An estimated nine-tenths of people aged between 10 and 24 worldwide are living in low- and middle-income countries (LMICs), and 60 percent of the population in Africa is under the age of 25. However, when it comes to planning, implementing or participating in community health interventions, young people are often left out of the conversation.
There are also additional challenges for young people in accessing essential health services and resources because of barriers such as affordability and social stigma. Improving knowledge and understanding around disease prevention and treatment is not enough to develop and sustain healthy behaviours, supportive social environments are also needed. Successful community participation in, and ownership of, health interventions leading to positive behaviour change need to form a part of this supportive social environment and involve the whole community, including the younger generation.
Within the countries where we operate, Malaria Consortium has been exploring how to integrate effective responses to youth issues into our programming and harness the potential of young people. In Uganda, Malaria Consortium as part of USAID’s Malaria Action Program for Districts (MAPD), undertook an analysis to better understand youth engagement in malaria service provision and delivery. The findings showed that young people were rarely included in programme planning or implementation for malaria service provisions and were often left out of village discussions. Based on the analysis, recommendations were made to engage youth in the design and delivery of capacity-building initiatives and encourage collaboration between district health authorities and young people.
In 2019, MAPD piloted the Vijana Leo (Youth Today) community-based activity to identify ways in which young people can be involved in malaria-related activities. Vijana Leo was implemented in Yumbe district, one of the 52 districts that MAPD supports through strategies including social behaviour change communication. In this pilot, the villages selected 23 youths, training them to design their own activities to promote both better health seeking activities and preventative measures within the household. They led activities such as community theatre, netball and football tournaments and health talks on malaria within the village. After witnessing an increase in their confidence and leadership skills, adults began to trust them to mobilise people in the community to take part in the malaria response. Iyosiga Swale, a youth champion from Aruguyi parish was later appointed as a new Village Health Team Member (VHT), taking on more responsibility for health activities within his community. “I believe young people, if trained and supported, can be good health educators for both their peers and adults,” Iyosiga shared.
Encouraging learning around malaria prevention is also important to minimise the socio-economic impact high disease burden can have, through out-of-pocket health expenses and lost hours at school for children and in work for parents caring for sick children. As part of the MAPD programme, Malaria Consortium supported the creation of malaria school clubs in 157 schools, reaching over 134,000 pupils in nine districts across three regions – Masaka, Rwenzori and Hoima. The programme provided resources and long-lasting insecticidal nets (LLINs), supporting club members to undertake activities in schools and their local communities to promote malaria prevention and awareness. In addition to promoting positive behaviour change within their family and community, there were direct benefits to the students themselves, with absenteeism from school seeing a massive decline from 76 percent to 35 percent following the instigation of malaria school clubs in these districts.
Malaria isn’t the only endemic disease to impact global health; over recent decades, the increasing number of arboviral disease epidemics has highlighted their escalating threat in an increasingly urbanised and globalised world. Arboviruses have high transmission rate in school settings but in spite of increased research and knowledge around the factors that cause the spread of arboviruses, this knowledge has not typically been imparted via the classroom, or the wider community. Involving young people, especially within a teaching scenario at school to improve recognition, prevention and control methods of diseases such as dengue is a cost-effective way to influence behaviour change, transmit knowledge and help reduce the disease burden.
In Myanmar, dengue is a priority disease, with over 10,000 cases occurring each year, many of these cases affecting children between the ages of five and nine years. The National Strategic Plan for Dengue Prevention and Control in Myanmar aims to include community and school-based vector control through the Aedes-free school programme – delivering educational and practical activities aimed at students and teachers in Yangon, Myanmar, enabling them to learn about and implement interventions with project staff overseeing the quality and coverage of the interventions through evaluation. By enhancing the vector control curriculum, students become more knowledgeable around the practices needed to control the spread of dengue, taking a more active role in community surveillance and vector control, and teachers can be equipped with a greater capacity to disseminate information and transfer knowledge.
Malaria Consortium is co-investigator on a project led by the Norwegian University of Life Sciences and Myanmar’s Ministry of Health and Sport, to assess the impact of student-driven interventions on dengue control in South Dagon and Shwepyithar townships in Yangon region – an area selected due to the high incidence of dengue. Through targeted dissemination, the results are expected to inform policy and reduce dengue transmission and exposure to risk factors in Myanmar and beyond, as well as improving the knowledge of dengue and vector control in students, who can bring that knowledge home to their families, encouraging them to undertake effective surveillance and vector control within their community.
Young people have the capacity to mobilise and influence their community and their involvement in community-driven vector control interventions can be an inexpensive, effective and sustainable means to help improve disease outcomes. Working with enthusiastic and motivated young people can drive social behavior change and slow or even reverse the spread of diseases like malaria and dengue within classrooms, homes and communities. To succeed in reducing the disease burden, children and young people must be considered in the design of interventions and actively encouraged to engage in vector control conversations and activities, to spread awareness, influence others and contribute to sustainable change.