The struggle of young people with the access to health services seem to be not finished yet, especially in terms of sexual and reproductive health. However, having access to such services are so vital in meeting youth’s needs regarding their sex life and their capability to reproduce. Further, having access to good and adequate health services that would prevent HIV or any sexually transmitted infections (STIs) and improve sexual and reproductive health remain a fundamental right for young people.

Around the world, millions of adolescents either boys or girls face barriers to maintain their sexual and reproductive health due to many factors such as the lack in the access to essential information and services as well as safe, effective and affordable contraception methods. In fact, these are mainly seen among girls who are increasingly at high risk of being coerced into unwanted sex or marriage resulting in early and unintended pregnancies, unsafe abortions, STIs, unsure childbirth and stillbirth. Adolescent boys are apparently at risk as well – both young boys and girls are vulnerable to STIs including HIV and appear to be disproportionately affected by HIV (UNFPA).

Understanding the obstacles preventing young people from getting access to good healthcare services so as to accurately solve them
These inadequacies in the access to health services among young people are mostly present in developing countries, where reproductive health problems are a leading cause to ill health and death for women and girls of childbearing age according to the UNFPA. A team of teacher-researchers and students from the University of Antananarivo conducted a study on sexual and reproductive health among young key populations in Southern Africa. The study consisted in assessing cases of African adolescents struggling with the access to healthcare services and the factors increasing this inaccessibility. For the case of Malagasy adolescents who have been surveyed, only 38 percent of both sexes have acknowledged that they already reached out to a healthcare provider to tackle issues on sexual and reproductive health. It is important to note that girls are slightly more numerous than their male counterparts. In fact, this low percentage is due to several factors which include the persistence of the taboo around sexuality. Affordability is one of the main obstacles for young adolescents upon the access to care services. Difficulty of access to contraception for minors is seen mostly in public health sectors, compelling youngsters to come with parents, and most importantly the failure of these public health sectors in providing good quality healthcare, which spurs young people to go to private health centers.

Nevertheless, despite such obstacles, issues on the access to sexual and reproductive health services for young people have been already addressed bymany international bodies. These entities strongly work on how they could help in supporting adolescents’ health and rights by delivering supportive health programs; such as the UNFPA who works with ministries, NGOs and other partners to advocate for and support the efficient delivery of a youth-friendly healthcare package of services which include universal access to accurate sexual and reproductive health information, a scope of safe and affordable contraceptive methods, special and quality care for all pregnant women and girls, counseling and the prevention andmanagement of STIs. Another organization which is also highly committed in promoting quality health services and products in more than 45 countries is PSI; and Madagascar is among these countries which have benefited from PSI’s healthcare programs. In fact, PSI Madagascar already works with the Malagasy government in the purpose to integrate innovative sexual and reproductive health programs into private networks and public facilities to reach rural and remote areas with mobile clinic services. At the same time, PSI Madagascar also focuses on prevention activities to reduce STI’s like HIV by expanding facility and community-based HIV prevention, testing, treatment, and care services available to all Malagasy young people dispersed in the 22 regions of Madagascar, mostly known as “key populations”.

Getting informed about the existence of these programs would be of great help for young people in improving their sexual and reproductive health and in being empowered by these ones.

Sources: UNFPA / PSI / Professor Jane Freedman, et al. « Santé sexuelle et reproductive chez les jeunes « populations clés » à Madagascar ».HEARD Madagascar research report 2020.