ARIESOFPROJECTSINDEVELOPINGCOUNTRIESASSISTINGTHEPARENTSOFADOLESCENTS7ORLD(EALTH/RGANIZATION
3UMMARIESOFPROJECTSIN
DEVELOPINGCOUNTRIESASSISTING
THEPARENTSOFADOLESCENTS
developing countries assisting
the parents of adolescents
School of Public Health, Baltimore USA. The time and effort of staff from the projects summarized must also be recognized as crucial to the preparation of this document and to the ongoing endeavour to assist parents.
WHO Library Cataloguing-in-Publication Data
Summaries of projects in developing countries assisting the parents of adolescents.
“World Health Organization … [et al.]”.
1.Adolescent health services. 2.Adolescent development. 3.Parents. 4.Sexual behavior. 5.Reproductive health services.
6.HIV infections - prevention and control. 7.National health programs. 8.Program evaluation. 9.Developing countries.
I.World Health Organization.
ISBN 978 92 4 159566 7 (NLM classification: WA 330)
© World Health Organization 2007
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Introduction 1 Abbreviated terms 2
African Region 7
1. Burkina Faso: Community participation to improve adolescent sexual and reproductive health 8
2. Kenya: AMKENI Project 16
EngenderHealth: 440 Ninth Avenue, New York, NY 10001
Telephone: 212-561-8000 p Fax: 212-561-8067 p e-mail: info@engenderhealth.org http://www.engenderhealth.org/ia/cbc/kenya.html
3. Kenya, the United Republic of Tanzania, and Haiti: Abstinence and risk avoidance (ARK) for youth 21
Johns Hopkins Bloomberg School of Public Health, Center for Communication Programs, Health Communication Partnership: 111 Market Place, Suite 310, Baltimore, MD 21202
Baltimore: Jennifer Boyle, jboyle@jhuccp.org p Field: Samson Radeny, samson_radeny@wvi.org http://www.jhuccp.org/africa/regional/ark.shtml
4. Kenya: Kenya Adolescent Reproductive Health Project (KARHP) 29 5. Kenya: Friends of Youth (FOY) 36
Population Council: P.O. Box 17643-00500, Enterprise Road, Nairobi, Kenya (254-2) 2713480/1/2/3 p fax (254-2) 2713479
or
Family Planning Association of Kenya: P. O. Box 30581, Nairobi, Kenya; 604296
e-mail info@fpak.org p http://www.advocatesforyouth.org/programsthatwork/developing/nyeri.htm
6. Kenya: Youth Intervention Programme (YIP) 42
The Prince Leopold Institute of Tropical Medicine in Antwerp, Belgium (ITM) Phone: +32 3 247.66.66 p Fax: +32 3 216.14.31 p Email:info@itg.be Nationalestraat 155 – B-2000 Antwerpen
http://www.itg.be/itgtool_v2/Projecten/Project.asp?PNr=85291
7. Malawi: Cool Parent Guide – promoting parent-young child communication 48
Save the Children: 54 Wilton Road, Westport, CT 06880
(203) 221-4030 (8:00 am - 5:00 pm edt) p (800) 728-3843 (8:00 am - 5:00 pm edt) Washington D.C., 2000 M Street NW, Suite 500, Washington D.C. 20036
(202) 293-4170 (8:00AM - 5:00PM EDT)
8. Senegal: Parents as Partners 59
United Nation Youth Association of Sierra Leone (UNYAOSIL) 13 Savage Street, Brookfields, Freetown, Western Area, Sierra Leone unyaosil@yahoo.com
9. Sierra Leone: United Nation Youth Association of Sierra Leone (UNYAOSIL) 68
Tel: (+27-11) 523 1000 p Fax: (+27-11) 523 1001 p Email: talk@lovelife.org.za http://www.lovelife.org.za/
11. Uganda: Modern senga 77
12. Uganda: Promoting Safer Choices for Adolescents (ProSCAd) 81
CARE Uganda: PO Box 7280, Kampala, Uganda
13. Zambia: Parent Elder Education Programme (PEEP) 85
Region of the Americas 89
14. Colombia: Mentor Foundation 90
Mentor Colombia: Carrera 13 nº 50 - 78 Piso 2, Bogotá Colombia, South America
Tel: +571-345 62 91 p Fax: +571-346 68 55 p Email: administracion@mentorcolombia.org Web: www.mentorcolombia.org
15. El Salvador: Familias Fuertes (Strong Families) Love and Limits 96
Pan American Health Organization: 525 23rd St. N.W., Washington, D.C. 20037, U.S.A.
(202) 974-3000
16. Haiti: Parents and Prevention 105
Johns Hopkins Bloomberg School of Public Health, Center for Communication Programs, Health Communication Partnership: 111 Market Place, Suite 310, Baltimore, MD 21202
http://www.hcpartnership.org/Programs/program.php?id=1
17. Jamaica: Adolescent Reproductive Health Project (Youth.now) 111 18. Nicaragua: Entre Amigas 119
South-East Asia Region 127
19. Bhutan: School-based Parents Education and Awareness (SPEA) Project 128
Save the Children: 54 Wilton Road, Westport, CT 06880
(203) 221-4030 (8:00 am - 5:oo pm edt) p (800) 728-3843 (8:00 am - 5:00 pm edt) Washington D.C.: 2000 M Street NW, Suite 500, Washington D.C. 20036
(202) 293-4170 (8:oo am - 5:00 pm edt)
http://www.savethechildren.org/countries/asia/bhutan.html
20. India: Development Initiative on Supporting Healthy Adolescents (DISHA) 138
International Center for Research on Women (ICRW)
1717 Massachusetts Avenue, NW, Suite 302, Washington, D.C. 20036 Tel: 202.797.0007 p Fax: 202.797.0020 p E-mail: info@icrw.org http://www.icrw.org/html/projects/projects_adolescence.htm
21. India: Expressions: Comprehensive life skills education & school mental health programme 145
Expressions India: Child Development & Adolescent Health Centre, VIMHANS No. 1 Institutional Area, Nehru Nagar, New Delhi- 110 065
Ph.: 26310511-520, 26926920 (Direct)
Email: jitendranagpal@rediffmail.com p Divyasprasad73@rediffmail.com
22. India: Society for the Care of Adolescents (SCAN) 152
sybhave@yahoo.com p tambhave@yahoo.co.in
23. Nepal: Participatory approach to adolescent reproductive health 160
24. Georgia: Guria Adolescent Health Project (GAP) 168
CARE International in the Caucasus: Chavchavadze Avenue, 74A, 0162 Tbilisi, Georgia http://www.care.org/careswork/projects/GEO056.asp
25. Lithuania: Parents in Partnership (PIP): A mutual self-help initiative for Lithuanian families affected by substance use 172
People in Partnership: Gaustadveien 8C, 0372 Oslo Norway Tel: +47 23 22 36 67 p pipcon@online.no
Eastern Mediterranean Region 181 26. Egypt: Ishraq 1 182
Save the Children: 54 Wilton Road, Westport, CT 06880
(203) 221-4030 (8:00 am - 5:00 pm edt) p (800) 728-3843 (8:00 am - 5:00 pm edt) Washington D.C.: 2000 M Street NW, Suite 500, Washington D.C. 20036
(202) 293-4170 (8:00 am - 5:00 pm edt) or
Regional Office—Egypt
Population Council: 59 Misr-Helwan Agricultural Road, Maadi, PO Box 168, Maadi Cairo, Egypt
Telephone: +20 2 525 5965/7/8 p Facsimile: +20 2 525 5962 E-mail and publications inquiries: pcouncil@pccairo.org http://www.popcouncil.org/projects/TA_EgyptIshraq.html
Western Pacific Region 187
27. China: Youth Reproductive Health (YRH) Project 188
28. China: Hong Kong Special Administrative Region:Childhood Sexuality Education Development Project 195
10/F., Southorn Centre, 130 Hennessy Road, Wanchai, HK 2575-4477 p 2834-6767 p fpahk@famplan.org.hk
http://www.famplan.org.hk/fpahk/en/template1.asp?style=template1.asp&content=home/mainpage.asp
29. Mongolia: Improving the outlook of adolescent girls and boys 201 30. The Philippines: Ebgan, Inc. 211
Ebgan Inc.: Room 314 Laperal Building, Session Road, 2600 Baguio City, Philippines Telefax 0063-74-447-002 p E-Mail 048ebgan@mozcom.com p http://www.ebgan.org/
31. The Philippines: Empowering parents on adolescent health and sexuality 218
Foundation for Adolescent Development: 1037 R. Hidalgo St., Quiapo, Manila 1001
Tel (632)7341788 p Telfax (632)7348914 p fadinc@codewan.com.ph p fadinc@pworld.net.ph http://www.teenfad.ph/about/programs/empowering.htm
32. Viet Nam: Improving knowledge on gender and reproductive health issues for families in rural Viet Nam 222
Research Center for Gender, Family and Environment in Development (CGFED) 19 – A26 Nghia Tan, Cau Giay, Ha Noi
Tel: 7565 929 Fax: 7565 874 p Email: cgfed@hn.vnn.vn
No 63- Lane 35- Cat Linh- Dong Da- Hanoi- Vietnam
Tel: (84-4) 7333613- (84-4) 8234288 p Fax: (84-4) 8234288 p rafh@hn.vnn.vn
34. Viet Nam: Working to improve the reproductive and sexual health of young people 234
In 2005, the World Health Organization (WHO) in collaboration with the Department of Pop- ulation and Family Health at Johns Hopkins University, commenced a review of interven- tions that aim to assist the parents of adolescents in developing countries improve ado- lescent health and development. Please refer to Helping parents in developing countries improve adolescents’ health for additional information. This effort sought to identify such projects and this document is a summary of the information collected.
The methodology employed to identify projects included a search of published studies through computerized databases including PubMed, CINAHL, EMBASE, PsychARTICLES, POPLINE and the Cochrane Library, and a review of the grey literature of international inter- governmental health/development organizations such as the United Nations Population Fund (UNFPA) and the United Nations Children’s Fund (UNICEF), as well as non-governmen- tal organizations (NGOs). Individuals and organizations working in the fields of adolescent reproductive health, substance abuse, violence and mental health were also contacted, in addition to a search of the internet. Whenever possible, project staff were interviewed by telephone using a standardized interview guide. Project summaries were drafted and reviewed by project staff.
Challenges in collecting information included the fact that organizations with relevant pro- gramming often provided very little detailed information on the internet and/or did not pro- vide up-to-date contact information for people related to the project. In addition, when projects stopped after implementing agencies withdrew support, it was difficult to identify and contact project staff. Moreover, project staff were occupied with implementation and had little time to contribute to this type of research effort. Finally, it must be noted that lan- guage barriers prevented the collection of information from project staff, as well as limiting the review to some specific regions of the world.
AA . . . Alcoholics Anonymous AB . . . abstinence and faithfulness
ABY . . . abstinence and behaviour change in youth ACASI . . . audio-computer assisted self-interviewing ACT . . . adolescent coordination team
ADC . . . Adolescent Development Centre (Mongolia) ADD . . . attention deficit disorder
ADH . . . adolescent health and development ADHD . . . attention deficit hyperactivity disorder ADP . . . Area Development Programmes (World Vision) AFHS . . . adolescent-friendly health services
Afrique Ado SR . . Operations research on improving reproductive health services for adolescents in French-speaking countries of Africa (WHO project)
AHUIRO . . . Association of Human Rights Organisations AID . . . Alternative for India Development
AJDRB . . . l’Associations Des Jeunes Pour Le Développement De La Région De Bitou ARV . . . antiretroviral (drug)
AV . . . audiovisual
AYA . . . African Youth Alliance
BCC . . . behaviour change communication
CGFED . . . Research Centre for Gender, Family and Environment in Development (Vietnam)
CARIMAC . . . Caribbean Institute of Media Communications (at University of the West Indies, Mona, Jamaica)
CASS . . . Chinese Academy of Social Sciences CBO . . . community-based organization
CBSE . . . Central Board of Secondary Education (India) CCC . . . community care coalitions
CDA . . . community development assistant
CDAHC . . . Child Development and Adolescent Health Centre (India) CDC . . . Centers for Disease Control and Prevention (USA) CDQ . . . client-defined quality
CEDPA . . . Center for Development and Population Activities (Egypt) CEEC . . . Central and Eastern European Countries
CEFOREP . . . Centre de Formation et de Recherche en Santé de la Reproduction CENCORED . . . Center for Communication Resources Development
CEPS . . . Centre for Studies and Social Promotion (Nicaragua) CFPA . . . China Family Planning Association
CLUSA . . . Cooperative League of the USA CM . . . community mobilisation
CMNA . . . Municipal Child and Adolescent Commission (Nicaragua) COPE . . . client-oriented, provider efficient (exercise by EngenderHealth) CRFH . . . Centre for Reproductive and Family Health (Viet Nam)
CS . . . child survival
CTL . . . local technical committees DAC . . . district advisory committees DCC . . . Dunlop Corbin Communication DDR . . . drug demand reduction
DISHA . . . Development Initiative on Supporting Healthy Adolescents (India) DORD . . . Daudnagar Organization for Rural Development
DRSTP . . . Drug Demand Reduction Staff Training Programme DSR . . . Division of Reproductive Health (Senegal)
DSW . . . German Foundation for World Population
DYCS . . . Department of Youth, Culture and Sports (Bhutan) EU . . . European Union
FAD . . . Foundation for Adolescent Development (Philippines) FGC . . . female genital cutting
FGD . . . focus group discussion FHI . . . Family Health International FHOK . . . Family Health Options Kenya FLE . . . family life education
FLMZ . . . Family Life Movement of Zambia
FOSREF . . . Foundation for Reproductive Health and Family Education FOY . . . Friends of Youth (Kenya)
FP . . . family planning
FPAHK . . . Family Planning Association of Hong Kong FPAK . . . Family Planning Association of Kenya FT . . . focal teacher
FTC . . . Future Threshold Centres (Mongolia) GAP . . . Adolescent Health Project (Georgia) GBV . . . gender-based violence
GEEP . . . Population Training Group
GRIDD . . . Groupe de Resourcement de Developpement et Éducation GT . . . Groupe Technique (Haiti)
GYRC . . . Guria Youth Resource Center (Georgia) HCMC . . . Ho Chi Minh City (Viet Nam)
HCP . . . Haiti Health Communication Partnership HIV . . . human immunodeficiency virus
IAP . . . Indian Academy of Paediatrics
ICRW . . . International Center for Research on Women IDF . . . Integrated Development Foundation (India) IEC . . . information, education and communication
IMAN . . . Integrated Management of Adolescents’ Needs, Pan-American Health Organization
ISFP . . . Iowa Strengthening Families Program ITM . . . Prince Leopold Institute of Tropical Medicine
ITPAH . . . Indian Academy of Paediatrics Training Program on Adolescent Health KABP . . . knowledge, attitudes, behaviour and practices
KAP . . . knowledge, attitudes and practices
KARHP . . . Kenya Adolescent Reproductive Health Project KEMRI . . . Kenya Medical Research Institute
KRC . . . Kabarole Research Center
KVS . . . Kendriya Vidyalaya Sangathan (India) LPS . . . life-planning skills
MC . . . Master of Ceremonies M&E . . . monitoring and evaluation
MHRD . . . Ministry of Human Resource Development (India) MIS . . . management information system
MOE . . . Ministry of Education
MOEST . . . Ministry of Education, Science, and Technology (Kenya) MOGSCSS . . . Ministry of Gender, Sports, Culture and Social Services (Kenya) MOH . . . Ministry of Health
MOYS . . . Ministry of Youth and Sports (Egypt) MRC . . . Medical Research Council (Uganda) MSCI . . . Margaret Sanger Center International
MSPAS . . . Ministerio de Salud Publica Y Asistencia Social (El Salvador) NA . . . Narcotics Anonymous
NACO . . . National AIDS Control Organization (India)
NAFADO . . . National Federation of Anti-Drug Organizations (Sierra Leone) NAYODE . . . National Youth Organization for Democracy (Uganda)
NCCM . . . National Council of Childhood & Motherhood (Egypt) NCE . . . National Council of Education (Jamaica)
NCERT . . . National Council of Education Research Training (India) NCT . . . National Capital Territory (Delhi, India)
NDCA . . . National Drug Control Agency (Sierra Leone)
NFVPP . . . National Network of the Family Violence Prevention Programme (Philippines) NGO . . . non-governmental organization
NORAD . . . Norwegian Agency for Development Cooperation
OVC . . . orphans and vulnerable children PAC . . . project advisory committee PAG . . . parent action group
PAHO . . . Pan American Health Organization
PATH . . . Program for Appropriate Technology in Health PCPD . . . Philippine Center for Population and Development PE . . . peer educator
PF . . . peer family
PEEP . . . Parent Elder Education Programme PEPFAR . . . President’s Emergency Plan for AIDS Relief PES . . . policy environment score
PHC . . . primary health care
PIP . . . Parents in Partnership (Lithuania) PLHIV . . . people living with HIV
PMTCT . . . prevention of mother-to-child transmission of HIV PPASA . . . Planned Parenthood Association of South Africa ProSCAd . . . Promoting Safer Choices for Adolescents (Uganda) PTA . . . parent-teacher association
PSG . . . parent support group
PSI . . . Population Services International
Puntos . . . Puntos de Encuentro Foundation (Nicaragua) RHF . . . reproductive health fair
RHIYA . . . Reproductive Health Initiative for Youth in Asia RHS . . . Reproductive Health Surveys (Jamaica)
RJS/Z . . . le Réseau Des Jeunes De La Sissili Et Du Ziro RTI . . . reproductive tract infection
SARS . . . severe acute respiratory syndrome SC . . . Save the Children
SCAN . . . Society for the Care of Adolescents (India)
SCERT . . . State Council Educational Research and Training (India) SDA . . . social development assistant
SHN. . . school health and nutrition
SIDA . . . Swedish International Development Cooperation Agency SPEA . . . . School-based Parents Education and Awareness Project (Bhutan) SRH . . . sexual and reproductive health
SRHR . . . sexual and reproductive health rights STI . . . sexually-transmitted infection
TCS . . . Tribal Culture Society (India) TD . . . transdisciplinary (approach)
TFPA . . . Tianjin Family Planning Association (China)
TOT . . . training of trainers
UNESCO . . . United Nations Educational, Scientific and Cultural Organisation UNF . . . United Nations Foundation
UNFIP . . . United Nations Fund for International Partnership UNFPA . . . United Nations Population Fund
UNICEF . . . United Nations Children’s Fund
UNHCO . . . Uganda National Health Consumers Organization UNODC . . . United Nations Office on Drugs and Crime UNYAOSIL . . . United Nation Youth Association of Sierra Leone USA . . . United States of America
USAID . . . United States Agency for International Development VAC . . . village AIDS committee
VCT . . . voluntary counselling and testing for HIV
VDH . . . Université Kisqueya, Voluntariat pour le Developpment d’Haïti (Volunteers for the Development of Haiti)
VIMHANS . . . Vidya Sagar Institute of Mental Health and Neurosciences (India) WHO . . . World Health Organization
YAG . . . youth action groups
YMCA . . . Young Men’s Christian Association YRH . . . Youth Reproductive Health (China)
African Region
adolescent sexual and reproductive health
Objectives of project
Goal: To improve the sexual and reproductive health of adoles- p
cents aged 10 to 19 years through community participation.
Objectives:
p
To engage community members, especially adolescents, u
in developing, implementing and evaluating activities designed to change knowledge, attitudes and practices related to adolescent sexual and reproductive health (SRH).
To build the capacity of a national NGO in the following areas:
u
Knowledge of adolescent sexual and reproductive health U
UCommunity participation, adolescent involvement Design of activities for changing knowledge, attitudes U
and practices.
To build the capacity of community-based adolescent-serv- u
ing organizations in the following areas:
Skills in adolescent involvement U
Skills and techniques in community participation U
Knowledge of adolescent SRH U
Skills for developing and implementing intervention strat- U
egies to improve adolescent SRH.
Note: Programming for parents/caregivers was only one of p
many facets of the project. The project aimed to create a community-driven – as opposed to external expert-driven – dynamic in an effort to sustain the project through increased community ownership, investment, commitment and partic- ipation. Adults (including parents) were among the commu- nity members who identified several priority areas in adoles- cent SRH as intervention goals. Two out of three intervention sites chose parent-child communication as a priority area for intervention.
Objectives of aspect involving/
addressing parents
To increase parents’ and adolescents’ level of comfort in dis- p
cussing SRH.
Organization(s) supporting project (technical, financial, evaluation)
Funding from the Mellon Foundation, Pacific Institute for p
Women’s Health (Pacific Institute), and Advocates for Youth (Advocates)
Training and technical assistance by Advocates p
Technical support in research and evaluation by Pacific Institute.
p
Afric A n re
Organization(s) implementing project
Mwangaza Action (a Burkinabé NGO) p
Mwangaza in turn partnered with three adolescent associa- p
tions: l’Associations des Jeunes pour le Développement de la Région de Bitou (AJDRB), l’Associations des Jeunes pour le Développement de Pama, and le Réseau des Jeunes de la Sissili et du Ziro (RJS/Z).
Project history
Timeline:November 1999: Preliminary survey p
July 1999 and April 2000: Organizational assessments p
p January 2000: Launch of community mobilization
October 2000: Knowledge, attitudes and practices (KAP) sur- p
vey for community-based interventions
December 2000: Training of peer educators (PE) p
January–February 2001: Launch of community-based p
interventions
July 2001: Community participation mid-term survey p
July 2001: Peer education mid-term survey p
September 2001: Adolescent-friendly training for health serv- p
ice providers
March 2002: End of community projects p
June 2002: Final evaluation of organizational capacity, KAP sur- p
vey, and community participation and peer education surveys.
Target populations
p Adolescents aged 10 to 19 years
Community members (including parents) from 20 villages in p
rural Burkina Faso (during phase I)
Mwangaza Action and the community-based adolescent- p
serving organizations in Pama, Bittou and Leo (phase 2).
Implementation and approach
Phase I:
Each adolescent association worked with one village commit- p
tee. As a result of the participatory process, communities at the project sites identified the following priority areas in ado- lescent SRH: HIV and other sexually-transmitted infections (STI), contraception, female genital cutting (FGC), parent-child communication, and adolescent-friendly health services.
Village committees subsequently identified strategies to p
address these priorities. Strategies chosen included: peer education; information, education and communication (IEC) through the use of folk and modern media and interpersonal communication; and training health centre personnel in ado- lescent-friendly reproductive health services.
8
Afric A n re
Implementation
and approach
4
Phase II:p The adolescent associations trained a total of 47 peer educa- tors aged 15 to 25 years in SRH. At each of the three project intervention sites, the peer educators conducted approxi- mately 30 group talks and 60 home visits per month around the priority topics. The peer educators sold about 600 condom packets per month and reached about 1024 adolescents per month.IEC activities: All three sites conducted topic-specific discus- p
sions open to all (either around a video, a music performance, theatre or a cultural fair).
Interventions
(a) Aimed to improve parental knowledge/skills/attitudes/actions:p IEC activities: The adolescent association at each site con- ducted approximately seven music and video activities per month, reaching up to 900 community members per month.
Topics addressed included family planning, contraceptive methods, HIV, STI, FGC and parent-child communication.
Similar to the adolescent peer educators, adult association p
members conducted home visits and engaged adults in dis- cussions about parent-child communication around sexuality issues. They reached about 60 adults per site per month. For the three sites combined, association members reached over 2900 community members per month.
Increasing parent-child communication was a priority for the p
adolescent associations in Bittou and Léo.
(b) Actions subsequently taken by parents with/for their children:
Parent participation in the project: The project intended to p
encourage positive attitudes towards SRH programming among parents in order to gain their acceptance of adoles- cent participation in project activities and/or to encourage par- ent participation in the intervention in consultative or observa- tional roles.
Increased knowledge and communication: The IEC activities p
intended to increase parental knowledge of SRH issues, and home visits aimed to address parent-child communication issues. The idea was that parents would be open to engaging adolescents in conversations about SRH.
Resource material used
Advocates for Youth Training Manual: Exercises were used from this curriculum, but the project was not built around the curriculum.
Afric A n re
Evaluation
p Initial needs assessment of the participating communities in 1999.KAP survey in October 2000 (This survey was originally p
intended to be the baseline but due to sampling problems, it was not used):
uOnce the project communities and the adolescent associa- tions defined the interventions, another KAP survey instru- ment was developed to gather only intervention-specific data as prioritized by the village committees and associa- tions (contraceptive use, STI/HIV, FGC, parent-child commu- nication and use of health facilities). It was administered to 547 young people, aged 11 to 21 years (used improved sam- pling method), 405 parents and 51 health service providers.
Community participation and peer education surveys in 2001.
p
Final evaluation conducted in June 2002 using the KAP survey p
(with two additional questions regarding personal experience with FGC and HIV testing. A total of 530 young people, aged 11 to 24 years (different from baseline), were interviewed, as well as 150 parents and 51 health service providers.
Data analysis for the final evaluation took place in December p
2002.
Outcomes
(a) Parent outcomes:High levels of community participation were achieved, and p
70% of interviewees, “…indicated that parents and other adults played consultative or observational roles.”
57.8% of respondents indicated parents participated as p
advisors.
Type of participation by parents and guardians (from final p
report1, p. 23) Type of
participation Number (final
evaluation 2002) % (final evalua-
tion 2002) % (mid-term evaluation 2001)
Observers 11 12.2 11.8
Counsellors 53 57.8 67.6
Active
participants 6 6.7 4.9
Decision-
makers 5 5.6 4.9
Non-specific 16 17.8 10.8
Total 91 100 100
8
Afric A n re
1 Yaro Y, et al. Community Participation to Improve Adolescent Sexual and Reproductive Health in Burkina Faso [Final Evaluation]. Los Angeles (CA), Pacific Institute for Women’s Health, 2003.
Outcomes
4
pAt the beginning of the project, religious leaders and some parents feared that the project would negatively impact on the behaviour of their children, and they were reluctant to sup- port it. At the end of the project, the adolescent associations reported good collaboration with parents, women’s groups, schools, religious leaders and politicians.Parents provided adolescents direction or advice on relation- p
ships and social issues, while health providers gave informa- tion to adolescents on SRH. Local authorities played an impor- tant role in decision-making, while traditional leaders played the role of advisors.
At the beginning of the project, peer educators were poorly p
regarded by many parents and community members. The advocacy carried out by the adolescent association succeeded in changing the perception of the communities toward the adolescents who were educating their peers on sexuality and other topics previously considered taboo.
21 of the 30 PEs indicated that their confidence increased as p
parents encouraged and even insisted that PEs come to talk to their children. In Léo, one PE stated: “Parents are the ones asking us not to stop and to continue our work. Parents appre- ciate the sensitization activities, as some perceive that when PEs slow down their pace, young people return to irresponsi- ble behaviours.”
(b) Adolescent outcomes:
There was an increase in adolescents stating they are comforta- p
ble discussing sexuality with their parents (from 36% to 55%).
Peer educators were no longer intimidated about carrying out p
their duties, felt more useful in their communities, and in high demand in neighbouring villages. Results suggest that the peer education component of the project was successful in improving access to information, contraception and services for adolescents.
Peer educators were in high demand in neighbouring villages.
p
Findings indicate that they needed material and financial sup- port in order to continue their activities.
Improvements in adolescent knowledge, attitudes and prac- p
tices around reproductive and sexual health:
Improvements in knowledge of HIV from 70% to 86%; an u
increase of 22% in current condom use among all adoles- cents from 51% to 73%, especially boys; increase in number of adolescents who know how to use a condom correctly from 52% to 84%; more unmarried adolescents expressed the intention of using condoms during the final evaluation than they did at the baseline stage (from 57% to 82%).
8
Afric A n re
Outcomes
4
uDuring focus group discussions, girls expressed greater ease with negotiating condom use with their partner(s).Among sexually active adolescents, there was an increase u
of almost 41% in the number who reported having only one partner in the last 12 months. This tendency toward having a single partner was particularly noted in boys.
14% increase in adolescents reporting that they would not u
excise their daughters from 72% to 86%; 83% of all adoles- cents agreed that FGC had negative effects.
Adolescent awareness of where to obtain contraception and u
SRH services increased from 62% to 78%, but there was no change in the low level use of services.
Other outcomes
Organizational assessment:As the project progressed, the communities recognized that the p
adolescent associations had a considerable interest in SRH, contrary to their perceptions at the mid-term evaluation. This finding confirmed the success of training provided by Advo- cates and Mwangaza to build organizational capacity in SRH.
The adolescent associations demonstrated a high level of p
expertise in project management, SRH, HIV, community partici- pation and training.
Community participation:
A large cross section of the community was included in project implementation, advising and decision-making. All the partici- pating communities were keen to adopt the interventions per- manently, demonstrating ownership of the project by the com- munities. “The interest of the community was evident during the evaluation dissemination meetings in January 2003, which attracted a large number of people, including members of the vil- lage committees, youth and parents.”
Anecdote: One village committee member turned out to be the father of one of the female peer educators. We [project staff ] learned that she was facing resistance from her brothers who were antagonizing her about her work as a peer educator, and it was the father who stepped in to tell his sons to let her do her work.
He explained how valuable it was, and how she was an important resource to the community. After his intervention, she stayed on as a peer educator. Without his support, she may not have been able to have done so because of resistance from her siblings.
Afric A n re
Lessons learned
For the project:pThe need to have a more systematized tracking of activities across sites and adolescent associations.
The need to strengthen supervision of peer educators to p
ensure documentation of activities.
The importance of having the capacity to keep up with needs p
of the community, whether it be assisting in the procurement of more condoms or providing additional training on emerging issues such as how to support HIV positive adolescents.
The need to revise and update project activities over time, p
such as in Léo, where the adolescent association began to explore how to target women performing FGC.
The need to involve health service providers from the planning p
stage and to provide them with frequent project updates so that the activities complement their work. This strategy could potentially result in providers more systematically adopting adolescent-friendly strategies, which will encourage more ado- lescents to seek health services.
The need to link to income generation programmes to sustain p
activities and provide remuneration for volunteers.
For the evaluation:
Development of simple tools that local partners could use with p
community members to document time spent on the project.
Establishment of monitoring procedures to document use of p
health centres after the intervention.
The adolescent associations need training in evaluation to p
enable them to understand the importance of their role in data collection and analysis.
Key elements of success:
Use of participatory methods based heavily on group p
discussion
Separation by sex and age initially p
Specific instruction/training on adolescent-adult partnerships p
Ensuring gender parity in all participatory activities, whether p
trainings, committees, or peer educators
Active adolescent, parent and other community member p
participation
Opportunities for exchange/site visits p
Common understanding of community participation from the p
outset
Flexibility and time p
Use of appropriate, local technology, materials and resources.
p
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Future plans
p Advocates and Mwangaza continue to seek funding to expand the project within Burkina Faso and possibly neighbouring francophone African countries.Pacific Institute is preparing a bilingual publication that will p
present the evaluation process and its possible future applica- tions to disseminate to project managers, policy-makers, NGOs
and agencies worldwide.
Afric A n re
Objectives of project
In coastal and western provinces of Kenya:
To increase the use of SRH, family planning (FP), HIV preven- p
tion and child survival (CS) services
To improve the quality of sustainable, comprehensive SRH/FP/
p
CS services, including HIV prevention services To increase healthy behaviours.
p
Objectives of aspect involving/
addressing families
To build skills to discuss, define and analyze problems and sit- p
uations around family relationships and SRH/HIV
To deepen the understanding of how communication, relation- p
ships and rights within the family can impact upon health To increase understanding of SRH/HIV issues
p
To increase understanding of, and demand for, SRH/HIV serv- p
ices among the women, men and adolescents.
Organization(s) supporting project (technical, financial, evaluation)
Funded by United States Agency for International Development p
(USAID) Kenya
Partners: EngenderHealth, Family Health International (FHI), p
IntraHealth International, and the Program for Appropriate Technology in Health (PATH).
Organization(s) implementing project
All of the above partners (EngenderHealth was the man- p
aging partner), along with several local institutions and organizations
PATH provided technical direction for community activities.
p
Project history
p Launched in March 2001.The project worked with 97 health care facilities and surround- p
ing communities to increase both demand for and supply of quality SRH and HIV prevention services.
Community interventions worked with adolescents, men, p
women and families through villages, churches, schools, work- sites, grass-roots organizations and community-based organi- zations (CBO).
Target populations
Adolescents aged 10 to 19 years and their parents.
p
Afric A n re
Implementation and approach
Approach:
Dialogue-based, family-oriented methodology, in response to p
community comments that parents were unable to talk to their children about HIV and SRH issues, and children chose not to ask their parents about their health and development con- cerns. Husbands would not talk to their wives, and wives felt they could not talk with their husbands. With such home envi- ronments, individuals had little chance of understanding, influ- encing and addressing their health concerns and needs.
In a departure from the usual approach, (that is to work with p
men, women and adolescents separately), AMKENI brought individuals together to explore health issues as a family. Roles, relationships, power dynamics, communication and decision- making within a family impact greatly upon the health of indi- vidual family members. By working with families, AMKENI increased the family’s ability to work together to address health (and health-related) needs and to live healthier lives, and increased the agency of individual family members as well.
By working with family units as a whole (parents and their p
adolescent children), the project recognized the importance of the family as the central, unifying structure for men, women and adolescents in the community. The family is the natu- ral setting where many health-related issues are addressed.
Regardless of which family member is directly affected by a health concern, the health outcome for that individual is often impacted by the family’s ability, or lack thereof, to identify the problem and determine the appropriate solution. The family – where members come together to share, communicate, make decisions and deal with consequences – holds tremendous potential for ensuring the health of each family member and of the unit as a whole.
Implementation of community activities:
pAMKENI worked with the Kenya Ministry of Health and an array of local Kenyan organizations to implement the project. They included CLUSA (Cooperative League of the USA), the Family Planning Association of Kenya, and Uzima Foundation.
AMKENI partners, along with the Ministry of Health (MOH) and p
community representatives, introduced intervention ideas through existing channels (e.g. barazas, or grass roots meet- ings) to ensure community acceptance and approval.
8
Afric A n re
Implementation
and approach
4
p Interventions were often implemented by the community for the community, allowing for greater ownership and flex- ibility. Such localized activities helped ensure that activities responded to the specific health priorities of the group and used the groups’ own resources to determine and enact solu- tions. Community groups were linked to health facilities, often influencing and/or participating in service delivery (e.g. organ- izing service outreaches with local providers).Interventions
(a) Aimed to improve family (parents and children) SRH and HIV knowledge, skills, attitudes and actions (through peer family and parent-child interventions):The Peer Family (PF) project was a facilitated process for par- p
ents and their adolescent children to develop a deeper under- standing of the impact of family roles, relationships, and com- munication on health-related problems and solutions:
AMKENI worked with community members to define ‘family’
u
and develop a detailed application and selection process for the participating peer families.
The family unit allows for equal representation from both u
the younger and older generations, as well as from both males and females.
A total of 150 families (and 592 family members) partici- u
pated in the pilot phase, which began in 2002.
The second element of this family-to-family intervention pro- p
vided a way for sharing the peer families’ experiences with the larger community. As participating family members acquired skills, discussed real-life situations, re-defined roles and sought health solutions, their insights were discussed with other interested families and community members:
Structured family-to-family communication included interac- u
tions between individual members of a family unit (e.g. par- ents and their children), as well as between separate fami- lies (e.g. two families that live in the same village).
Over the course of the project, families learned problem- u
analysis and problem-solving skills, gained understanding of specific HIV-related issues, such as voluntary counselling and testing (VCT), STIs, prevention of mother-to-child trans- mission (PMTCT) of HIV, antiretroviral drugs (ARV), home- based care, etc., shared family experiences and predica- ments through family-to-family interaction, and analyzed family roles, relationships and health problems to arrive at
new solutions.
8
Afric A n re
Interventions
4
(b) Actions subsequently taken by parents with/for their children:Peer families held
p barazas with other community members to share experiences and invite broader participation. When pos- sible, barazas were linked to health service outreach.
Peer families across villages and churches met to share expe- p
riences. This was useful in helping to sustain a process that received no financial or other support (other than technical) from AMKENI.
Several peer family groups started ‘merry-go-rounds’ or sav- p
ings programmes, which helped the group sustain participa- tion over time.
Resource material used
Facilitators used a variety of resources (e.g. discussion guides, facilitation skills/tools) to provoke and stimulate discussion (although much of the dialogue/activities for PF sessions was participant-driven).
Evaluation
pTwo years after beginning the peer family project, AMKENI and PATH conducted a qualitative review of activities.AMKENI also conducted a large household survey in project p
areas, which showed an overall impact on awareness, knowl- edge and health service utilization; unfortunately, impact spe- cific to the project cannot be isolated from this data.
Outcomes
p Men, women and adolescents were willing and able to sit together to address health issues. The project found a high level of participation, low attrition and high demand from other community members. This indicates that communities saw the benefit of family-oriented interventions (even without external incentives).Behavioural and social changes exceeded expectations: family p
members reported that relationships were much stronger, with more communication. Family groups addressed related risk- associated behaviours such as gender-based violence (GBV) and alcohol consumption, and family members indicated a greater sense of unity and support.
Specific examples of changes within families included:
p
Improved health-seeking behaviours (especially FP and VCT u
among parents)
Sitting together as a family during meal-times (this is not u
a common practice in some communities, where the father eats separately)
Husbands sharing financial information and decision-making u
with wives
Parents discussing SRH issues with children (e.g. fathers u
demonstrating condom use with their sons); providing sup- port for children who have been abused or raped; and addressing other issues like alcohol and domestic violence.
Afric A n re
Lessons learned
p In addition to the outcomes listed above, a key lesson learned was that family-oriented interventions are acceptable, even when dealing with sensitive issues such as sexual behaviour.PF feedback also shows that a community-driven, facilita- p
tive approach (as opposed to a project-driven, more didactic approach), can work well with families.
More structured diffusion (and sharing of experiences/ideas p
with the broader community) might well yield stronger results.
Future plans
p AMKENI has already adapted the PF approach to scale up par- ent-child programmes with a focus on HIV prevention.Although AMKENI is coming to an end, some elements of the p
PF experience will be continued by PATH as part of follow-on projects in Kenya and elsewhere.
Afric A n re
Abstinence and risk avoidance (ARK) for youth
Objectives of project
To expand and strengthen HIV prevention efforts through the p
promotion of positive social norms that reduce the risk among young people aged 10 to 24 years of becoming infected with HIV.
pTo offer young people a safe, enabling environment where together they can recreate social norms of behaviour that help them traverse risks they face in their daily lives.
Overall objective of ARK communication activities: to promote, p
support and reinforce abstinence and faithfulness (AB) behav- iours. These behaviours included:
Sexual abstinence for young people u
Secondary abstinence for sexually active young people u
Mutual faithfulness in marriage for married young people u
Communication between young people about sexuality u
Communication between young people and their partner(s) u
about sexuality
uParent-child communication around abstinence and faithfulness.
To increase capacity of community-based structures, includ- p
ing faith-based organizations (FBO), to support abstinence and faithfulness among young people.
Objective of aspect involving/
addressing parents
To create an enabling environment for the adoption of AB p
behaviours in the community, including assisting parents to talk to young people and each other about issues around sexuality.
Organization(s) supporting project (technical, financial, evaluation)
Financial: USAID, through President’s Emergency Plan for AIDS p
Relief (PEPFAR).
Organization(s) implementing project
World Vision Inc. and World Vision Area Development Pro- p
grams (ADPs)
Johns Hopkins Bloomberg School of Public Health, Center for p
Communication Programs, Health Communication Partnership Faith-based organizational partners.
p
Afric A n re
Project history
p Five-year initiative in the United Republic of Tanzania, Kenya and Haiti launched in 2005.The discussion guides and radio strategy are complete, and in p
use. These are the cornerstone of the ARK toolkit (see materi- als below).
Training of trainers began in Kenya in June 2006.
p
The United Republic of Tanzania is translating the guides and p
will then roll out training. Similarly, Haiti is adapting and trans- lating the guides and will follow this with training.
The radio broadcasts aired in Kenya and the United Republic of p
Tanzania through 2006. Haiti will begin broadcasting in 2007.
Project is now operational.
p
Target populations
Primarily: girls and young women aged 10 to 14 and 15 to 24 p
years with a particular focus on those aged 10 to 14 years.
Secondarily: boys and young men aged 10 to 14 and 15 to 24 p
years with a particular focus on those aged 10 to 14 years.
Thirdly: parents and other caregivers of young people involved p
in ARK programming with an emphasis on orphans and vulner- able children (OVC), caregivers, religious leaders, teachers, pol- icy-makers, opinion leaders, health providers, traditional heal- ers and traditional birth attendants.
Five districts in Kenya: Bungoma, Migori, Nakuru, Suba and p
Teso; five districts in the United Republic of Tanzania: Hai, Monduli, Karagwe, Bukoba Rural and Handeni; two depart- ments in Haiti: La Gonave Island and Central Plateau.
Target groups by country in 2007:
p
Target
Group Kenya United
Republic of Tanzania
Haiti 2007 Total
10 to 24
years 54 100 73 047 5000 132 147
25 years
and older 26 748 26 152 1575 54 475
Afric A n re
Implementation and approach
Approach:
Theme of ARK: behaviour change through small groups and p
peer support
Applies the transdisciplinary (TD) approach: the target is five p
critical outcomes:
Well-being of young people u
Empowered young people u
Transformed relationships u
Interdependent and empowered communities u
Transformed systems and structures.
u
To realize the TD approach, ARK has adopted a five-step p
project implementation cycle called ‘Process of Awakening’:
Establish young people and parental advisory groups u
Conduct common ground ‘Melting Pot’ meetings u
Develop/adapt communication materials and projects u
Train young people and parent mentors u
Provide supportive supervision.
u
Implementation:
Implementation in partnership with FBOs. Partnerships were p
formed to implement activities in primary and secondary schools.
Utilization of expertise and on-the-ground presence of World p
Vision Area Development Programs (ADP):
ADPs cover large geographic areas with 50 000 to 100 000 u
people per ADP. They: a) are selected for common issues, contiguity of villages, and management feasibility; b) address macro- and micro-level causes of poverty; c) require long-term commitment (12 to 15 years); and, d) are targeted to specific groups.
Communication activities began in ADP communities in u
Kenya, and are spreading to hard-to-reach groups in the districts.
Interventions
(a) Aimed to improve youth knowledge/skills/attitudes/actions:p Interventions to improve young people’s knowledge/skills/atti- tudes and actions:
Programming for young people: youth action groups (YAG) u
included anti-HIV clubs and peer educators to foster the adoption of AB behaviours by strengthening their capacity for healthy behaviours. Teachers were trained to overcome attitudinal barriers to effective communication regarding young people’s sexuality such that they can facilitate, coun-
sel and reinforce AB messages.
8
Afric A n re
Interventions
4
uAB activities were, where possible, linked to the contin- uum of care where it exists, so that both young people and adults know where they can go for information/assistance on HIV-related health issues. For example, where present, VCT centres and adolescent SRH staff from urban and rural districts were involved and linked with ARK activities.Approaches to reduce risk among young people who are u
already sexually active were also supported.
Interventions to improve parental knowledge/skills/attitudes/
p
actions:
Trained FBO leaders to incorporate AB messages in their u
weekly sermons.
Parent action groups (PAG) were equipped to communicate u
and counsel young people about sexual health and healthy choices. ADP-organized community care coalitions (CCC) pro- vided basic health, education and psychosocial support to OVC caregivers and people living with HIV (PLHIV) to pro- mote/reinforce AB messages.
Communication interventions:
Group dialogue: One of the creative components of the ARK p
project strategy was the common ground or Melting Pot meet- ing. The melting pot brought together parents and young peo- ple to discuss matters of abstinence and mutual faithfulness.
Facilitated by ARK sub-grantees and trained volunteers, group discussions, and later, one-on-one parent-young people dis- cussions, were held to practice communication around sen- sitive topics such as abstinence, life skills decision-making, faithfulness, and young people’s sexuality. Following on from the facilitated conversations, young people and parents devel- oped action plans and did outreach to encourage others to also communicate on these issues.
Training: Training was conducted to facilitate getting ARK skill- p
building guides and other tools into the communities. ARK conducted training of trainers (TOT) for ARK sub-grantees, who then trained village level trainers and volunteers from the YAGs, PAGs, district advisory committees (DAC) and CCCs in ARK communities. Additionally, training was provided for peer coaches and other adult populations (religious leaders, teach- ers, service providers, etc). Once trained, young people and parents conducted outreach in their communities, using mate- rials and tools developed by ARK to reach their peers.
8
Afric A n re
Interventions
4
pInteractive drama: Drama is an importance vehicle for commu- nicating messages on sensitive issues of sexuality. The ARK communication team trained local drama groups on the prin- ciples, theories and application of participatory community theatre as an effective tool of communication for social and behaviour change. The groups were also trained to develop their skills in message development and script writing and to identify problems in communities they represent – particu- larly those related to HIV. The trained groups developed action plans, which they used to undertake interactive drama per- formances in market places, schools and churches.Community radio: Short spots were broadcast, as well as p
longer interactive discussion segments. Experts spoke on ARK key messages in the latter, and took questions from young people via a call-in. To complement radio programming, lis- tener groups were established in the project sites. The role of these groups was to stimulate discussions among different age groups on abstinence and being faithful. Members of the listening groups also shared what they learned from radio with members of the local performing troupes in order to enhance the quality of their presentations and performances.
Radio was also linked to ARK’s training activities for par- p
ents, young people, and other stakeholders concerning life skills and parent-young people communication on matters of sexuality.
The ARK-branded parent communication guide was u
designed to help parents and responsible adults communi- cate effectively with their children about sexual health and their futures. The guide provides an opportunity for parents and responsible adults to work with young people to prac- tice and model healthy behaviours.
After training, the radio programme serves to provide sup- u
port messages in order to create demand and direct young people to appropriate places for services.
If certain behaviours are to be sustained, there is need for u
people to receive motivation and information on a regu- lar and sustained basis. The interactive nature of the pro- gramme, through call-in sessions, was a vital channel for feedback and helps generate topics for subsequent
discussions.
8
Afric A n re
Interventions
4
pThe radio programme also served to publicize ARK activities and services. Publicity of programme activities enhanced the level of awareness of messages and increased involvement of young people and the community in the project. Such awareness and involvement created interest and support from members of the community, which in turn created an enabling environment for implementation, increased demand for services provided by and through the ARK project, and consequently motivated young people to practice abstinence or being faithful.(b) Actions subsequently taken by parents with/for their children:
Parents and responsible adults were encouraged to develop p
trusting and supportive relationships with young people that allow them to openly share their thoughts and feelings regard- ing their sexual health in particular, and motivates them to take appropriate action to protect themselves from HIV and other sexual risks.
To be truly effective, parents and responsible adults were also p
encouraged to:
Educate themselves and be willing, even when uncomfort- u
able, to talk with young people about issues of sexuality, relationships, love and commitment.
Discuss explicitly with young people the value of delaying u
sexual activity and the importance of abstinence in protect- ing their health.
Encourage strong decision-making skills by providing young u
people with age-appropriate opportunities to make decisions and to experience the consequences of those decisions.
Resource material used
ARK toolkit:
An interactive
p Skills Building Guide for adolescents aged 10 to 14 years to communicate with other adolescents (peer educators/coaches)
An interactive
p Skills Building Guide for youth aged 15 to 24 years to communicate with other youth (youth peer educators/coaches)
An interactive
p Skills Building Guide for parents, teachers and other adults to communicate with young people, access useful resources (e.g. ARK-branded parent communication guide) The
p ARK Passport, a personal tool to reinforce and strengthen young people’s personal commitment to AB
Games and activities (rather than lessons) serve as independ- p
ent tools to complement guides. These will be added on throughout the life of the ARK project.
Useful reference materials, such as partner materials used p
prior to adaptation of ARK guides (including materials devel- oped by PATH (Tuka Pamoja), as well as ARK faith-based part- ners Scripture Union and Kenya Student Christian Fellowship).
Afric A n re
Evaluation
p Recipients of funding through PEPFAR Track 1 ABY (abstinence and behaviour change in young people) mechanism were not permitted to use project funding for research. Instead, USAID enlisted MEASURE to form an independent evaluation team.MEASURE visited ARK in the United Republic of Tanzania and Kenya in June 2006.
In Kenya, the team found:
p
ARK is one of the few projects training community members u
and parents/adults with a specific project.
The five-day drama training was focused and directed.
u
Having trained teachers, training other teachers may weaken u
the project when delivered by second level teachers.
The United Republic of Tanzania visit revealed:
p
ARK works in remote areas where few other organizations u
work.
Drama group trainings require more content.
u
Use of two radio stations allows for wide distribution of AB u
messages.
Suggestions were made for both country projects to p
strengthen the interventions.
Expected outcomes
(a) Expected parent outcomes:
The project is ongoing, and so outcome data is not yet p
available.
Strengthened parental skills and community capacity.
p
(b) Expected adolescent outcomes:
p Reduced HIV transmission through:
Abstinence for young people u
Secondary abstinence for sexually-active young people u
Mutual faithfulness in marriage for married young people u
Communication between young people about sexuality u
Communication between young people and their partners u
about sexuality
Parent-young people communication around abstinence and u
faithfulness.
Afric A n re
Other outcomes
p Scaled-up life skills and value-based, age-appropriate HIV educationCoaching, mentoring, support and referral systems in place to p
support abstinence and faithfulness
Advocacy by faith- and community-based organizations for AB p
messages and programming
Government entities mobilized and educated to support ARK p
goals and messages
Multiagency networks supporting AB programming p
strengthened.
Lessons learned
Not applicable.Future plans
Not applicable.Afric A n re
Health Project (KARHP)
Objectives of project
To improve knowledge about SRH and encourage a healthy p
attitude towards sexuality among adolescents
To delay onset of sexual activity among younger adolescents p
To decrease risk-associated behaviours among sexually active p
adolescents
To meet adolescents’ reproductive health information and p
service needs by increasing access to health facilities To educate in-school adolescents about SRH within a frame- p
work of information about life-skills and development.
Objectives of aspect involving/
addressing parents
To address the sensitivity of SRH issues and create a support- p
ive environment within which educational and service delivery activities could be implemented
To facilitate open discussions around SRH with the intention of p
encouraging less punitive attitudes
To garner support for SRH education for adolescents in the p
communities
To increase parent-child communication concerning atti- p
tudes and norms surrounding SRH (not necessarily factual information).
Organization(s) supporting project (technical, financial, evaluation)
Funding by USAID p
Technical assistance by PATH and Frontiers in Reproductive p
Health.
Organization(s) implementing project
Frontiers in Reproductive Health (Frontiers) p
PATH p
Government of Kenya, three ministries: Ministry of Education, p
Science, and Technology (MOEST); Ministry of Health (MOH);
former Department of Social Services now within Ministry of Gender, Sports, Culture and Social Services (MOGSCSS).
