Youth participation in advocacy activities has many benefits – one being to influence policy and services that effect their lives while seeking ways to addressing their needs and interests. In pursuit to changing positively stakeholders’ mindset, perception and attitudes toward safe abortion, the Zambia Association of Gynaecologists and Obstetricians [ZAGO] collaborated with many stakeholders – one of which being young people or youths. Many youth-led organisations were incorporated in the Advocacy for Safe Abortion Project (ASAP) that ZAGO has been implementing since 2019. One of the major reasons for incorporating youths was based on the fact that to achieve quality advocacy outcomes, collaboration with like-minded stakeholders is key. Key in many ways considering that collaboration does not only strengthen the campaign, it also creates trust, recognition, resiliency as well as facilitates rapid transmission of information to the wider community.

This strategy was validated by the final project assessment visits to selected ZAGO trained youth teams on the Copperbelt, Central and Eastern Provinces.

ZAGO conducted follow ups visits to youth groups that were trained in Central, Copperbelt and Eastern Provinces. The aim of the follow up visits was to assess how the trainees were sensitising people in their respective communities, to encourage them not to relent and also understand the challenges they face. Youth groups on the Copperbelt that were assessed include those in: Chingola, Mufulira, Kitwe, Luanshya, and Ndola; and Kabwe in Central Province. In Eastern Province, youth groups in Mambwe, Chipangali, Chipata, Katete, Sinda, Petauke, and Nyimba districts were visited. The assessment revealed how youths have owned the safe abortion advocacy. The follow-up visits were a learning curve. In Petauke for example, youths are engaging many stakeholders including community leaders such as Village headmen, traditional healers, parents and school authorities to share with them information about the dangers of unsafe abortion. While doing this, the young people encourage their peers to visit and make good use of the youth/adolescent friendly spaces in  health facilities – to enable them access various Sexual Reproductive Health Rights (SRHR) services including safe abortion. Amazingly, one of the peer educators/advocates #TheresaDaka is using social media, particularly #TikTok, (https://www.tiktok.com/@telia74) to educate the masses about safe abortion. This is a step in the right direction to addressing not only high cases of unsafe abortions, but also teenage pregnancies, and early marriages in Petauke and the province as a whole.

In Sinda and Nyimba, the ZAGO youth teams have attached great seriousness and commitment to the cause. Friendly/adolescent spaces are fully functional, with Sinda alone having opened in about 12 health facilities and have dedicated staff to handle adolescent matters while young people freely interact and share information with high level of confidentiality. This means that more young people are now able to access Sexual SRH services with ease.

In Chingola, Kitwe and Ndola, the ZAGO youth teams are implementing a number of advocacy strategies, including door-to-door community sensitisation, school debates drama, poems etc. Referrals of women and adolescents girls to health facilities that offer safe abortion services have increased exponentially; with some adolescent friendly spaces functioning at full capacity. This situation encourages young people to seek Sexual Reproductive Health information with ease. More women and adolescent girls now have access to SRH services including safe abortion resulting in less cases of maternal morbidity and mortality.

The development is not only reassuring, but also a fundamental step towards achieving the much anticipated zero reduction of abortion related maternal deaths by 2030. However, in spite of the tremendous efforts made by the ZAGO youth safe abortion teams countrywide, challenges continue to be presented, inter alia:

1. Service charges by CAC providers on those seeking the service. This is one of the barriers to accessing safe abortion service among women and adolescent girls. The youth revealed that despite positive uptake of information on safe abortion and the free of charge offer in public health facilities, women and girls are still being changed by some providers – thus compelling service seekers to seek unsafe abortion elsewhere instead.
2. Lack of CAC providers: The youth lamented the lack of CAC providers as some facilities have only one provider. However, in the absence of the provider, service seekers have nowhere to go. This results in them seeking unsafe methods available in the community.
3. Lack of drugs/MVA kit and consumables: Youth expressed concern that women and adolescents are forced to buy drugs as facilities do not have in stock. This defeats the “free of charge” narrative being sensitised by the safe abortion advocates. Since majority of abortion seekers are poor and unable to buy the drugs, they end up in the hands of unscrupulous and illegal services being offered in the community.
4. Long distance to health facilities: The unavailability of facilities that offer safe abortion possess a huge challenge to accessing the service. In areas like Mufulira, some facilities do not offer the service and create a barrier to those in far flung settings to access the service. As a result, women and adolescent girls are compelled to seek illegal and unsafe abortion within the community.
5. Cost of movement: Youth expressed concern that they are unable to access remote areas as they do not have the incentives to do so. All the youth are doing the work on voluntary basis. Having no support is posing a challenge on them to go to areas where the need is more dire.

ZAGO is thus considering to take following action:

• Engaging CAC providers through workshop against the tendance of charging people seeking safe abortion service
• Training more CAC providers in the country
• In conjunction with General Nursing and Midwives Council, engage the Ministry of Health to consider deploying more CAC providers across the country
• Engage the Ministry of health to ensure more health facilities provide safe abortion service
• Engage potential donors like FIGO among others to look at possible ways on how the youth could be incentivised to smoothen their mobility

ZAGO has and will continue to engage the youths and many other stakeholders including traditional leaders, marriage counsellors, SMAGS, traditional healers, the media, health workers, police, college nurse tutors, school authorities and the wider community – to avoid losing the gains achieved over the years.