Young people's equitable access to holistic SRHSR

According to the 2016-2017 Demographic Health Study report, the proportion of women aged 15-19 who have started their reproductive life increases with age, varying from less than 1% at the age of 15 to 29%. at the age of 19.

Concerning sexual relations and reproductive health behaviors before the age of 15, 3% of adolescent girls and 9% of adolescents had their first sexual intercourse before the age of 15. The provincial education directorates reported 4,687 cases of pregnancies with an annual increase of 50%. The age at pregnancy for the majority of girls was between 16 and 18 years. With this situation of high fertility rates among adolescents, the precocity of sexual relations, pregnancies and marriages, the low level of use of modern contraceptive methods and the prevalence of unsafe abortions, all the factors come together to lead to a high maternal and child mortality among adolescents.

The health statistics directory shows 2,589 cases of abortions recorded during the year 2017, including 249 among adolescents aged 15 to 19, or 9.6%.

In the same vein, predominantly young, the HIV seroprevalence rate among sex workers increased from 38% in 2007 to 21.3% in 2013 and the IBBS 2021 study reveals that this rate reached 30% while it is 15,3% among drug users.

The main risk factors are linked to traditional barriers, poor comprehensive sexual education, and the social, legal and political environment that is unfavorable to sexual well-being and bodily autonomy among young people.

Marginalized, they do not have sufficient access to sexual and reproductive health information, products and services. Very few professionals deal with them.

If nothing is done,their situation of rejection&marginalization imposes risky behavior on them, exposing them to self-stigmatization, sexually transmitted diseases,unsafe abortion, lack of well-being and bodily autonomy, unwanted pregnancies, theft, family or public nuisance, sex work, gender-based violence, mental illness and even suicide. Worse still, children born to drug-using mothers, as well as children born to HIV-positive mothers, are for the most part affected by this situation. If nothing is done for them, they manifest abnormal behaviors in adolescence. They too need close support.

Our main mission is to promote sexual and reproductive health among young people in vulnerable situations. Transversally, we help prevent HIV and drug use among young people and care for addiction victims. This is why we have set up the "Bright Future Generation" center, with two separated sites for young women and men  

Our solution is to:

1.Facilitate access for supported young people to sexual and reproductive health information, products and services

2. Adapt the infrastructures of our center to the wishes of the young people supervised linked to their conviviality and free expression

3. Favor the “One Stop Shop” approach to offer them a complete package of integrated services

4. Promote comprehensive sexuality education in collaboration with parents and community leaders

5. Promote the strengthening of empowerment through income-generating activities already initiated in our center to prepare young people under supervision for self-care

6. Promote the inclusive and meaningful participation of young people throughout the process of improving conditions of access to sexual and reproductive health information, products and services

7. Transform supervised young people into change makers and at the same time ambassadors&advocates within their surrounding communities

Our proposed solution is aimed at vulnerable young people in general, and more specifically at young drug users, sex workers and young people living with HIV.

1. According to the demographic health survey, young girls who have dropped out of school as a result of unwanted pregnancies are marginalized and discriminated against by the surrounding community. With no access to sexual and reproductive health services and living in precarious conditions, they turn to sex work to survive and feed their children. In so doing, they expose themselves to disease, violence of all kinds and self-stigmatization.
2 Drug users, both girls and boys, are in much the same situation of risk as sex workers. They need education and information on sexual and reproductive health, as well as incentives to demand related products and services. 

3. Already on lifelong antiretroviral treatment, most of young people living with HIV are orphans. They have difficulty accessing sexual and reproductive health services because of stigmatization and self-discrimination.

Although our focus is on sexual and reproductive health, our approach is to privilege conviviality through recreational games as well as empowerment through income-generating activities already operational in our center, notably bread and soap making, sewing, food crops and rabbit breeding.

In addition to learning how to empower themselves, the young people supervised will have access to sexual and reproductive health information, products and services.

In short, the young people under supervision are empowered, make decisions about their sexuality, express their needs and assert their rights.

We have what it takes to implement the proposed solution:

 *Our organization has been in operation since 2002 and has extensive experience in the field of young people's sexual and reproductive health.
*We have the advantage of having established partnerships with the Network of Young People Living with HIV, the Burundian Girls' Association, the Ministry of Public Health and community leaders in our intervention zone.
*We have two separate sites for supporting girls and boys, with equipment and materials for income-generating activities already operational to promote self-help among the young people we support (bread, soap and sewing making) and rabbit breeding.

*We have a recreation area to enhance conviviality (playground ex basketball).
*We have a pool of young community mobilizers already trained to reinforce peer coaching.

*We have the advantage of working with the media so that our messages can reach as many young people as possible (print and broadcast media, online newspapers, testimonials, etc.).

As our target is huge, we prefer to focus on the most needy, who we welcome to the center - around a hundred a year. These enable us to reach other needy young people in their respective communities through community relays. This work is carried out in synergy with community leaders and media professionals.

The solution we propose is innovative for these reasons:

-Targets disadvantaged young people in terms of equitable access to sexual and reproductive health services,

-Favors an integrated approach to reproductive health and HIV,

-Reduces stigmatization and self-discrimination,

-Promotes conviviality through a diversity of activities: recreational games, training, empowerment learning,advocacy

-Promotes inclusive and meaningful youth participation

1 Impact objective: Marginalized young people in Bujumbura have access to sexual and reproductive health information, commodities and services.

2. Indicator: At least 40% of marginalized youth have access to sexual health information, commodities and services within one year.
*At least 70% of marginalized young people have access to sexual and reproductive health information, products and services within five years.

3 To achieve this, our organization will put in place a sexual and reproductive health support system that involves young people themselves in an inclusive and significant way, from its design, implementation, monitoring and evaluation.

To reach as many vulnerable young people as possible, our organization will involve community leaders, peer educators, community mobilizers and media professionals.

Our organization's strategic objective is that "marginalized young people in Bujumbura have access to sexual and reproductive health information, products and services". Our performance will be achieved if at least 40% of marginalized young people have access within the next 12 months, and 70% within 5 years.

This performance would be verified by data from attendance reports at "youth-friendly" health centers and the level of satifaction of vulnerable young people themselves. Intermediate results would be seen in terms of knowledge acquired, information received, and changes in attitudes and behaviours of beneficiaries with regard to sexual and reproductive health. 

The intervention package would essentially consist of awareness-raising, making available information tools, education and communication for behavior change, training, focus groups, campaigns, radio&TV broadcasts, peer education, community mobilization and promotion of parent-child dialogue.
We may come up against risks linked to traditional and religious beliefs, but we are ready to identify potential allies in order to remove any obstacles.

Full-time staff: 7

Part-time staff:4

Contractors: 6

Volonteers: 4

The work of these staff is supported by peer educators and community mobilizers in various districts of the city of Bujumbura.

Our organization "Jeunesse porte-flambeau pour combattre le sida et la drogue" has been officially operational since June 2002. Sexual and reproductive health has been one of our priority areas of intervention for 21 years, because you can't talk about HIV and drugs among marginalized young people without talking about sexual and reproductive health.

The young people we work with have become our colleagues, our peer educators, our community mobilizers. Others have become civil servants, parents and shopkeepers..., and it's they who are advocating equity and inclusion.

1. Our management team is made up of various categories of people: a young former sex worker, a young former drug user, a young man living with HIV, a mother who represents the parents as well as technical staff.

2. The objective is first to involve our beneficiaries regardless of their identity or sexual orientation so that they freely express their needs and participate themselves in responding to their concerns. It is also with the aim of involving parents because they constitute the pillar of change in attitudes and beliefs at the family level.

Our concern is that all categories of our beneficiaries participate significantly and inclusively in the design, implementation, monitoring and evaluation of the project.

1. We draw our resources from membership fees, sponsors, grants or donations

2. Key activities:

-Production of information, education and communication tools for behavior change (leaflets, posters, roll ups, banners, etc.)

-Production of strategic documents on sexual and reproductive health

-Organization of training, focus groups,

-Organization of awareness campaigns

-Production of shows and magazines on radio, television and online newspaper

-Use of social media

-Learning about empowerment through income-generating activities

-Sports, cultural and religious supervision

-Referral of needy cases to the medical care structure of the Network of Young People Living with HIV

-Support for children born to HIV-positive mothers and drug users

 -Monitoring&evaluation

3. Areas of intervention: sexual and reproductive health among vulnerable young people, strengthening empowerment, prevention of HIV and drug use

4. Key parties involved: Ministry of public health and the fight against AIDS, the Network of young people living with AIDS, Ministry in charge of youth, Ministry in charge of national solidarity, health centers friendly to young people, media professionals

To sustain our interventions, our organization strives to:

*Internally, promote income-generating activities so that the profit contributes to financing certain categories of activities

*Instill in our beneficiaries the principle of responsibility, accountability and self-care

*Update the resource mobilization strategy and diversify technical and financial partners

To sustain our interventions, our organization strives to:

*Internally, promote income-generating activities so that the profit contributes to financing certain categories of activities

*Instill in our beneficiaries the principle of responsibility, accountability and self-care

*Update the resource mobilization strategy and diversify technical and financial partners