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Transitions
Volume 14, No. 3,
April 2002
This Transitions is
also available in [PDF] format.
Mobilizing
Communities for Change—The Youth to Youth for Healthy Life
Project
By Amy Weissman, Youth Reproductive
Health Specialist, Save the Children
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Participants
agreed that most health services in Mangochi were
not youth-friendly, and the youth identified issues
that included long waiting times and lack of confidentiality. |
In Mangochi District, Malawi, Save
the Children recognized that improving the reproductive and sexual
health of the district's youth required changing community norms. Young
people, in partnership with key adults, needed to participate in planning,
implementing, and evaluating activities. First, Save the Children worked
with the community to assess the needs of Mangochi youth. Focus group
discussions with youth, parents, community leaders, service providers,
and other key stakeholders identified concerns and perceptions about
youth's reproductive and sexual health. Youth conducted focus groups
among their peers, while adults conducted discussions and interviews
among adults.
In a workshop, participants used the needs assessment data to identify priority
issues, including sexual exploitation and violence, harmful traditional practices,
and inadequate reproductive health services. During the workshop, representatives
of young people's clubs, organizations working with youth, government officials,
and religious leaders designed the Nchanda
ni Nchanda pa umi Wambone (Youth to Youth for Healthy Life)
project, using Save the Children's community mobilization approach. Although
youth participated and some of their expressed concerns were among the priority
issues, young people lacked the confidence and the authority to make their
primary concerns heard. This experience underscored the importance of structuring
planning sessions in such a way that those with less power have an equal voice.
Although influencing community norms required engaging key adults in all aspects
of the project, Save the Children also believed that youth must "drive" the
process. For example, young people exchanged ideas with health providers about
issues that need to be addressed to achieve youth-friendly care. Youth and
health care providers held dialogues in the seven health centers in the project
area. Participants agreed that most health services in Mangochi were not youth-friendly,
and the youth identified issues that included long waiting times and lack of
confidentiality, such as health providers' reporting to parents when youth
sought reproductive health care. The young people's suggestions regarding these
issues—for example, maintaining confidentiality, assisting clients quickly,
assuring privacy, and refraining from being judgmental —were included
in a training course for health services providers. The training course also
addressed clients' rights, including the right to information, respect, and
confidentiality, and to make informed and responsible choices. As a result,
young people began to seek out the trained professionals by name.
Recent evaluation indicated that using a community mobilization approach has
been effective. When compared to baseline, male youth demonstrated significant
increases in knowledge about STIs and HIV/AIDS as well as significant increases
in condom use. Female youth reported increased abstinence. In addition, because
the project focused not only on youth, but also on their social environment,
the evaluation indicated changes in communication patterns between adults and
young people. Significantly more males and females in the project area than
in the control site reported talking with their parents about a romantic or
sexual relationship. Community participation not only enhanced community ownership
of the project but also ensured cultural relevance and increased sustainability.
To promote adolescents' adoption of healthy practices, programs need to address
youth and their social environment. In Mangochi District, community
participation has been key to doing so.
Transitions (ISSN 1097-1254) © 2002, is a quarterly publication of Advocates for Youth—Helping young people make safe and responsible decisions about sex. For permission to reprint, contact Transitions' editor at 202.419.3420.
Editor: Sue Alford
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