7 ways to make SRHR services youth-friendly!
6th June 2024
How can countries around the world make SRHR services more accessible for young people?During our conversation, Yahan outlined seven key pillars for youth-centred healthcare service and delivery:
1. Confidentiality
Yahan explains that young people should “feel comfortable telling the healthcare providers the problems they are facing, what kind of management they want”, and also the importance of “ensuring that youth have their autonomy, [so that] their decision will not be influenced by, for example, parents, their peers, or just stigma in general.”
2. Accessibility
Being able to access services, both financially and physically, is paramount: “if the youth we are talking about do not have parents to support them, or do not have…a stable… source of income, how are they going to access the care financially? Also, distance. For example, if a youth lives in rural areas, how are they going to access, for example, breast cancer screening or cervical cancer screening? …a lot of things like that are only…centred in urban areas.”
In this age of misinformation, Yahan believes that young people need to have accurate information about their care, and also what their rights are when it comes to that care. She tells us that during training programmes she’s delivered, young people have said to her: “‘I was not happy with the care I received at a clinic, but I just did not feel comfortable raising it to a doctor because…they are much older, and I don’t wanna speak, cause I feel they surely know better.’” Yahan goes on to say that healthcare providers are responsible for communicating both the level and kind of care young people can expect.
4. Empowerment and participation
“Healthcare providers should always be encouraging youth… to actively…participate in the decision-making of their care, making sure they have the means, the power, they feel confident enough to participate, not only just the basic level of decision making related to their care, but also their self-care.” Yahan is also passionate about the fact that young people should be trusted to make good decisions, and not discriminated against because of their age.
5. Cultural sensitivity and diversity
Whether it’s gender, ethnicity, age, or religion, Yahan stresses that “there's a lot of diversity amongst youth today… So, just ensuring, everything that I have mentioned, maybe youth from one culture is comfortable doing that, but youth from another culture might not be.” She says that healthcare providers need to understand that, and instead of forcing their opinions onto young people, they need to take time to understand what the youth they’re talking to wants: “it's okay if you want something that's different. It's okay to have that diversity amongst youth.”
6. Comprehensive care
Yahan characterises comprehensive care as focusing on the young person’s wellbeing, rather than just looking at physical ailments. She gives an example of a youth who comes in with a lot of bruising and old scars – they should not just be treated for their physical issue.
“We are not just fixing the fracture and whatever health issues that come with it. We are also making sure to screen for, for example, bullying, to screen for domestic violence…”
7. Continuity of care
Young people should not have to repeat the same information multiple times to different healthcare providers in order to guarantee continuity of care: “our healthcare system needs to ensure that there is a way to document all the healthcare assessments. The healthcare needs of the youth - what have they accessed? Is there any follow-ups we should be doing? Because a lot of time, it really depends on whether the young person wants to bring it up themselves.”
She cautions that this principle sometimes conflicts with confidentiality, though. There’s a balance to be struck, which she explains in Sydney, where she is based, is already in place: “…if someone wants to attend…a sexual health clinic, their records [are] completely separate from [the] public one...”
Why are these improvements to youth SRHR services so important?
At the societal level, Yahan says, it’s prudent for governments to invest in reducing the burden of disease in the years to come. A young person who doesn’t receive the right treatment now may have more problems later in life, when they’re in middle or old age.
And on the individual level: “…when we are talking about one person, we also need to remember that behind one person is always a family, there is always a community. So, by investing in one person, you are actually just investing in that family, in that community.”
A young person’s peers can also benefit from better SRHR services. If a youth “meet[s] anyone that is struggling as well, it's kind of like igniting one little match, and then it's going to, you think you only reach that one person, but it's going to be able to impact and magnify slowly. So, it is really important to be able to just start from one person.”
What is IFSMA doing to campaign for these changes?
Yahan’s organisation, the International Federation of Student Medical Associations, has 139 National Member Organisations (NMOs) from 130 countries. Many NMOs organise SRHR capacity building and advocacy programmes.
In Australia, Yahan tells us about a recent four-week education and advocacy campaign that IFSMA ran. It covered sexual health, LGBT plus health, period poverty and sex work. The project was a success – reaching over 1000 medical students – and receiving attention from the country’s health minister.
She also describes the latest IFSMA Asia-Pacific SRHR Summer School that was held in Nepal: “we do a lot of peer-to-peer education. And we welcome more than a 100 trainers and trainees…once the trainees graduate, they will be able to deliver that training [at] their local and also national level. So, they are going to be teaching other medical students on exactly how to deliver care, how to advocate for access to safe abortion or how to deliver comprehensive sexuality education to medical students, but also sometimes to healthcare professionals.”
How can we get to a world where we see these improvements for youth SRHR in place?
For Yahan, there is one central thing that needs to happen: “involving healthcare professionals and also, of course, youth themselves in deciding exactly how the future of healthcare should go.”
Only when young people are heard and listened to, can real change come.