Youth Friendly Clinics is the solution

Fatma Elzahraa GeelNational Population Council

June 2014

Presentation Outlines

• Why do we need YFCs in Egypt?• Are YFCs Covering Egypt• Objectives • Methodology• Previous Studies• What have we found?• Implications• Recommendations

Why do we need YFCs in Egypt?• Youth constitute one fifth of the population

( Almost 16.9 million)• Youth seek a range of reproductive health

information and services• Adults and communities are generally not

equipped to respond to young people’s needs• YFCs provide comprehensive services and

counseling• Great majority of YFCs’ clients were satisfied with

information and services they received and were willing to come back to the clinics.

Are YFCs Covering Egypt

• MOHP has 9 Clinics scattered all over 6 governorates (Cairo,

Qalubia, Menoufia, Behera, Sohag, and Aswan).

• EFPA has 16 YFCs scattered all over 10 governorates (Ismailia,

Dakahlia, Qualubia , Menoufia, Behera, Kafr el sheikh,

Matrouh, Aswan, Menya, and BeniSuef).

• Less than half of Governorates are covered by YFCs( 11 out of

26 governorate).

Objectives

1- Identify the youth RH needs

2-Clarify the source of information

3 -Specify the role of YFCs .

4 -Explain the main obstacles that prevent youth to use the services.

5 -Determine the actions required.

Methodology

• Eight in-depth interviews with YFCs services providers

• FGDs with 84 young people and 80 with parents

• Exit interview with 140 youth clients (64 males and 76

females).

• All the interviews were conducted during June-August, 2010 at

YFC premises in 3 governorates(Ismailia, Suez, and Behera)

• Secondary analysis of Young People Survey data, 2009

Previous Studies• FHI in October and November 2007• Several gaps exist that need to be bridged to ensure that

YFCs become effective• Needs for accurate and simple RH information through an

attractive approach• Service providers and peers should be well trained to

communicate, reach out for youth of all segments and present simple

• More services and medical specialties together with upgrading the quality of delivered services will improve utilization.

Previous Studies

• FHI and UNFPA in March 2009• There is still a long way to go to meet the SRH needs of youth • The non-use of existing services is might due to that young

people face many barriers to use sexual and reproductive health services, for example culture and norms restrict young people’s access to affordable services and correct information, or they may feel embarrassed at being seen at clinics or, simply, they do not have information that such services exist.

• Sometimes, the negative attitudes of the service providers limit young people’s access to SRH services.

What have we found?

Both of them Seek the information

“Both young man and woman seek sexual information from different sources”. A young

woman“

Young people need RH information

YOUNG MALE(%) YOUNG FEMALE(%)

36 46 Puberty and physiological change

21 29 Marriage

4 9 Childbirth

9 5 STIs and sexual weakness

4 2 Psychological issues

26 9 Risky behaviors and others

100 100 Totals

Young man were worried about the possibility of problems with their genitals

and masturbation,

“Sexual weakness is my main worry, because if a person unable to practice sex that might lead to divorce”. A young man

From whom do they get the information?

1- Three out of Five females got information from

family and almost one out of two males got it

from peers

2- Almost half of the young people found this

information inadequate

Parents and their sons find it difficult to talk about these issues

“ It is very difficult to discuss such issues with family, what can you say?. We just advise

him to get married. Not only parents embarrassed but also young people who feel

shy about talking, whenever I want to discuss anything with my son, he says oh

mother don’t talk about that.”

An uneducated mother.

“Oh sure there is a lot of information required for me and for my father who is 50 years

and does not know”

Educated young male.

“My married friend sometimes provides information about marriage that makes

me

scared…I can’t discuss everything with friends. If they are educated it will be

better”

An uneducated female.

Sometimes friends might cause a problem...they might train each other how to

smoke...young males are worse than young females…A mother can guide her

daughter but for the sons they are fully alone”

An educated female .

Friends sometimes can’t be supportive

“students want to know some information about how to make

‘Gosl’(الغسل ) or showering after having sex, but the religion

teachers do not provide it. Some students don’t even know

how to act in case of having Masturbation ”

A young educated male.

“Teachers used to not discuss such issues with students.

A Young educated female.

Teachers may not provide enough information

How did the community perceive the YFC?

• It was just a Family Planning

clinic.

• However, regardless of the

names, they were satisfied with

the services provided in

the clinic.

Do the community know about YFCs ?

“This is not a Youth Friendly Clinic. This is a Family Planning

Clinic…I have been working close to it for a long time and I

don’t know what it is…the fourth Channel should provide a

program about it, or a car with a microphone should move

around to tell about it and its activities”

An educated father

YFCs can provide clear accurate information

“Having such a clinic is useful in order to provide clear,

accurate information without interference from parents.

My older daughter got married but her husband didn’t know

how to practice sex for 15 days…there should be a raising

awareness for males and females”

An educated mother

Are YFCs Clients Satisfied?

• 80% were satisfied with the hygiene• 74% were described their discussion with

services providers as good• 80% described both privacy and the treatment

inside the clinic as good, although there were slightly variation by location

• 92% considered the cost was reasonable• Overall 93% of clients said they would revisit

the clinic.

Obstacles Affecting Accessibility of YFC Services: Services providers point of view

1. RH issues still unacceptable

2. Misconceptions that lead people to believe the discussion of RH issues is

improper.

3. YF clinics have a hidden agenda and play a negative role in the community .

4. Limitations on the mobility of females to either attend conferences or visit

YFCs.

5. Males feel that they have sufficient information which makes them

unwilling to pursue more sources.

Obstacles Affecting Accessibility of YFC Services: Community point of view

• Lack of information about YFCs.

• Inaccessibility to the clinics.

• Services are under the umbrella

of family planning clinics

• Lack of privacy.

• SRH issues sensitivity

Implications

• Lack of addressing the SRH needs of the youth with lack of community support may expose them to seek information from non trusted sources.

• Consequently, this may lead to risky behaviors.• Lack of knowledge about YFCs is considered as

a lost opportunity to address the youth SRH needs.

Recommendations

• Revisit the role of YFCs to provide premarital care or examinations

• Encourage young people to participate in reformulate the role of YFCs.

• YFCs can conduct outreach activities at schools and sporting clubs

• Build the capacity of existing youth centers to provide youth-friendly services through

collaboration between MOHP and MOYS

• Develop advertisement and social marketing plan by collaborating between MOHP,

National Information Council(NIC) and National Population Council

Thank you