Reminiscing time from my mid-adolescence; once I had a vaginal infection and went to a gynecological department of a government-run hospital near my house. I was very nervous in the first place because sexual health and reproductive health issues of young people is usually surveilled and tabooed. I mustered all my courage and visited the hospital. When I visited the gynecological department, there were women patients visiting for antenatal and postnatal care. When it was my turn, the doctor threw in a hostile and judgmental look. Without a proper conversation followed by a harsh tone, the service provider directly asked me whether I was pregnant. The question further made me uncomfortable and I immediately told her my problem. She was very angry with me for wearing tight jeans and scolded me. She asked me to come later wearing loose pants as she will have to see the infection. With such attitude by the doctor, I left the hospital untreated and went to some private clinic instead.
In relation to my bad experience with the SRH service for youths in Nepal; we can imagine the situation of young women and adolescents in the rural and remote parts of Nepal.
Is it due to minimum participation and leadership of young people in developing, implementing and monitoring policies and service deliveries relevant to their health?
Nepal including other south Asian countries is in the phase of demographic transition where we have been observing a maximum population of young people in the history. Hence, it is the time we invest in young people, health, and well-being especially around sexuality and get them actively involved in policy making and leadership activities. If we fail to do so at this crucial time, we will have to regret in the future for sure. We often address youths as the future, but I strongly believe that youths are not only the futures but are also the change makers of the present time. If we invest in young people and their health, including stigma-free SRH services at the present time, then only we can imagine the healthy, sensitized and empowered future who will create the same society in future.
Young people are the one who are mostly affected by the issues related to SRH. Especially, the SRH need is higher in adolescent girls and young women. Hence, investments should be allocated accordingly. The current, as well as future service providers, should be well trained. Similarly, the policymakers should also remember that youths are not a homogenous population, they are the population with diversity and their needs are also different. The SRH services should also address the intersectionality within youths. The attitude of service providers should be stigma-free; in addition, other factors of the service should also be stigma-free such as infrastructures, information access and so on.
In order to achieve the dreams that we collectively aspire i.e. stigma-free SRH services for youths, we need the contribution of all individuals and collectives. Youth participation in health system should not be tokenized. Instead, meaningful youth participation should be promoted. The true leadership capacity of young people should be recognized and the platform for leadership should be provided accordingly. Intergenerational mentorship should be promoted for the meaningful youth participation in developing, implementing and monitoring policies and service deliveries relevant to their SRH. The youths of today also need to prepare the next generation for the leadership position.
We also need to hit the root problem and work collectively to challenge and question the hierarchical social structure that is promoting the stigma and denial of SRH services for youths. Similarly, the stigma-free SRH services should be perceived as a fundamental human right by all including health service providers, policymakers, administrations and other concerned individuals and institutions.
The stigma-free SRH service should be provided without any discrimination on the basis of the class, caste, gender identity, sexual orientation, status of disability, marital status, geography, literacy status, religious background or any other ground. In order to achieve the SGDs, the investment in young people, especially young women is very important and their meaningful participation and leadership in developing, implementing and monitoring policies and service deliveries relevant to their SRH is extremely crucial.
Pushpa Joshi, Young Feminist Activism Team Member, LOOM