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Meeting Young People in Ethiopia Where They Are for Greater Health Equity

For EngenderHealth, it is important to look at gender from an intersectionality lens and develop a deep understanding of where we work and who we work with to ensure our programs serve the individuals and communities who are hardest to reach in support of health equity. This means that in Ethiopia we intentionally reach out to and engage with young people in Addis Ababa through our program, A Rights-Based Approach for Enhancing Sexual and Reproductive Health and Rights (SRHR) in Ethiopia.

Challenges Young People Face in Addis Ababa

Although Ethiopia has made great progress in expanding access to sexual and reproductive health (SRH) services and promoting the rights of girls, women, and young people through legal and policy changes, young people continue to face challenges in realizing their SRHR.

When it comes to contraception in Ethiopia, young people are being left behind. Young people (10 to 24 years) make up the largest proportion of the population in Ethiopia. And yet, an estimated one-third of young people do not have access to SRH services. Further, the highest unmet need for contraception is among adolescents ages 15 to 19 years. While modern contraceptive use among currently married women increased remarkably from 4% in the 1990s to 35% in 2016, 39.8% of unmarried adolescent girls ages 15 to 19 reported an unmet need for modern methods of contraception.

In addition, with regard to sexual and gender-based violence (SGBV), Ethiopia’s Demographic and Health Survey 2016 indicated that 23% of women between the ages of 15 and 49 have experienced physical violence and 10% have experienced sexual violence. Those affected by SGBV are less likely to utilize the services due to inaccessibility, existing social values and norms, existing gender norms, service provider bias, and lack of accurate information on available services. The COVID-19 pandemic has exacerbated the situation, increasing the prevalence of SGBV experienced by women and girls around the world. In Ethiopia, the number of confirmed rape and domestic violence cases has increased by approximately 25 to 30%.

As SGBV increases, there is an urgent need to strengthen health systems and expand SRH services, particularly to young people. This is critical for the health and development of young people in Ethiopia.

Reaching Young People Involves Engagement, Partnership, & Policy

To serve young people, we must meet them where they are and actively engage them in program design, planning, and execution. Our Rights-Based Approach for Enhancing SRHR in Ethiopia program, funded by the Swedish International Development Cooperation Agency, aims to work with young people enrolled in the public education system in grades 8 through 10 and those enrolled in night school programs. By working with young people enrolled in night school programs, we aim to reach one of the most vulnerable groups—young women—many of whom have migrated from rural areas of Ethiopia to serve as day laborers and live-in domestic workers. These young people are at an increased risk of physical and sexual exploitation, making SGBV prevention and services essential.

The program also works to engage with duty-bearers—those who are responsible for providing health and education services and those who make and implement SRHR and SGBV-related laws and policies as well as intimate partners and family members—to strengthen the enabling environment to support young people in demanding and exercising their SRHRs.

In order to engage young people in the program, we:

  • Collaborated with radio and TV stations to develop and disseminate SRHR and SGBV information, integrated with COVID-19 prevention messages, to the community in Addis Ababa
  • Created age-appropriate and educational video spots in local languages on SRHR and SGBV that were broadcasted on TV and disseminated over various social media platforms
  • Supported the Ministry of Women, Children, and Youth Affairs to launch a mentorship program, matching young women with mentors from different fields (the government, civil society, private sector, and academia) to foster the knowledge, skills, support, and guidance they need to make informed decisions
  • Engaged famous young TikTokers from the program intervention area to spread SRHR messages to continue education amid school closures due to the COVID-19 pandemic

To engage with duty-bearers the program has:

  • Trained healthcare professionals to identify and support SGBV survivors at four project-supported health facilities that will provide SGBV-related screening, counseling, treatment, and referral services all under one roof
  • Trained educators (biology teachers and school principals) on SRHR with a focus on gender-responsive facilitation skills and integrated COVID-19 precaution measures to support school re-opening efforts during the pandemic
  • Collaborated with the Addis Ababa Police Commission to develop and expand helpline services for SGBV response and to integrate SGBV-related support as part of the existing police line so that SGBV survivors have access to health and legal support from police officers, psychological counselors, lawyers, and through referrals to health facilities
  • Collaborated with a local civil society organization, Ethiopian Women Lawyers Association, to coordinate SRHR advocacy activities, facilitate referral pathways to safe houses, and provide free legal service to SGBV survivors
  • Trained members of an SGBV prevention committee at the sub-city level to support community engagement, provide information, track the number of SGBV incidents in their community, and provide referrals to relevant services (including legal, health, and psychological services), as well as to economic training and opportunities through the Ministry of Women, Children, and Youth Affairs
  • Utilized EngenderHealth’s GYSI training tool to help staff, healthcare providers, educators, and local government officials reflect, challenge, and change their personal gender-based, age-related, and sociocultural biases, perceptions, and stereotypes
  • Collaborated with the Ministry of Women, Children, and Youth Affairs and the Ministry of Health to organize a series of advocacy activities to raise awareness about SGBV and to facilitate action in support of women’s rights and gender equality during the 16 Days of Activism Against Gender-Based Violence, from November 25th (International Day Against Violence Against Women and Girls) to December 10th (International Human Rights Day)

By meeting young people where they are and meaningfully engaging them across program activities while also engaging with duty-bearers we are able to expand access to SRHR information and services for all young people—including the most hard-to-reach young people.

Toward a Gender-Equal World Where ALL People Achieve Their SRHR

To ensure that every Ethiopian has a fair and just opportunity to live their healthiest life possible, we must reach out to those who are often left behind when it comes to SRHR—young people.

Are you a young person? We’d love to hear your experience of demanding or accessing your SRHR! Are you a duty-bearer? Share your thoughts with us on Twitter and tag @EngenderHealth.

Do you want to support a gender-equal future where ALL people can achieve their SRHR? Donate today to continue our work reaching out to hard-to-reach groups.