Where Schools Fit Into Youth-Friendly Health Services

 By: Micaela Rodrigues, Marketing Director, PSI Mozambique

Across the Republic of Mozambique, three in four unmarried sexually active adolescent girls do not use contraception—a lack of access that drives two in five girls to attempt aborting an unintended pregnancy.

Countering the risks associated with early pregnancy and unsafe abortions necessitates radically broadening how girls can source sexual and reproductive health services. Doing so effectively, however, requires designing methods tailored to the realities on the ground.

In January 2017, PSI/Mozambique launched Project Ignite, a program funded by the Dutch Ministry of Foreign Affairs to increase and sustain the informed use of contraception among Mozambican girls aged 15-19. Through innovative human-centered design (HCD) processes that informed our flagship Tem+ Escolas program, we’ve distributed more than 28,000 contraceptives to 7,572 youth. Tem+Escolas brings peer educators to schools to motivate students through life planning and immediate goal setting. With this critical first step, peers can serve as a bridge for young people to link their goal setting with the necessary contraceptive counselling–school nurses then provide the service delivery. Our work is ongoing—but we’re energized by the promise of how far we’ve come.

Igniting Change: Reaching Girls with SRHR Information

When it comes to sexuality and contraceptive use, Mozambican youth have few reliable information sources to turn to. The subject is taboo at home; parents lack knowledge surrounding the topic and have raised their children in an environment that largely condemns sexual activity among unmarried couples. Pharmacists and healthcare providers often seem intimidating to girls given they deal primarily with adults; friends are no better sources as they too face an information void.

Enacting sustainable change required surmounting these existing challenges.

Applying an HCD approach, PSI/Mozambique worked alongside adolescent girls (aged 15-19) to holistically understand girls’ experiences, needs and barriers surrounding contraceptive access and use. Utilising insights gathered around service delivery and by journey mapping young peoples’ sexual reproductive health and rights (SRHR) needs and key intervention moments, we identified schools as a viable touch point to reach most girls with SRHR information and services. From there, we designed Tem + Escolas tailored to the specific challenges Mozambican girls face with respect to motivation, access, awareness and use of contraceptive counselling and services in schools.

Our work has delivered remarkable findings.

We are contributing to comprehensive sex ed by introducing youth-friendly health services in the school environment. Our initiative focuses on the globally accepted quality of care standards, all while extending to talk with girls about how they feel and what they want. This approach meets adolescent needs in a way that has not commonly been introduced in traditional youth service delivery programs.

Through our work, we understand that first impressions during service delivery at school corners matter. The quality of interaction with peer motivators and school nurses (taking the time to establish a dialogue, using approachable language, providing guidance on relationships, being clear on the side effects of contraceptives) proves critical to building confidence and reducing anxiety among girls seeking to access SRHR services.

We are capitalizing on the rich social influence that young people have with their peer groups and are bringing them into the Ignite program as key motivators. They inspire and lead their peers in immediate goal setting, before linking those life plans to the contraceptive service delivery that the school nurse can offer. Our work recorded the highest levels of engagement when educators divorced contraceptive use from sexual intentionality or as a method reserved solely for adults.

As we’ll share at the 2nd International Social and Behavior Change Communication Summit this April: we are igniting change. Through Tem+ Escolas and PSI/Mozambique, we are fuelling tangible and, most importantly, lasting impact in Mozambique. We are elevating young people as equal partners in program development, and we are reaching more girls with SRHR information and contraception services today than ever before.

Eager to learn more? Connect with Project Ignite Director Olivier LeTouze.

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