Adolscents to Youth to Young Adults_Hainsworth_5.11.11
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Adolscents to Youth to Young Adults_Hainsworth_5.11.11
- 2. May 11, 2011
- 4. Issues Related to Early Marriage & Childbearing Pervasive gender inequality Little value placed on girls Unequal power relationships and decision-making Poverty Girls are economic burden Marriage forms family alliances economic benefits for family Cultural norms Prescribe marriage before puberty (Amhara) Social expectation Immediate childbearing – “prove fertility”
- 6. Skills
- 9. Local NGOs (YMCA, ECS)
- 10. Girls’ clubs
- 11. Youth Centers
- 12. CHWs
- 14. Advocate for elimination of harmful traditional practices (HTPs) and GBV
- 17. Improved life-skills and SRH decision-making
- 18. Improved access to quality YFS
- 19. Positive changes in community norms regarding HTPs and GBV
- 20. Increased number of adolescent girls receiving treatment for fistula
- 21. Increased leadership opportunities for girls and young women Intermediate Impacts Educational attainment Increased % of young women in leadership roles Delay of marriage & childbearing Reduction in unintended pregnancies Reduction of STIs and HIV Reduction of HTPs & GBV Key Issues Girls clubs School drop-out Identification & treatment of fistula Interventions Early marriage Teen STAR (life skills education) Early pregnancy Scholarships & supportive learning environment for girls Outcomes Unintended pregnancy Mentoring Fistula Peer education Intermediate Impacts STIs and HIV Key Issues Youth friendly services & youth centers Age 10 - 14 Age 15 - 19 Age 20 - 24 Other HTPs (FGC) and GBV Age 10 - 14 Age 15 - 19 Age 20 - 24 IEC and community outreach through VCHWs & HEWs Reduced TFR Increased CPR Improved SRH and Well-Being Prevention of HTPs (early Marriage, FGC) & GBV: Community Action Committees, community conversations, training of judicial & law enforcement officials on HTPs, GBV and legal framework
- 23. 10,549 students completed the Teen Star program
- 25. 70 adolescent girls received scholarships
- 26. 432 fistula cases identified and repaired
- 29. Religious leaders are key change agents, influencing public opinion.
- 30. CHWs, peer educators, and providers also played important role.
- 32. Total planned marriages cancelled:
- 34. 19% (control)
- 36. Considerations and Recommendations Follow up girls who received scholarships to determine: impact on subsequent SRH decisions and behaviors (age of marriage, FP use, spacing of children) impact on education, participation in workforce or public spheres
- 37. Co-Authors Worknesh Kereta Senior Adolescent Sexual and Reproductive Health Advisor Pathfinder International, Ethiopia BogalechAlemu Senior Advisor for Gender and Harmful Traditional Practices Pathfinder International, Ethiopia Mengistu Asnake, MD, MPH Deputy Technical Director, Integrated Family Health Program Pathfinder International, Ethiopia
- 38. For More Information, Please Contact: Pathfinder International Headquarters Nine Galen Street, Suite 217 Watertown, MA 02472 USA Phone: (617) 924-7200 Fax: (617) 924-3833 Web: http://www.pathfind.org or Integrated Family Health Program-Ethiopia P.O. Box 12655 Tel 251 1 440 7642 Fax 2511 1 440 7679 Addis Ababa, Ethiopia wkereta@pathfind.org
Notas do Editor
- As one can see from the statistics, Ethiopia is facing a burgeoning youth population coupled with high rates of early marriage and early childbearing. In Amhara, the situation is particularly dire with almost half of all rural women married before they reach 15. Nationwide 40% of all 19 year olds are either pregnant or have given birth.
- The underlying reasons for early marriage and childbearing are pervasive gender inequality where little value is placed on girls or women’s lives, Poverty where marriage is seen as a way to pass the economic burden of having a girl onto another familyCultural norms that prescribe early marriage as a way to protect against unwanted pregnancyAnd scial expectations that pressure young women to prove their fertility directly after marriage
- To combat these issues and empower girls and youth women, Pathfinder began the WAGE program in 2004 with funding from the Packard Foundation. Many of the activities were also cost-shared with the USAID flagship FP/RH project. We are now in the third phase of the program but for the purposes of my presentation, I will focus on Phase II since Phase III has only been running for a little over a year and we don’t yet have evaluation data
- The program is implemented at the local level throughWomen’s associations (AAWA, ORWA, AWA)Health Extension WorkersLocal NGOs (YMCA, ECS)Girls’ clubsYouth CentersCHWsPeer Educators
- The overall goal of the program is To improve the SRH, rights, and social status of adolescent girls and women in Amhara, Oromia, and Addis With key objectives of Increase awareness of gender, gender-based violence (GBV) and SRH issuesAdvocate for elimination of harmful traditional practices (HTPs) and GBVIncrease access to and utilization of youth-friendly services (YFS)
- The WAGE program is a multisectoral program that is based on a lifecycle model. As you can see from these slides, many of the issues cut across many of the age groups although some are unique to particular age cohorts. Interventions were then designed to address the different challenge faced within the lifecycle and while some of the interventions are open to a wide age range, some of them tend to target the younger women like keeping girls in school through scholarships and support networks or the teen star program which is a life skills program, while others such as YFS tend to focus more on older adolescents. The GBV and HTP prevention activities however span the entire lifecycle. The intended program outcomes are: Increased school retentionImproved SRHImproved life skills and SRH decision makingIncreased access to SRH servicesLook at slideand the intermediate impacts areEducational attainmentIncreased % of young women in leadership roles Delay of marriage & childbearinReduction in unintended pregnanciesReduction of STIs and HIVReduction of HTPs & GBV
- Some of the results of Phase II were more than > 8 million adolescents and women reached with SRH information10,549 students completed the Teen Star program49,323 students reached by PEs (Year 3) and 43,603 in- and out-of-school youth counseled by youth counselors
- 231,789 YFS visits– 18,444 clinical services 213,345 for IEC 70 adolescent girls received scholarships432 fistula cases identified and repaired1,962 law enforcement officials trained on laws related to early marriage, HTPs, and GBV
- External evaluation conducted by ACPHI in 2009 found that: Girls’ clubs and CACs instrumental in cancellation of > 4,000 early marriages. This photo is a girl whose marriage was cancelled as a result of the programModern contraceptive use increased from 25% to 35%52% had been tested for HIV – a 26% increase from baselineIncreased awareness of existence of YFS and YFS location. Data limitations prevented a trend analysis in YFS visits.
- In addition, MEASURE conducted an evaluation of early marriage in Amhara in 2009 focused on the catchment areas of Pathfinder’s WAGE program and World Learning’s program. Most of the findings presented here highlight Pathfinder’s interventions.It found75% of young women, 83% of young men, and 65% of caretakers exposed to early marriage prevention messages through non-print media.Religious leaders are key change agents, influencing public opinion.CHWs, peer educators, and providers also played important role.Girls’ Club members more likely to initiate discussions about stopping planned marriages and higher prevalence of cancelled marriages.
- Peer education is critical as more adolescent girls turn to their friends than to family or teachers when faced with an unwanted marriage.Total planned marriages cancelled: 27% (intervention) 19% (control)Changes only noted in urban areas
- Based on these findings, some considerations and recommendations looking to the future are to:Emphasize changing male attitudes and practices regarding early marriage, couples communication, SRH and gender equity—(reach boys who are forming attitudes)Explore why little change in rural areas regarding early marriage and needed changes in program strategyEvaluate what happens after a girl’s marriage is cancelled (long-term implications on age of marriage?)Assess changes in girls’ agency as a result of program interventions (decision-making, negotiation, participation)
- Follow up girls who received scholarships to determine: impact on subsequent SRH decisions and behaviors (age of marriage, FP use, spacing of children)impact on education, participation in workforce or public spheres