1.7 What are the challenges to participation and how can we address them?

There are a number of challenges to making sure children are listened to by health professionals. As we discussed earlier, in many countries and cultures, including in Africa, there is a considerable resistance to the idea that children and young adults have to be consulted and listened to. It runs counter to the assumption that adults know best and that children lack the experience and competence to take responsibility for decision-making. Many parents and professionals are also concerned that providing children with information about their medical condition might be painful for them to accept. They argue it is better to protect children from such information and choices. The following discussion looks at five particular challenges and provides some ideas on how to address these.