Evidence, Engagement, Access and Education – The Healthcare Workforce Speaks Out for Better Adolescent and Young Adult SRHR Provision in the COVID-19 Pandemic

It seems fitting, on International Youth Day 2020, to show solidarity with organisations that represent the global adolescent health workforce to raise awareness of hidden challenges for youth in the midst of an ongoing crisis. The International Association of Adolescent Health (IAAH) is proud to join with Family Planning (FP2020) in launching this statement on Adolescent Sexual and Reproductive Health and Rights (SRHR) during the COVID-19 pandemic.

The past few months have seen the imposition of laws and regulations that severely restrict the freedoms of the general population of countries around the world. We have been asked to reduce our social interactions so that we can limit the transmission of the SARS-2-CoV virus. Many commentators have acknowledged the disproportionate impact that this has had on adolescents and young adults (AYA). This is a unique and fleeting period of life, with many significant milestones and some important tasks to accomplish as the foundation for healthy adulthood.

AYA sexuality is a subject that is difficult to approach – in the home, in the medical setting and in educational settings. There are complex social and cultural traditions worldwide that forbid unmarried AYA from acting upon their sexual desires. It seems easier for adults not to think that AYA engage in any kind of sexual activity, so that they do not have to confront – or talk about – the reality of the developmental changes that manifest in the urge to form and consummate relationships of whichever sexual orientation each AYA claims as their own.

During the first lockdowns of this pandemic – and no doubt there will be more – AYA have been at risk of more than the loss of their social networks and activities outside the home. Dependent on parents or carers for all their resources, they have been subject to the power of older members of the household. Some have talked of the ‘shadow of the pandemic’ – increasing domestic violence and abuse against women and girls in locked down households. There will also be the continuance of AYA relationships outside the home, permitted or otherwise. The dire economic situation may lead to AYA being forced into transactional sex to bring food and resources into the home.

Read the statement here.

• Ensure COVID-19 guidance is informed by research evidence about adolescent health and development and SRHR
• Facilitate meaningful engagement of young people in the design, development, implementation, and evaluation of COVID-19 guidance
• Promote adolescents’ access to quality information, products, and services that address sexuality and reproductive health
• Educate parents and community stakeholders about how best to support adolescent SRHR as the pandemic continues to evolve

Ignoring these challenges is not an option. Our statement has four key requests that we can summarise as ‘evidence, engagement, access and education’ (see above). The theme of International Youth Day 2020 is ‘Youth engagement for global action’. This statement requests platforms for young people to articulate their needs and preference in COVID-19 guidance, for them to contribute to the design and delivery of programs to address those needs, and to hold adults to account to meeting those needs. The creativity and pragmatism of AYA can be harnessed to find innovative solutions to long-time problems considered insurmountable.

Recognising that it has always been difficult for AYA to receive accessible, confidential and youth-friendly SRHR services, the healthcare workforce can help to dispel the public’s magical thinking about AYA abstinence, help parents confront the reality of sexual activity as part of AYA life, and take action to minimise harm. Advocacy must fight the reversal of hard-won gains in SRHR progress. Contraceptive methods must be widely available, which might lead to some innovation in task sharing so that pharmacists and community health workers can play a full role in ensuring access.

COVID-19 has exacerbated existing challenges to AYA sexual and reproductive health and rights. This statement warns that ‘At times of crisis… global commitments to adolescents risk being forgotten’. We join together on International Youth Day to commit the multidisciplinary AYA healthcare workforce to making these challenges visible, continuing strong advocacy, and to creating meaningful partnerships with adolescents and young adults to make positive change that should ‘build back better’ for global SRHR.

The statement is also available in Spanish and French.

CAH director, Professor Susan Sawyer is the current president of IAAH. With her permission this article has been posted here.