More than half of Ethiopia's population are young people under the age of 24. Credit: Sheikh Rajibul Islam/duckrabbit
Ethiopia -- where international advocates will open their biennial International Conference on Family Planning on Nov. 12 -- has succeeded in bringing down the unmet need for family planning from 36.6 percent of currently married women 15-49 in 2000 to 26.3 percent in 2011. But the unmet need is greatest among those aged 15 to 19. In that age range, almost one-third want contraception and cannot get it.
The great need of young people for integrated family planning, sexual and reproductive health (SRH) and HIV prevention services is not limited to Ethiopia, and is one of the great challenges facing conference participants. This is particularly true of youth from marginalized groups such as people living with HIV, sex workers, men who have sex with men, transgender people and people who inject drugs, who may be particularly vulnerable to sexually-transmitted infections, including HIV, and other reproductive health issues.
Consider these facts, provided by the International HIV/AIDS Alliance, an alliance of nationally based, independent civil society organizations committed to community action on AIDS:
• 1.2 billion people globally are between 10 and 19 years of age, and 88 percent of them live in developing countries.
• Girls aged 15-19 account for 11 percent of all births globally, many of which are unintended.
• Young people 15-24 account for 40 percent of new HIV infections and 5 million young people are living with HIV. Many of these youth also have family planning needs.
• Young people most affected by HIV often are the people with the least access to family planning services.
• Low contraceptive use and HIV transmission have been attributed to lack of knowledge, high costs, stigma and limited supplies and access to services, all issues that can be addressed by integrating family planning and HIV services.
What is family planning and HIV integration? One example is a family planning clinic that also provides HIV counseling and testing. Or an HIV counseling and testing center that provides family planning services. It means moving away from the segmented approaches that have prevailed in the recent past and there are multiple benefits to doing so:
• Integration can increase access to services by youth.
• Integration is cost-effective.
• Integration promotes dual protection from HIV and unintended pregnancy.
• Integration can reduce stigma, especially for young and marginalized populations.
Ethiopia is one of five countries where a partnership of international and national organizations spearheaded by the Alliance has started a program earlier this year called Link Up to reach more than 1 million young young people living with and most affected by HIV. In the three countries with generalized HIV epidemics -- Ethiopia, Uganda and Burundi -- Link Up will work to ensure that family planning is integrated into existing HIV services for young people, and vice versa.
And in Ghana, DKT International, Marie Stopes International and the Grameen Foundation have just launched a new youth brand called No-Yawa ("no problem" in the local language), that integrates services and information for SRH/HIV and family planning.
"Integration of these issues is a natural fit for young people because they don't separate these issues as they relate to their personal lives," said Christopher Purdy, executive vice president of DKT International. "They see these issues as part of their sexual lives and we have responded to this programmatically."
While conference participants will sit through innumerable presentations of scientific and research studies, they will also look at programs such as Link Up and No-Yawa as examples of projects currently being implemented that respond to the real needs of vulnerable young people, in Ethiopia, Ghana and elsewhere, in a targeted and efficient way.