Episode 3 – A Youth Takeover! Healthcare designed for the next generation

Note: This episode of the podcast contains discussions about sensitive topics, including mentions of suicide and sexual violence. Listener discretion is advised. If you or someone you know is in crisis, please seek help from a trusted professional or a helpline.

In Episode 3 of the HIV Reimagined podcast, we've handed the reins to a dynamic panel of young voices. Get ready for an engaging dialogue with young advocates around the world about making health care delivery better for adolescents and young people.

The episode is hosted by Stephanie Ndlovu, an actress and advocate from South Africa. In addition to acting in the show MTV Shuga, a series that aims to help young people navigate various health issues including sexual and reproductive health and rights, she is the co-Chair of MTV Staying Alive, an international initiative focused on behavioral change. 

She is joined in the studio by our panel of experts to discuss the challenges of mental health services for young people, the promise of peer support models and digital tools, and the critical role young people play in shaping effective health care policies and programs. 

Nicholas Kee is an advocate and technology expert serving on the U-Report Youth Council in Jamaica. Miriam El-Mahdi, joining us from Copenhagen, is a global health student interested in sustainability and digital health. Viet Minh Trinh is the Health Program Coordinator at Lighthouse Social Enterprise in Vietnam, and an advocate for young key populations and LGBTQ+ youth. Mutua Ndereva is an artist and activist from Kenya raising issues in his community through art. 

The impact of mental health on young people, especially during times of crisis like the COVID-19 pandemic, takes center stage in this episode. The pandemic exacerbated the social, economic, and psychological challenges faced by young populations. Viet Minh Trinh raises issues faced by LGBTQ+ youth in Vietnam who were increasingly isolated in vulnerable situations, and faced further stigma and discrimination during the pandemic. Mutua Ndereva highlights the devastating consequences of pandemic-related job loss among young people in an informal settlement in Nairobi. More people were facing mental health challenges at the same time that barriers to accessing health care services skyrocketed. Miriam El-Mahdi notes that many of these barriers for mental health care had already existed – rather than introducing new tools, including digital interventions, during a crisis, there is an urgent need to build up and sustain avenues for comprehensive mental health support for young people. 

They discuss the digital space as holding immense promise for improving health care services for young people, especially by providing another avenue to facilitate peer-to-peer interactions and implement proven models of peer support. Peer-led initiatives and programmes, such as those championed by Lighthouse and MTV Staying Alive, serve as a bridge between young people and the health services they need.

The discussants address the importance of including young people meaningfully in decision-making. For health care systems that are responsive to the needs of young people and especially for young key populations, those individuals must be at the center of programme planning and policy making. Young people should have a central role in designing health care services tailored to their needs – not just for HIV prevention and care but also for broader sexual and reproductive health services as well as mental health care and psychosocial support. Ultimately, improving the health and well-being of young people hinges on giving them governance spaces and compensation to represent their peers, advocate for their needs, and help shape systems.

Features

Vuyokazi Vuyolissa, peer educator from MTV Shuga

MTV Shuga is a series under the MTV Staying Alive Foundation that focuses on sexual and reproductive health, HIV, and other health priorities for young people. In addition to delivering critical health information through the drama series, the campaign supports peer education on the ground, training young people to be sexual health educators in their communities. Vuyokazi Vuyolissa works on a peer education program called Ukulungisa Ubuntu (Mending Humanity) in South Africa. Using videos featuring young individuals sharing their stories and perspectives, the peer educators create a safe space and facilitate open discussions with groups of young people in the community about gender-based violence and sexual health. For many participants, this is one of the first opportunities to express concerns, ask questions, and share their experiences related to sexual and reproductive health with a group of peers.

Jay Shapiro, founder of Usiku Games; Arnold Mwanjila, head writer at Usiku Games

Jay Shapiro is the founder of Usiku Games, a social impact game developer based in Kenya, and chairperson of the Pan Africa Gaming Group (PAGG). Usiku Games combines the evidence on peer support and behavior change with the power of technology and gamification. The games, as head writer Arnold Mwanjila explains, are not preachy or prescriptive but rather provide users with various elements within the games’ stories that reflect real-life behavior. These role-play games often include health-related behaviors and have potential to connect young people with critical prevention and treatment interventions. Notably, Usiku Games strives to center locally relevant stories and situations that are relatable to users in Africa. 

Nelma Passe, national volunteer for sexual and reproductive health at Voluntary Services Overseas (VSO International); translated by Kate Sutcliffe from VSO International

VSO International and Light for the World are the implementers of the EAGLE or ‘Empowering Adolescent Girls to Learn and Earn’ project in Mozambique. The project works with adolescent girls and young women who are out of school to achieve economic independence. As part of this project, Avert developed the Yaya app, a learning tool that aims to provide 3000 adolescent girls and young women with a user-friendly, self-directed set of action, orientated knowledge-based resources on life skills, sexual health, and relationships. 

National volunteer Nelma Passe discusses the process of co-creating the Yaya app and shares how the co-creation process made this new digital health intervention more acceptable to the community. Engaging adolescent girls and young women in the app’s development and design became an intervention in itself to boost their confidence and empower them to share knowledge about sexual and reproductive health. The co-creation process showed that many participants already knew of potential solutions to various challenges in the community but lacked confidence and external support. Her experiences highlight that to improve sexual and reproductive health outcomes, creating these spaces to engage the community as partners is as important as sharing health information. Learn more about the Yaya app and watch a demonstration.

As the speakers in this episode overwhelmingly emphasize, young people know what they need from health care systems. Their active involvement in the design and implementation of health care policies and programmes ensures that the services adequately meet those needs. The panelists remind us that we all have more to do to guarantee that young people's voices are heard and prioritized in order to build a more inclusive and compassionate health care system.

What should health care designed for young people by young people look like? Share your comments with the HIV Reimagined team at childrenandaids@unicef.org.