Youth Groups in Zambia Clinics Prove that Knowledge is Power

Young people in remote communities in Zambia can have limited access to reliable information about sex, drugs, and alcohol, enabling regrettable decisions. The USAID DISCOVER-Health project has stepped in to provide comprehensive sexual and reproductive health education, emotional support, and information on HIV prevention to young people in areas around its supported health facilities. The project introduced ‘youth-friendly corners’ in health facilities for young people to have somewhere safe to meet, exchange experiences, and get the information they need to make healthy choices.

The project first rolled out this initiative in 2017. There are now 50 active youth-friendly corners across 89 project sites in Zambia. Key populations, such as young men and women, need support as Zambia edges closer to HIV epidemic control. Providing a physical space for young people in their local communities has been incredibly successful in helping them access health services.

The project’s work with the DREAMS program, which focuses on adolescent girls and young women (AGYW), is working well: in fiscal year 2021 (FY21), it initiated 17,638 AGYW on pre-exposure prophylactic (PrEP) treatment. The project is ramping up its efforts to find, test, and link young men to HIV prevention and treatment. In FY21, it tested 39,421 young men between the ages of 18–34 for HIV. Of the 2,979 (8%) who tested positive, 2,782 (7%) were linked to treatment. The youth-friendly spaces facilitated these successes.

The Kantolomba Health Post

Kantolomba Health Post is located in a high-density community with high unemployment near the city of Ndola. Families who live there often prioritize food and housing needs over health care. Yvonne Banda is a reproductive, maternal, newborn, child, and adolescent health specialist at the health post, where she also oversees the youth-friendly corner.

Yvonne’s team encouraged young people at the health post to organize themselves.

“We found they were maybe not so open to adults receiving them at the clinic,” she said. “Whereas, if they found their fellow youths, they were more likely to open up and be honest about what it is they were suffering from or dealing with.”

Francis is 29 years old and an executive member of the Kantolomba youth-friendly corner group. “I joined this group because I wanted to commit suicide. Back in 2013, I got a girl pregnant. I felt so negative and like I had nothing to contribute. It was a really hard time. I had no friends really and my family isolated me. I was very lonely and I wasn’t thinking straight.”

In early 2018, Francis reconnected with a friend who was a member of this youth group. “He told me my suicidal thinking wasn’t right and he got me to sit down and plan for the future. I didn’t want anyone to know about my secret. But slowly, I felt protected and safe coming here. I knew the information and support I was receiving would save my life.” Eventually Francis got a job and was able to support his son and complete his education.

From young people, for young people

The Kantolomba group meets weekly on Saturdays. There are about 100 members, ranging from 17 to 29 years old. They meet in smaller groups to discuss issues and topics that are particularly relevant and timely, such as developing self-confidence to making sexual health choices. Yvonne and the other providers at Kantolomba provide guidance and correct health information.

The group also conducts community outreach. Francis says, “We talk to other young people, we ask them about their challenges and try to find solutions. We’ve all faced challenges ourselves by what we’ve gone through, whether that’s about school, HIV, PrEP. I share my own experience and show how I managed to come out of a hard time.”

Like Yvonne, Francis believes the key to the group’s success is that it is run by the young people themselves. “We live in the community, so we know what’s happening on a day-to-day basis. We use music and dance, too! Once you give young people the information, they’re keen for it. The challenge was they didn’t know about these sexual health services or information before; a lack of knowledge was the issue.”

Bernadette is one of the young women reached by the group. She is 20 years old and has a 2-year-old son, Benson, whom she is raising alone. “I got pregnant in Grade 12. It was an unplanned pregnancy. I never finished my education. I really felt like my life had been cut short and I was so worried about my future. I had put in all this effort and now it had gone to waste. I spoke to my friends about how I was feeling. One of them had heard about the youth-friendly space here at the clinic and suggested I join.”

The group offered support and information at a time when Bernadette really needed it. “I’ve learned a lot. They’ve taught me how to look after myself and my child, and how to be a good mother. One of the best things I’ve learned though is about family planning, contraception, and not having another unplanned pregnancy.” Bernadette now counsels other young women. “I share what I’ve been through and the message that things can improve.”

Yvonne is proud of youth-friendly corner groups’ impact. “We are seeing more young clients coming to the clinic and accessing services, young women in particular. The youth-friendly corner really complements what we do at the clinic.”

I’ve seen some amazing changes, watching young people come from really tricky situations and now they’re advocates for change, boosted with information, like Francis and Bernadette.”