Midwives – Gate keepers or game changers for youth-friendly reproductive healthcare?

Youth-friendly services
During the training, specific attention was given to providing information and services to adolescents and young people, free from judgement and stigma. To that end, Rutgers facilitated an online course offering participants awareness of their personal, professional and societal values around SRHR. The online training consisted of three sessions: on provider attitudes towards young people accessing services, on adolescents and young people’s ability to choose for themselves and one on communication techniques and practice for youth-friendly counselling.

Esther Solange Ewolo, a midwife in Yaoundé, Cameroon, was one of the first midwives who was trained. “In the training, I noticed that many midwives are reluctant to prescribe contraception to young people. We learnt in the training that this is not compulsory by law. Of course they can consult their parents should they wish to, but there is no obligation to do so. We as midwives are there to respond to the needs of young people themselves, so they can make their own informed choices,” Esther Solange recalls.

“The training revealed that midwives are not necessarily aware of the legislation governing adolescents and young people’s access to SRH services in their countries,”  , one of the training facilitators for Rutgers. “Their way of working sometimes is stricter than the actual legislation,” she adds.

When asked whether the training changed the perspective of midwives on young people, Esther says: “Yes indeed. They listen more carefully to their needs.”

What’s next
Although Esther and Mounaya are seeing positive changes in their communities, they both agree there is still a long way to go. Esther: “We tend to put the focus on the abstinence message. There is still the wrong perception that when we talk about sexuality with young people, it will only encourage them to have sexual intercourse. And so, health professionals tend to avoid the subject altogether, or they focus on the negative aspects of sexuality. We need to explain that when you offer reliable information about contraceptive methods, it will allow young people to make their own decisions.”

Mounaya adds: “Young people in Benin, especially in the northern region, where I am from, still have difficulties finding their way to SRH services and information, especially when it comes to accessing safe abortion care. We need to create an environment that allows them to find their way to reliable information and products, without adding unnecessary barriers for them.” Mounaya is full of ideas on how to do this. “For example, I have seen that creating an anonymous hotline staffed by midwives is a great way to do this. Midwives are trusted professionals in our region, and having them staff call centers can help us reach adolescents and youth with reliable information, in an anonymous and easily accessible way. I hope we can grow these call centers in the future, so that young people in all parts of the country know about these services.”