Catalyzing adolescent participation around HIV in Mozambique
Young people packed the conference space; an ‘electric current’ ran through the room. For the first time, adolescents from across Mozambique, including some living with HIV, had been provided with a platform to share their ideas on improving the HIV response for young people with their government and UN officials.
The consultation, which occurred in November 2015, was urgently needed. In Mozambique, an estimated 122,000 adolescents are living with HIV. Adolescent girls are four times more likely to be living with HIV than young men. Half of Mozambican girls are married before their 18th birthday.
The meeting was convened as part of the All In to end Adolescent AIDS (All In) initiative; a global platform launched by UNICEF and UNAIDS to drive better HIV/AIDS-related results for adolescents. All In promotes the use of evidence to support development of more effective strategies, policies, programmes and services for adolescents living with and affected by HIV. A strong focus is on engaging and mobilizing adolescents as leaders and agents of social change.
To kick off All In, institutions working on health in Mozambique – including the government, international organizations and civil society – conducted a rapid assessment to better understand how HIV affects adolescents. The results demonstrated that from the age of 15, girls are significantly more likely to contract HIV than boys of the same age. It also revealed a growing number of AIDS-related deaths among adolescents aged 10 - 19. After the assessment, the National AIDS Council, UNICEF and others organized opportunities for adolescent dialogue.
Twenty-eight adolescents from eleven provinces across the country gathered in Maputo for the intense debate.
Cecília Dimande is one of the young leaders who participated in the consultation as the Mistress of Ceremony. Cecília first became involved with All In when she was 18, but her contribution as a youth activist started much earlier.
When she was 10, Cecília joined Radio Mozambique as a radio announcer and producer for children’s programs. As part of her work, she traveled to orphanages in Mozambique and met many children whose parents had died of AIDS.
“When I saw how many children were in the orphanages, I knew I needed to continue doing something,” she said. At the All In consultation, Cecília was one of the older participants – and meeting so many young adolescent activists was inspiring.
“They traveled so far to discuss HIV issues, and they were so engaged and involved – they really understood what they were talking about. The adults were the shy ones in the back and the teenagers were in front. There was a power in the air,” said Cecília.
Mozambique’s National AIDS Committee worked to make sure that the young people involved felt in charge of the process. They fostered a safe space for adolescent participation including the establishment of a youth Steering Committee; selected young facilitators and relied on local organizations to choose participants.
During the meeting, adolescents and young people identified core issues and interventions for an improved national HIV response. Their recommendations included appropriate health information tailored for different age and key groups, increasing the coverage of adolescent and youth friendly services in government health units, counselling on alcohol and drugs, and improving the curriculum for teachers to provide high quality comprehensive sexuality education. They also shared personal stories, as well as perspectives from their peers back home, providing critical context to the numbers derived from the national assessment.
The consultation sent a clear message to government and partners: the participation of adolescents must be taken seriously in order to see progress on preventing HIV among adolescents. It has helped to spur the involvement of adolescents in different health spaces around the country, including as members of provincial HIV working groups, particularly during the implementation of the All In phase II in 2017.
In the context of the national programme on adolescent sexual reproductive health called Geração BIZ, the government along with UNFPA, UNICEF and other key partners, continues to engage over 125,000 adolescents and young people on sexual and reproductive health topics through the mobile phone platform U-Report (or SMS Biz, as it’s known locally). Through U-Report, adolescents can be polled for their opinions on topics like how to encourage condom use or make health services more youth friendly. Users can also direct questions about their health to one of 48 available peer counselors.
Mozambique is not the only country in Eastern and Southern Africa to mobilize adolescent participation around HIV as part of All In. Similar efforts are underway in Botswana, Kenya, Namibia, Swaziland, Tanzania and Zimbabwe to name a few.
For Cecília, now 20, participating in the adolescent consultation has expanded her horizons. Cecilia recently traveled to Geneva, Switzerland as part of her country’s delegation for the launch of the Global Coalition on HIV Prevention, where she represented the voices of young people in Mozambique. These kinds of linkages are exactly what All In hopes to facilitate through supporting meaningful youth participation.
Cecília says the consultation continues to motivate her to fight the stigma faced by young people living with HIV. “The way we treat people affects their health,” she said. “I want to do my part – whenever I have an opportunity to do something, I will.”