Beyond the Silence & Why Information Alone is Not Enough

by Safaa Garelnabi, Co-Founder — Hope Springs Health Foundation Uganda | A 2026 LDA Program Partner

I grew up in Uganda, witnessing gender inequality and cultural silence around sexual and reproductive health, which left girls without basic information that would shape their lives. Due to a lack of awareness, the girls did not know how their bodies worked, what their rights were, when to seek care, or where to go and what to do when something was wrong. Combined with the pressures that came with poverty, this was quietly pushing them out of school, sometimes into teenage pregnancies, early marriages, and into futures they had not chosen.

I saw firsthand that when the right information was given early enough, it could keep a girl in school, support her to make informed choices, and ultimately change the direction of her life. I wanted to be a part of making that crucial information accessible. That’s what inspired me to get into public health, and more specifically, Sexual Reproductive Health and Rights (SRHR) as an educator and a leader.

Lessons from the Lockdown

When schools closed in 2019 during the COVID pandemic, teenage girls in rural communities were the ones who suffered most. Families were struggling financially, and many girls ended up in sexual relationships with older men in exchange for basic commodities such as sanitary menstrual products.

Studies showed that COVID-19 lockdowns led to a measurable increase in teenage pregnancies, reversing previous declining trends. National reports further indicate that the pandemic made existing vulnerabilities worse, with increased poverty, school closures, and limited access to sexual and reproductive health services driving higher rates of transactional sex and early pregnancy among adolescent girls. All this was alarming and painful to witness.

Girls Watching the Sara: The Trap video by UNICEF during a Sugar Daddy Awareness Class as Part of the AI Powered Sexual Education Project | March 2024

Eastern Uganda is one of the poorest regions in the country, and in communities where poverty runs deep, it brings with it entrenched cultural practices that keep teenage pregnancy rates persistently high. The national average stands at 25%; yet in some parts of the region it reaches as high as 40%. Through my direct work with schools and community health workers in the region, I was already aware of the rates of teenage pregnancy.

“These weren’t just numbers to us, but patterns we kept encountering in the communities we worked in. Watching it happen in communities I worked in, to girls I knew by name, was different. It made me angry. It made me feel responsible to do something beyond my job description.”

Safaa Garelnabi, Co-Founder Hope Springs Health Foundation Uganda

I wasn’t alone in that feeling. Two colleagues, who had spent years working on adolescent health, maternal health, and community health systems strengthening programmes, kept seeing the same things in the conversations we had with community health workers, in the public schools we visited, and in the stories girls and women shared with us directly. Together, we started volunteering when schools reopened.

It was especially clear in adolescent health, during Sexual Reproductive Health (SRH) training, when we had honest conversations with girls about period stigma, cross-generational relationships, what drives them, and how to navigate the pressure. Seeing the need and impact more clearly, we decided to scale our efforts.

In 2023, Hope Springs Health Foundation Uganda was established by starting awareness classes and training facilitators from within these communities to continue the work without us. It was our way of doing something deliberate about a problem we had each carried personally and professionally for years.

Not through programmes designed far from the communities they serve, but through approaches grounded in what people actually need. We combined health education, community engagement, and technology to reach adolescents in practical, accessible ways. More importantly, we worked to build something that communities would own, where those participating are not just recipients but facilitators, taking the work forward in their own voices and on their own terms.

Girls Reading the Sara: The Trap Booklet by UNICEF During a Sugar Daddy Awareness Class Session as Part of the Sugar Daddy Awareness Project, January 2026. The Booklets are used in Schools without Electricity

The Club the Girls Built

At one of the secondary schools we work with in Mayuge District in Eastern Uganda, a school with over 700 students, girls were regularly missing class during their periods. Not only because of pain, but also because of shame. Many didn’t have access to proper menstrual products, and they feared staining their uniforms or being teased, which kept them at home. It was an open secret that was not addressed.

Mary, a 15-year-old schoolgirl, was in a sexual relationship with her 22-year-old boyfriend; she did not know that girls could get pregnant even on safe days. When she approached a healthcare worker for advice on contraception, she was ridiculed and sent back home without appropriate counselling or support. We met Mary during the initial assessment visit to the school before the intervention training, where she was identified as part of the target group.

When we ran the menstrual hygiene training at the school — on both the theory and practicals on sexual reproductive health management — the 20 girls in attendance were engaged and full of questions. The kind of questions that come when someone finally feels safe enough to ask, such as the myths and misconceptions of periods: “Is it true that cooking while on your period will bring you bad luck?” They learned about their bodies, how to manage their periods safely, and how to make reusable sanitary pads.

After the training, those same girls started an SRHR Club at their school. They wanted to keep the conversation going. They then invited boys to join and went further, teaching them how to make reusable sanitary pads. Mary was subsequently included in the school-based club formed later as part of the intervention activities.

Over time, things shifted at that school. Girls talked about menstruation without lowering their voices. Boys stopped making it a source of jokes. Attendance during periods improved. A single training session turned into something the students built and owned themselves.

Scaling Hope for the Community, by the Community

We didn’t plan the club. The girls did. That tells us more about what works for that particular community. When young people are given the space to understand issues that affect them in a way that feels safe and relevant, they take ownership. It becomes something they lead, not something delivered to them. This has shaped how we design our programs.

Safaa and the Girls Discussing the Risks Associated with Sugar Daddies for the Sugar Daddy Awareness Project | January 2026

We now focus on combining knowledge with practical solutions, because information alone is not enough if young people still lack access to basic commodities. By integrating skills like making reusable pads, we support more sustainable, locally driven solutions. Our goal is to help more schools create and sustain similar peer-led initiatives that continue beyond our direct involvement.

Between 2023 and 2025, over 2,000 girls across 10 schools have gone through our Sugar Daddy Awareness and Menstrual Health Programme, school-based interventions that combine sexual and reproductive health education and peer-led discussions. All to equip adolescents with knowledge, practical skills, and decision-making tools. Six trained facilitators are now running it independently in some of Eastern Uganda’s most affected communities.

The work continues.

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