Engaging Third Party Service Providers

Lack of Youth Friendly Centres

"This gives us a challenge because when we provide girls with SRHR information and they want to make informed decisions for example, they also want to access health services. Mostly they meet with service providers who are blocked by culture and they ask them judgemental questions or sometimes deny them the services." Sadili Oval Sports Academy, Kenya

Adolescent girls often have questions, concerns or medical/psychological needs that they might not want to share with their parents, or that their sport programme is not necessarily equipped to answer or address. There are many people who can act as counsellors or advisors to youth: health providers, teachers, religious leaders, community leaders, school principals, and relatives. Throughout the programme, it is important to stress that participants should contact you or other adults whom they trust to discuss problems or concerns related to SRHR that may arise. If the problem or concern requires outside expertise, coaches and programme staff should mention existing services in the area that deal with the issue or problem, and guide participants through the process of accessing those services. This could be counselling, clinical health services or legal services.

Inadequate Service Providers
Simply referring adolescent girls to the correct service is half the battle. One reason why providers of SRHR services exercise so much power is that their clients, in particular adolescent girls, often feel embarrassed, anxious, or socially vulnerable. Just to reach a facility offering contraceptives, abortion care, or STI treatment, adolescent girls frequently have had to overcome a number of psychosocial and financial hurdles.

Many programme partners have heard rumours about or actual accounts of inconsiderate or humiliating treatment by providers at a facility. Sexual and reproductive health services often require people to disrobe and have their genitalia or vagina scrutinised, which can cause acute shame if privacy is not ensured or if the provider is of the opposite sex.133 Others may be seeking services secretly in the face of spousal, mother-in-law, or parental disapproval or opposition: if they are found out, they could suffer serious consequences. It may take considerable courage for people to surmount these fears and ‘risk’ obtaining services.134

While adolescent girls within sport programmes may be exhibiting resilience and courage by seeking SRHR services, they may still experience considerable apprehension which could be exacerbated or ameliorated by providers. If providers do not respect their privacy or confidentiality, adolescent girls could be ridiculed, beaten or even ostracised. Those who are more socially marginalised, such as the unmarried or poor, or those with disabilities, are even more susceptible to whatever might transpire at a clinic or health centre.135 Their reduced social standing makes them more easily humiliated. Many may have struggled to secure enough money for transport or consultation fees. For those who lack resources to travel elsewhere, providers’ practices towards them could dissuade them from acquiring services in the future, which could have consequences on their own health and well-being.

Adolescent girl-friendly SRHR service providers should:

  • Be specially trained in adolescent health issues, including SRHR.
  • Show respect for adolescent girls.
  • Consider the best interests of adolescent girls and take into account their evolving capacity.
  • Ensure privacy and confidentiality.
  • Have separate, adequate space or special times set aside for consultations with adolescent girls.
  • Be in an easy-to-reach location and be open at convenient times.
  • Be free of charge or affordable (context dependent).

Prior to referring girls to SRHR service providers, it is a good idea for programme staff to visit and meet the staff. Some partners take group trips to familiarise girls with routes, check-in procedures and meet staff. In addition, sport programmes can provide “buddies” such as coaches or facilitators who accompany the adolescent girls and access the services together, providing emotional support.