Comprehensive Programmes for Adolescents
The African Youth Alliance (AYA) is a four-country effort to apply proven HIV/AIDS prevention approaches on a wider scale. Operating in Botswana, Ghana, Uganda and the United Republic of Tanzania, AYA is a collaboration between U.S.-based NGOs, Pathfinder International and the Program for Appropriate Technology in Health (PATH), and UNFPA. These organizations work with implementing partners within each country: government agencies, NGOs and community-based organizations.
AYA’s overall goal is to improve adolescent reproductive health. Specifically, it is designed to:
- Reduce rates of HIV/AIDS, other STIs and pregnancy among young people.
- Promote the delay of sexual debut, and, among already sexually active youth, the use of condoms and other contraceptives.
- Eliminate harmful traditional practices and forced and coerced sex.(2)
AYA uses six major strategies, each adapted to country-specific needs:
- Gaining national and community support through advocacy.
- Developing folk and mass media efforts, life skills programmes, peer education and counselling, and social marketing campaigns aimed at behaviour change.
- Improving young people’s access to—and the quality of—reproductive health services by institutionalizing youth-friendly services in a variety of settings.
- Integrating sexual and reproductive health into existing livelihood skills development and training programmes for youth.
- Building the institutional capacity of country-level partners to plan, implement, manage and sustain programmes and services.
- Coordinating programme activities and sharing lessons learned and best practices.(3)
All of the strategies aim to ensure youth participation, gender equity and sustainability. Implementing partners will be expected to continue the work after the five-year AYA operation ends. Management and advisory structures have been set up to facilitate collaboration among partners and sectors within each country and for AYA overall.
Dozens of grants have been awarded to in-country partners and activities are under way in each country. Public and NGO clinics have been assessed and many are being upgraded for youth-friendliness. Community mobilization efforts known as Participatory Learning and Action (PLA) have been started in many communities. Life planning training has been conducted for school programmes. Young people are actively involved, offering advice on programme strategies, developing magazines and other media materials, and representing AYA at international conferences.
In Botswana, a Youth Advisory Committee coordinates efforts and ensures that young people participate at all levels. District and village committees—between 65 and 75 per cent youth—are charged with maximizing youth input in planning community activities. Young people are also involved as counsellors, service providers, educators, advocates and performers, and actively participate in collecting data and monitoring and evaluating activities.
Ghana’s Youth Advisory Board advises the AYA country team and develops innovative ways to reach young people. In collaboration with the National Youth Council, the Board is exploring the formation of a National Youth Parliament. AYA youth representatives provide input to NGOs, international agencies and the Ministry of Health on training programmes for doctors and other health professionals to deliver youth-friendly reproductive health services.
In the United Republic of Tanzania, AYA and others have developed a Youth Involvement and Participation Framework to ensure programme objectives reflect young people’s priorities. Young people are involved in monitoring and evaluation to determine whether programmes adequately meet their needs, and will soon participate in lobbying and other advocacy activities.
In Uganda, young people have participated fully in strategic planning, orientation at national and district levels, and curricula development. They work as peer counsellors and as team members in mobilizing parents and communities, in helping to design media messages, and in participating in negotiations with school administrators, local council leaders and health facility managers.
AYA’s biggest challenge has been developing mechanisms for collaboration among its many partners. Expanding the scale of activities is another challenge, both organizationally and in finding evaluated programme models to build on. Partners are committed to finding solutions to structural and technical challenges, and to sharing experiences with other large-scale programmes in the field.
LOVELIFE IN SOUTH AFRICA
Africa, the National Adolescentfriendly
Clinic Initiative aims to make
health services more accessible and
acceptable, to establish national standards
and guidelines, and to train health workers
to provide quality services. It is a component
of loveLife, a national HIV prevention
programme aimed at South African adolescents.
LoveLife encourages young
people to wait until they are older to have
sex, and when they do, to have one partner
and to use condoms consistently. It is targeted
at teenagers because most HIV
infection in South Africa occurs before the
age of 25, with young women mostly
becoming infected between 15-20 years of
age. With the bulk of the country’s population
still under 20 years, the most effective
way to slow the spread of HIV/AIDS is to
stop significant numbers of young people
from getting infected.
The main target group is 12- to 17-yearolds,
but special programmes focusing on
children 6 to 12 years of age are also part of
the campaign. The comprehensive sexual
health strategy harnesses popular culture
to promote sexual responsibility and
healthy living, encourages parent-child
discussion and the participation of religious
leaders, while at the same time developing
services that are youth-friendly.
The campaign recognizes that standalone
youth centres may not be
cost-effective or sustainable and cannot be
established at the scale needed to meet
the needs of most adolescents. It has
developed criteria for certifying existing
clinics as adolescent-friendly. Early evaluation
results suggest that considerable work
is needed for clinics to achieve accreditation,
and to develop an operation that
district and provincial health systems can
maintain with minimum resources. An
expansion of the programme is planned.
Organized by the Henry J. Kaiser Family
Foundation, loveLife is being implemented
by a consortium of four partner organizations:
Advocacy Initiatives, the Planned
Parenthood Federation of South Africa, the
Reproductive Health Research Unit, and
the Trust for Health Systems Planning and
Development (HST). More information
can be found at: www.lovelife.org.za. See Sources