Planning for a healthy future
Helping a new generation take control of their health
Young mothers and their babies face the highest risk of complications during pregnancy and childbirth, and early childbearing limits young women’s opportunities for education and employment. The 2017 Lao Social Indicator Survey (LSIS II) indicates the highest levels of unmet need for modern contraception are found amongst adolescents and unmarried women. Early marriage and adolescent pregnancy are significant concerns given their high prevalence amongst the rural, poor and least educated population groups, and given the large youth population. Adolescent mothers are more likely to have children with low birth weight as a result of inadequate nutrition and anemia during pregnancy.
In Lao PDR, the Ministry of Health, the Government of Luxembourg and UNFPA, UNICEF and WHO are working together to improve the health of women, newborns, children and adolescents through a UN Joint Programme (UNJP). One of the key components of the UNJP is to increase the availability of adolescent and youth friendly sexual and reproductive health services (AYFS) through training health workers to provide services to adolescents and young people in line with new national guidelines.
From her small consulting room in a Savannakhet health centre, Dr. Napha Southichak has been responsible for Maternal and Child Health, but of growing importance is her role in leading the youth-friendly health centre where young people can access sexual and reproductive health services.
“It’s very important that young people are given proper information that is tailored to their needs, so that they know how to prevent unwanted pregnancies and sexually transmitted infections and that they know where they can get services and treatment.”
Dr. Southichak embodies the recent drive to improve the responsiveness and effectiveness of health services and make services more people-centred. “It’s part of Lao culture not to speak about sexual behaviour but this is a new generation. I encourage them to come to me and I’ll make sure they feel comfortable and that they are assured that everything is confidential. They take this away and share with their friends.”
In a country with diverse ethnic groups, linguistic and geographical differences, improving health care quality and strengthening health workers’ counselling skills is an urgent requirement. With support from the UNJP, health workers in Bolikhamxay, Savannakhet and Bokeo provinces are being trained in providing youth-friendly sexual and reproductive health services. Once trained, these staff return to their health centres where they are supported to provide services to adolescents and young people.
The UNJP also supports them to do outreach to local schools and communities to increase awareness and demand. Once staff are trained, one person can reach out and provide services to more than 3000 youth annually.
Dr. Southichak sees that many young people are learning about sexual health through their peer networks online. Today, 24-year-old Nina has come for a consultation with Dr. Southichak. “I heard from friends in my area that if you think you might have a problem that you can come to the clinic. They told me they are good here and provide a good service. That makes me feel comfortable.” Nina and her friends have come to the clinic a few times for different services including STI treatment and contraception.
This is an important example for Dr. Southichak. Nina thought her symptoms were likely caused by eating too much salty or spicy food. “These beliefs are common,” she says, “it’s very important that we educate young people.” For Nina this support has been important.
“They have given me the medicine I need, so I know I will feel better. I also know that to make sure I don’t get sick again that I will use condoms.”
Dr. Southichak is pleased to see that the action she has long advocated for is being taken. “I’ve always said we need more support groups in villages and extra funding to provide outreach, so health workers can speak to adolescents and tell them to come to the health centre if they are worried or have any questions about reproductive health.”
In targeting adolescents and young people and tailoring services to their specific needs, the UNJP aims to make young people more confident in seeking information and help them to protect their health. Promoting adolescent health not only has a positive impact on young people themselves but on society as a whole. “We tell all of our friends about the services we receive at the clinic,” said Nina and her friend. “The services we receive here are so helpful, we want to make sure that everyone knows about it. The only thing we wish is that more people knew about this and could be helped through village visits and more youth-friendly clinics.”