The 4th Edition of the Annual Adolescent Conference on Sexual and Reproductive Health and Rights (SRHR) recently concluded in Kigali with a renewed call from adolescents to the government to remove barriers that continue to make SRHR services hard to access.
Organized by Health Development Initiative (HDI), the conference ran under the theme, "From Narrative To Action: What Is Missing?” and sought to engage adolescents, policy makers and stakeholders in advocacy efforts to remove barriers to accessing sexual reproductive health and rights and services.
In his opening remarks, the Executive Director of HDI Dr. Aflodis Kagaba, called on the participants to use the conference as an opportunity to engage policy makers and health actors and to share their ideas and recommendations to advocate for the changes that they want.
"This is your conference. It’s your platform and a safe space to express your needs and ideas and to engage policy makers in the areas where you may have identified gaps in accessing SRHR information and services,” he said.
The Adolescent Sexual Reproductive Health and Rights Advisor at Plan International, Alice Bumanzi, welcomed the idea of the annual dialogue and explained that such dialogues with young people help organisations like hers to come up with effective policies and well-informed decisions for young people.
"We believe that once people are well informed, they make better decisions. So, we encourage you to share with us your experiences and those from your peers and parents so that in the end, we have a clearer picture of the gaps in areas like Comprehensive Sexuality Education,” she noted.
Some challenges
Francine Uwayezu, a nurse who oversees the Youth Corner at Remera Health Center said that although there has been some improvement in the dissemination of SRHR information, young people in rural areas continue to lag behind.
She added that although sexual and reproductive health services are available, health centers are yet to designate a person or persons specifically in charge of adolescents and young people.
"At the health center, a nurse in charge of young people is also required to execute other duties that are unrelated to young people. As a result, young people are forced to wait in long queues where sometimes, many of them eventually give up and leave. This is a gap that should be taken seriously,” she said.
Representing young people, Deborah Kansiime, a youth SRHR champion and student at African Leadership University (ALU) said that although there are youth corners providing SRHR information and services, there is still a challenge of mindset where cultural and religious beliefs continue to cause stigma towards young people seeking these services.
"The primary people that should be providing accurate SRHR information should be teachers and parents, but resources must be invested in educating them first. If they have the right information and attitude, it will be easier for them to encourage young people to visit these health centers for more,” she said.
Revise the law
Responding to questions related to limitations in the law relating to human reproductive health, the President of the Network of Rwandan Parliamentarians on Population and Development (RPRPD) Dr. Gamariel Mbonimana admitted that there was need for its revision to reflect current realities.
Article 7 of the Law relating to human reproductive health stipulates that every person who has attained the majority age has the right to decide in relation to human reproductive health issues. The majority age in Rwanda is 18.
Additionally, the Law relating to medical professional liability insurance specifies that "the health professional who intends to provide healthcare services to a minor or an incapable person must endeavor to inform their parents or their representative or guardian and obtain their prior consent.
At the conference, several participants argued that by putting the age at 18, younger adolescents are left out, subsequently exposing them to HIV and/or unwanted pregnancy.
Mbonimana said that although there have been many public calls to bring the age at which adolescents can access SRHR services, the discussions regarding changes in this law will also scrutinize articles stipulating parents’ responsibilities towards their children with regard to reproductive health and the education system’s push for the promotion of Comprehensive Sexuality Education (CSE).
"The parliament has started the process to revise this law and the article regarding age and parental consent will also be discussed. The parliament will seek ideas, suggestions, and opinions because from what we have seen in other countries, adolescents and young adults are not required to have parental consent to access SRHR services. The discussion for us now is whether access should be put on age15,16 or 17,” he said.
The conference was also used as a platform for the dissemination of the ICPD25 commitments made by the government and the progress of their implementation. Rwanda made six commitments and among them is the increase adolescent sexuality reproductive health service utilization coverage and improving family planning uptake and decrease unmet needs.
The 2-day National Conference on Adolescents’ Access to SRHR information and services brought together over 150 participants from four provinces and the City of Kigali, including adolescents, young people, policy makers and stakeholders; government institutions, Civil Society Organizations working on SRHR, SRHR adolescent champions and development partners.