World Vision International
article • Friday, September 8th 2017

Four ways to make health centres safe for children and adolescents

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Juliet shared her peers' health requests with her government

In the Northern Uganda district of Kole where I live, young people are desperately in need of youth-friendly health services. In our country, children are at risk of malaria, HIV, TB and sexually transmitted diseases. In my village, girls as young as twelve years have become pregnant because of a lack of sex education in schools, because of peer pressure, through a lack of parental care, or child marriage.

Also, many children have no full birth certificate because families have to pay for them. This puts them at risk of abuse by adults: if you can’t prove that you’re a child no-one can be prosecuted for defilement. I know the ideal is for adult women to bear children, but we get no formal sexual education and several of my classmates have been married off in their teens—one girl in my class was only 13 years old.

When young people visit health centres they are often are ignored because they don’t have money or because they are too young to be taken seriously. Pregnant girls are often judged and verbally abused: a classmate of mine was so badly treated by health centre staff that she did not go for medical help again until the day the baby was delivered. One of the questions that are always posed to the girls is: “Where is the father of the child?” This challenge makes the girls feel bad since many times the man responsible has denied being responsible and run away.

Making children's voices heard

In my community, youth have been invited to join in with community meetings and given the opportunity to give their opinion about the health services provided. I, on behalf of other young people in my community, delivered a call for action to the district leadership highlighting the issues that young people think are hindering health service delivery and solutions to the issues. This call for action was received by the Resident District Commissioner and his entire council together with the Chief administrative officer with his technical team who are public servants.

Among the issues shared with the district leadership were no ambulance and a poor electricity supply; a delay in medicine supply from the national medical stores in Entebbe; children sharing wards with adults; and some medical staff selling government drugs which are supposed to be free.

Bringing children's voices to the world

Juliet told the World Health Assembly how to improve health centres for children and youth

In May I travelled to Geneva in Switzerland, to share with the World Health Assembly a story of how the local government improved our health facility after young people spoke up about the problems there and I made the following recommendations to the audience:

  1. Put adolescent-friendly services at every health facility
  2. Ensure young people are allowed to access health services without being asked so many questions. For example, when a young mother goes for antenatal services she should not be verbally abused because she has fallen pregnant, but she should be helped.
  3. Ensure that young people are given the opportunity to interact with members of parliament and government at every level, to contribute to decision making and monitoring of services.
  4. When young people speak, their views should be considered. This will give energy to young people knowing that their views are heard and acted upon.

My dream is to be a nurse when I finish school and work in health centres with child-friendly services—including nutrition and psychosocial support—so all children can speak about their health with adults who are there to protect them.


Juliet Atoke is a 17 year old girl from Northern Uganda who is a speaker of the child club  in her community supported by World Vision Uganda. Through her engagement in this club Juliet has learned about children's rights and been supported to engage with local authorities to promote children's needs and recommendations. In May she was selected by her peers to represent them at the Global Citizen Dialogue during World Health Assembly in Geneva, sharing children's recommendations with the Ministry of Health of Uganda and other decision makers present in the room.

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