Bangladesh: Peer Educators Raise Awareness of Adolescent Reproductive Health and Rights

Adolescent mother and child watch a folk music group perform in Burumdi village

Bangladesh’s population of 146 million makes it the seventh largest in the world. It is also one of the most crowded places on earth – the average population density is over 2,600 people per square mile. The country is surrounded on three sides by India; to the south is the turbulent Bay of Bengal. During the monsoon season, which lasts from July through September, half the country is under-water and the other half is waterlogged.

Despite three decades of efforts to reduce population growth and provide quality reproductive health and family planning services, birth rates remain high. The average family has four children. Young people dominate the country’s population: 40% of the entire population is under the age of 24, while one-quarter are adolescents between the ages of 10 and 19. Girls continue to marry at early ages; many have their first child before they turn 19. Though the contraceptive prevalence rate is increasing in Bangladesh – 54% of all married women now practice some form of family planning – only 30% of married adolescent girls use contraception.

The challenge for the government is to increase awareness of reproductive health issues and foster opportunities for young women and men to earn money, delay marriage and acquire life skills.

A multi-faceted project, executed by UNFPA and UNICEF, with funding provided by the United Nations Foundation, is making a real difference in the lives of adolescent girls. It is being implemented by the Department of Youth Development under the Ministry of Youth and Sports, with assistance from national NGOs, including the Population Services and Training Center, Marie Stopes Clinic Society, Family Planning Association of Bangladesh and Concerned Women for Family Development. Since the project began in 2000 much has been accomplished:

1. Local communities in 30 upazillas (sub-districts), located in 10 of the country’s 64 districts, have been sensitized on the need to delay marriage, educate girls and provide them with life skills and access to appropriate reproductive health information and services.
2. Some 240 young women have been trained as peer educators on Personal Social Education, which includes reproductive health, family planning, sexual health and life skills issues; most work in poor, remote communities.
3. Life skills sessions for young women and men have been introduced in most National Youth Training Centers. At these Centers, youth acquire basic income generating skills and are encouraged to set up their own businesses with micro-credit schemes run by the Ministry of Youth and Sports.
4. Traveling theatre groups have been sponsored in the poorest districts. These groups perform skits on the need to delay marriage, plan families, finish school, avoid HIV/AIDS and STIs and be more gender sensitive.

Syeda Sajia Afrin Tania.

In the rain-soaked village of Mamurkhain, outside Bangladesh’s second largest city, Chittagong, peer educators Syeda Sajia Afrin Tania and Mushrat Jahan Mitu talk to a group of married adolescent girls, aged 16-20, about issues that affect the quality of their lives. It is a lively discussion. The girls have many concerns – problems with menstruation, how to maintain personal hygiene, how to delay pregnancies, and where to go to get treatment for reproductive tract infections and pre- and post-natal care, among others.

Mushrat Jahan Mitu

“I became a peer educator,” explains Tania, “because I wanted to know more about these important life issues. I am 18 and have no plans to marry, but many of these girls regret that they were forced into early marriages when they were 15, 16, or 17 years old. Most could not finish secondary school and have no skills, no way to earn money for the household. They feel isolated and neglected. The worse thing is they have no knowledge about reproductive health or where to go to get help and services. We perform a very important function in these remote communities.”

As part of the project's outreach activities, Tania, a peer educator.

Tania’s colleague, Mitu, has been a peer educator for two years. “I meet many young married couples at youth clubs or in their homes,” she says. “In many cases the girls don’t know where to go to get help or information. Young women look to me to help solve their problems and give them advice on personal issues, such as family size and spacing pregnancies. This is a great responsibility,” continues Mitu, “ but I have no regrets about volunteering for this work. I am now a respected member of my community because of my involvement with these very basic health issues.”

The project has reinforced the ongoing work of the Ministry of Youth and Sports to educate youth and provide disadvantaged adolescents with skills and training so they can build a future. Many form their own businesses after graduating from one of the Ministry’s 47 National Youth Training Centers around the country. The Centers use an integrated approach, combining theoretical knowledge with practical hands-on experience; now they also include courses on reproductive health and rights. Students spend three months at the Centers where they receive room and board. The rigorous programs focus on:

• Raising livestock or poultry
• Farming fish
• Growing vegetables and fruits
• Marketing
• Horticulture
• Computer sciences; and
• Life skills

Mr. S. M. Waliur Rahman

Mr. S. M. Waliur Rahman, Director General of the Department of Youth Development in the Ministry of Youth and Sports, is enthusiastic about the project. “These issues have a wide impact on society,” he points out. “UNFPA has played a vital role in this unique initiative.”

Fazlur Rahman, Bangladesh’s enthusiastic Minister of Youth and Sports, is equally delighted with the impact that the UNFPA/UNCIEF project is having in poor communities. “If we do not tend to the needs of youth,” he points out emphatically, “we are undercutting our own future.”

Back in Dhaka, Bangladesh’s capital and home to 13.2 million people, a training session for peer educators is underway at the headquarters of the NGO, Population Services and Training Center. Here girls from around the country receive one-week training courses on a wide variety of reproductive health and life skills issues.

Dr. Mahfuza Rifat

Master Trainer, Dr. Mahfuza Rifat, an attractive, dynamic woman in her mid-twenties is lecturing a group of peer educators on various forms of contraception. The girls, all between the ages of 18 and 23, are captivated by the presentation.

“I have a masters degree in health economics from Dhaka University,” explains Dr. Rifat. “But I like to do these training sessions; I like interacting with people and providing them with information and communication techniques so they can return to their communities and do successful outreach and education activities.”

Unfortunately, there are many misconceptions about family planning and the use of contraceptives. “One of the most common misconceptions that our peer educators need to deal with is the widespread notion that using contraceptives makes you sterile or that they are bad for your health,” points out Dr. Rifat. “Giving these girls real life skills training helps them overcome objections from village elders and parents.”

UNFPA’s Bangladesh office was instrumental in helping to design the curriculum for the training courses. “I was selected by UNFPA to help develop the curricula and all versions were reviewed by outside experts, as well as government officials,” explains Dr. Rifat. “In addition, the media, especially newspapers and radio, have helped pave the way for more open discussions of these issues in society.”

Syeda Tania, the peer educator from Anwara District, near Chittagong, will attend university in a year. She will major in journalism. “Participating in this project has opened my eyes to more possibilities. I write stories for a popular monthly magazine and contribute articles to a daily paper in Chittagong on adolescent issues,” she says. “I would not have such ambition without the experience of being a peer educator.”

Ends.