Celebrating Diana – a true champion of SRHR/HIV integration

By Georgina Caswell

Georgina

Georgina Caswell, Regional Programme Advisor, Africa on the inspirational work of family planning specialists who are adapting their services to reach young people who have the least access to them.

I remember the very first workshop we held with programme managers under the Link Up project in Uganda. I was so nervous. We were about to embark on a big, complex project. We were asking family planning and HIV providers who were used to working on their own specific health issues to find a way to work together in order to provide integrated sexual and reproductive health and rights (SRHR) and HIV services.

We were also focusing these services on young people from key populations who have the least access to services, specifically, young people who sell sex, young men who have sex with men, young people living with HIV and other vulnerable young people. Given strong public opinion and the political developments about sex workers and LGBT people in Uganda at that time, I knew we were going to have some tricky conversations at the workshop. What could I say? What was off limits? How would people respond?

I’ll never forget meeting Diana (see photo below) on the first day of the workshop. She introduced herself as Marie Stopes International Uganda’s project manager for Link Up. Besides her killer heels, which are hard to miss every time you see Diana, she was full of questions. Nothing was off limits. She wanted to know what exactly we meant by ‘integration’, who exactly we meant by ‘young key populations’, how we would work together and when we were going to get started. This was the beginning of Diana’s Link Up journey.

Diana is not new to, or shy about, controversial issues. After all, she works for Marie Stopes, which over the years has been bold about providing post-abortion care services, a sensitive topic in itself. Perhaps it was this experience of providing much-needed services to young women that facilitated Diana’s transition to working with young people who are most marginalised and excluded in society.

Diana visited the networks and organisations of key populations. She listened to what they had to say about their experiences; of feeling judged and being treated badly in health facilities, of not making it to health facilities because of the opening hours or distance to them and of wanting to access all the services in one place, in one go, rather than spending a lot of time visiting different sites. Diana asked the youth and key population partners what they would want to do differently; and then she championed and supported them to implement these ideas together.

They held community dialogues to further learning and understanding around a range of SRHR issues; organised fun out-of-hours activities for young people who sell sex during clinic opening times; conducted a structured programme of clinical outreach to brothels and slums; developed a vibrant and engaging health promotion campaign called ‘stay on top of your game’; and supported youth camps and other youth-led initiatives, including the Y+ beauty pageant and street art.

<p>Diane Amanyire, Head of Youth and Key Populations at Marie Stopes International Uganda, facilitating a health awareness session.</p>

Diane Amanyire, Head of Youth and Key Populations at Marie Stopes International Uganda, facilitating a health awareness session.

What is special about Diana is not only what she is doing to respond to the needs and ideas of young people but how she approaches the work she does, which we can all learn from:

  • Consulting regularly with young people on their experiences, their priorities and ideas to continuously improve services and being open to and receptive of their suggestions;
  • Promoting the leadership of young people by giving them jobs, with clear job descriptions and showing we value their expertise by paying them;
  • Providing training opportunities for healthcare providers to meet and develop their  knowledge and skills so they can provide HIV testing and counselling and STI diagnosis and treatment services, in addition to family planning;
  • Mentoring health providers by spending time with them, creating a space where they feel comfortable to share the challenges they face in their work as they take on new skills and work with young people who have specific experiences and needs;
  • Trying new things with young people by helping them develop their project ideas, encouraging them, letting them lead and supporting them from behind;
  • Looking out for innovative project ideas in other countries and going on learning visits and courses that are beyond our comfort zone (Diana, for example, took part in a training led by the Alliance and Health4Men on how to provide competent care to men who have sex with men); and
  • Constantly interrogating ourselves and our own perspectives and feelings about the work we are doing, why we are doing it and how we are doing it so we ensure we are empowering young people – and not further stigmatising and alienating them - through the language we use, the questions we ask them and the judgements we make.

At this time of the year many of us reflect on change, learning and new possibilities. As we begin 2016, I would like to celebrate Diana and all the Diana’s in the world, who are striving to provide young people with quality and comprehensive SRHR and HIV services, embracing the diversity of young people, pushing the limits in creative programming with young people and are challenging themselves and others to listen to young people and to reflect on how to think and respond differently in the work we do everyday.

Photo: Diana Amanyire, Head of Youth and Key Populations at Marie Stopes International Uganda, who will be attending the International Family Planning Conference in Nusa Dua, Indonesia, 25-28 January 2016.