Globally, adolescents and youth face many societal and cultural barriers that undermine access to their sexual and reproductive health rights (SRHR). Many are unable to access important reproductive healthcare services, including modern contraception and maternal health care, comprehensive sexual education, and opportunities to make informed autonomous decisions about their sexual and reproductive health.
The consequences of this are particularly acute amongst adolescent girls. A lack of sexual education and knowledge of their SRHR can lead to early pregnancy, which can have negative consequences for their health and well-being, as well as that of the newborns.
In 2019, the World Health Organisation (WHO) estimated that every year, 21 million girls aged 15-19 in developing countries become pregnant, of which 55% were unintended pregnancies. Despite several countries making efforts to improve the health status for adolescents, they are still one of the most under-served groups in existing health services.
Developing reproductive health strategies
Family Planning 2030 (FP2030) is the only global organisation that works sorely on advancing family planning and reproductive rights. FP2030 is committed to extending access to and use of reproductive health services to people globally by working collectively with governments, civil society, youth, and donor partners.
Commonwealth Alumnus Dr Jacqueline N Fonkwo joined FP2030 in 2021 as the Global Consultant – Youth Partnerships. In her role, she offers strategic managerial guidance to design and execute FP2030’s global adolescent and youth strategy.
Dr Fonkwo is also the co-founder of Youth 2 Youth, a youth-led education platform focused on adolescent health in Cameroon. Here, she harnesses the power of digital technology to transform adolescent health in Cameroon.
Designing regional healthcare solutions
A medical doctor by profession, Dr Fonkwo credits her Commonwealth Scholarship and Master’s in Global Health in launching her career in global health practice.
The course’s programme-oriented approach and emphasis on qualitative research methods equipped her with necessary skills to transition from being a medical doctor to a global health consultant. This included ways of translating scientific approaches into practical solutions in global health interventions.
On completing her Master’s, Dr Fonkwo joined FP2030. She recollects this was a time of transition for the organisation. In 2020, FP2030, formerly known as FP2020, re-evaluated their strategy to better meet the 2030 family planning agenda. A significant change was to de-centralise from the organisation’s base in Washington DC and set up four regional hubs across the world.
Dr Fonkwo was crucial in designing and leading the adolescent and youth portfolio for the regional hubs, working directly with youth leaders to advance adolescent and youth SRHR in multiple countries. She was instrumental in the recruitment of youth managers in FP2030 hubs in Abuja (Nigeria), Nairobi (Kenya), Panama (Panama), and Kuala Lumpur (Malaysia).
Working directly with young people
Working in partnership is key to the success of FP2030’s strategy to strengthen family planning through its regional hubs. Dr Fonkwo leverages partnerships with youth leaders, donor partners and other stakeholders to support countries in developing global health commitments and youth responsive strategies. She works closely with governments to make commitments to ensure women and girls have improved access to modern contraceptive products, increased SRHR awareness, and better decision-making ability regarding their reproductive health.
Working directly with young people is core to achieving better SRHR for adolescents. To ensure young people are effectively represented, Dr Fonkwo designs capacity-strengthening workshops for youth partners to enhance skills on youth and gender integration in their work. Through this work, she has fostered youth leadership in global health by directly managing over 42 youth leaders from over 42 countries.
“When I joined the organisation at a time of transition, I was instrumental in the recruitment and the onboarding of the youth managers in these different hubs. I provide them with the assistance in their work that they need to be able to manage their regional adolescent and youth portfolios.”
Dr Fonkwo has also worked to strengthen FP2030’s relations with key donors, such as the United States Agency for International Development (USAID), the WHO, the UK Foreign and Commonwealth Development Office (FCDO), and the Bill and Melinda Gates Foundation. She ensures donor partners are aligned with FP2030’s strategy, coordinating efforts for meaningful youth engagement and partnership, and sharing feedback to strengthen partnerships and programmes. This has helped in bridging the gap between governments and global donor partners to enable countries to access resources to deliver their commitments.
Recently, Dr Fonkwo led the development of the Global Adolescent and Youth Strategy which was launched in April 2024 in Cotonou, Benin, during the Global Youth Dialogue, organised by United Nations Population Fund. This is an important strategy which will inform FP2030’s future work.
Promoting awareness
Prior to pursuing her Master’s, Dr Fonkwo practiced medicine in her local community in the northwest region of Cameroon. In 2016, her work and community were severely impacted by the Anglophone crises which disrupted health and education systems.
During this time, Dr Fonkwo observed the impact of disrupted services on adolescent girls’ sexual and reproductive health, which included a rise in teenage pregnancies, unsafe abortion practices, and a general lack of awareness on SRHR and family planning.
“An 18 year old girl came to the clinic. She was pregnant and she went to get an abortion with someone who was not trained and they perforated her uterus. When she got to us, she had a complicated situation. When we examined her and did the necessary tests, we realised that it was an ectopic pregnancy, and so there was a need to operate. Such cases were increasing, and I took it upon myself to talk to young girls who visited the clinic about their sexual reproductive health.”
In 2018 Dr Fonkwo co-founded Youth 2 Youth, which soon became one of the leading initiative in the region focused on promoting awareness of SRHR to adolescents and youth. Utilising her clinical experience and knowledge of delivering community health initiatives on SRHR, the organisation soon gained wider attention and recognition.
In 2019, Youth 2 Youth partnered with the then FP2020 and Dr Fonkwo was appointed the youth focal person for Cameroon. This appointment enabled her to apply her expertise on SRHR at a national level and support Cameroon’s commitment to advancing family planning.
A significant gap in previous strategies to advance family planning was the representation of adolescents. Through continuous efforts by Dr Fonkwo through Youth 2 Youth and the FP2020, in 2022 the government of Cameroon revised its national commitments on SRHR and a specific SHRH commitment was made for adolescents and youth.
“Because of my clinical background and some of the information that we were able to push ourselves to learn, [and support from] civil society organisations, [we learned] how to engage effectively with different community members on sexual conduct because it’s a very sensitive topic… [Our] work grew from being in just one of the regions to a national effort.”
Healthcare information for young people
Dr Fonkwo stresses that advancing family planning is not without challenges. There is a common perception that young people and adolescents are not sexually active and because of the taboo around talking about sex and sexual health, people do not engage on the topic. Moreover, commitments made by governments towards adolescents and youth in general are often tokenistic and without adequate funding to deliver relevant services.
To increase awareness amongst young people, during her Master’s Dr Fonkwo implemented some of the learnings from a module on programme design to develop a project proposal to create a mobile application for Youth 2 Youth.
The proposal successfully secured funding from Grand Challenges Canada and the mobile application now provides free healthcare information and services to young people in Cameroon. As of 2023, the mobile application received more than 1,000 subscribers.
Dr Fonkwo has also initiated dialogues with community leaders and stakeholders on the impact of the ongoing Anglophone crises on adolescent and youth SRHR. These dialogues have helped engage people at the community level and identify gaps in health concerns related to young people.
Learning the fundamentals of public health practice
Looking back on her studies, Dr Fonkwo notes that pursuing her Master’s at Queen Margaret University provided her with the opportunity to meet like-minded people from across the world. She found interactions with her peers useful in understanding public health interventions in their communities.
Dr Fonkwo hopes to continue to support youth leaders and engage communities and governments to strengthen efforts in adolescent and youth sexual and reproductive health. She hopes her work will enable communities to become self-reliant and access health care services without barriers.
“The Commonwealth Scholarship was a very timely opportunity as I was considering making a transition from clinical practice. The impact of the Scholarship was that it gave me the opportunity to be able to study and understand the fundamentals of public health practice.”
Jacqueline N Fonkwo is a 2020 Commonwealth Shared Scholar. She completed a MSc in Global Health at Queen Margaret University.
