Raising Voices for Better Choices empowered youth in rural Malawi to provide feedback on the performance of youth-friendly sexual and reproductive health (SRH) services through the development and piloting of a mobile data collection tool. Project partners Simavi and Youth Net and Counselling (YONECO) worked with district health authorities to educate young people on quality health services and invited their input in the design of the mobile tool designed for youth participation in monitoring the quality of youth-friendly health services offered in five rural health facilities in Malawi. The project also trained “mystery clients” who conducted undercover visits to health facilities to assess the quality of services. The results for each health facility were published on an online map and are used to inform meetings with health officials and other stakeholders on addressing service gaps. The project allowed young people and health providers to track the quality of service delivery and identify areas for improvement.
Youth were generally satisfied with low quality of service. They did not know what youth-friendly looks like, and then realized [poor quality] should not be the case.
—Simavi Staff Member
The Need
While youth-friendly health services are included in the Malawi government’s health strategy, a recent evaluation by the Ministry of Health found that quality was low and that less than a third of youth are aware of youth-friendly SRH services. Raising Voices for Better Choices responded to this gap by educating young people in Malawi about their rights to quality SRH services and giving them a voice to stimulate change.
Key Learnings
Educating youth on what quality SRH services look like is empowering and can lead to improved aspects of youth friendliness in health facilities. Simavi learned that young people are generally satisfied with low-quality services because they do not realize that health services can be delivered differently. The trainings provided through Raising Voices for Better Choices help young people to know that they could and should receive high-quality, youth friendly health services. Based on direct input from youth, wait times were reduced, healthcare workers developed a greater respect for privacy matters, and health centers became friendlier towards youth.
Stakeholder buy-in is important for implementing a program that creates lasting change. While the start of the project was initially delayed in order to get permission from district health authorities, their cooperation and participation gave Raising Voices for Better Choices legitimacy with local service providers and created a favorable environment for the project findings to inform action plans aimed at improving the quality of youth-friendly health services.
We really try to look at quality from the perspective from young people. … Now we look to see what is important for youth to feel [and to] experience, so that services are accessible for them.
—Simavi Staff Member
