Protecting the Next Generation in Malawi: New Evidence on Adolescent Sexual and Reproductive

This 49-page report presents key findings from research that explored the sexual and reproductive health needs of Malawi’s youth. According to the publication, the information was gathered from young Malawians themselves through focus group discussions, in-depth interviews, and a nationally representative survey on sex, relationships, marriage, HIV/AIDS, and pregnancy, among young women and men aged 12–19. The research is part of a larger project, conducted in Burkina Faso, Ghana, Malawi, and Uganda, titled "Protecting the Next Generation: Understanding HIV Risk Among Youth". The report proposes that despite widespread challenges, there is cause for optimism. It states that adolescents want to learn more about sexual and reproductive health matters, and many have already adopted protective sexual behaviours.

Key research findings included the following:

• For many, adolescence marks the onset of sexual activity and its concomitant health risks.
• Young people get sexual and reproductive health information from many sources. More young people (71%) receive information on sexual and reproductive health from the media than from any other source, and the radio is the most cited form of mass media. Young people prefer health care providers over any other source for information on sexual and reproductive health. Yet the proportion who receive information from health care providers (57%) is lower than the proportion who say they prefer them as a source (66%).
• Young people’s knowledge is broad but not deep. For example, more than 90% of young people are aware of HIV/AIDS. However only 51% of females and 65% of males know that abstinence, being faithful, and using a condom are three ways to avoid HIV infection. Young people hold misperceptions about pregnancy and condoms. For example, among 12–19 year-olds, 44% of females and 32% of males believe that a condom can be used more than once.
• Outreach efforts must be tailored to the diverse needs of young people. Females and rural youth tend to receive less education, and thus less school-based sex education, than their male and urban counterparts do. Rural youth are less likely than their urban peers to have obtained information on contraception from a reliable source.

The report states that action is needed on many fronts to meet the sexual and reproductive health needs of adolescents. It suggests the following:

• It is vital that accurate information on sexual and reproductive health be made available to all youth. Comprehensive school-based sex education taught by trained educators in all schools should be a top priority.
• Community-based and mass media education campaigns should provide accurate information and dispel myths about pregnancy and HIV. Such efforts should be designed for disadvantaged and hard-to-reach youth.
• To make sure sexual and reproductive health services are accessible and inviting to adolescents, service providers should be trained to offer youth-friendly care and information. Young people should also be informed about where they can obtain services, including HIV testing services.
• Stakeholders should address social and cultural barriers that increase adolescents’ vulnerability to sexual risk by addressing stigma surrounding female sexuality, discouraging early marriage, and encouraging responsible behaviours, especially among males.
• The Government of Malawi, in conjunction with the international donor community, should provide sufficient funding to fully implement its national programmes and policies that support adolescent sexual and reproductive health.

The report concludes that evidence points to the need to design and implement comprehensive, appropriately designed prevention strategies that will fit young people’s diverse circumstances and experiences.