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Valerie Mahar provides program support to the Gender Roles, Equality and Transformations (GREAT) Project at Georgetown University’s Institute for Reproductive Health Washington, D.C. headquarters office. The GREAT Project is made possible through support provided by the United States Agency for International Development (USAID) under the terms of the Cooperative Agreement No. AID-OAA-10-00073.
Many of you reading this are likely familiar with the long history of civil conflict that plagued northern Uganda for more than 20 years. This conflict led to massive disruption of health services, internal displacement of people, the erosion of traditional social and family structures, and a generation of young people who have grown up surrounded by violence. Because of the heavy toll the conflict has taken on northern Uganda, these youth are particularly vulnerable to poor reproductive health outcomes (e.g., unintended pregnancy, HIV infection) and gender-based violence.
Born from an understanding that gender norms significantly influence the reproductive health of boys and girls, partners Institute for Reproductive Health, Georgetown University, Pathfinder International, and Save the Children began collaborating in 2010 on the Gender Roles, Equality and Transformations (GREAT) Project with the hope of promoting gender-equitable norms to provide the youth of northern Uganda with a strong foundation for building healthy lives.
Local Ownership: Involving Everyone
Working with youth to lay this foundation can be challenging, but in the two years since the project began, the GREAT team made extensive strides in engaging stakeholders and local communities, especially through the formation of a technical advisory group (TAG) and a participatory project design process. The project design was informed by a workshop with the TAG, consisting of representatives from district local governments, NGOs, cultural institutions, police and officials from the ministries of Health, Gender and Education. Also at the heart of the GREAT team’s efforts is a comprehensive community mobilization strategy known as the Community Action Cycle (CAC), designed to reinforce intervention activities by building the capacity of community, religious, and clan leaders to be agents of change in their communities. The Project will recognize and celebrate community champions who demonstrate commitment to gender-equitable behaviors and plans to work with village health teams who support the expansion of youth-friendly sexual and reproductive health services through a comprehensive Service Linkages Strategy.
Grounding Community Transformation in Evidence
The GREAT team used ethnographic research findings to design activities that resonate positively with these communities in northern Uganda. Centered on a radio drama (which was identified in our program review as a powerful means to catalyze discussion and promote wide-scale behavior change), a series of cohesive and scalable products were designed with overarching themes, using the same characters to create a unifying thread for all products. This enables groups to discuss the common plot, extrapolate the themes to their life experiences, and move into action.
After participating in activities developed by the GREAT Project, one boy concluded:
“We are all children of the family. I want my sister and I both to be healthy and have bright futures.”
Other young boys ages 10-19 responded in a similar way, committing to help their sisters with household chores in an effort to protect them and give them equal time for schoolwork.
While still in its early stages, initial findings from the GREAT Project have given the team hope that large scale transformative change in gender norms and adolescent sexual and reproductive heath outcomes is attainable.
For more information about the early 2013 rollout of scalable products in northern Uganda or the intervention design, check out our Phase I project brief and our recently published ethnographic research findings.
Stay tuned for future updates on GREAT!
From November 14 to 15, FHI 360, on behalf of the IYWG, together with the Youth Health and Rights Collation hosted on online discussion titled, “The Road to Bali: Engaging Young People in Meaningful Ways.” The e-forum provided participants with the opportunity to engage with moderators in a discussion about including young people’s voices and needs in international policy, programs, donor decision-making processes and civil society consultations. The discussion was moderated by policymakers, program managers, donors and youth advocates. The online event generated a lot of conversation about what issues young people feel are most pressing, what meaningful youth engagement is, and what young people want to say to policymakers, donors, and program implementers.
One important topic that arose during this discussion was the distinction between “tokenistic” and meaningful youth participation. Young people do not want to be peripherally included in program planning or policy discussions. It is not enough to invite young people to attend these discussions; instead, young people want to be involved in these discussions, to be invited as active participants, and to take part in implementing the decisions made during these discussions. Many e-forum participants shared the exciting work they are doing through their programs to promote and strengthen youth participation. These program examples included the “Tanora Garan’Teen” program in Madagascar, Restless Development’s work in Zimbabwe, and the Uganda Youth & Adolescents Health Forum. This knowledge exchange provided positive examples of work organizations are doing right now to ensure that young people are not only present for discussions about issues that affect their health and well-being but active partners in developing and implementing programs to address the issues.
E-forum participants stressed that young people need not only to be included in program and policy discussions, but that the lines of communication need to be opened between young people and other stakeholders such as adults and religious leaders. Some e-forum participants shared barriers that they face, such as negative opinions of youth and taboos around discussing sexual and reproductive health, which impede their involvement in their own communities. It is important to remember that meaningful youth participation can occur at all levels including the local, country and global level.
As part of this discussion we asked participants what they felt were the most pressing issues affecting the sexual and reproductive health and human rights of young people. The most common issues that arose were unemployment, government corruption, and lack of sexual and reproductive health information. When asked what young people wanted to tell donors, policymakers, and program planners about these issues we received some great responses:
Thank you to all who participated in this great discussion. If you were not able to participate you can read the discussion archive here.
Every fourth Thursday in November, Americans celebrate Thanksgiving—a holiday dedicated to giving thanks for whatever and whomever we are grateful to have in our lives. In honor of this U.S. tradition, we are asking people around the world why they are thankful for contraception.
There are many reasons to be thankful for contraception. Contraception provides young people the choice to determine their own future. Modern contraceptive use prevents 3.1 million unintended adolescent pregnancies each year. When adolescents are able to avoid unintended pregnancy they are more likely to stay in school and to earn a greater income throughout their lifetime. This is true for both adolescent mothers and fathers; boys who become fathers are also less likely to complete secondary school than their non-parenting peers. Preventing unintended pregnancies among adolescents also reduces the number of maternal deaths worldwide—adolescent pregnancy and pregnancy-related complications are the number one cause of death among female adolescents. Finally, condoms play a dual role: they help prevent against pregnancy and HIV infection. By preventing early or unintended pregnancy and HIV infection, contraception saves lives and improves educational and employment opportunities for young people.
We are thankful for the millions of lives contraception saves and for the opportunities it provides not only young people, but all women and men worldwide. That is why this Thanksgiving we want to know why YOU are thankful for contraception. Log on to our Facebook page and tell us about the positive effects that access to contraceptives has had on your life, or why you are grateful for the promise contraception holds for all people worldwide.
Joy Cunningham, is a Senior Technical Officer at FHI 360 where she manages a portfolio of global youth activities, including oversight for activities conducted under USAID’s Interagency Youth Working Group (IYWG).
Those of us committed to improving the sexual and reproductive health of young people anxiously awaited USAID’s Youth in Development Policy, which was released earlier this month. The policy stresses the importance of a holistic approach to youth development, in recognition that programs can’t address any single issue in isolation. Young people live multi-dimensional and often complex lives, particularly in developing countries, and programs need to reflect that reality.
As an advocate for youth sexual and reproductive health, I was heartened by the policy’s emphasis on a cross-discipline approach to improving the lives of young people. We can’t work in silos to improve access to education or build economic opportunities, for example, if we are not also helping protect young people from HIV, treating those living with HIV, or preventing early and unintended pregnancy. We must work toward a generation of young people healthy enough to enjoy the benefits they might reap from other development opportunities. The Youth in Development Policy reflects that sentiment as well, stating the importance of sexual and reproductive health as an essential component of youth development.
USAID highlights four key areas of opportunity and of challenge for young people: economics, education, peace, security and democracy, and health. Not only are sexual and reproductive health (SRH) key components of the health needs emphasized by the policy, but SRH considerations are embedded throughout the policy. The policy includes attention to hard-to-reach groups such as migrant and refugee youth, street children, rural youth, married girls and young people with disabilities. Also, key protection issues such as early marriage, gender-based violence, trafficking and rights of LGBT populations are addressed, all with sexual and reproductive health implications.
Now that we know what the policy looks like, we have already begun asking the next questions: What will happen now? How will the results of the recent election affect USAID’s spending on youth in development, and specifically, sexual and reproductive health? How will this policy evolve into strategies, frameworks and programs? How will it play out at the country level?
I hope that the release of USAID’s policy will bring global attention to the critical importance of young people’s sexual and reproductive health as a fundamental, foundational component of their overall development. We’ve got to begin youth development work with healthy young people and ensure they stay alive. Pregnant girls rarely stay in school. Young people who are living with untreated HIV might not live long enough to contribute to their country’s peace and democracy efforts. At FHI 360, we believe young people are catalysts for positive, sustainable change. Let’s help them reach their full potential.
“By the year 2015, there will be three billion people under the age of 25. They are the future…they are also the now”—James D. Wolfensohn, Former President of the World Bank (2003)
Nearly half of the world’s population is under 24 years old, and most young people live in developing countries. Young people globally face multiple challenges including political instability, rising rates of unemployment, and mounting sexual and reproductive health disparities. However, a growing youth population also means a growing opportunity for change. Young people are energetic, creative, and are often the leaders of change in their communities, but their voices have been historically missing from major policy and programming dialogues and decisions. Young people have the potential to transform the social and economic fortunes of their communities, particularly in least-developed countries. Their contributions can enrich and inform policies, programs, and donor decisions. If we are to achieve lasting change in the health and lives of young people, we must engage young people themselves in development decisions.
In December, at the International Conference on Population and Development (ICPD) Beyond 2014 Global Youth Forum (GYF), hundreds of young people from around the world will meet in Bail to develop global recommendations for policymakers and other stakeholders on health, education, employment and livelihood, families and well-being, and fully inclusive civic participation. In preparation for this event, FHI 360, on behalf of the IYWG, together with the Youth Health and Rights Coalition are hosting a virtual discussion titled, “The Road to Bali: Engaging Young People in Meaningful Ways,” November 14‒15, 2012. During this exciting virtual event, delegates from the Global Youth Forum and international policymakers and donors will moderate a discussion on how best to ensure that young people’s voices and needs are included in international policy, programs, donor decision-making processes and civil society consultations. You can join the discussion by logging on during the event, or by pre-submitting questions via our website.
We hope that the issues raised during this forum will not only spark further conversation during the GYF, but also contribute to an ongoing global dialogue about the importance of youth engagement.
You can participate in the global youth forum—before, during, and after our e-forum—on Twitter at #icpdyouth or by registering as a virtual delegate.
This month, USAID released its first policy ever to focus on youth and development. The policy titled, “Youth in Development: Realizing the Demographic Opportunity,” provides guidance on pursuing innovative and cost-effective approaches to empowering youth to contribute to and benefit from their countries’ development efforts. The policy focuses on an integrated approach to youth development highlighting young people’s multifaceted needs in the areas of education, economic inequality, health disparity, and political unrest.
The goal of the policy is to “Improve the capacities and enable the aspirations of youth so that they can contribute to and benefit from more stable, democratic, and prosperous communities and nations.” The main objectives outlined are (1) to “strengthen youth programming, participation and partnership in support of Agency development objectives,” and (2) to “mainstream and integrate youth issues and engage young people across Agency initiatives and operations.” In reaching these goals and objectives, USAID expects to achieve the following outcomes:
- Youth are better able to access economic and social opportunities; share in economic growth; live healthy lives; and contribute to household, community, and national well-being.
- Youth fully participate in democratic and development processes; play active roles in peace building and civil society; and are less involved in youth gangs, criminal networks, and insurgent organizations.
- Youth have a stronger voice in, and are better served by, local and national institutions with more robust and youth-friendly policies.
The policy also provides a conceptual framework for youth in development and includes guiding principles for achieving the policy’s outcomes and objectives. The conceptual framework includes four elements: (1) support, (2) protect, (3) prepare, and (4) engage. The policy’s guiding principles are outlined as follows:
- Recognize that youth participation is vital for effective programs
- Invest in assets that build youth resilience
- Account for youth differences and commonalities
- Create second chance opportunities
- Involve and support mentors, families, and communities
- Pursue gender equality
- Embrace innovation and technology by and for youth
As stated by USAID, the new policy “is a critical step towards a fresh approach to development, one that proactively ensures youth can fulfill their dreams for prosperity, freedom, and justice.”
“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 on young people and HIV. The original post, located on “Impatient Optimists,” is available here. John Mwikwabe is a peer educator with the Kenya Red Cross Naivasha Sub Branch.
In a country where half of its population lives below the poverty line and many people make less than a dollar per day, life can be challenging. Many families struggle just to put food on the table. The responsibility to be the breadwinner, traditionally borne by parents, is extended to all family members. Children are forced to contribute to running the households, often before completing their primary level studies. Many young people find it difficult to get well-paying jobs, and often end up opening up “vibandas” (small vendors shop) to sell vegetables and groceries. In Naivasha, where I live, I see more and more young girls entering into sex work. As a peer educator, I have worked with some of the girls, their classmates and their neighbors and from them have learned staggering information.
“At first I just wanted to help at home, earn some money and save enough to help my mum. But later I realized I could buy whatever I wanted and that felt good for a change.” – 13-year-old female who is involved in sex work
The young woman quoted above is a standard 8 pupil at a nearby primary school. Her mother is fully aware of her daughter’s night shift duties but feels there is little she can do. Often, her daughter can bring home Kshs. 1,500 to Kshs. 2,500 (about $16-27 USD) in one night. The mother had to divorce her husband because of his heavy drinking and sees her daughter’s work as their family’s life-line despite the risks her daughter is exposed to.
I have seen other young women become involved with older men to supplement their family’s incomes; these types of relationships also increase young women’s vulnerability to STIs and HIV. There is a huge gap in providing these young girls who are in school, especially in primary school, with relevant information on prevention messages. There have been programs, but they often occur on the weekends when many adolescent girls go to visit their “clandes” (men who have money and are married).
As a peer educator, I mostly work with out-of-school youth—however even for those in school, comprehensive sexuality education is not available. The gap in available information about HIV risk impedes the war against HIV and AIDS and the promise of a brighter future for adolescent girls. Young people, and especially adolescent females, need information about reproductive health services and HIV prevention so that they are empowered to make informed decisions concerning their lives.