You are currently browsing the monthly archive for September 2012.

This post, written by Elizabeth Futrell, originally appeared on the K4Health blog and can be accessed here.

© 2003 Ansem Ansari, Courtesy of Photoshare

I was overjoyed to give birth to my first baby—a girl—earlier this year. Before becoming a mother at age 32, I graduated from high school, college, and graduate school. I served as a Peace Corps volunteer in Morocco and married a fellow volunteer.  I traveled the world, living and working on three continents. I changed careers. I volunteered as a prison tutor, an advocate for people living with AIDS, a financial literacy mentor for low-income women, an editor of a quarterly literary publication, and an auxiliary board member of Heshima Kenya.

Without contraception, my life likely would have been quite different. In fact, while I now have a baby, several of my childhood friends have teenaged children. My junior year in high school, nine of my friends or acquaintances were pregnant. Several more miscarried or had abortions. I was raised Catholic in a middle-class American suburb, and my weekly teen group taught us that abstinence was our only contraceptive option. By the time we finished high school, 2 of the 12 members of our group had given birth. 

 Though U.S. teen pregnancy rates have dropped in recent years, access to quality reproductive health and family planning information and services for young women is still a pressing issue in America and around the world. The World Health Organization (WHO) estimates that 16 million girls, ages 15-19 give birth every year; 95 percent of these births occur in developing countries. Interestingly, WHO reports that seven countries account for half of all adolescent births: Bangladesh, Brazil, the Democratic Republic of Congo, Ethiopia, India, Nigeria, and the United States.

Unlike my high school friends, who generally received prenatal services and gave birth in hospitals under the care of obstetricians, many adolescent mothers in developing countries receive little or no prenatal care and give birth without the presence of a skilled birth attendant. As a result, many of these young women face debilitating but preventable conditions such as obstetric fistula, uterine rupture, or even death. Like my high school friends, they are less likely to finish school and to have economic opportunities than their peers who have not given birth during adolescence.

World Contraception Day, which falls each year on September 26, is a global campaign with a vision for a world where every pregnancy is wanted. Its mission is to raise awareness of contraception so that young people can make informed sexual and reproductive health decisions.

Contraception saves lives. It also changes lives. When girls and women are able to choose with their partners when and how often they have children, their educational path lengthens, their economic opportunities strengthen, and their capacity to become active, dedicated citizens of their communities, and the world, soars. The benefits of a woman’s access to family planning reach far beyond her and her family; there is no limit to the good a woman can do in the world when her potential is unleashed. For proof, visit Women Deliver’s list of the 100 most inspiring people delivering for girls and women.  

To learn more about contraceptive options, please visit the K4Health Toolkits.

© 2006 Khumar Taghieva, Courtesy of PhotoshareThis post, written by Rebecca Shore, originally appeared on the k4Health blog and can be accessed here.

The world is a scary place, especially for women. Many live their lives in fear and are constantly treated like second-class citizens. Photographer Stephanie Sinclair of National Geographic took a close look at child marriage and created a 10-minute film Too Young to Wed: The Secret World of Child Brides. She captured the true consequences of the practice of child marriage. This practice, though illegal nearly everywhere worldwide, is still practiced by many cultures, in many countries. This video focuses on India, Yemen, Afghanistan, Nepal, and Ethiopia and the acts of child marriage. Throughout the video, several girls are interviewed about the lives they live as young brides. It is dramatic and at times hard to watch, but it gives a glimpse into the pain and fear that runs these young girls lives.

Though child marriage is on the decline, it has been a slow decline. Because child brides are used for their family’s financial gain and because of myths—like the myth that virginity cures HIV— child marriage continues throughout much of the developing world. According to the International Center for Research on Women (ICRW), if present trends continue, 100 million girls will marry over the next decade. In countries like Niger, Chad, and Mali, the rate of girls married before 18 is over 70%.

The negative results of child marriage are astounding. Child brides are often victims of abuse, rape, and even murder, and they have little to almost no input into their own decisions. Once a girl gets married she is usually forced to leave school, which perpetuates the cycle of poverty. However, the more educated girls are, the less likely they are to become child brides. Maternal mortality and obstructed labor leading to fistula are also common among child brides both because young girls’ bodies are still immature and because of a  lack of knowledge about maternal health, lack of control over medical decisions, and lack of access to timely and adequate health care.

Child marriage is a devastating practice that is still all too common in the poorest countries in the world and continues to perpetuate poverty. Organizations and campaigns to end child marriage are helping to change the landscape for girls everywhere. The more people who are aware of this practice, the more we can hope to change and end this behavior. Everywhere in the world, women are not just fighting for equality, they’re often fighting for their lives.

For more information or to get involved, take a look at these organizations that are committed to the cause:

For more information on Stephanie Sinclair, visit her web site.

To learn more about early marriage and youth sexual and reproductive health, read the IYWG YouthLens, “Addressing Early Marriage of Young and Adolescent Girls.”

“The Stories Behind the Statistics” is a series we developed for the Gates Foundation blog, “Impatient Optimists.” The following post is the second in our three-part series on contraception. The original post, located on “Impatient Optimists,” is available here. Primrose Nanchani Manyalo is a field officer at Restless Development, a youth-led development agency.

No matter where you live in the world, contraceptive access is essential to the sexual and reproductive health of young people. This is also true of young people in Zimbabwe, where I live and work. My experiences with young people in this country have taught me that they face numerous challenges in trying to access contraceptives and the repercussions young people deal with when they can’t: teen pregnancies, unsafe abortions, death due to child birth, and HIV/STIs (sexually transmitted infections).

At Restless Development, a youth-led organization to address the most urgent issues facing young people around the world, we have set up youth-friendly corners and centers around Zimbabwe (the country where I’m from and in which I work) that are a haven for young people who need services. These services include providing access to condoms, and offering ways to meaningfully engage in advocacy about the reproductive health and rights of young people. At one of the youth-friendly corners we run, young people tell us that contraceptives are available at the local pharmacies and clinics. These include morning after pills, barrier methods, implants and other hormonal methods. Nevertheless, there are still many hindrances that lead to the overall unavailability of contraceptives among young people in Zimbabwe.

Young people in the city of Harare say they cannot walk into a pharmacy or clinic and purchase or request contraceptives because they think providers will feel that “they are still too young.” Others revealed that they fear being laughed at by their peers or treated as outcasts in their community because they “shamefully indulged in sex before marriage.”  These psychological and social barriers are further exacerbated by provider bias, cultural barriers, the high cost of contraceptives at private pharmacies, and a lack of youth-friendly services.

Natsai, one of our youth group members, told us she could not speak openly about contraceptives with her peers, teachers, or parents. When she became pregnant at 16, her mother took her to the clinic to get the hormonal IUD (a type of contraceptive), which would prevent her from becoming pregnant again until she was at least 23. Though the move was noble, it came too late.  If the contraceptive service had come earlier, it would have prevented her from becoming pregnant at such a young age, dropping out of school, being rejected by her boyfriend, and living with the psychological trauma that comes with motherhood at an early age.

Finally, some young people in my community decide not to use contraceptives because of myths they’ve heard and misconceptions about how contraception works. Some young people believe that if you use contraceptives you will not be able to bear children later on. Clearly, there is a need to educate young people about contraception.

Having contraceptive access and choice is a basic health right. If contraceptive access is realized, some of the appalling sexual and reproductive health challenges faced by young people, particularly by girls and young women, will be addressed.  Efforts to ensure contraceptive access for young people, coupled with provision of comprehensive sexual and reproductive health education, can help young people make healthier and informed choices about their lives.

Finally, advocacy efforts should address not only issues of access, but also young people’s need for youth-friendly and affordable services provided by nonjudgmental health care workers. Policy-makers, donors, young people, and other relevant stakeholders should work together to develop policies and strategies to improve access to contraceptives and other sexual and reproductive health services for young people in Zimbabwe.  By also addressing societal attitudes, and cultural barriers we could go a long way in protecting young people’s lives.

You can help Restless Development empower the youth of Zimbabwe. Learn more and share with your friends and family.

This post, written by Joy Cunningham, originally appeared on the FHI 360 “Degrees” blog and can be accessed here.

Many of us who spend our time in the youth sexual and reproductive health (YSRH) world don’t often cross paths with those in the business of economic empowerment and livelihoods programs for young people. Although both worlds are aware of the converging paths, funding streams generally keep us operating on parallel roads. Therefore, I was pleased to facilitate a panel session this morning at the conference: “Exploring the Intersection of Adolescent Girls’ Reproductive Health and Economic Empowerment.” During a lively session, panelists shared their experiences with both issues for girls. Some of the themes were:

  •  Even though we are aware of the problem, the data on SRH and economic empowerment for girls, taken together for developing countries, is shocking. The rates of HIV, maternal mortality and morbidity, poverty and isolation paint a dismal picture for girls.
  • Programs that target girls and adults in the community, with messages on both SRH and economic empowerment, are showing some successes. There’s more to learn, but results are encouraging.
  • Models that incorporate peer education and work with girls on SRH and economic empowerment show positive results: the Tesfa program led by the International Center for Research on Women, the Siyakha Nentsha program in South Africa led by Population Council, and a program by Restless Development in Northern Uganda all included a peer education component.
  • Reducing social isolation seems key for increasing both SRH and economic outcomes for girls. Girls need access to other girls for many reasons, but importantly, to give them an outlet to talk about themselves: their ideas, dreams and goals.
  • It’s important to work with the adults, not just the girls. Teachers, parents and faith leaders all play roles in girls’ lives, and we need to get them on board with difficult topics. Sex and money are not easy to discuss with young people, and the adults need to build their skills to do it.

Today’s session initiated some vital discussion about next steps. It’s my hope that the two worlds of SRH and economic empowerment for young people will start to cross more often and begin to operate more closely together. This year’s conference is an encouraging step toward that. Look for more information on this topic, including a research brief and e-forum, by visiting the Interagency Youth Working Group website.

Tomorrow, FHI 360 on behalf of the IYWG, will host a panel presentation at 2012 Global Youth Economic Opportunities Conference on the intersection of adolescent girls’ economic empowerment and sexual and reproductive health. 

Adolescent girls face multiple economic disparities and sexual and reproductive health challenges.  Adolescent girls are more vulnerable to HIV and other STIs than males, and experience high rates of sexual violence, pregnancy, maternal mortality and morbidity and early marriage.  Females make up more than 60% of all young people living with HIV and account for 72% of young people living with HIV in sub-Saharan Africa. An estimated 16 million girls between the ages of 15 and 19 give birth each year and childbirth related complications are the number one cause of death among girls ages 15-19. One out of seven girls in developing countries marries before age 15, and approximately 1 in 5 females will be a victim of rape or attempted rape in her lifetime.

Along with myriad sexual and reproductive health challenges, adolescent girls also face multiple economic disparities. Of all out-of-school youth, 70% are girls. Globally, young women are less likely to be employed than young men and earn lower wages than young men. Furthermore, increased household responsibilities among adolescent girls hinder their ability to find work outside of the home and to attend school.

Economic disparity is both a cause and a consequence of negative sexual and reproductive health outcomes.

Girls with low socioeconomic standing are at an increased risk of marrying early and of engaging in transactional sex or intergenerational relationships. Lower socioeconomic standing also increases young women’s chances of experiencing sexual and intimate partner violence; all increasing adolescent girls’ risk of early pregnancy and HIV infection. Likewise, early and unintended pregnancy as well as HIV infection can hinder young women’s economic opportunities. Girls who become pregnant are more likely to leave school early, bear more children at shorter intervals, and have a lower income throughout their lifetime. Adolescent girls who become infected with HIV may be less able to find work because of stigma surrounding the disease, or less able to keep work because of their illness.

Research suggests that multi-faceted program approaches to adolescent girl’s health and economic empowerment can improve these outcomes. Our panel tomorrow, entitled, “Exploring the Intersection of Adolescent Girls’ Reproductive Health and Economic Empowerment,” will share innovative programs from Population Council, ICRW, and Restless Development all addressing the  intersection of girls’ economic empowerment and sexual and reproductive health.

“Exploring the Intersection of Adolescent Girls’ Reproductive Health and Economic Empowerment” will take place on September 12, 2012 at 9:00 a.m. in room 300 of the Inter-American Development Bank’s Conference Center.


Nike-USAID partnership in Kenya helps struggling female fish sellers attain safety, solidarity and success in alternative industries.

This post, written by Clara Kakai, originally appeared on USAID’s FrontLine blog and can be accessed here.

Two years ago, 21-year-old Beatrice Kasina was a struggling fish seller on the shores of Kenya’s Lake Victoria.

Seventeen-year-old Ruth Otieno was unemployed and fully dependent on the meager income of her fisherman husband.

Credit: Emma Odundo

‘Value Girl’ Betty Anyango, 20, tends to chicks in a demo house. She is now a successful micro-entrepreneur who helps other young women start similar projects.

Twenty-three-year-old Susan Opiyo, a single mother of two, was hawking tiny fish, called omena, by the roadside, desperate for motorists to stop and buy so she could feed her young children.

These three women’s stories echo those of hundreds more in Kenya’s lake region, where dependence on fish as the only economic resource is commonplace. But sadly, the fish industry is in decline. Environmental degradation, illegal fishing and interference with fish breeding sites have depleted fish reserves in the lake waters.

With rising competition for fewer fish, young women are particularly vulnerable. Many resort to risky sexual behavior because they do not own boats and have to rely on the whims of fishermen for supplies. The fish-for-sex trade has been an issue of concern for several years. One analysis published in 2009 reported the rate of HIV prevalence was 30 percent among the people who live and work in fishing communities.

Today, however, life has dramatically improved for the three young women, who hold their own as successful micro-entrepreneurs. Kasina rears chicken; Otieno is a vegetable farmer; Opiyo is involved in raising poultry and vegetable farming. The three have one thing in common: They are all “Value Girls.”

Value Girls is a Global Development Alliance jointly funded by The U.S. Agency for International Development (USAID) and the Nike Foundation to improve the socio-economic status of young women by giving them alternative sources of income. It works with women between the ages of 14 and 24 who live in the fishing communities of rural Nyanza and Western Kenya.

“Decades of research show that improving the economic status of women improves food security, wealth creation and economic growth,” says Beatrice Wamalwa, a gender specialist at USAID/Kenya.

Studies also show that higher incomes for women result in healthier households because women are more likely to spend their incomes on their children’s nutritional and educational needs. According to the Food and Agriculture Organization, rural women are essential actors in reducing hunger, undernutrition and poverty because they make up 43 percent of the agricultural labor force in developing countries.

Credit: Natasha Murigu

Susan Akoth Owindu at Kaswanga farm on the shores of Lake Victoria pumps water to irrigate her vegetable garden. The Value Girls program has helped to improve the lives of over 1,400 Kenyan women.

Value Girls is tapping into young women’s potential and is contributing to the goals of the U.S. Government’s Feed the Future initiative: reducing hunger and poverty through agriculture and improved nutrition.

The Value Girls program works through three local organizations in six districts. In market surveys, poultry and vegetable farming were deemed the most viable alternatives to fishing because of their sustainability and potential to increase women’s incomes.

According to Emma Odundo, a senior program officer with the Value Girls program, these organizations recruit women working on the beaches of Lake Victoria. “The program first mobilizes the women into self-selected groups of five or six, where they begin a savings scheme, elect leaders and decide on an income-generating activity. They are then given technical, business and financial literacy skills as well as demonstrations for either poultry or vegetable farming,” Odundo said.

Participants also receive start-up support. Poultry groups receive in-kind matching grants of the total value of their savings, usually the equivalent
of $20 to $60 per group member, while vegetable-farming groups get
fencing for the farms they lease. The groups can also access loans from
microfinance institutions to expand their businesses or buy equipment such as water pumps for irrigation.

“Poultry Farming Changed My Life”

Value Girls allows young women to have stable incomes and reduces their susceptibility to abuse and sexual exploitation. The women’s successes are also rippling through the region.

In poultry farming, for example, the young women are now the largest buyers in Nyanza and Western provinces of day-old chicks from Kenchic, the largest poultry management firm in Kenya. Between July and September 2011, 250 young women placed orders for a total of 8,000 day-old chicks—which should earn them a combined gross income of around $36,500.

The increased incomes have propelled the women’s value within their households and the community: They are now considered significant contributors to society.

“My husband has a newfound respect for me because I can now ease his financial burden,” says Otieno.

“Poultry farming has changed my life,” says an elated Kasina, who is now making more in a day than she used to make in a week.

Credit: Emma Odundo

Everline Odhaimbo waters her vegetables at Kaugege Beach. USAID’s Value Girls program is helping to reduce hunger and poverty in the country through agriculture and improved nutrition.

For Opiyo, it is the healthy appearance of her children that gives her the most joy. With the added bonus of a woman mentor for each of the business groups, the three are optimistic that they will surpass their current successes.

Their new lifestyles have been replicated by more than 1,400 other young women who joined the program since 2009. Having exceeded last year’s target of 1,000 women, and expanded from eight to 39 beaches, USAID’s $1.9 million Value Girl program may be ending in November—but none of the young women plan to abandon their new livelihoods.

“The metamorphosis is amazing. When hundreds of dependent young women become self-reliant, the effects will be felt for generations,” says Pharesh Ratego, Value Girls project manager at USAID, after visiting several beneficiaries. “By the looks of it, chicken and vegetables may soon replace fish as the local delicacy in the region.”

Learn more about livelihood programs and sexual and reproductive health on our website:

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This blog is brought to you by the Interagency Youth Working Group (IYWG) with financial assistance from the U.S. Agency for International Development and the U.S. President's Emergency Plan for AIDS Relief. The content is managed by FHI, which functions as the secretariat for the IYWG.
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