By Ruth Desta, Sexual and Reproductive Health Program Manager, PSI Ethiopia
As our program insights show: in Ethiopia, unmarried girls in relationships may not plan to have sex – as they shared, “it just happens!”
And still, stigma and misperceptions continue to stand between unmarried girls and their ability to choose contraception.
Through PSI’s flagship adolescent sexual and reproductive health (SRH) project Adolescents 360 (A360), we’ve learned that when we bring young people in as co-designers of the solutions that serve them, we, together, can deliver programs that support girls to see the relevance of contraception to their lives.
It’s a model ripe for replication – and one we, the A360 Ethiopia team, used as we expanded our focus to respond to the needs of unmarried Ethiopian girls too often left behind.
What Girls Told Us
Away from home, exposed to new cities, ideas, and–of course–boys, girls face higher risks for unwanted pregnancy.
Yet, young people shared, girls often feel uncomfortable approaching health providers for ASRH information and services for fear of judgement or, worse yet, being turned away.
Our A360 team tested prototypes of school-based contraceptive counseling programs and found that both girls and boys feel that school is a safe place for them to receive SRH information and services, because they want services that are private and confidential.
However, school-based, Western-funded SRH projects face resistance from communities. Many fear that global NGOs and donors will infuse SRH education with Western culture and, by extension, encourage adolescents to have sex from an early age.
Moreover, our insight gathering phase showed that while education administrators want students to engage in sexual education, they’re cautious about what and how much information reaches students for fear it may encourage young people have sex.
And while our program didn’t have the time nor resources to respond to this specific challenge, we did take extra steps to ensure transparency in our communication with school administrators. The MoU that was signed between health, education regional bureaus and PSI gave us legal framework to implement the program.
Through multiple iterations – and some adaptations to account for COVID-19—we landed on a solution: programming that starts the conversation with girls’ dreams, with contraceptive services provided, on-site, on-demand and for free.
We’ve documented the insights that informed the process. And we’ve highlighted the 5 learnings we took away from testing prototypes while in a pandemic. We invite you to give them a read.