223237 On the Streets: An Empowerment-Based, 3-Country Intervention to Improve Health for and by Vulnerable Adolescents in Latin America

Wednesday, November 10, 2010 : 12:50 PM - 1:10 PM

Rupal Sanghvi, MPH , Founder, HealthxDesign, Brooklyn, NY
River Finlay, MPH , Programs, International Planned Parenthood Federation/Western Hemisphere Region, New York, NY
Shelly Makleff, MPH , Evaluation, IPPF/WHR, New York, NY
Marissa Billowitz, MA , Programs Dept., IPPF/WHR, New York, NY
Amidst the backdrop of the Millennium Development Goals (MDGs), efforts to effectively address the poor health outcomes of vulnerable adolescents with high street exposure remain limited. At the nexus of police brutality, drug trafficking, sex trafficking, sexual assault and gang involvement, these adolescents experience poor health outcomes, with little access to services. Concomitant structural inequities place them at further risk of experiences that jeopardize healthy transitions to adulthood.

International Planned Parenthood Federation (IPPF/WHR) Member Associations implemented an initiative, in Bolivia, Guatemala and Peru, to increase service access, improve health behavior and strengthen the policy landscape. Incorporating a peer-based, harm reduction approach, the project reached over 165,000 people ages 10-24 and providing over 360,998 services. The project was also successful in reaching younger adolescents (20% ages 10-14 and 63% under 19). A behavioral surveillance survey was utilized to demonstrate the positive effect of the intervention on key SRH behavioral outcomes (including condom use at last sex, contraceptive use, and health seeking behavior). Using a “dose-response” element, the survey analyzed effectiveness by degree and type of intervention and found the combined approach of services and education consistently most effective. In addition, a provider survey identified gaps in core competencies, and areas for self care.

Through complementing program strategy with a policy focus, each country achieved policy change that improves access to care for vulnerable adolescents. Thus, the project represents an important contribution to promising approaches for scale-out and replication beyond the project sites.

Learning Areas:
Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs

Learning Objectives:
1. Describe why access to health services for vulnerable adolescents is a social justice issue. 2. Describe the results, including policy changes and changes in key outcome variables for adolescent behavior and knowledge. 3. Discuss lessons learned and promising approaches for reaching vulnerable adolescents. 3. List available tools and resources for evaluating behavior change among vulnerable adolescents and for assessing provider-readiness and need for support in meeting the special needs of vulnerable adolescents.

Keywords: Access and Services, Adolescents, International

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the Program Officer for Youth programs at IPPF/WHR, responsible for the ongoing street youth intiiative.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.