Improving access to adolescent sexual and reproductive health and rights
Adolescence (ages 10-–19) can be an uneasy time for girls and boys because of sudden changes to the body, the starting of a period, new social norms and expectations, the possibility of child, early and forced marriage (CEFM) and early pregnancy. During this time, adolescent girls and boys need access to health care and education that addresses their specific needs and challenges. Through our Strengthening Health Outcomes for Women and Children (SHOW) project, we’re training health care workers to provide gender responsive and adolescent-friendly health services and empowering youth to be leaders of their own sexual health to help them make informed decisions about their future.
Explore this six-part multimedia series by scrolling through the content below to learn more about how this gender transformative* Gender transformative projects have an explicit rights-based intention to transform unequal gender power relations which are often at the heart of many disadvantages faced by women and girls; the focus goes beyond improving the condition of women and girls to improve their social position. Gender transformative projects address the root causes of gender inequality and promote the value of women and girls health project is helping entire communities champion women and adolescent girls’ health while moving the needle on gender equality.
Learn, demand, Lead
Adolescents girls and boys have specific sexual and reproductive health needs, and require tailored health services.
Director of Health
Plan International Canada
There is now a peer group of adolescent girl champions. This is bringing people into the future.
LHI,SHOW Partner, Nigeria
The SHOW adolescent groups made a big difference. girls are now making their own decisions AND raising their voices.
Dr. Najia Amin Salsabil
Plan International Bangladesh
Adolescent-friendly health services for girls and boys should be accessible, affordable or free, and have convenient hours.
staff should be trained professionals who are non-judgmental, maintain confidentiality, and respect.
The health facilities should be equipped with the appropriate drugs, supplies and equipment; be appealing and 'friendly' with, for example, adolescent and breastfeeding corners, privacy screens and safe, separate toilets.
SHOW Improved health centres to provide:
· adolescent-friendly spaces
· clean birthing rooms
· new sex-segregated toilets
· safe water supply
After receiving training on gender responsive and adolescent-friendly health services, I provide counselling to people who come to my clinic. I tell people not to discriminate between boys and girls, and maintain client privacy.
Bangladeshi health worker
Adolescents are generally shy to say why they've come to see me. When they say they have a bellyache, I know it’s usually about a sexually transmitted infection. Then, I do counselling.
With the project, we have identified a space where teenagers can have more privacy for information.
Midwife, rural senegal
It's very important to teach the girls about the challenges with child marriage. They are becoming more confident to share what they learn.
Peer Group Facilitator, Bangladesh
As with all SHOW programming, we worked with partners to improve health services, and with communities to build demand for them.
“We wanted young people to know more about their sexual and reproductive health and rights,” says Theodora Quaye. “Adolescents can take action when they have information.”
SHOW created a variety of ways to engage adolescents – through youth clubs, radio shows, community discussions and dramas.
In Haiti there are the “Champions of Change” – mixed youth groups where adolescent boys and girls can learn about sexual and reproductive health and rights together.
“Young boys in general think they are superior,” says Dr. Elie Juin, the SHOW Coordinator in Haiti. “They believe they should have first choice to go to school, or to play outside while girls stay home and do the housework. This program allowed them to see things differently.”
Dr. Juin says he’s personally seen change. He says young people talk about new ways of seeing and doing things including boys helping at home or girls talking freely to their parents about their needs.
In Senegal, SHOW built on the existing “Club Education à la Vie Familiale” (Education for Family Life) or EVF, which are youth peer groups encouraged by the Ministry of Education. These are spaces for youth to talk about adolescent issues, including about pregnancy, HIV, early marriage and gender-based violence.
One major motivation is to keep girls in school, says Aminata Traore Seck, an SRHR specialist within the Ministry of Education. In Senegal, about a third of girls are married before age 18, and about 18% of adolescents living in rural areas become pregnant.* Source: Senegal Demographic and Health Survey 2018
The first step to create the Clubs is to train teachers who can facilitate groups based on a curriculum that includes pregnancy, contraception, and personal and menstrual hygiene. Clubs are mixed and girls are encouraged to be club President. They meet and plan for larger activities with other students, such as sessions on pregnancy.
Senegal also trained midwives and nurses to be resource persons for the clubs. Adolescents can visit them at the health facility, and they can also participate in group activities, to give information and start conversations.
“These SHOW-sponsored clubs make a big difference,” says Aminata Traore Seck. “Parents changed their minds and started to accept the clubs. They realised these were helping to keep their girls in school. They saw there were real solutions.”
One student, Oumou, has been a gender equality leader in her community in Senegal. She talks with her family, her EVF club and community members about contraception, pregnancy and safe delivery.
“I believe if we raise family awareness and share information, the situation will change. Because men will find out that we have relevant ideas,” Oumou says. “Boys help in house chores, but not often, she says. “This situation may change one day, because sometimes my younger brother helps me sweep the house. This did not happen before.”
The EVF clubs continue in Senegal.
An adolescent survey conducted by SHOW partners in Senegal shows that the percentage of surveyed adolescent girls who thought it was important to delay pregnancy in order to complete their studies almost doubled, from 28% to 59%. More boys said they thought the health centre was keeping more accessible hours. More girls felt health workers would respect their confidentiality.
In Ghana, a similar survey showed that girls who mentioned modern contraception as a way to avoid pregnancy increased from 48% to 98%.
click the links below to read more about the SHOW learnings in adolescent sexual and reproductive health and rights.
- Gender Responsive, adolescent-friendly referrals
- Responding to the Needs of Adolescents
- Sexual and Reproductive Health Programming: Program Evidence for a Gender Transformative Approach
- Quantitative Research in Ghana: Adolescent Sexual and Reproductive Health & Rights (ASRHR) Research for Strengthening Health Outcomes for Women and Children (SHOW) Project
- Quantitative Research in Senegal: Adolescent and Sexual and Reproductive Health & Rights (ASRHR) Research for Strengthening Health Outcomes for Women and Children (SHOW) Project (French only)
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