The Young and Alive Initiative team share how their youth-led approaches to sexual and reproductive health and rights has resulted in a stronger, more powerful youth movement in Tanzania.
In early 2012, Dr. Sesilia Shirima, a medical student in Mtwara, Tanzania, started her clinical rotation in the gynecological ward at Mtwara Ligula Hospital, supporting deliveries in the labor ward. On her first night shift, she met a 14-year-old pregnant girl delivering a baby. Sadly, this was not an uncommon occurrence. In Mtwara region, there were nearly 500 school dropouts from secondary schools and 100 school dropouts from primary schools due to teenage pregnancy. According to the law in Tanzania at the time, pregnant school girls could not go back to school after giving birth. As a result, they found themselves with a child to support and no qualifications for a job. There was no doubt that communities in the region lacked access to adolescent friendly sexual health information and services.
In response to her experience, Dr. Sesilia, together with other medical students, began volunteering with a sexual health club at their college based in the Mtwara College of Health and Allied Sciences. They used their free time outside of their medical studies to meet young people in communities and in schools, sparking dialogues around sexual health and responding to their questions. They reached an average of 2,000 young people each year with accurate information on sexual and reproductive health. From this collaboration, the group founded Young and Alive Initiative (YAI).
UBONGO NA FLEVA
In early 2017, YAI registered as an organization in Tanzania. YAI is among the few youth-led organizations whose work focused on improving adolescents’ and young people’s sexual and reproductive health and rights (AYSRHR). Most YAI members were also working as doctors in health care settings in the southern highlands of Tanzania. One of YAI’s first grants as an organisation was an Opportunity grant from AmplifyChange to implement sexual health work within local communities in Tanzania. The unique way to reach a wider audience of young people with the right SRHR information was using bongo flava music, a famous music genre in Eastern Africa. YAI designed the Ubongo na Fleva Project primarily as an advocacy project to influence local policy changes using the voices of young people themselves.
From 2017 to 2019, YAI worked with 15 young people and artists to develop stories that were later converted into music. Some highlights from the project are ‘Musa’, a song that speaks about the challenges of young people and unsafe abortions, and ‘Condom’, a song about the magic of condoms having a dual role in enhancing pleasure and providing protection. A few stars from the Ubongo na Fleva project included Ammy Chiba, Zill Vega, Jayzon Star, Ciana, and famous music producers Gach B and Miss Geezy, who went on to make it to the top ten of the Tanzania Bongo Star Search tournament in 2022. All these stars used their talents to transform the narrative built around sexual health and young people in the southern highlands and Mbeya region.
The produced songs were disseminated on local radio and TV and performed during the Ubongo na Fleva Festivals which also featured sexual health service provision. The festivals encouraged government commitment to improving sexual health services for adolescents and young people within the local context. The Ubongo na Fleva project contributed to the advocacy wins such as the ban of children under 18 into pubs at Chunya Districts. It additionally led to the invitations of 23 adolescents and young people onto the comprehensive councils of health plans (CCHP’s) in Makete District of Njombe Region. These councils are where most health planning begins before they move into national health planning, including national policies and strategies.
SUPPORTING FUTURE ADVOCATES
There is no doubt that interventions led by young people add value in improving sexual health outcomes, including improved policies and service provision. Understanding that we won’t remain young forever and the need to have more young leaders in the AYSRHR field, we designed the Young and Alive Fellowship aimed at building the new generation of young leaders to lead sexual health work within their own communities. YAI integrated positive sexual health training approaches by including Pleasure Principles in our interventions. The first cohort of YAI fellows included 15 young people from diverse backgrounds from across Tanzania. We made deliberate efforts to include young people from marginalised communities. The impact of the fellowship on positive change is real: fellows are not only influencing local action, but also global action. One fellow, for example, is advocating for intersectional mental health and sexual health issues and spoke during the Global Forum for Adolescents in 2022, hosted by PMNCH at WHO.
We have seen great success in our work, however we still face some challenges. For instance, we are working towards improved sustainability models of our projects to ensure continuity once project funding phases out. Our work is socially and culturally sensitive, so we have to identify ways to ensure the acceptability and accessibility of our interventions. We acknowledge that more work needs to be done by partners, UN and international organizations, and donors to add protection for actors working on AYSRHR and human rights. Over time we have learned that you do not have to stay in partnerships that diminish your organisational values, such as if a partnership enforces discrimination to marginalised groups. Using your work to promote your mission and vision as an organisation should always be the main focus.
Since 2017 YAI has observed positive growth of our influence. In Tanzania we are part of key decision making teams such as the National Family Planning technical working group and the National Adolescents’ Health technical working group. At a global level, we are the co-chairs of the IBP Network at WHO, members of the youth-led AYSRHR-J Global Roadmap for Action, members of the NextGen RH community of practice, and more. In Tanzania we host annual national youth summits which are currently among few sustainable platforms for youth leaders working on AYSRHR in Tanzania. Recently, YAI endorsed the Pleasure Principles, which are key to achieving better sexual health outcomes.
YAI looks forward to the future and continues to lead positive change for young people across Tanzania and the world. To achieve better AYSRHR outcomes, we cannot work alone. We are excited to influence meaningful collaborations and equitable partnerships between youth-led organisations, governments, national organisations and international organisations.
