Developing a participatory model addressing the reproductive health needs of young women in Haiti

A review of community involvement in adolescent sexual and reproductive health (ASRH) programs suggests that these approaches have some impact on knowledge, attitudes and behavior change, but may have the greatest impact on community norms that influence ASRH.^1,2 Given their influence on community norms, participatory approaches may be an important strategy for achieving healthy timing and spacing of births (HTSP) among adolescent mothers and girls. Studies indicate the importance of supportive environments on youth health seeking behaviors, especially community acceptance of reproductive health services for youth ³ and the role of influential persons in households.⁴

A replication of a participatory ASRH model is being implemented in Haiti to validate the model's effectiveness in improving HTSP among young mothers and girls (15-24 years). In Haiti, among women between 15 and 19 years of age, 50% of births occur at intervals of less than two years. The model addresses community norms that serve as barriers to method and service use, while simultaneously improving youth friendly services. Participation is built into all project phases: 1) participatory action research; 2) strategy design; 3) intervention implementation; and 4) program evaluation. Family planning method and service use will be assessed through health service statistics analysis.

These findings will provide important evidence regarding the strategic role of community participation approach for influencing social norms that facilitate HTSP among adolescent mothers and girls. The multi-level solutions for addressing HTSP identified during the participatory process are significant in their potential for long-term, sustainable impact on the health outcomes of adolescent mothers, girls and their children.