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Ugochi Daniels1, Gwyn Hainsworth, MEd2, Carolyn Boyce, MA2, and Judy Senderowitz3. (1) UNFPA, 220 East 42nd Street, New York, NY 10017, 2122975164, email@example.com, (2) Pathfinder International, Nine Galen St., Suite 217, Watertown, MA 02472, (3) Consultant, 575 Station Rd., Amherst, MA 10002
Programmes seeking to improve adolescent sexual and reproductive health (ASRH) are typically based on health promotion, social and behavior change. Delivering an integrated, comprehensive range of interventions — at a scale capable of halting and reversing current HIV trends —remains a challenge.
The African Youth Alliance — a partnership among the United Nations Population Fund, the Program for Appropriate Technology in Health, and Pathfinder International — worked to improve ASRH in four countries, reaching over 350,000 young people with Life Planning Skills Education and Counseling, providing RH and HIV prevention services to over 1,000,000 young people, and working extensively with governments and communities to create a supportive ASRH environment. The AYA model consisted of integrated, comprehensive, multi-sectoral, and scaled up programs. This unique approach sought to implement all components simultaneously, while building capacity and fostering coordination to encourage sustainability of ASRH services.
AYA learned that: 1. Risk reduction messages were most effective among youth perceiving themselves at medium or high risk of contracting HIV. 2. Change — most evident among secondary school males; most significant in reported condom use. Messages — ‘awareness' more effective with younger students; ‘healthy relationships' stronger among secondary schoolers 3. More females visited static facilities; most visitors sought counseling. Males preferred outreach services, with male condoms most often sought from peer providers. Advocacy and coordination led to policy change which facilitated interventions. Integration was key. 4. Scaling up required investment in the capacity of implementers which increased sustainability. 5. Youth participation proved vital in program delivery and built leaders to drive sustainability.
The presentation recommends: 1. A primary school priority: building confidence and skills to refuse sex and negotiate condom use. 2. Scaling up, sustainability, youth participation, integration and partnerships are closely inter-related and require planning, sufficient resources and early operationalization. 3. A large-scale, multi-component programme requires district-level mechanisms and community involvement to sustain implementation. 4. Define implementation “gold” standards and processes to ensure standards maintenance at all sites. Use standards to monitor. 5. Identify expected contribution of youth participation and to programme objectives.
Learning Objectives: Participants attending this session will be able to
Keywords: Adolescent Health, Prevention
Related Web page: www.ayaonline.org
Presenting author's disclosure statement:
Any relevant financial relationships? No
The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA