Using the Mentoring Approach to Meet Family Planning Needs of Underserved Youth in Madagascar

Background

Youth aged 10-24 years represent 32% of the total population in Madagascar. The 2008/2009 DHS revealed that among youth 15-19 years, the unmet need for FP is 26.9% (compared to 14.6% among married women) and 26% had at least one child. Madagascar’s Community-Based Integrated Health Program (CBIHP) trains and supports community health volunteers (CHVs) to provide health services, including FP/RH. In select CBIHP communes, youth peer educators (YPE) and CHVs were paired using the community mentoring approach to increase knowledge and utilization of FP/RH services among youth in urban and rural communes.

 

Methods

The panel method was used to monitor FP/RH service provision by CHVs and, where applicable, YPEs, on a monthly basis in 45 communes, supplemented by qualitative interviews. Data was analyzed using excel and SPSS 20 software, with Anova test for significance.

 

Results

Overall, from January 2013 to December 2014, the use of contraception among youth significantly increased in all communes (p<0.005). Among communes with YPEs, greater increases were seen in rural communes with YPEs than in urban communes with YPEs (p<0.005). The main motivators to use FP services are acknowledgement of FP importance (p =0,000) and friends’ support (p = 0.004).

 

Conclusions

Providing community-based services through CHVs increased knowledge and use of FP/RH services among youth overall. The community mentoring approach for CHVs and YPEs augmented this effect, especially in rural areas with reduced access to health facilities or other youth-friendly services. The YPE approach is responsive to youth needs for peer support.