Peer-led research · Sexual and reproductive health · Uganda
What Young People Want
At Reproductive Health Uganda, I worked with SafeHands on a study that put young people on both sides of the interview. Thirteen young researchers asked their peers where they went for answers about sex and relationships. I bring that experience to organisations that want to listen carefully, train field teams and make their research useful.
Presented by
Survey method
Who asked whom
In October 2021, 13 young peer researchers used outreach tablets to survey more than 250 young people in Fort Portal, Kabarole District, western Uganda.
What the partners wanted to know
SafeHands and Reproductive Health Uganda examined what information young people wanted about their sexual and reproductive health and rights (SRHR), whether or not they were sexually active. The questions explored knowledge, attitudes, practices and behaviours, from contraception and periods to consent. They asked where young people found information online and offline.
How to read the results
SafeHands reports that more than 250 young people took part. The five findings describe the Fort Portal respondents. The published methods give limited detail on participant selection, response rates, question wording and the group sizes behind some comparisons.
Finding 1 of 5
Information gaps left young people unsure where to turn
Rural distance, stigma and conflicting advice could leave a young person uncertain where to start.
When information is scarce
The published account calls this an “information desert”. Young people living far from a health centre, especially those without a mobile phone, had fewer ways to get a reliable answer. A question about contraception could require a journey before the conversation even began.
When a question is difficult to ask
Information could exist at school, at a clinic or at home and still feel out of reach. Menstruation was a particular example. Taboos made it difficult to start a conversation and helped inaccurate beliefs pass as accepted facts.
When too many answers compete
Respondents also encountered conflicting messages about sex, periods, contraception and consent. This “information flooding” left them uncertain which account to believe, online and in face-to-face conversations.
Workshop discussion prompt
Where can someone ask a first question privately, especially if a clinic is far away?
Finding 2 of 5
Young people used phones but struggled to verify information
Young people used their phones to look for answers about sexual and reproductive health. Finding an answer and knowing whether it was accurate were separate challenges.
What people used
Facebook, WhatsApp and Instagram were among the platforms respondents favoured for finding and sharing content. A message could pass from one friend to another before anyone had checked it.
What made it difficult
Young people described having to sort accurate health information from false claims, including material intended to mislead them about sex and contraception. Having more material to read did little to resolve contradictions.
What the authors called for
SafeHands and RHU called for reliable online sexual and reproductive health information and practical digital literacy skills. Young people needed a way to judge the source of a message as well as a place to find it.
Workshop discussion prompt
If two messages give different answers, who could help you check them?
Finding 3 of 5
Girls faced a wider digital divide
The survey found differences in who owned a phone, who had to borrow one and who felt equipped to use it for health information.
Ownership and borrowing
Young women and girls were less likely to own a mobile phone. Many relied on a friend or family member to lend them one. A service designed around personal phone ownership would reach these users differently.
Age mattered
The difference in mobile phone ownership and access was wider among young women under 17. Age and gender both mattered when the programme considered whom digital information could reach.
Access included skills
The authors reported that many young women needed support to navigate digital health content. They called for basic digital literacy work that would help adolescent girls take part with confidence.
Workshop discussion prompt
How would a girl who shares a phone find the same information through an offline route?
Finding 4 of 5
Friends were often the first people asked
Respondents felt more comfortable talking with peers about sex and relationships than approaching a parent or teacher. They also used those conversations to make sense of things they had seen online.
Why friends mattered
A conversation with someone of a similar age offered privacy, familiarity and language that felt natural. Peers understood some of the fears and awkwardness that could stop a young person asking an adult.
Where trust could go wrong
A trusted friend might repeat an inaccurate claim in good faith. The same confidence that made the conversation possible could also give a rumour more weight.
A role for peer educators
The partners identified peer educators as a source of accurate information in a setting where young people felt comfortable. They recommended involving peer educators in the design of digital content so it addressed real questions in familiar language.
Workshop discussion prompt
What questions do young people ask a friend before they would ask a health worker?
Finding 5 of 5
Many mistook the absence of a ‘no’ for consent
The publication describes respondents who recognised a verbal “yes” but held conflicting beliefs about silence, refusal and the right to withdraw consent.
Silence and refusal
Some respondents treated silence as agreement. Others interpreted refusal as an invitation to persist or believed consent was unnecessary. The partners describe jokes and casual comments as ways these ideas circulated.
Changing one’s mind
Misconceptions occurred among both young women and young men. Young men were three times as likely as young women to believe a person could not withdraw consent during sex. This is a comparison of a reported belief, rather than a measure of behaviour.
Definition and practice
Among respondents who said consent was unnecessary, half could still identify a spoken “yes” as consent. The authors concluded that recognising a definition alone could leave deeper attitudes untouched and called for work to reframe those attitudes.
The denominator for “half” is the group who said consent was unnecessary. The article supplies no underlying group counts for either comparison.
Workshop discussion prompt
How would you teach consent in a situation where a person changes their mind?
Use of the research
Where the findings lead
SafeHands and RHU intended to use these findings to shape the KISS project and track changes in knowledge and attitudes in Fort Portal. The publication identified several things the programme could change in its own practice.
Make trustworthy answers easier to find
Young people needed reliable material on the channels they actually used and practical ways to check a claim. Those without a personal phone also needed access to information closer to home.
Involve peer educators in making content
Young people’s descriptions of conversations with friends gave the partners a reason to involve peer educators in shaping topics, language and responses. Peer educators could also help a young person recognise when to seek qualified advice.
Address the attitudes beneath a definition
The findings on consent indicated why the ability to recall an answer could coexist with beliefs that undermine it. The authors called for work that addressed those beliefs directly.
Project credits
Sources and credits
Young peer researchers gathered the responses. SafeHands and Reproductive Health Uganda published five findings on access to information, trust, digital inequality, peer networks and consent.
Research and fieldwork
SafeHands and Reproductive Health Uganda, working through the Knowledge and Information on Safe Sex project. Young people administered the survey in October 2021. SafeHands published its account in 2022.
Photographic context
The cover photograph is an earlier Big Picture competition entry by Shivan Kya. It illustrates the role of friends and phones. The image credit refers to the photography competition.
Editorial and design
Fortunate Kagumaho worked on the study at Reproductive Health Uganda. Editorial design and discussion prompts by La Conteur. The prompts are available to teams that want to use these findings in a workshop.
SafeHands. What Young People Want. May 2022.
SafeHands. Annual Report 2019–2020, pp. 11–16.
La Conteur · Professional practice
Commission community research
Bring us a programme decision and the people whose experience should inform it. We work with local researchers to choose a sound method, listen in the languages people use and produce evidence that teams can act on.
Design and train
Identify who needs to be heard. Agree on sampling, consent and privacy. Pilot the questions and train peer researchers to ask without leading, probe respectfully and record answers consistently.
Check and interpret
Review responses during fieldwork, document missing data and check denominators before comparing groups. Invite community members to test whether our interpretation reflects what they meant.
Report and return
Deliver a methods note, a full report and an illustrated brief. A feedback session lets participants see how their evidence has been represented and lets programme teams agree what to change.
For enquiries, contact fortunatekay@gmail.com
Fortunate Kagumaho · Research and training
Ask a question your programme can act on
I can work with you to choose the research question, train community interviewers, check the evidence and turn the findings into a report your team can use.
For enquiries, contact fortunatekay@gmail.com