We spoke to young people from the Western Balkans about how their access to sexual and reproductive health and rights was affected by the COVID pandemic, and asked them about their vision for re-designing a more youth-friendly future in which young people can flourish.  This 23-year-old LGBTIQ man from Bosnia and Herzegovina is a medical worker and an activist for youth SRHR*. As a volunteer peer educator, he supports other young people to learn and develop crucial life skills relating to their sexual and reproductive health.   Describe your experience of access to SRHR education, information and care before and during COVID. Before COVID, I received information through some NGOs and if I went directly to the doctor. Very little was said about these topics in our country and information was only visible if I searched for it myself. Then during the pandemic everything moved to the internet and a lot of information started to be shared on social networks.   Did anything change for the better for you during the pandemic in terms of access to SRHR? The pandemic has helped a lot in terms of better content and more accurate information on the internet. A new trend has been born, where influencers started to create content and dedicate their profiles to these topics. Thanks to the excellent response, this trend continued even after COVID and became part of everyday life. We forgot how to do things in person, so we left a lot of it to online platforms. I think that no matter how many shortcomings there are, it is very good because of the availability of information to everyone.   What was the biggest obstacle to your SRHR during the pandemic? How could decision-makers/medical professionals have improved this?   Unfortunately, during the pandemic, SRHR was not always in focus because of the “war” response to the virus. The high death rate and people’s fear of COVID meant that there was not much focus on the topic, and little media attention. People sadly still don’t understand the importance of SRHR. What could have changed is that doctors and politicians should have spoken more publicly about this topic and raised people’s awareness, but unfortunately they didn't do that.   What lessons should governments and professionals who work with youth learn from the pandemic about how to look after young people’s health and wellbeing in a crisis? A very important lesson they should have learned is that they were not taking the right approach towards young people. If we have interesting and educational content, peer educators and youth leaders can easily reach them. It’s important to talk about taboo topics that every young person faces. We can only achieve change by changing the approach and understanding their needs.   What is your number 1 recommendation on what is needed to make services more youth-friendly? I recommend that more workshops be held to provide information to health workers and people who work directly with young people so that they can provide answers to their questions. Care and support providers are often prevented from providing young people with accurate information because they themselves learn and receive information in an old-fashioned way. Lack of knowledge is the key to the problem.   * SRHR = sexual and reproductive health and rights Interview conducted by Azra Mehmedovic, a member of the regional youth group of the IPPF EN project Youth Voices, Youth Choices, funded by MSD for Mothers

We spoke to young people from the Western Balkans about how their access to sexual and reproductive health and rights was affected by the COVID pandemic, and asked them about their vision for re-designing a more youth-friendly future in which young people can flourish.  Lana is a 17-year-old from Bosnia and Herzegovina who works as a volunteer peer educator, supporting other young people to develop crucial life skills relating to SRHR*.   Lana, describe your experience of access to SRHR education, information and care before and during COVID. In terms of overall SRHR education before and during COVID-19, I was very uneducated. At the beginning, I was 14 years old, so personally, I considered talking about SRHR topics very embarrassing and taboo. I was a kid and did not know that it is totally normal and important to talk about SRHR at that age. I live in a country where it is usually seen as “weird” to talk about SRHR, especially at my age at the time, so I felt like I shouldn’t participate in discussions on the topic. I was very uninformed and took minimal care of myself as regards SRHR, especially during COVID. It was a very hard time for everyone, and I was still finding myself, so it was really difficult for me to put priorities in the right place, especially with everything closed down; I had no access to any kind of SRHR education.   Did anything change for the better for you during the pandemic in terms of access to SRHR? How are things now? Sadly, nothing changed for the better during the pandemic. I was still just a kid and SRHR was a taboo topic for me and I was very uninformed. Luckily, after the pandemic, I started to realize that it’s totally normal and important to talk about sexual and reproductive health. Now I tend to help everyone who feels unsafe talking about it to realize that it is not taboo, as I used to think, and actually very important. I feel safe in my own body and I make sure I access education about SRHR as much as I need to. I make sure to take care of myself as regards to healthcare and I have been feeling a lot better, happier and safer since.   What was the biggest obstacle/challenge to your SRHR during the pandemic? How could decision-makers/medical professionals have removed this obstacle?   My biggest challenge was overcoming the fact that SRHR is not seen as a normal topic to talk about and cover, especially for a 14 year old. Speaking to a professional, either a medical professional or my parents, would have helped a lot. I would have felt safer talking about the topic and would have realized from a young age that it is a totally normal topic to cover and is important for keeping myself healthy and happy.   What lessons should governments and professionals who work with youth learn from the pandemic about how to look after young people’s health and wellbeing in a crisis? Listening. A lot of young people, including me, were afraid to open up. I lacked in-person communication and it has affected my SRHR education a lot. Personally, a heartfelt recommendation to professionals working with young people on this topic is to talk with them as much as they need to and as much as those young people feel the need to talk. I think it is very important for us to get heard and someone listening to our insecurities about talking over a specific topic would help youngsters open up and understand that it is not a taboo topic. COVID has made me realize that, if I have a question or a problem as regards to SRHR, I would want myself to be heard and for a professional to really listen to me and help me. I think it would help other young people a lot.   What is your number 1 recommendation on what is needed to make services more youth-friendly? What difference would this make in the life of a young person like you? Again, greater availability of professionals in health centres. It is very important for our voices and thoughts to be heard. It is a great way of helping us and making us understand that people really do listen to us and really do want to help us. It would help a lot, like it helped me.   What helped you to become engaged as a peer educator on SRHR? How has this experience been so far? I have been through a lot of things in life. I want to help people understand that it is okay if we all have our problems but I also want to help people lead their life in the right direction, overcoming those problems. I love helping people. I love seeing smiles on their faces after something that they thought might ruin their day and then overcoming it. It is the most beautiful thing ever. I want to educate people on various topics and help them understand that we, young people, are as much of a person as adults are. We have our own problems too. We also want to be heard. We also want to get educated on topics that are socially labelled as “inappropriate to youngsters”, but are as a matter of fact, just put that way by society and are totally normal to be addressed from teenage years. My experience as an educator has been wonderful. I had managed to help people open up, feel happier with themselves and in their bodies and realize that life is beautiful if you make it your own utopia. I love this hobby of mine and hope to continue it as long as I can.   * SRHR = sexual and reproductive health and rights Interview conducted by the Institute for Population and Development, IPPF's member in BiH, as part of the project  Youth Voices, Youth Choices, funded by MSD for Mothers

We spoke to young people from the Western Balkans about how their access to sexual and reproductive health and rights was affected by the COVID pandemic, and asked them about their vision for re-designing a more youth-friendly future in which young people can flourish.  Timur is a 17-year-old from Bosnia and Herzegovina who works as a volunteer peer educator, supporting other young people to develop crucial life skills relating to SRHR*.   Timur, describe your experience of access to SRHR education, information and care before and during COVID.  Before COVID, it was much easier to work on trainings and projects related to SRHR. Everything was done live and with the mutual interaction of participants and lecturers. Although we quickly adjusted during the pandemic, communication was difficult without live contact, but we successfully kept things going. As a peer educator and a young person, I had great access to information about SRHR. I knew who to turn to, but most other young people didn't. During COVID it was very difficult to find accurate information about SRHR.   Did anything change for the better during the pandemic in terms of access to SRHR? If so, has this continued since COVID is no longer an urgent crisis?  Yes, the pandemic has allowed us to get to know online tools better, and this enables us to process some topics in a much more interesting way. We have continued to use some methods we discovered in the first phase of COVID because we saw that they were easier but also better or more interesting for the participants themselves.    What was the biggest obstacle to your SRHR during the pandemic? The biggest challenge for peer educators was how to reach young people to provide information about SRHR. But even for me as a young person it was very difficult to find information and to reach professionals in health centres who deal with SRHR. The next challenge was that most of the NGOs in my vicinity closed their open centers and youth centers. Before the pandemic, young people could find all relevant information in these places. Now, most youth centres are open again, though some are working at reduced capacity.   What lessons should governments and professionals who work with youth learn from the pandemic about how to look after young people’s health and wellbeing in a crisis? I think it's important that authorities and health professionals learn how important it is to have a ready response to crisis situations. And how important it is that in situations like this, they "leave no one behind". They should focus even more on health and ensure the availability of services for vulnerable groups. The next thing that governments and health professionals could learn is that online tools are very important and can be useful.   What is your number 1 recommendation on what is needed to make services more youth-friendly? What difference would this make in the life of a young person like you? I think it is important to introduce many more online platforms that offer answers to young people's questions. That way we have access to accurate information. It would make a difference because young people would use accurate information they got from qualified people via the internet, where they spend a lot of time today, and not the false information they find on portals, written by people who are not experts in these topics.   What helped you to become engaged as a peer educator and activist for SRHR? How has this experience been so far? It helped me to get more involved when I saw how much benefit and importance it has, both for me and for all those who participate. With small steps, we change the consciousness of society and educate people about topics that are present in their environment.   * SRHR = sexual and reproductive health and rights Interview conducted by the Institute for Population and Development, IPPF's member in BiH, as part of the project  Youth Voices, Youth Choices, funded by MSD for Mothers  

We spoke to young people from the Western Balkans about how their access to sexual and reproductive health and rights was affected by the COVID pandemic, and asked them about their vision for re-designing a more youth-friendly future in which young people can flourish.  Alex is a 19-year-old LGBTIQ girl, studying at university in Blagoevgrad, Bulgaria. As a peer educator, she supports other young people to learn and develop crucial life skills relating to their sexual and reproductive health.   Alex, describe your experience of access to SRHR* education, information and care before and during COVID.  My access to sexual and reproductive healthcare before COVID was relatively normal, for example a gynaecologist visit, but during the pandemic, it was rather harder to go because I had to present a negative COVID test to be examined. At some point, in-person consultations with doctors were extremely limited, unless it was with reference to COVID or life-threatening - so regular check-ups were not really happening. I didn’t receive any adequate sexuality education either before or during the pandemic. The only time sexual health was discussed in my 12 years of schooling was back in elementary school and it only included only a talk with the girls on menstrual pads and periods. I believe online information became more accessible because of COVID. As a result of the limited consultations with professionals, more people sought answers on the Internet. Of course, we must keep in mind that information has to be checked carefully. Also, reliable information in Bulgarian is very limited.   Did anything change for the better during the pandemic in terms of access to SRHR? I suppose more information regarding SRHR became available online because of the huge demand. A good thing is that the information is still relevant today even though COVID is no longer an urgent crisis. Personally, I got into the habit of looking for answers myself and checking if the source was reliable or not. Other than that, I would not say that COVID had any positives.   What was the biggest challenge to young people’s SRHR during the pandemic? How could decision-makers/medical professionals have removed this obstacle?   One of the biggest problems was the misleading and unreliable sources of information about sexual and reproductive health. In addition, adequate information is mostly in English. I believe a fact-checking system to verify all factual information could be helpful in preventing the spread of misinformation. I faced that problem when I and other 3 friends conducted a few educational workshops on the topic of comprehensive sexuality education. While putting together the information we needed, we came across numerous invalid data and false statements.   What lessons should governments and professionals who work with youth learn from the pandemic about how to look after young people’s health and wellbeing in a crisis?   From what I have seen, many adults do not seem to understand the burden this crisis has had on us and therefore neglect our mental health. Affordable and regular psychologist appointments should be a priority. There is this stigma around mental health that you seek help only if you are “not normal”. That is completely false and puts our generation under pressure and makes us not take proper care of our well-being (which often includes going to a psychologist). Also, many of the professionals (both teachers and medical practitioners) were sharing their personal and controversial opinion on the pandemic and vaccinations which has to be limited. A personal experience I had was when I went to get vaccinated and my GP would not allow me to, saying that it was unnecessary and even “dangerous”.   What is your number 1 recommendation on what is needed to make services more youth-friendly? What difference would this make in the life of a young person like you? More young and inclusive professionals working in the sphere are needed. For example, many of my female peers insist that female gynecologists examine them. LGBT+ inclusivity is also important, as currently many of us cannot share a key part of our life neither with a gynecologist nor a psychologist. The difference would be that we will be more open and share what really concerns us so we can seek adequate help. It is much easier to talk to someone close to your age or background.   What helped you to become engaged as an activist? How has this experience been so far? The idea that I can do something about the desperate need for a change and make my voice heard was what helped me get involved. So far, I mostly enjoy working with other young people and seeing them as determined and hopeful as I am. Every new idea has been welcomed with enthusiasm and encouragement by many of my peers, which makes it clear that youngsters are looking forward to a change and improvement. However, as I mentioned, we held several workshops about comprehensive sexuality education and we faced many obstacles. The project was very scarcely funded, which made it very hard to implement properly and exactly how we have envisioned it. Also, finding people to attend the workshops was fairly hard as well and we could not get any support from our teachers and school staff. They did not welcome the idea because the topics of sexual health and LGBT+ inclusivity are still taboo in our society - so they were scared of how the parents would react. On the other hand, the people that came to the workshops had very encouraging feedback and even a demand for more similar events. * SRHR = sexual and reproductive health and rights Interview conducted by Viktoria Nikolova, a member of the regional youth group of the IPPF EN project Youth Voices, Youth Choices, funded by MSD for Mothers

We spoke to young people from the Western Balkans about how their access to sexual and reproductive health and rights was affected by the COVID pandemic, and asked them about their vision for re-designing a more youth-friendly future in which young people can flourish.  Greis Osmani is a 23-year-old from Tirana, Albania. She is a medical student, peer educator and activist for young people’s sexual and reproductive health and rights.   Greis, describe your experience of access to SRHR* education, information and care before and during COVID.  Before the pandemic, I used to take part in a lot of workshops, projects and volunteer work in national NGOs. As a volunteer, especially with the Albanian Center for Population and Development (ACPD), I was trained in subjects like abortion stigma, gender equality and rights, contraceptive methods and sexuality education. I was well informed about other topics such as HIV/AIDS. The first year of the pandemic, the focus of the government and NGOs etc shifted more towards COVID and general health issues, not related to SRHR. Step by step, young people and the general public started getting used to online platforms, which gave us other opportunities to hold trainings online and carry on sharing safe information with other youth.   Did anything change for the better during the pandemic in terms of access to SRHR? I believe it had pros and cons. First, we had to learn how to properly use new digital platforms and tools such as Zoom, Google Classroom and Meet, and add more interesting activities such as Murals and Quizzes. This made our online experience much more fun, aside from basic informative meetings, and we continue to use these platforms. Online platforms enable us to create a broader network of young people from different countries who connect more quickly, and for free, to share personal experiences as SRHR activists and empower one another. We are still learning and developing digital communication skills. We hope the moment will come when all young people feel comfortable using online tools, without facing a single barrier.   What was the biggest challenge for SRHR during the pandemic? One of the biggest challenges I personally faced was the inability to express myself freely online and completely share personal experiences. Face-to-face meetings connect young people more with one another. One feels freer to talk with peers in person rather than share with those you may never meet in real life. It’s hard to break the ice in digital meetings that make people feel uncomfortable speaking directly and opening up. Also, it is very important that, as educators, the things we share in theory with other peers come to life in practical ways. For example, online we can’t distribute free condoms, and it’s harder to teach young people how to use them correctly.   What lessons should governments and professionals who work with youth learn from the pandemic about how to look after young people’s health and wellbeing in a crisis?   They need to understand the realities of young people’s access to SRHR, the gaps we face, our needs etc. They need to carry out more surveys to see how young people are coping with all the changes since the pandemic. They need to give us youngsters more opportunities to raise our voices, to engage in activities, to work as volunteers, to give us more hope for our future. It’s extremely hard for a teenager to stay at home distancing him/herself from everyday life and joy. COVID-19 was devastating for young people and had a big impact on their perspectives on life and desire to do more. Mental health was affected. Young people need to be able to maintain a healthy life, to experience happiness, and to invest in their future to become good doctors, lawyers, engineers and so on, to build a better lifestyle. Social connections and communication are key to mental health - that’s why creating safe platforms with adequate and necessary information for young people’s needs is crucial for their well-being.   What is your number 1 recommendation on what is needed to make services more youth-friendly?  For services to be youth-friendly, it is crucial to build trust between young people and health professionals. Youth-friendly services are included in our primary health care package and are provided by other private institutions and NGOs such as ACPD through its own clinics. However, trust and communication need to be built. The role of health mediators is also very important, especially if they are young themselves. This facilitates communication with youth as it is easier to share with someone your age; you feel more understood and can open up when the service is presented in a friendly way. It’s also important to create positive environments where young people can engage with each other, for example reading or studying in groups to make it less hard for them to express their true selves. It makes a big difference when a young person finds a reliable service, and seeks help when they are feeling lost. So social workers and innovative communication methods in my opinion are the key.   Tell us about your experience as an activist for young people's health and rights! My experience has been great. It started in high school taking part in a social experiment and then I got more interested in topics like human rights, comprehensive sexuality education and SRH. I have learned so much from people I met during my activism years, I feel like my public speaking skills have gotten better with time. I have found subjects like SRHR which I feel are close to me because I’m about to become a doctor next year and my contribution started long ago in young people’s health. I’m constantly inspired by different projects to keep doing what I am doing now and create a stronger and empowered future for next generations here in my country Albania and beyond. I am happy that I have found role models in this journey of mine, I have heard speeches that are quotes for me to live by. I am grateful that there have been individuals that have pushed me to do better and engage more. I’m looking forward to the next chapters... * SRHR = sexual and reproductive health and rights Interview conducted by Marjo Rabiaj, a member of the regional youth group of the IPPF EN project Youth Voices, Youth Choices, funded by MSD for Mothers  

San Marino recently legalised abortion care, one year after the landmark referendum. In 2021, 77% of citizens voted overwhelmingly to overturn the 150-year-old law to make abortion legal in the first 12 weeks of pregnancy. Abortion care is also available after the 12 weeks mark if serious foetal anomalies put a woman’s life or health -- physically or psychologically -- at risk. The cost of the procedure will be covered by San Marino’s public health system. Previously, women living in San Marino, were forced to travel to Italy or somewhere else to access the care they needed. We sat down with Karen Pruccoli, activist and President of the Union of San Marino Women to discuss the changes in the microstate. Karen is an entrepreneur and advocate for civil rights and women’s rights. How does it feel to have legal abortion in San Marino after 150 years of criminalisation? It feels great – incredible that we have this law. We are celebrating this long journey to get this law, but also we are also feeling sad we have this law only after so many years of trying to convince our politicians that San Marino’s citizens deserve to have this kind of law. Italy had its abortion law from 1978, so we were very behind. I am satisfied and happy, but unfortunately it arrived after too many years. What was the combination of factors that led to a win on abortion rights in San Marino despite having such a strict past on the issue? The main factor why we have this law is Unione Donne Sammarinesi – Union of San Marino Women - which was re-vitalised in 2019, but originally dates from the early 70s and started as a movement for women’s rights. The Union was revived in 2019 and geared its efforts towards trying to convince politicians that a new law on abortion was necessary. Once we realised it was difficult to gain political support, we courageously decided to ask for a referendum. It would have been nearly impossible to get legal abortion in place with the current makeup of the parliament, having a conservative majority, against reproductive freedom. If we were waiting for the parliament to be more progressive and pro-women’s rights, it would have taken another 20 years. So I think the main reason why we have this law is because of the Union which fights for women rights, civil rights, and human rights in the Republic of San Marino. What are your thoughts on the new abortion law in San Marino? We are very happy with the quality of this law, but it was a difficult journey. We met with conservative parties and groups against abortion to discuss how the new law would look like. They initially wanted to propose a law that was much more conservative and stricter. We were very worried at this stage. Those involved in the drafting of the San Marino law on abortion even considered implementing conditions similar to those in Hungary - where women are now forced to listen to the embryonic cardiac activity before being able to access care. It was indeed difficult to push for a modern law, a progressive law that would respect women’s freedom of choice and place it at the centre of the legislation. However, Unione Donne Sammarinesi did not give up and advocated daily on social media, in the press, and by reaching out to communities and the country at large.  The resulting law is in line with the decision of the referendum – where 77% voted YES to ‘women being able to make reproductive choices in their lives’. To a certain extent the current San Marino law is better than the Italian one. In San Marino, we have family planning centres where women, men and young people can receive unbiased sexual and reproductive care. We also tried to mitigate the risk of medical professionals denying care based on personal beliefs, a huge problem in Italy. In San Marino, in the event doctors are not willing to provide abortion care, the state is obliged to find doctors who will, even if they need to bring them from aboard. What are the next steps for your advocacy work? Next, we will be working on combatting violence against women and domestic violence. An expert group on the topic from the Council of Europe visited San Marino and produced a report on how the Istanbul Convention (on preventing and combating violence against women and domestic violence) was implemented in the country. We had a lot of issues and are currently working on amending these. What is your opinion on deciding rights through popular vote?   We had two referendums on human rights: one asking to include the protection of sexual orientation in our human rights charter and one on abortion. This first referendum was in 2019 and 72% were in favour of non-discrimination based on sexual orientation. And we know the result on the referendum on abortion. But, I think it is dangerous to have a referendum on human rights especially in Italy as it is a Catholic state, with strong conservative parties. We had no statistics that could could help us understand if people in San Marino were ready to legalize abortion. At that point we were asking for legal abortion for the past 20 years and we saw no other solution than to put it in the hands of the people. We followed closely what happened in countries like Gibraltar and Ireland and took inspiration from their successes. So, we decided to take the risk and go for the referendum. But, as far as I am concerned, a referendum on human rights or civil rights is risky.   What is your message to those still fighting for their reproductive freedom? Never give up! I think it is important to have at least one big and strong organisation of women’s rights activists that include women, men and young people. It’s also important to create a conversation, provide information and keep the attention on the topic. For so many years in San Marino, abortion was not discussed. Same as topics like domestic violence and medical assisted suicide (euthanasia). Even today, misleading information on abortion exists out there, so we need to be a strong organised group that is able to share accurate information and create a space for conversation.   Illustration: Ipsita Divedi for IPPF EN x Fine Acts