Young people’s choice and voice concerning sex and relationships: effects of the multicomponent Get Up Speak Out! Programme in Iganga, Uganda
Abstract Background Young people in Uganda face challenges in achieving their sexual and reproductive health and rights (SRHR), such as lack of information, limited access to services, teenage pregnancy and sexually transmitted infections. To address this, their empowerment – including their ability...
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| Format: | Article |
| Language: | English |
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BMC
2022-08-01
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| Series: | BMC Public Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12889-022-13919-x |
| _version_ | 1811281906785845248 |
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| author | Tasneem Kakal Christine Nalwadda Miranda van Reeuwijk Maaike van Veen Lincie Kusters Ophelia Chatterjee Charles Owekmeno Maryse Kok |
| author_facet | Tasneem Kakal Christine Nalwadda Miranda van Reeuwijk Maaike van Veen Lincie Kusters Ophelia Chatterjee Charles Owekmeno Maryse Kok |
| author_sort | Tasneem Kakal |
| collection | DOAJ |
| description | Abstract Background Young people in Uganda face challenges in achieving their sexual and reproductive health and rights (SRHR), such as lack of information, limited access to services, teenage pregnancy and sexually transmitted infections. To address this, their empowerment – including their ability to express themselves and make decisions, is a key strategy. This study assessed how young people’s voice and choice concerning sex and relationships changed over the period of 3 years of implementation of the Get Up Speak Out! programme. Methods Data were collected through a household survey with young people (15-24 years) and through focus group discussions, in-depth interviews and key informant interviews with youth and community stakeholders in 2017 for the baseline and 2020 for the end-line. Using the difference-in-difference technique and thematic analysis, changes in key outcomes were assessed over time between intervention and control area. Results There were limited changes over time in the intervention area, which did not differ from changes in the control area. Young people were able to express themselves and expand their decision-making space on sex and relationships, in particular if they were older, male and in a relationship. Young women negotiated their agency, often by engaging in transactional sex. However, youth were still restricted in their self-expression and their choices as speaking about sexuality was taboo, particularly with adults. This was influenced by the political and religious climate around SRHR in Uganda, which emphasised abstinence as the best option for young people to prevent SRHR-related problems. Conclusions Young people’s SRHR remains a challenge in Uganda in the context of a conservative political and religious environment that reinforces social and gender norms around youth and young women’s sexuality. The limited effect of the programme on increasing young people’s voice and choice concerning relationships in Uganda can be understood in the context of a ban on comprehensive sexuality education (CSE) and the COVID-19 pandemic. These structural and emerging contextual factors enforce the taboo around youth sexuality and hinder their access to SRHR information and services. Multi-component and targeted programmes are needed to influence changes at the structural, community and individual level. |
| first_indexed | 2024-04-13T01:43:15Z |
| format | Article |
| id | doaj.art-8748cbf327424af1a3af718b413b383a |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-04-13T01:43:15Z |
| publishDate | 2022-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-8748cbf327424af1a3af718b413b383a2022-12-22T03:08:08ZengBMCBMC Public Health1471-24582022-08-0122111310.1186/s12889-022-13919-xYoung people’s choice and voice concerning sex and relationships: effects of the multicomponent Get Up Speak Out! Programme in Iganga, UgandaTasneem Kakal0Christine Nalwadda1Miranda van Reeuwijk2Maaike van Veen3Lincie Kusters4Ophelia Chatterjee5Charles Owekmeno6Maryse Kok7KIT Royal Tropical InstituteMakerere UniversityRutgers WPFRutgers WPFKIT Royal Tropical InstituteKIT Royal Tropical InstituteSRHR AllianceKIT Royal Tropical InstituteAbstract Background Young people in Uganda face challenges in achieving their sexual and reproductive health and rights (SRHR), such as lack of information, limited access to services, teenage pregnancy and sexually transmitted infections. To address this, their empowerment – including their ability to express themselves and make decisions, is a key strategy. This study assessed how young people’s voice and choice concerning sex and relationships changed over the period of 3 years of implementation of the Get Up Speak Out! programme. Methods Data were collected through a household survey with young people (15-24 years) and through focus group discussions, in-depth interviews and key informant interviews with youth and community stakeholders in 2017 for the baseline and 2020 for the end-line. Using the difference-in-difference technique and thematic analysis, changes in key outcomes were assessed over time between intervention and control area. Results There were limited changes over time in the intervention area, which did not differ from changes in the control area. Young people were able to express themselves and expand their decision-making space on sex and relationships, in particular if they were older, male and in a relationship. Young women negotiated their agency, often by engaging in transactional sex. However, youth were still restricted in their self-expression and their choices as speaking about sexuality was taboo, particularly with adults. This was influenced by the political and religious climate around SRHR in Uganda, which emphasised abstinence as the best option for young people to prevent SRHR-related problems. Conclusions Young people’s SRHR remains a challenge in Uganda in the context of a conservative political and religious environment that reinforces social and gender norms around youth and young women’s sexuality. The limited effect of the programme on increasing young people’s voice and choice concerning relationships in Uganda can be understood in the context of a ban on comprehensive sexuality education (CSE) and the COVID-19 pandemic. These structural and emerging contextual factors enforce the taboo around youth sexuality and hinder their access to SRHR information and services. Multi-component and targeted programmes are needed to influence changes at the structural, community and individual level.https://doi.org/10.1186/s12889-022-13919-xSexual and reproductive health and rightsAdolescentsYouthUgandaVoiceChoice |
| spellingShingle | Tasneem Kakal Christine Nalwadda Miranda van Reeuwijk Maaike van Veen Lincie Kusters Ophelia Chatterjee Charles Owekmeno Maryse Kok Young people’s choice and voice concerning sex and relationships: effects of the multicomponent Get Up Speak Out! Programme in Iganga, Uganda BMC Public Health Sexual and reproductive health and rights Adolescents Youth Uganda Voice Choice |
| title | Young people’s choice and voice concerning sex and relationships: effects of the multicomponent Get Up Speak Out! Programme in Iganga, Uganda |
| title_full | Young people’s choice and voice concerning sex and relationships: effects of the multicomponent Get Up Speak Out! Programme in Iganga, Uganda |
| title_fullStr | Young people’s choice and voice concerning sex and relationships: effects of the multicomponent Get Up Speak Out! Programme in Iganga, Uganda |
| title_full_unstemmed | Young people’s choice and voice concerning sex and relationships: effects of the multicomponent Get Up Speak Out! Programme in Iganga, Uganda |
| title_short | Young people’s choice and voice concerning sex and relationships: effects of the multicomponent Get Up Speak Out! Programme in Iganga, Uganda |
| title_sort | young people s choice and voice concerning sex and relationships effects of the multicomponent get up speak out programme in iganga uganda |
| topic | Sexual and reproductive health and rights Adolescents Youth Uganda Voice Choice |
| url | https://doi.org/10.1186/s12889-022-13919-x |
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