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January 6, 2004

In collaboration with partners in three countries, Ipas has piloted a new approach to making reproductive-health services more attractive and accessible to young people: asking adolescents themselves for advice. The success of pilot projects in Ethiopia, Nigeria and Vietnam which involved men and women aged 18-26 in creating youth-friendly sexual- and reproductive-health services suggests a model that could prove useful in other settings.

Adolescents are particularly vulnerable to unwanted pregnancy, sexually transmitted infections and other reproductive-health risks. For example, despite widespread consensus on the importance of preventing early and unwanted pregnancies among young women, such pregnancies continue to occur for a variety of reasons. These include:

Experts agree that addressing these and other issues that contribute to unwanted pregnancy among adolescents is critically important. Yet while many reproductive-health projects involve peer education by adolescents, few programs seeking to address young people’s needs for related information and services actually include them in designing and developing services.

Working with local NGOs in Ethiopia, Nigeria and Vietnam, in 2003 Ipas initiated three pilot projects to test the feasibility of bringing young people and providers of abortion-related care together to define youth-friendly services. A secondary emphasis of the projects was incorporation of a gender and human-rights perspective.

In all three countries, the young men and women participated in educational sessions that included the topics of reproduction, reproductive rights, contraception, pregnancy, unsafe abortion and safe abortion. In Ethiopia, health-service providers joined the adolescents in these sessions, which resulted in recommendations for making sexual and reproductive-health services youth-friendly. In both Nigeria and Vietnam, the young people developed dramas about unwanted pregnancy and its consequences, which were performed for health-service providers and followed by discussions between the two groups.

Many similar issues were raised in all three countries. For example, adolescents in all settings described being subject to judgmental and even punitive behavior from providers and recommended that steps be taken to make services non-judgmental, non-critical, respectful and patient. They also recommended that the service-delivery environment be friendly, welcoming, and guarantee privacy and confidentiality, and that providers be skilled in both clinical procedures and counseling. Providers acknowledged their need for more training, especially in the areas of information, education and counseling.

The greatest strength of the pilot projects was that the young people were able to participate actively and creatively in affecting an issue of direct relevance to their own lives. The projects put the young people on equal footing with the service providers to ensure that their concerns and needs become the basis for improvements to youth-friendly sexual and reproductive-health services.

In general, the young people were encouraged by the participation of the health-care providers and enthusiastic about the projects' outcomes. As one participant from Nigeria said, "If such a thing could be repeated, I'll not recommend it to friends alone, but my siblings, my colleagues, neighbours, church members, course mates, everybody."

For additional details, read the comprehensive report from the Ipas Adolescent Working Group.

For more information, contact:
Kirsten Sherk
Senior Associate, Media Relations
e-mail: sherkk@ipas.org
phone: 919.960.5612
fax: 919.929.0258