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Congratulations to the whole team! Your idea is very great; I wish it gets one day implemented in my country, DRC. All the best


NDUME commented on SRH Services Access Facilitation and Education (SAFE)

Dear Ashley,
Thank you so much for the new positive feedback! Actually, the expects have pinpointed what is really needy and challenging for this idea. Hopefully, future feedback and eventual accompaniment will enable all of us make it real and thereby save lives of many rural youths. Again, thank you for sharing.



NDUME commented on SRH Services Access Facilitation and Education (SAFE)

Dear OpenIdeo team,

Thank you so much for your comments on our Idea. Here are our replies to your very thoughtful questions:

(1) Local availability and affordability of quality SRH services are keys to consistent access. However, that factor alone cannot guaranty consistency in service use; we need to create among the youths a service-seeking behavior through information, education and social marketing.

(2) We have noted a number of real and possible barriers associated to risks, especially as DRC is a post-conflict country with destroyed socio-economic basic infrastructures and means of livelihood:

• Physical access poses different constraints depending on areas under consideration. Some villages can be accessed by the main roads so that using a car, precisely a 4WD vehicle. For other villages, you need a motorbike because there is no road. When it comes to villages along Moero Lake or Luapula River, a speedboat is needed for commodities delivery.
• Social norms can be hostile to all or some service options. Ignoring that element may result in people not accessing services although these are available. Commodities supply MUST be accompanied by actions aimed at shifting social norms.
• Lack of incentive may turn most volunteers from this idea in favor of other work for livelihood purposes.
• Youth and adolescents unfriendly services will do more harm than good to the beneficiaries. Special training to healthcare providers and other involved stakeholders is very necessary.

• In rural areas, making an informed choice from an array of contraception (implant, IUD, pill, Depo Provera injection, male or female condoms, emergency contraception or copper IUD, fertility awareness, vasectomy or tubal litigation, etc.) is very critical.
• There still are strong false factual beliefs behind contraception use and true facts should be properly provided because illiteracy may also play a negative role for some youths.
• Initial social marketing activities will help progressively determine which contraception options are needed and where.
• Those data will inform decisions on which commodities to order for a specific community.
• In addition, consumption report from local health facilities or Rural Health Service Committee will help determine when the next order can be done to avoid stock-out.

• Abortion is a crime in DRC! It is only officially done in cases of medical emergencies, what leaves the mother with stress, trauma, grieves, hopelessness, self-blame, low self-image and other psychological problems especially in communities where fertility and motherhood are highly valued. Specifically for young and adolescent girls, abortion is common due to (i) immature reproductive organs or (ii) untreated or mistreated sexually transmitted infections.
• On the other hand, some mothers show hate towards their babies and/or husbands especially in event of unwanted pregnancies, non-spaced births, or pregnancies from rape case.
• Nurses, midwives and Traditional Birth Attendants (TBA) will be trained in order to provide quality and effective post-abortion and post-partum counseling for birth spacing and STI prevention

(5) Insights into desire or demand in the communities
Following multiple awareness-raising activities conducted by different actors, most rural populations are somehow aware of Sexual and reproductive health. The problem is that services are not available even for the few people who need them. Either, SRHR services are not provided on a continuum basis nor are they comprehensively supplied. Sometimes, a condom distribution program may pop up for only six months. Faithful users will then be forced to slide back to unsafe sex for want of commodities. At other time, a Family Planning program is brought in, but without STI or HIV services. Sexual education and service is a package which should be provided comprehensively.

Should you need more information, please do not hesitate to come back to us

Ndume Eliya Nduelib