“What’s in the box?”

We are in Hawaryat Town in southwestern Ethiopia, standing in front of a school library which also functions as a clubhouse. Outside, a padlocked box is an imposing sentinel.  We are told it was created by members of the Modesty Club. Girls use the box to submit confidential questions about contraception, reproductive health and sexuality. Every week, the box is opened and the club votes on which issues to discuss. If there is a question they cannot address, a local health extension worker is invited to provide counseling and other services.


It turns out that most questions are about menstruation and what to do about a lack of clean toilets and feminine hygiene supplies. This is lockboxheaderunfortunately a leading cause of girls dropping out of school in Ethiopia. The Modesty Club is determined to change this. They provide girls with free sanitary napkins, free counseling, and sexual education—and even a comfortable place to rest when they’re experiencing painful menstrual cramps.

The adults who are our chaperones on this site visit look around nervously as the club members explain what they do. When asked for examples of other questions girls may have, many demur and I have to lean forward to hear their mumbled responses.

Their discomfort is so clear I cannot help but be struck by the unintentional but powerful symbolism of the club’s name and especially the symbolism of that locked wooden box.

Worldwide, complications due to childbirth and unsafe abortion are currently the leading cause of death for women aged 15 to 19 and  half of all new HIV infections occur among young people between 18 and 24 years old. Yet, far too often, the sexual and reproductive health needs of youth are hindered by unfriendly policies or cultural taboos that make discussing and meeting their needs “immodest.” Furthermore, young people are often expected to keep their needs and desires locked away. The result is that they are one of the most vulnerable groups when it comes to access to comprehensive sexual education and reproductive health services.

On Sunday, at the International Conference on Family Planning, African youth activists demanded an end to harmful policies and cultural practices that prevent them from exercising their rights and accessing sexual and reproductive health services. These include policies that require young people to get parental consent to get services, lack of comprehensive sexual education in schools, and family planning providers who don’t respect their confidentiality or who are judgmental of their choices. Later in the week, policymakers at a high level ministerial meeting reaffirmed the importance of investing in youth and the critical role family planning plays in improving their social and economic well-being, as well as the prosperity of their communities and nations.

The London Summit on family planning and now FP2020 provide an exciting opportunity to make sure that youth sexual and reproductive health and rights become a global priority. Most importantly, improved youth policies that are informed by youth and which are built upon a foundation of rights and empowerment will ensure that young people receive services that are youth-friendly and which address the totality of their needs. With more than 40 percent of the world’s population being under the age of 25, we cannot afford to keep youth sexual and reproductive health and rights under lock and key. Our future depends on it.