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

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.