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CASE STUDIES: Reaching Out |
Breaking Down Barriers to Contraception in Bangladesh In Bangladesh early marriage and childbearing are common: almost half of women between 15 and 19 are married. Yet, young couples seldom seek reproductive health services. This is partly because the birth of a child proves a woman's fertility to her in-laws. As a way to reach out to married young people, a UNFPA-supported project identifies and registers newlywed and young couples with one or two children, and offers them orientation sessions and one-to-one basic counselling. The newly married women are often accompanied to orientation sessions by their mothers-in-law and husbands. The sessions serve to break the social and psychological barriers against contraceptive methods. The programme also educates young couples about the risks of early childbearing and closely spaced births, and provides information on maternal and child health. Contraceptive use among newlyweds in this programme jumped from 19 percent in 1993 to 39 percent in 1997. Significantly, nearly one third of men have started attending these sessions on their own –suggesting greater motivation, social mobility and family acceptance than in the past. Unmarried young men and women also attend sessions, suggesting growing demand for information among adolescents. An increasing number of sessions are being hosted in private homes, which indicates wider community acceptance of reproductive health services. Literacy is the Entry Point in Mali A project in Mali addresses adolescents’need for more education through 96 literacy centres. The centres are designed to reach young people, both in and out of school, with a focus on migrant girls, domestic workers, victims of violence and abuse, and those who are marginalized by poverty or other reasons. The project, Meeting the Development and Participation Rights of Adolescent Girls, is a collaborative effort among UNFPA, the United Nations Development Programme (UNDP), UNICEF, the Government of Mali and local and national NGOs. Beyond improving literacy, it aims to:
Reaching the 'Busy Generation' in Mozambique Following ICPD, the Government of Mozambique made a commitment to investing in youth and adopted a National Youth Policy that aimed to increase youth participation in policy development and improve their sexual and reproductive health. The Geracao Biz project was designed and developed by youth, who named it to reflect their sense of themselves as a 'busy generation'. The project promotes behaviour change both among students and out-of-school youth. The Ministry of Youth and Sports, Ministry of Health and the Ministry of Education share coordination and execution, involving their respective provincial directorates, NGOs and community-based organizations including youth associations. UNFPA and Pathfinder International provide technical assistance. The project began in two provinces and with new donor support has now expanded to six; national coverage is a long-term goal. The project’s guiding framework supports:
Objectives include:
The number of adolescents aged 15-19 visiting clinics for counselling and services increased more than ten-fold in Maputo following the establishment of youth-friendly services; the number of young men served nearly doubled. The proportional increase in young men served was even higher in Zambezia Province. Counselling and contraception are reported as the two most popular services in both areas. Geracao Biz has peer activists in 10 of Maputo’s 13 secondary schools and activities in 64 schools in Zambezia. The project is helping integrate reproductive and sexual health information into a new basic national curriculum along with a package of in-school and extra-curricular activities. Using Girl Guides to Improve the Health of Adolescent Refugees Girl Guide units, with trained peer educators and links with clinical services, have been established in several refugee sites, through the combined efforts of UNFPA, Family Health International and the United Nations Refugee Agency in Egypt, Uganda and Zambia. The project used the Girl Guides as a channel for information about health issues in general, as well as reproductive health more specifically, and for training peer educators. In addition to learning and sharing reproductive health information, the peer educators became more self-confident, developed a sense of group identity, and benefited from a relationship with a mentoring, caring adult female, according to the project evaluation. Essentially, the Girl Guides offered a safe space in which the displaced adolescents could learn and grow. Future plans call for materials developed in local languages and on reaching out to boys as well.
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