ADVOCATES FOR YOUTH

Transitions
Volume 14, No. 3, April 2002

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The Participatory Approach Improves Youth's Reproductive Health in Nepal

By Sanyukta Mathur, Program Associate, International Center for Research on Women

In Nepal, the International Center for Research on Women and EngenderHealth, along with Nepali partners, currently involves young men and women—married and unmarried, between the ages of 14 and 24 years—in all aspects of research and implementation of a comprehensive reproductive health program. Lessons and obstacles from this project are highlighted below.

1. The project involves the community at all stages and in many ways. Youth and adult advisory groups exchange information between the community and the project team. An adult advisory group supports youth-centered activities. Activities, such as community mapping, body mapping, problem trees, and lifelines, allow youth and adults to discuss health experiences and expectations and to identify youth's needs. To translate the research results into interventions, five youth task forces review youth's reproductive health needs and identify feasible interventions in one of five areas: information and education, counseling, reproductive health services, economic and personal development, and community norms and attitudes.
   
   The project also works with community members—youth and adults—to implement the interventions. For example, trained service providers provide youth with culturally appropriate information and counseling. Workshops enhance communication between youth and their parents. Project partners work with youth to explore restrictive social norms and to provide reproductive health information and education. Finally, project partners involve community members in workshops to discuss and assess the progress of the activities to date.
2. Participation is not easy to achieve. Reproductive health issues are complex and sensitive, and involving the community in planning, implementing, and evaluating a project requires an intensive commitment of time and resources, especially for training field staff. Moreover, questions arise about the extent to which the community "owns" a project that was conceived, funded, designed, and initiated by outsiders. Another issue is maintaining the participation of community sub-groups, which fluctuates between high and low levels and requires special efforts to maintain. A final issue is ensuring participation of community members by age, gender, ethnicity, and social status and ensuring that a particular group does not dominate project activities.
3. Community Participation Yields Rich Rewards. The project yields an in-depth, first person perspective of Nepali youth's reproductive health issues. Involving the community gives a comprehensive understanding of the social, cultural, and economic context of young people's lives. Youth-designed interventions—such as social dramas and adult education programs—are new, interesting, and creative and meet the comprehensive needs of youth. Finally, the participatory approach mobilizes the community, increasing demands for reproductive health information and services.

The project involves communities in many ways and at all stages, but participation is not easily achieved nor maintained. The rewards are rich and exciting although project partners still wait to see if the approach will lead to sustainable change.

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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