Dr. Adriane Martin Hilber,Dr. Sonja Merten,Karin de Graaf,Dr Ndayishimiye Juvénal
Survey report 2014
This study evaluates the baseline situation for the Dutch-funded programme ‘Making Sexual and Reproductive Health Work for the Next Generation’. The programme aims at improving young people’s sexual and reproductive health (SRH) in three central African countries: the Democratic Republic of the Congo (DRC) where the programme targets four health zones (Katana, MitiMurhesa, Idjiwi, Walungu) of the South Kivu Province; Rwanda in four districts (Gicumbi, Kirehe, Nyaruguru, Rusizi) in four provinces; and Burundi in six provinces (Bururi, Cankuzo, Karusi, Makamba, Rutana, and Ruyigi)
Who are the young people in Burundi?
The majority of young people surveyed were single and lived with their parent(s) or a relative.More than half of the respondents had some level of education, with 58% currently being in school, however, a large group of young people did not access any education at all (15% young women and 5% young men).
Very high proportions of young people visited a religious service at least once a week (90%), followed by community activities (33%) and youth centers (12%). Generally, young men participated more actively in sports activities (66%) compared to young women (37%).
Exposure to radio at least once a week was high (63%) and 56% of respondents declared owning a mobile phone. Access to the internet was rather low, however higher among young men (4%) compared to young women (1%)
What do young people know about sexuality?
Survey population groups
Young people: 15-24 years Adolescents: 15-19 years Youth: 20-24 years
About half of the surveyed young people (53%) had received sexuality education; and 32% accessed this information in the last 12 months. The main place where they received sexuality education was at school (91%) followed by health centres (8%).Despite having recently received sexuality education, sexuality knowledge was rather low and quite inconsistent.
Young people had particularly low knowledge on women’s fertility patterns. For example, about half of the young people reported that a woman cannot become pregnant the first time that she has sexual intercourse (56%); and 54% thought that birth control pills offer protection against sexual transmitted infections and HIV – both answers being incorrect. Generally young men had better knowledge scores (46%) compared to young women (28%)– measured by the ability to answer 6 out of 7 questions correctly.
Who is sexually active?
Among the young people, more women (32%) than men (24%) disclosed having had sexual intercourse, yet the median age of sexual debut for women was at 19.2 years and for men18.9 years. Among young single people, 11% reported having had sex, as compared to 46% of those in a relationship but not living together. The majority of youth (51%) reported to have had sexual intercourse as compared to adolescents (12%).
Who is using sexual and reproductive health services and where do they go?
More young women than men reported having previously used sexual and reproductive health services. The majority were youth who had accessed services within the last 12 months. Young people using services were also more likely to be married/living with a partner (74%), as compared to young people in a relationship but not living together (23%) or single (7%). In general, young people tend to access these services primarily in health centers (63%), followed by hospitals (19%).
Who are the young people with children?
Respondents with children were mainly found among youth (31%) and to a lesser extent among adolescents (2%). A majority of young people that were married and living together had children (72%). Of the female respondents who were pregnant or already had a child at the time of the survey, a high proportion stated that their last pregnancy was unplanned (45%).
Who is using contraceptive methods?
Knowledge of modern contraceptive methods is high amongst young people (97% of sexually active unmarried women and 99% of sexually active unmarried men could cite 5 methods of modern methods). Actual uptake of modern contraceptive methods among the same group is very low (17% for women and 12% from men). Yet, the potential future demand for modern contraceptive methods (i.e. young people who do not wish to get pregnant, and are not against the use of modern contraceptives) is high among sexually active young people with about half (46% women and 58% men) considered as potential future users of family planning methods, although they are currently non-users.
Who is experiencing physical and sexual violence?
More than a quarter of young people reported having experienced physical violence at least once since the age of 15, with a larger proportion among young men (32%) compared to young women (19%). Perpetrators of physical violence were mainly family members and teachers.
Over a quarter of young female respondents (26%) and 9% of male respondents reported being a victim of sexual violence. Perpetrators of sexual violence were mainly current partners, friends, colleagues, or neighbours.
The majority of young people having experienced sexual violence (53%) consulted either a friend or family member (50%); however none of the respondents mentioned consulting a health service provider or other professional institution or service.
How do health professionals interact with adolescent and youth clients?
The survey conducted among health service providers offering sexual and reproductive health services showed that despite the fact that most health professionals had received training and guidelines for these services, they reported low confidence in their knowledge and skills to provide these services to young people. Similarly, community health workers reported low confidence in having sufficient knowledge to sensitize young people on sexual and reproductive health and on knowing how to communicate with them about the benefits and risks related to these services (i.e family planning).
Counseling on contraceptive methods
The results across the three surveys show discrepancies in the perceived quality of family planning service provision (between health professionals, community health workers and young people). The vast majority of service providers (95%) reported that they informed their clients about side effects or problems that may occur with contraceptive method use and what to do in case they occur (99%). However, among young people who reported using family planning services, only 53% reported having received adequate information about side effects and how to appropriately manage them when they occur (51%).