By Grace Gitau, James Murray, and Samuel O. Okumu
Since 2020, Amref Health Africa UK has been working in partnership with The Postcode Global Trust, The SOL Foundation and The Clifford Chance Foundation to implement a Sports for Health programme for young people living in Nairobi’s informal settlements. Here, Amref’s Grace Gitau, James Murray and Samuel O. Okumu explain how sport can build young people’s confidence and create opportunities for frank, empowering conversations around sexual and reproductive health.
Life skills, health, confidence, and positivity can all be enhanced through physical activity and sports. Essential skills like teamwork, communication, and problem-solving are inherent in sport; and coaches and team members become important role models and friends. In this way, sports teams are a lab where sexual and reproductive health and rights (SRHR), gender norms, and resilience can be taught through play and social learning.
Additionally, sports can enable access to hard-to-reach and vulnerable groups, like learners who have dropped out of school, unemployed youth, and adolescent boys and girls. Sports can be introduced through community-based interventions, with low barriers to entry and costs for participation. Sports teams offer young people the opportunity for repeat contact with their peers and coaches in a safe space and thus create a natural forum for interaction, discussion, learning, and follow-up. The ability of sports to facilitate the development of young people’s life skills make it a powerful and accessible means of translating knowledge, attitudes, and behaviour into positive action.
For all these reasons, Amref Health Africa has used sports to increase access to SRHR information, services and empowerment for adolescent girls aged 10-19 years in Nairobi’s Dagoretti and Mukuru Informal Settlements. Over a two-year pilot phase of the Sports for Health project, we created an environment to empower girls and strengthen their protection in communities centred on 30 sports clubs, reaching 3,000 girls aged 10-19 and some 9,079 community members.
Over the course of the project, Amref measured improved agency, negotiation skills and overall capacity of girls to positively influence access to adolescent and sexual and reproductive health service that, over time, will help reduce school dropout rates, delay sexual debut, and improve academic performance amongst other aspects of their lives.
Scaling up for a second phase
Amref Health Africa aims to continue the Sports for Health project into a new multi-year phase. This second phase will build on key project learnings that show sports enable girls to actively challenge norms about their roles and capacities in the community, and in this way, help the girls to become a catalyst for the transformation of gender norms and roles by triggering key discussions around the issues that affect them most.
These are some of the lessons we have learnt and aim to scale up in our next phase.
Pictured: A taekwondo tournament in Dagoretti, December 2020 (c) Khadija Farah
1) Sports are a great platform for captive and motivated dialogue
As an entry point for dialogue with adolescent girls and communities, establishing sports teams has helped facilitate conversations about SRHR. It is natural for adolescent girls to ask questions and get guidance about their bodies and their health in relation to sport. This may start with questions about healthy eating, getting stronger or increasing endurance: but with properly trained coaches, peer champions and the involvement of community health volunteers , a sports setting can be an effective space to deliver SRHR education. In this sense, sports programmes offer unique opportunities to start non-threatening dialogues that could lead to in-depth conversations on more sensitive issues such as menstruation, testing for HIV, hygiene check-ups, and mental health etc.
Similarly, sports are also a great platform to engage boys and men, without whom, addressing gender inequities in health and promoting SRHR is not possible. Communities and individuals are at risk when girls and boys are not educated about life skills and gender dynamics. Sports programmes in which boys and girls are taught life skills can impact an entire community’s sense of what is possible in terms of communication, mutual respect, and the potential for girls’ contributions on and off the playing field. In this way, boys and girls become part of each other’s peer empowerment instead of contributing to unequal and destructive power dynamics. In doing so, they challenge the primary building block of their assumptions that can contribute positively to changing gender norms.
Vivian Mbithe, peer champion and football coach, Mukuru
"The programme personally had a great impact in my life because I was trained on various issues in regards to health that I had no prior knowledge of. I have gained new skills as a peer champion and a trainer and the process has improved my self-esteem."
Image (c) Henry Thuo, 2021
2) Sports create social safety nets
Sports encourage girls to get out of their homes to learn important life skills like decision-making and agency that enable them to effectively exercise their SRHR. Values and opinions of parents, family members, or caregivers greatly impact the SRHR decisions girls make - and sometimes, not always, these influences can be harmful. By participating in sports, girls learn to ask for help and are exposed to wider ideas and trusted alternative sources of information that can assist them to make informed decisions and defend their choices concerning SRHR.
What we have learnt, especially during the COVID-19 pandemic, is that most gender-based violence happens in the home. Sports inherently emphasise interactions based on principles of ubuntu* since any individual’s participation is based on mutual respect and everyone who is involved can only achieve what they want by working together. In this context, girls in sports teams are not alone and they share responsibilities and concerns for teammates, which is an opportunity to create healthy social safety nets that can be a lifeline for someone experiencing abuse, ensuring they know it is okay to ask for help and find out options available to them.
*The African philosophy of “ubuntu” is a concept in which the individual self is constructed through your relationships with other people and begins with the premise that “I am” only because “we are”.
3) Sport encourages boundary-setting in an enabling environment
All sports have rules and boundaries; and learning, abiding, and enforcing the rules is part of the game. Our project, through the trained network of peer champions and sports coaches, used practices and matches to educate girls about SRHR and sport to help them understand what is acceptable and what an infringement is. We found that using their sporting experience, as a framework helps girls develop an appreciation of fairness, justice, and respect, and evidence suggests this leads to girls to speak about rule-breaking more regularly on and off the field.
While it is still anecdotal, girls’ appreciation of boundaries was reinforced by the confidence sports encouraged. Whether it was the first time squaring up a sparring partner in Taekwondo, the first spike in a volleyball match, or a goal in football, sports offer a chance to develop courage and experience overcoming hurdles and fears. Reporting abuses, standing up to harmful practices or an offender, or just saying ‘NO’ to unwanted advances takes more courage than any sporting situation. But what we have learnt suggests that a girl's capacity and experience in overcoming the anxiety of reporting or seeking assistance and remedies is enhanced by her athletic experience.
4) Sport builds trust and social cohesion
Anyone who has ever been a part of a team knows how strong the relationships between teammates can be, on and off the field. These relationships develop over time because of interacting, learning to communicate, and working together to overcome obstacles and to attain shared objectives. The result is a trusted social network that can be a huge help in navigating puberty and SRHR for any girl and especially those who are made more vulnerable because of poverty, becoming pregnant, or those who have survived gender-based violence.
Sports teams naturally establish a sense of community and often can be a source of local pride. By supporting the creation of sports teams, the project helped create a safe public space for girls to inhabit in their communities that they might not otherwise have had access to. By participating in a space dedicated to them and where they receive support from team members and coaches, they are more freely able to ask questions, learn and confidently speak about SRHR at home, at school or with their friends. Also, by encouraging the communities to gather to watch matches, the project could also reach parents, family members, and community leaders with accessible information about the importance of SRHR for keeping girls healthy and safe.
Sports for Health in Nairobi
In the first two years of the programme,
When girls participate in sports and their communities support them, opinions of girls’ and young women's skills and strengths transform. In our own experience, we witnessed community members cheering on the girls’ sports teams at tournaments and events, while being encouraged to listen and learn more about SRHR, especially how it impacts the young athletes.
Through careful and positive programming, sports can be filled with lessons on self-esteem and confidence-building for improved SRHR in communities. Girls are also given the chance to become leaders, develop physical strength, be exposed to great role models, be recognised for their improvements, and be applauded for using their voices. And this is important because girls who are confident in themselves and their knowledge are far more likely to resist peer pressure to have sex before they are ready – in short, reducing the chances of engaging in behaviour that can lead to unwanted pregnancy and STIs.
In our second phase of the project, we will expand our programme into two new areas, namely Dagoretti North and Embakasi West (both informal settlements in Nairobi) and maintain activities in our current locations. Over 36 months and with a budget of £2 million we can replicate our success and expand impact. This time round, over 9,000 girls and boys from marginalised communities will be able to learn about their SRHR through sport, dialogue, peer support networks, enabling environments, and blessings from the wider community.
In their own words
Amref staff and community members involved in Sport for Health describe the impact the programme is having on life in Dagoretti and Mukuru.
Video (c) Henry Thuo for Amref Health Africa