2.10 Respecting children’s capacities to participate

There is a tendency across East Africa, as in other regions of the world, to deny children the opportunity to take responsibility for decisions and actions that they are competent to take. Children are expected to listen and do as they are told. They are not expected to contribute their own ideas, influence their own communities, or contribute to decision-making. Yet they are often capable of understanding and engagement far beyond the assumptions that adults have. For example, it is a common concern of children that health professionals fail to acknowledge their ability to be involved in decisions about their own health care. However, children should be encouraged to take responsibility and participate in those decisions and activities over which they do have competence. And like adults, children build competence and confidence through direct experience – doing things rather than just being told about them. It is a ‘virtuous circle’ – in other words, the more children participate the more skills they acquire and the better they are able to participate in the future. The more children are recognised and encouraged to be involved in decisions and take responsibility, the more they will acquire the capacities to do so effectively. For example, you can actively engage children and young people in discussions about how to protect themselves from infection, managing pain relief, approaches to sexual health or how to change dressings.