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No wealth without health

MUBENDE, Uganda – Edith Nambalirwa’s smile lights the bustling business district in downtown Mubende. Watching as she glides her fingers with ease, knitting strands of a customer’s hair into intricate braids in her growing practice, it is easy to think that her life has been plain sailing.

Nothing could be further from the truth. As a child, Edith faced challenges that could easily have broken her spirit, but with sheer determination – and the help of one of UNFPA’s interventions – she is fast becoming a successful entrepreneur. And a role model for other young people, especially girls.

Hairdressing comes naturally to Edith, 20, who has grown up watching and learning from her mother. She was raised by her single mother, her role model, after her father passed away when she was a child. 

Empowered by Youth Enterprise Model

Three years ago Edith participated in UNFPA’s outreach project, the Youth Enterprise Model (YEM), and received crucial information on her sexual and reproductive health and running a business. Since then, her hair salon has continued to grow; she has had to relocate to accommodate an expanding clientele base.

I do not want to have a baby if I do not know how to provide for her.

“I lost my dad when I was young and I’ve faced so many challenges,” Edith says. She is determined to change the future for herself and her children so that they are not confronted by the same difficulties.

She uses the information she has learned from UNFPA’s YEM project to protect herself from unintended pregnancy, sexually transmitted infections (STIs) and HIV. With unwavering confidence, she says: “I do not want to have a baby if I do not know how to provide for her.” 

Shaping a new future through health and economics

Like many parts of East and Southern Africa, Uganda’s disproportionate incidence of HIV and AIDS among young adults – by far the leading cause of death among youth and disproportionately among young girls – plays a prominent role in human capital destruction[1], contributing to a net annual loss of one per cent of GDP[2]

When young women are economically vulnerable, they are more likely to engage in high-risk behaviours in efforts to survive[3]. For example, a girl may enter an intergenerational relationship, early marriage or sex work to support herself, which puts her at risk of teen pregnancy, STIs, HIV, and dropping out of school. 

About 59% of young people in vocational training institutions and small and medium enterprises are sexually active, yet only 2 in 5 use contraceptives.

Risky sexual behaviour among young women also impacts their ability to save capital, complete vocational training and be healthy and productive workers and entrepreneurs[4]. About 59 per cent of young people in vocational training institutions and small and medium enterprises are sexually active, yet only two in every five of them are currently using a contraceptive method.

Given the crucial link between health and business, there is an overwhelming need to address sexual and reproductive health issues within business environments. UNFPA’s Youth Enterprise Model has taken this principle into practice – proving that a combined approach can make a profound impact on the lives of many.

“I want to be an example for youth”

Edith, inspired by what she had learnt through UNFPA’s Youth Enterprise Model, decided to become a peer educator to share her knowledge with others. As a hair stylist she is able to build a unique and meaningful connection with her clients, who are mainly girls and young women. 

“For the young girls, it’s easy because I’m young and they are also young. They can talk to me and tell me their problems,” she says. She shares examples of salon customers she has helped, including a young person she convinced to stay on antiretroviral treatment, and another, to save and invest money earned.

She also supports mothers in communicating and supporting their children better as they journey through adolescence.

“I want to be an example for youth. I want to help my Uganda,” she says with a sparkle in her eyes. “If I cannot do it with money, let me do it with knowledge.” 

A new and innovative approach: more about the Youth Enterprise Model

The Youth Enterprise Model approaches communities holistically by focusing upstream (influencing national policies and strategies) and downstream (working with local businesses, health facilities and communities). 

It is funded by the David and Lucile Packard Foundation and implemented by UNFPA in partnership with Communication for Development Foundation Uganda, Reproductive Health Uganda and Straight Talk Foundation. UNFPA East and Southern Africa supports YEM in resource mobilization efforts.

The real value of the Youth Enterprise Model is economic empowerment of individuals. There is no freedom without economic freedom. - Dr. Akinyele Eric Dairo, Practice Manager, Sexual and Reproductive Health, UNFPA East and Southern Africa

The project has trained 50 small and medium enterprises, 23 institutions, 27 health facilities and 6 financial institutions on youth-friendly service delivery to young people in enterprises. 

Knowledge about their sexual and reproductive health among young people is improving in the target districts. For example, in 2013, 53 per cent of youth believed a girl could not get pregnant if she had sex while standing. This misconception decreased to 34 per cent in 2016.

The Youth Enterprise Model is going where no one else has gone. No one in this country has attempted to merge health with business like this. - Hassan Sekajoolo, Straight Talk Foundation

The Youth Enterprise Model has led to a significant boost in contraception use among young people, including uptake of condoms, implants, pills and injectables. More than 61 per cent of young people in targeted small and medium enterprises and vocational training institutions have started using contraceptives in the past 12 months.

Through projects like the Youth Enterprise Model, Uganda has the power to harness the strengths and advantages of a surge in the youth population. When youth are given the knowledge and skills they need, they will lead the – new and prosperous – way forward.

By Corrie Butler

[1] World Bank. (2005). Poverty reduction: Does reproductive health matter? Washington D.C.: Margaret E. Greene and Thomas Merrick.

[2] Bonnel, R. (2000). HIV/AIDS: Does it increase or decrease growth in Africa. ACT, Africa Department, Washington, DC, World Bank.

[3] US Agency for International Development. (2009) Fact sheet on youth reproductive health policy: poverty and youth reproductive health policy initiative. 2009

[4] Correia M, Bannon I, editors. The other half of gender: men’s issues in development. Washington (DC): World Bank; 2006