19 live in rural areas.
  • Nearly 1 in 3 adolescents have lost one or both parents.
  • More than 9 in 10 of all adolescents are unmarried; however almost 1 in 5 young women aged 15–19 are married.
  • Of the 22% of 15–19-year old women who have given birth, one-third did not want their last birth at all, and an additional one-fifth wanted the birth at a later time.
  • 76% of young women and 63% of young men are worried about getting HIV/AIDS.
  • Nearly 7 in 10 young women and half of young men are worried about getting pregnant or getting someone pregnant.
  • Nearly half of adolescents are worried about their health, and at least 4 in 10 are worried about getting enough to eat.

    Dr. Sabrina Bakeera-Kitaka a Senior Lecturer; Paediatric & Adolescent Health Specialist in the Department of Paediatrics at Makerere University College of Health Sciences Mulago National Referral Hospital  in her address affirmed that; •Adolescents are typically sexually curious and easily sexually aroused. •	The risk-taking and rebellion occurring during adolescence is part of their need to establish their identity. •	Adolescents' behaviour during this time is not indicative of who they will be as adults. •	Adolescence is a time of both great opportunity and increased risk. •	It is a time of dramatic changes including in physical, emotional, intellectual and social development

    Dr. Sabrina Bakeera-Kitaka a Senior Lecturer; Paediatric & Adolescent Health Specialist in the Department of Paediatrics at
    Makerere University College of Health Sciences Mulago National Referral Hospital in her address affirmed that;
    • Adolescents are typically sexually curious and easily sexually aroused.
    • The risk-taking and rebellion occurring during adolescence is part of their need to establish their identity.
    • Adolescents’ behaviour during this time is not indicative of who they will be as adults.
    • Adolescence is a time of both great opportunity and increased risk.
    • It is a time of dramatic changes including in physical, emotional, intellectual and social development

WHAT THE WORLD HEALTH ORGANISATION (WHO) STATES;

“One in every five people in the world is an adolescent, and 85% of them live in developing countries and

Nearly two thirds of premature deaths and one third of the total disease burden in adults are associated with conditions or behaviours that began in youth, including tobacco use, a lack of physical activity, unprotected sex or exposure to violence.”

Dr. Barbara Asire; MBChB,  MMed Paediatrics, DPPM the Program Officer Adolescent HIV care and Treatment MOH-ACP  Highlighted some Barriers to Utilization of services by adolescents  at different levels as; •Stigma and discrimination •	Gaps in service delivery at health facilities •	Long time spent at facility •	Lack of privacy •	Limited counseling •	Attitudes of health workers •	Communication between schools and health facilities •	Training gaps •	Barriers at family level o	Lack of transport •	Barriers at Policy level; HCT policy consent vs assent •	Barriers at school; school regulations •	Gender disparities in access to services by ALHIV; boys seek care when they are sick   In her Recommendations on Access, Utilization and Quality to the participants: •	Peer counsellors should be trained and made available at all facilities since adolescents feel free with their peers and expressed a fear of the older counsellors. •	Improve eMTCT among pregnant adolescent girls especially in hospitals •	Integrate FP services in HIV care especially in special clinics . •	Adherence strategies should lay more emphasis on rural health facilities •	Boys and those who are new on ART should be targeted by adherence interventions. •	Stigma in schools and communities should be addressed by everyone in order to improve adherence •	Harmonize a training curriculum •	Engage ALHIV/ young people in adolescent services •	Improved collaboration with other line ministries •	Improve community engagement

Dr. Barbara Asire; MBChB, MMed Paediatrics, DPPM the Program Officer Adolescent HIV care and Treatment MOH-ACP
Highlighted some Barriers to Utilization of services by adolescents at different levels as;
• Stigma and discrimination
• Gaps in service delivery at health facilities
• Long time spent at facility
• Lack of privacy
• Limited counseling
• Attitudes of health workers
• Communication between schools and health facilities
• Training gaps
• Barriers at family level
o Lack of transport
• Barriers at Policy level; HCT policy consent vs assent
• Barriers at school; school regulations
• Gender disparities in access to services by ALHIV; boys seek care when they are sick
In her Recommendations on Access, Utilization and Quality to the participants:
• Peer counsellors should be trained and made available at all facilities since adolescents feel free with their peers and expressed a fear of the older counsellors.
• Improve eMTCT among pregnant adolescent girls especially in hospitals
• Integrate FP services in HIV care especially in special clinics .
• Adherence strategies should lay more emphasis on rural health facilities
• Boys and those who are new on ART should be targeted by adherence interventions.
• Stigma in schools and communities should be addressed by everyone in order to improve adherence
• Harmonize a training curriculum
• Engage ALHIV/ young people in adolescent services
• Improved collaboration with other line ministries
• Improve community engagementIts at this point that CFYDDI continues to act as a vital link to provide quality youth friendly information and services and advocacy Service point with non-judgmental engagement and motivational approaches which go beyond merely providing information to helping young people identify own risks and devise protective measures.

Its at this point that CFYDDI continues to act as a vital link to provide quality youth friendly information and services and advocacy Service point with non-judgmental engagement and motivational approaches which go beyond merely providing information to helping young people identify own risks and devise protective measures.

Lets continue to make every effort to ensure that youth services are genuinely accessible and open to all young people regardless of their background, accept every young person for who they are, valuing them first as individual people who are learning and who may need support before challenging their opinions and actions and confronting them with consequences.

CFYDDI Youth  Peer Leadership team

CFYDDI Youth Peer Leadership team

Compiled by CFYDDI behaviors change and communication Team

Present at the Meeting.