Asia needs to invest in youth's reproductive health

Investing in the youth's sexual and reproductive health is the key to stemming some of developing Asia 's major health challenges increasing HIV infections and maternal deaths. Representatives from the youth sector should also be allowed to participate in both crafting and implementation of policies involving sexual and reproductive health to ensure that they're responsive to the needs and interest of the young adults and adolescents in the region. This is the consensus among the over 3,000 participants in 7th Asia Pacific Conference on Reproductive and Sexual Health Rights ( APCRSHR). The biennial conference, which was convened by the Philippine NGO Council on Population Health and Welfare, Inc. (PNGOC), was held last week in Manila and gathered lawmakers, youth leaders, health providers and members of civil society from Asia and the Pacific. Angga Dwi Martha, youth advocate for the UN Population Fund in Indonesia, emphasized the need for "meaningful youth participation." In a speech he delivered at the conference, Martha said young people like him should be involved in decision-making that would affect their lives and that includes decisions on their sexual and reproductive health. Anzaira Roxas, program coordinator of the Family Planning Organization of the Philippines (FPOP), said that while the youth is touted as a valuable human resource, it's young people who are most likely to suffer from problems like sexually transmitted infections and unwanted pregnancy. Roxas said measures like expanding access to youth-friendly health services and increasing youth participation in policy making can help in improving the youth's sexual and reproductive health. Such calls made by youth leaders themselves is crucial, given that the conference was held at a time that policy makers in the region have to examine their health-related commitments to Millennium Development Goals (MDGs). With less than a year to fulfill these goals, most countries are still off track when it comes to achieving the targets reducing maternal deaths and HIV infections. The UNDP said in its 2013 Global MDG Report that only Cambodia and Fiji with relatively low and concentrated epidemics achieved universal access to treatment for HIV/AIDS. With regards to maternal health, only five countries (Bhutan, Iran, Maldives, Nepal and Vietnam) have achieved the target to reduce maternal mortality rate while five other countries ( Bangladesh, Cambodia, China, Laos, and Timor-Leste) are likely to meet the target by 2015. In both cases it's the young people, those aged between 15 and 24, who are most likely to contract sexually transmitted infections (STIs) and HIV, get into unwanted pregnancy and die from complications arising from unsafe abortions. The World Health Organization said in South Asia and some parts of Southeast Asia, maternal causes of death (haemorrhage, sepsis, abortion complications) account for a high proportion of deaths among young women. There are about 1.27 million youth living with HIV in the region, with India, Nepal, Myanmar and Indonesia having the highest numbers of youth infected with HIV. STIs prevalence is also high. In Bangladesh, the youth accounts for more than half of the patients who sought treatment in hospitals and health centers, while in Thailand, STI cases among students is increasing. The WHO attributed this to several reasons including the existence of laws and policies that are indifferent to the sexual and reproductive health needs of adolescents. Young people, especially those who are considered legally minors, are precluded from buying condoms and contraceptives and/ or availing of counseling, testing and abortion services without the consent of adults. This was compounded by the lack of information on STI prevention, lack of funding and public services, and the biased and judgmental attitudes of health care providers which prevent them from effectively and sensitively dealing with adolescent clients. And yet despite these challenges, there's proof that youth participation has indeed led to some success in curbing sexually risky behavior and providing services that are affordable, appropriate and non discrimination. This was evident in the reports presenrted by youth leaders. Ngaire Jasmine Utanga, youth volunteer at the Cook Islands Family Welfare Association (CIFWA) and one of the renown youth leaders in the Oceania region, stresses the importance of outreach programs in encouraging youth participation and promotion of sexual and reproductive health. "It's the only way for young people to know more about our ( CIFWA's) programs, for them to enjoy being a young person while learning more about sex and reproductive health issues," Utanga said. Utanga reported that CIFWA has already made several inroads in improving the youth's sexual and reproductive health in her country. These include training peer educators on sexual health and working with health and education officials to include education in sexuality in the academic curriculum. In the Philippines, where reproductive health is still a hot button issue, organizations like the FPOP managed to educate the youth about sexuality and reproductive rights According to FPOP's Roxas, who is the organization's focal person on peer education, this was done through establishment of clinics for young people, conducting comprehensive sexuality education (CSE) and youth organizing. In Nepal, Shambhavi Poudel, youth volunteer for the Family Planning Association, reported that teaching CSE in schools led to lower maternal mortality rate. Despite these successes, youth leaders acknowledged the challenges remain. FPOP's Roxas recommended more supportive environment for young people and to this end suggested that a research must be done to address important knowledge gaps. CIFWA's Utanga, meanwhile suggested the need to provide youth friendly services and train more peer educators on CSE.