Youn Adult Re roductive Health State of the

SOIA Irainin Course IA·

FOCUS on Young Adults Febuary 18-23. 2001 Abuja Nigeria @ 2001 FOCUS on Young Adults

or adapted Any part of this pu blication may be copied, reproduced, distributed of the without permission from the author or publisher, provided the recipient gain and materials does not copy, distribute Or adapt materials for commercial as the source of provided that the authors, and FOCUS on Young Adults, are credited adaptations of the such information on all copies, reproductions, distributions and and material, The FOCUS on Young Adults program promotes the well-being International in reproductive health of young people. FOCUS is a program of Pathfinder School of partnership with The Futures Group International and Tulane University Cooperative Public Health and Tropical Medicine. FOCUS is funded by USAID, therein are those of Agreement # CCP-A-00-96-90002-00. The opinions expressed Agency for the authors and do not necessarily reflect the views of the U.s. reproductive health can International Development. Publications addressing adolescent be downloaded from the FOCUS web site: http://pathfind.org/focus.htm iii

TABLE OF CONfENTS

Acknowledgements ...... vi SOTA Course Facilitators in Alphabetical Order ...... viii Monitoring and Evaluation Course Facilitators ...... ix Youth-Friendly Services Course Facilitators ...... ix Mvocacy Course Facilitators ...... ix List of Acronyms ...... x Executive Summary ...... xii

Introduction ...... 1 A. Statement of Purpose of the SOTA ...... 1 B. Goal and Objectives ...... 2 Purpcse of this Report ...... 3 A. Course Design ...... 4 B. Excerpts of Key Speeches at the Opening Ceremony ...... 7 Country Background ...... 8 A. Current Situation in Nigeria ...... 8 B. Health of Nigeria ...... 9 SOTA Course Thematic Areas ...... 11 A. Understanding Adolescence ...... 11 Our Perceptions ...... 11 Current State of Affairs ...... 12 Fertility Regulation ...... 14 High-Risk Fertility Behavior ...... 14 Making the Transition ...... 16 Summary ...... 16 B. Risk and Protective Factors ...... 17 Socioeconomic Factors ...... 17 Environmental Factors ...... 17 Cultural Factors ...... 18 The Media ...... 18 Religion ...... 18 Summary ...... 18 ------._------

iv

19 C. Creating an Enabling Environment ...... 19 Current Policies Affecting Young People in Nigeria ...... 21 From Policy to Practice ...... 22 The Ghanaian Experience ...... 22 Summary ...... 23 D. Services ...... 23 Youth-Friendly Services ...... 24 Meeting the Needs of Specific Young Adults in Nigeria ...... 28 Summary ...... 29 E. Communication ...... 29 Role of the Media in Reproductive Health Communication ...... 30 Developing Effective Communication Strategies ...... 30 Social Marketing and Behavior-Change Communication ...... 30 Summary ...... 31 F. YARH Strategies and Approaches ...... " ...... 31 Program Approaches and Lessons Learned in Nigeria ...... 34 Summary ...... 35 G. Monitoring and Evaluation (M&E) ...... 35 H. Next Steps ...... 39 Commitment and Summary ...... ~ ...... 40 Conclusion ...... 40 A. Evaluation ...... 41 B. Partner Assessment ...... 42 C. SOTA Course Evaluation ...... 43 Monitoring and Evaluation Training Course Report ...... 43 A. Course Description ...... 44 B. Goals and Objectives ...... 45 C. Description of Participants and Organizations ...... 46 D. Highlights and Emerging Issues ...... 47 E. Recommendations and Course Evaluation ...... 48 Youth-Friendly Services Training Report ...... 48 A. Course Description ""'"'''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''' 49 B. Goals and Objectives ...... 49 C. Description of Participants and Organizations ...... 50 D. Highlights and Emerging Issues ...... 50 E. Recommendations and Course Evaluation ...... 51 Advocating for Change in YARH Training Report ...... 51 A. Course Description ...... 52 B. Goals and Objectives ...... 52 C. Description of Participants and Organizations ...... 52 D. Highlights and Emerging Issues ...... 53 E. Recommendations and Course Evaluation ...... v

Appendix 1: SOTA Course Agenda ...... 55 Appendix 2: Resource Directory ...... 73 Appendix 3: Participant List ...... 93 Appendix 4: Session Outputs ...... 119 Appendix 5: Bibliography and References ...... 123

TABLES Table 1: Selected Indicators of Development in Countries in the Region ...... 10 Table 2: Knowledge of Contraceptive Methods ...... 14 Table 3: Knowledge of STDs and High-Risk Behavior ...... 14 Table 4< Use of Condoms ...... 15 Table 5: Progress Toward Achieving the Goals of the "1999 National Strategic Framework for Adolescent Reproductive Health in Nigeria: A Status Report" ...... 36 vi

OCUS on Young Adults (FOCUS) would like to thank Fthe United States Agency for international Development for its support of the SOTA and the skills-building training courses in particular and the work of FOCUS in general. The support of the government of Nigeria, including the Federal Ministry of Health (FMOH) and state health departments, is unprecedented in FOCUS training courses, Commitment to YARH issues at this level shows great promise for the advancement of YARH in Nigeria. We would also like to thank The Policy Project, the Ford and MacArthur Foundations, Pathfinder International/Nigeria, AHI, and the AHIP for their financial, material, and technical support for the SOTA and the skills­ building courses. Their contribution to the success of those events is immeasurable, and for that contribution FOCUS and the course participants are deeply grateful. Course organizers would also like to thank the trainers and facilitators who were the guardians of information and who guided participants through the training process. Their expertise, flexibility, and ability to listen to participants were instrumental in adapting the course content so that it remained relevant to the experiences of the partiCipants. We would also like to thank the many young people who presented, moderated, and participated in discussions. Their boldness and deSire to be heard will serve as a vii

much-needed asset for YARH staff members in the SOTA and the skills­ professionals of the future. In addition to bUilding courses. Their support and those directly involved in the training were commitment gives us hope for the future the many people who worked behind the of YARH in Nigeria, and we look forward to scenes to ensure the timely receipt of the continued application of the newly session outputs, presentations, and other acquired knowledge and skills. Finally, we materials that supported the training and would also like to acknowledge the many will undoubtedly serve as an ongoing people we were unable to accommodate­ resource for people working in YARH. because of the overwhelming response­ We would also like to thank the for their interest in YARH. It is hoped that hundreds of organizations and individuals they will partner with those in attendance who supported the participation of their so that the benefits of the training will reach beyond the boundaries of the course. viii

Bahljjatu Bello, Program Officer Adolescent Health and Information Project Kano, Nigeria Vane55a Carroll, Communication5 Advisor FOCUS on Young Adults Washington, DC, USA Holo Hachonda, Youth Communications Coordinator Johns Hopkins University/Center for Communications Programs Lusaka, Zambia Charity Ibeawuchi, Senior Program Officer ihe POLICY Project Abuja, Nigeria TlJuana A. Jame5-Traore, Program and iraining Advisor FOCUS on Young Adults Washington, DC, USA Bimbo Jlde-Aremo, Senior Program Officer Action Health Incorporated Lagos, Nigeria Scott Moreland, Country Manager ihe POLICY Project/ ihe Futures Group International Durham, NC, USA Moji Oyelami, Master irainer Network Consultant Ibadan, Nigeria ix

Leah Wanjama, Consultant YOUTH-FRIENDLY SERVICES The POLICY Project COURSE FACILITATORS Nairobi, Kenya Kristin Nelson, Research Associate Tulane University/FOCUS on Young MONITORING AND Adults EVALUATION COURSE New Orleans, LA, USA FACILITATORS Mojl Oyelaml, Master Trainer Susan E. Adamchak, Consultant Network Consultant Tulane University/FOCUS on Young Ibadan, Nigeria Adults ADVOCACY COURSE New Orleans, LA, USA FACILITATORS Emily Zielinski-Gutierrez Scott Moreland, Country Manager Graduate Student/Research Associate The POLICY Project/ Tulane University/FOCUS on Young Adults The Futures Group International New Orleans, LA, USA Durham, NC, USA Theresa Effa, Advocacy Chris Onyejekwe, Master Trainer Advisor Network Consultant The POLICY Project Lagos, Nigeria Abuja, Nigeria Leah Wanjama, Consultant The POLICY Project Nairobi, Kenya x

AHI Action Health Incorporated AHIP Adolescent Health and Information Project AIDS Acquired Immuno-deficiency Syndrome AIN Adolescents in Nigeria ARFH Association for Reproductive and Family Health ARH Adolescent Reproductive Health CA Cooperating Agency CCP Center for Communication Programs CDFON Child Development Focus of Nigeria CEDPA Center for Development and Population Activities CEO Chief Executive Officer CHESTRAD Center for Health Sciences Training. Research. and Development CRH Center for the Right to Health CSO Civil Society Organizations CSW Commercial Sex Workers FAHPAC Family Health and Population Action Committee FAWE Forum for African Women Educationalists FGC Female Genital Cutting FGM Female Genital Mutilation FMOH Federal Ministry of Health FOCUS FOCUS on Young Adults FP Family Planning xi

GPI Girls' Power Initiative PAC Post-Abortion Care HDI Human Development Index PACNet Post-Abortion Care Network HEAP HIV/AIDS Emergency PHC Primary Health Care Action Plan PLWA People Living WIth HIV/AIDS HMIS Health Management PVO Private Voluntary Organization Information Systems RH Reproductive Health HIV Human Immuno-deficiency RH&D Reproductive Health Virus and Development HURUMA Human Rights Union for SCC Sagamu Community Center Medical Action in Africa SFH Society for Family Health HPI Human Poverty Index S&RH Sexual and Reproductive HPN USAID Health. Population. Health and Nutrition SOTA State of the Art Training lAC Inter-African Committee SWAAN Society for Women and ICPD International Conference AIDS in Africa on Population and Development SWODEN Society for Women Development IEC Information. Education. and Empowerment of Nigeria and Communication TYE Total Youth Empowerment IPAS International Projects Assistance Services UNAIDS Joint United Nations Programme on HIV/AIDS JAAIDS Journalists Against AIDS UNDP United Nations Development LPE Life Planning Education Programme MIS Management Information UNFPA United Nations Population Fund System UNIFEM United Nations Development M&E Monitoring and Evaluating Fund for Women MOH Ministry of Health USAID United States Agency for NACA National Action International Development Committee on AIDS VSO Voluntary Services Organization NDHS Nigeria Demographic and WHO World Health Organization Health Survey WHON Women's Health Organization NGO Nongovernmental of Nigeria Organization NIMR YARH Young Adult Reproductive NPC National Population Council Health NPP National Population YEF Youth Empowerment Policy for Development. Unity. Foundation Progress. and Self-Reliance YFS Youth-Friendly Services NYAP Nigeria Youth AIDS Program xii

he training course titled Young Adult Reproductive THealth State of the Art (SOrA) training course was held in Abuja, Nigeria, February 18-23 and February 26- 28,2001. rhe SOrA was designed and organized by FOCUS on Young Adults (FOCUS) and rhe POLICY Project, in partnership with the Ford and MacArthur Foundations, Pathfinder International/ Nigeria, Action Health Incorporated (AHI), and the Adolescent Health and Information Project (AHIF), all of whom provided both technical and material support toward the course. rhe courSe was designed for USAID Health, Population, and Nutrition (HPN) staff members, USAID-associated cooperating agencies (CAs), donors, other international organizations, government agencies, and nongovernmental organizations (NGOs) providing or preparing to provide programs and services to youth in Nigeria. rhe aim of the SOrA was to (1) raise awareness of issues and opportunities related to young adult reproductive health (YARH) in Nigeria, (2) increase capacity among those who influence the design and funding of youth programs, and (3) assist stakeholders in advancing the national strategic framework and plan of action that emanated from the report of the National Conference on Adolescent Reproductive Health that was held in 1999, rime for Action. xiii

The SOTA course consisted of two implementing partners considered the parts conducted over eight days. The first themes to be crucial to achieving the goals week was attended by 118 participants and and objectives of the course. provided a general overview of current data The course was highly participatory; and issues related to YARH globally and to it included a significant number of young Nigeria specifically. During the second people who made presentations, offiCiated week, 83 people participated in one of as session moderators, facilitated small three skills-based courses. Those courses groups, and served as discussants in small were held concurrently on (1) Assessing groups and at plenary sessions. Alongside and Planning for Youth Friendly Services, the adults, the youths challenged ideas as (2) Monitoring and Evaluating Molescent they thoroughly analyzed the issues Reproductive Health Programs, and (3) presented and as they put forth useful Mvocating for Change in YARH. Course suggestions for improving YARH. facilitators were guided by recently During the SOTA workshop, the produced tools, training manuals, books, participants reviewed the current and other resource materials produced by situation of YARH in Nigeria and of FOCUS and the POLICY Project. Sessions programming efforts that are under way. were facilitated using participatory and The population of Nigeria was estimated to experiential learning methodologies. be 118 million in 2000, with more than 250 The SOTA began with an impressive ethnic groups. The three dominant groups opening ceremony attended by top-ranking are the Hausa in the North, the Yoruba in officials from the Federal Ministry of the Southwest, and the Ibo in the Health (FMOH) and from the United Southeast. The population is States Agency for International predominantly rural, with only about 36 Development (USAID), heads of USAID's percent of Nigerians living in urban areas. CAs, and Nigerian implementing partners. Young people in Nigeria age 10-24 number The course progressively assisted 36.7 million, representing 33 percent of participants to explore issues under eight the total population (The WorldS Yt:Juth, thematic areas: 2000). Childbearing begin" early, with • understanding adolescence; about half of women aged 25 and older • creating an enabling environment; having become mothers before the age of • risk and protective factors; 20 and with 18 percent of all women • services; currently age 15-19 having given birth to at • communication; least one child. • strategies and approaches; Socioeconomic, environmental, and • tools/research, monitoring, and cultural factors greatly influence YARH in evaluation; and Nigeria. Public poliCies, traditional • next steps. practices, and available re50urces are out Those eight areas were identified of sync with the needs and realities faCing during meetings held throughout Nigeria young people. Poverty, poor educational with NGOs, government ministries, donors, attainment, high rates of unemployment, and CAs, and were based on their and a disintegration of traditional cultural assessment of their needs. Furthermore, and family supports often mark the xiv

transition from childhood to adulthood for intersectoral collaboration such as Nigeria's youth today. Years of military rule partner6hip with the media, and persistent following colonization was marked by weak conservative influences in dominant governance, mismanagement of funds, religions and cultures. As a result and to a corruption, and the lack of infrastructure. large extent, the conditions in Nigeria have Although democratic rule was returned to meant that young people have poor access Nigeria in 1999, the process of rebuilding to RH information and services. Despite has been slow. It is against this backdrop those negative effects, culture, tradition, that institutions and organizations are and religion also hold promise for exerting attempting to provide reproductive health a positive effect on YARH. (RH) information and services to youth. As noted, the needs of young people The perceptions about young people vary with age, gender, development, and life and about their abilities held by those circumstances. Therefore, in an effort for adults who make decisions about policies, programs to be more responsive, Nigeria programs, and services greatly influence needs to better target prog rams and the rights to which they feel youth should services on the basis of those factors. The be entitled a6 well a6 the availability of groups that need more targeted services programs and services. The current YARH include youths living on the street or in environment refects conservative and refugee camps, commercial sex workers re6trictive policies and program6 that fail (CSW), youths living in rural or hard-to­ to support young people's rights and their reach areas, homosexual youths, youths acceS6 to appropriate reproductive health who are HIV positive, young people who are information and services. In addition, many physically and mentally Challenged, victims programs treat youth as a homogeneous of rape and incest, and those who are group, without regard for their married or out of school. psychosocial and emotional development, Identified as a significant need was or for their life circumstances. However, building institutional and organizational young people's hope for a better future lies capacity in a range of areas, including in a better understanding of their differing program design, implementation, needs as they grow and develop. management and evaluation, staff Nigeria is making progress in creating training, management information an enabling environment for YARH as systems, and advocacy. There is also a evidenced by the inclUSion of fundamental need for more information, material, and human rights in the constitution and of human resources. In part in response to national policies on health, HIV/ AIDS, and this need, the course made the full range education. Policy reform is a work in of FOCUS materials available, as well as progress, with additional reforms relevant materials from other anticipated in the near future. However, organizations, including the Population fulfilling the intention of those policies and Council, Family Health International, and plans has been hindered by poverty, poor Johns Hopkins University's Center for funding of public health and education Communications Programs. Each programs, weak advocacy for policy participant received a coPy of all reforms or implementation, weak presentations made during the courses, a xv

resource directory (developed during the northern Nigeria, and post-abortion care course with participant input), and a (PAC). Learning about these approaches, complete list of participants with contact their successes, and their challenges proved information to facilitate and stimulate to be a special opportunity for many. further collaboration and networking. Finally, a review of the 1999 National A fair amount of time was devoted to Strategic Framework for Adolescent examining the relationship between YARH Reproductive Health in Nigeria revealed that and the media. A combination of the media only a modest increase in YARH feeling prohibited from actively engaging programming has occurred in the past two the public in open discussions on sexuality years. Huge gaps--especially in the areas and of the challenge of financial . of policy and legal reforms, capacity sustainability has led to the need for a building, and data gathering and mutually beneficial partnership between information management-were identified. the media and YARH programs. This Individual and organizational commitments alliance will both increase and sustain the were made to begin to bridge those gaps. promotion of positive YARH messages FOCUS agreed to send such written while keeping the media financially viable. statements back to the participants with a Besides the profound effect that the brief survey to remind them of their media have on the RH messages commitment and to see the progress they communicated, they also serve as a major have made in achieving their goals and the source of information for many youth. obstacles they have faced. However, decisions about what to report As a result of the course's success, and how to do so are often driven not by participants proposed that a second SOTA social considerations but by economic and be held in Nigeria to accommodate the political factors that sometimes conflict increasing number of youth-serving with the social good. Throughout the organizations and others that this course course, representatives from the media was not able to accommodate. were engaged in a variety of formal and The skills-building courses on informal forums to discuss those Monitoring and Evaluation, Youth Friendly challenges and to strategize ways of Services, and Advocacy that followed the enhancing the partnership. SOTA workshop were designed to increase Representatives of organizations were technical knowiedge and abilities and to helped to develop skills for working with the enable participants to apply concepts and media more effectively and productively. materials to their own work. The Even though most YARH programs in participants selected for each follow-up Nigeria have not been rigorously evaluated, course were those charged with that a number of NGOs are using promising responsibility in their organization. They program models and approaches. Those attended with the expectation that all programs include youth involvement, micro­ participants had at least a minimal level of enterprise, school-based life-planning background and experience in the subject education, work with religious institutions, area and that after returning from the market-based programs, youth involvement course, they would have their organization's in advocacy, work with youth in rural mandate to apply what they learned. 1

A. STATEMENT OF PuRPOSE OF SOTA eTION he Nigerian State of the Art Training (SOTA) course on TYoung Mult Reproductive Health (YARH) wa5 de5igned and organized by FOCUS on Young Mult5 (FOCUS) and The POLICY Project, in collaboration with the Ford and MacArthur Foundation5, Pathfinder Intemational! Nigeria, Action Health Incorporated (AHI), and the Adole5cent Health and Information Project (AHIP). Participant5 included policymakero and advi50ro at the federal and 5tate government level5, program managero and leadero among donor and development agencie5, member5 of the robu5t and burgeoning nongovemmental organization (NGO) community, and youth in Nigeria. Tho5e profe55ional5, benefactoro, and beneficiarie5 of YARH reaped the intellectual and experiential harve5t of thi5 couroe, which provided an opportunity to review the current 5ituation and foreca5t future need5 for youth information, program5, and 5ervice5 in Nigeria. The SOTA course aimed to rai5e awarene55 of i55ue5 and opportunitie5 related to young adult reproductive health in Nigeria and to increa5e capacity among tho5e who influence youth program de5ign 2

and funding. In addition, the course sought B. GOAL AND OBJECTIVES to assist the stakeholders in advancing strategic framework and plan the national n accordance with the purpose of from Time for of action that resulted the course, the SOTA report of the National Action, the contributed to strengthening and on Adolescent Reproductive I Conference increasing the capacity of the participants held in 1999. Health in YARH program knowledge and skills. Specifically, the SOTA course design and content were meant to: • provide an overview of the Reproductive Health (RH) issues affecting young people in Nigeria and around the world; • help individuals and organizations make more informed decisions and increase their capacity to design, implement, and evaluate YARH programs and services; • defne adolescence, explore factors that influence the transition from adolescence to adulthood, and examine the impact of this transition on sexual and reproductive behavior; • identify program- and policy-related strategies that increase, enhance, and sustain services to young adults; • increase collaboration, build networks, and decrease competition among youth­ serving organizations; and • lead to identifying specific steps for advancing the national strategic framework and plan of action that emanated from Time for Action (Federal Ministry of Health, 1999). The skill-based courses that followed the SOTA aimed to • increase technical knowledge and ability, and • enable participants to apply concepts and materials to their own work. 3

he purpose of this report is to document the proceedings Tof the SOTA course on February 18-23 and the skills-building courses on February 26-28, 2001, in THIS Abuja, Nigeria. The report is organized to present the course design, country background, outputs, and outcomes of the various sessions under eight thematic areas. Those themes were developed as a result of meetings with governmental organizations and NGOs in several regions of Nigeria wherein they discussed concerns, issues, and challenges faced in designing and implementing programs and services. Under each theme is a 5eries of key questions that all of the presentations and group work sought to answer. The themes are as follows: • understanding adolescence; • creating an enabling environment; • risk and protective factors; • services; • communication; • strategies and approaches; • tools, research, monitoring, and evaluation; and • next steps. The report appendices include the following: • the agenda that guided the workshop (AppendiX 1), 4

• a SOTA course resource directory to A. COURSE DESIGN assist participants in accessing resources relevant to YARH work (Appendix 2), he course had two parts • lists of participants in the SOTA and spanning an eight-day period. three skills-building courses T (Appendix 3), Part I consisted of five days of • session outputs and a materials list facilitated discussions and presentations (Appendix 4), and by international and national program • bibliography and reference materials planners, managers, service providers, (Append ix 5). researchers, and young people. The course was attended by 118 people representing various levels of federal and state government ministries, international organizations, donors including USAID and its implementing partners, NGOs that provide or are preparing to provide YARH programs and services, and young people involved in program and service delivery. The first day started with an official opening ceremony attended by a representative of USAID, top-ranking officials from the FMOH, heads of collaborating agencies, and Nigerian implementing partners. The sessions that followed over the five-day period progressively assisted the participants in exploring issues under the eight thematic areas of the course. By the end of the course, strategies evolved for increasing and enhancing efforts to reach and serve youth and for advancing the status of YARH through improved application of the National Strategic Framework outlined in the Report of the National Conference on Adolescent Reproductive Health in Nigeria held in 1999 (Federal Ministry of Health, 1999). The SOTA featured presentations on a range of issues related to YARH including current research findings, demographic and other data that outline 5

the status of YARH in Nigeria, policy and Three communications "mini­ advocacy issues that support or restrict versities" were added to draw particular YARH programs and services, and attention to concerns about creating promising strategies and approaches that relationships with the media; developing reach and serve youth. quality information, education, and A remarkable feature of the course communication materials; effectively using design was the role given to young old and new technologies; developing people--not only as participants, but also distribution plans; and monitoring and as presenters sharing their experiences, as evaluating the effectiveness of session moderators and discussants, and communication strategies. as facilitators of small groups. Alongside Discussions over lunch were arranged the adults, the youths challenged ideas to provide an opportunity to discuss using a thorough analysis of the issues emerging issues not planned as part of the presented, thus leading to useful core course content. Those issues included suggestions for improvements in YARH. further exploration of unserved and In line with the course design, most underserved populations, such as youths sessions began with presentations of key living in rural and riverine areas, papers, followed by small-group homosexual youths, youths living on the discussions, presentations of the group street or in refugee camps, commercial sex work, critiques, and recommendations. workers (CSW), and youths who are Small-group facilitators prepared and physically or mentally challenged. submitted synthesized reports of The course concluded with discussions that were organized by the participants reviewing progress made SOTA secretariat. Facilitators met daily toward implementing the 1999 National to review and amend course content to Framework for Action on YARH. accommodate the needs of participants Impediments to enhanced YARH and emerging issues. programming in the country were identified Small-group facilitators were drawn and new strategies were discussed as from a cadre of local and international participanu made personal commitmenU trainers, including two people from YARH to increasing YARH program actions and programs in Zambia and Kenya. A few improving the YARH environment in Nigeria. others had participated in previous SOTA As a follow-up activity to the SOTA, courses. This combined experience enriched FOCUS pledged (1) to send back the course planning and implementation. In "Statement of Commitment" to each addition, experiences that provided a participant after six months so it can broader YARH experience included those of serve as a reminder of the commitments official delegates from international they made and (2) to learn of their agencies and other African countries­ progress toward achieving their goals. speCifically Ghana, Kenya, and Zambia-in About 60 percent of the policy formulation and innovative activities participants completed the SOTA that have had an effect on YARH evaluation. Most rated the course highly programs in their countries. successful in terms of content, format, presenters' knowledge of their subject 6

matter, delivery of presentations, visual A total of 83 people from aids and other materials, and the government agencies, international management of group sessions. The development organizations, and NGOs participants also valued the mini­ participated in the training courses. This university sessions and lunchtime number included 25 in the Youth friendly discussions. There were recommendations Services course, 29 in Monitoring and for increased time for sessions and group Evaluation, and 29 in Advocacy. work to allow for more in-depth analysis, The fOCUS-led training courses were discussion, and synthesis. In addition, the adapted from two manuals of the same evaluations noted that little or no names in the fOCUS tool series. In this attention was given to nomadic and way, participants were helped to handicapped youths, victims of child understand the concepts of principles of abuse, problems of trafficking of youth M&E and YfS, as well as to apply the (internal and external), and unemployed tools to their work. The advocacy course youths. used a training manual developed by The The SOTA course's closing ceremony POLICY Project. All three courses used was attended by the key collaborators and supplemental materials plus participatory participants. Certificates were awarded and experiential learning approaches. The and words of thanks were offered by YfS course had the added feature of site FOCUS to all the participants. visits to area health facilities to meet with staff members, parents, and youths to Part 1/ offered three days of assess the youth friendliness of the concurrent skills-building courses on the facilities. This course also used processes following: outlined in the tool. 1. Assessing and Planning for Youth Even though the duration of the Friendly Services (YFS), courses was judged to be too short, most 2. Monitoring and Evaluating (M&E) participants believed that they garnered Adolescent Reproductive Health new experiences, clarified concepts, and Programs, and shared ideas that will enhance their work. 3. Advocating for Change in YARH. 7

B. EXCERPTS OF KEY SPEECHES AT THE OPENING CEREMONY

Adolescents are a large and growing ..... Youth are a great and a most segment; of the population .... In Nigeria. valuable resource. We as adults, young people represent; over 30 percent of governments. and the private sector the total population. but most importantly have been granted an awesome and they are the bedrock of t;he fut;ure of our great; privilege ... W proJ;ect and to country .... Adolescents may experience cherish t;hese precious and invaluable resistance or even hostility from adults in treasures. their attempts to obtain reproductive "This SOTA t;hat; is about; to st;art health informat;ion and services. They. places Nigeria on t;he tohreshold of a therefore, stand an increased risk of brighter. more promising future for tohe sexually t;ransmitted diseases. HIVfAIDS. Nigerian yout;h. Over t;he next; tohree unintended pregnancies. and ot;her health days. important; quesUons will be consequences that can affect their future raised and solut;ions will be explored and t;he fut;ure of t;heir communities for for the enormous challenges of wday many years to come. and of t;he years to come regarding " ... I must sound a note of caution the reproductive health of young t;hat adolescent sexuality is a people in Nigeria ... and while tohese sensitive subject in all cultures. challenges may seem daunting, we are Programs that offer reproductive encouraged ... because we do not health services to adolescents can have to grapple alone on tohese issue5. expect to encounter some resistance "Rather, we are im~pired and rene'o'led from their community. Efforts must be in energy and in spirit; by tohe very made to ensure that; gatekeepers are presence and participation of tohe fully aware. accurately informed. and young persons who will be involved in all activities. participating in t;his J;raining ... " ... It is clear that; focusing on together ... we find mUUJal respect adolescent reproductive healt;h is both and digniJ;y. and appreciaUon for the a challenge and an opportunity for commitment and dedication that health care providers.... Targeting each brings. young people for health informat;ion "USAID is proud of iJ;s associaUon and services can be a gateway to with t;his SOTA. And tohat; is 1·loy I am promoting healthy behavior. Working excited about; it;. why I pledge my together, parents. communiJ;y leaders. support of t;his effort... ." and health professionals can create programs t;hat address young people's Remarks of Ms. Lynne Gorton, Director of needs and help t;hem enjoy a healthy Health and Education, USAIOINigeria, at "the adolescence and become healthy and opening ceremony of SOTA, February 19. 2001 responSible adult;s."

Speech of the Honourable Mini5ter of State for Health Dr. Amina Nda[o[o on the occa5ion of SOfA in Nigeria held at the Sheraton Hotel and Towero, Abuja. Nigeria, on Monday, February 19. 2001 8

A. CURRENT SITUATION IN NIGERIA

igeria, the most populous nation south of the Sahara NDesert, lies on the West Coast of Africa and occupies approximately 923,768 square kilometers of land. The borders stretch from the Gulf of Guinea on the Atlantic Ocean coast in the south to the fringes of the Sahara Desert in the north, with territorial boundaries defined by the Niger and Chad Republics in the north, the Cameroun Republic in the east, and the Republic of Benin in the west. As a federal republic, Nigeria has 36 states and a federal capital territory, Abuja. In the recent past, for administrative convenience, the country has been divided into six geopolitical zones, namely the Northeast, Northwest, Southwest, the Middle Belt/North Central, Southeast, and the South-South. More than 250 ethnic groups are in Nigeria, with three dominant groups: the Hausa in the north, the Yoruba in the Southwest, and the Ibo dominating the Southeast zone. More than 80 percent of Nigeria's earnings come from crude oil production. Even though a large proportion of the population is engaged in agriculture, because of its subsistence nature and lack of purposeful investments, agriculture's 9

contribution to the gross national product B.HEALTH OF NIGERIA is low. The country is ranked among the poorest countries of the world. More than 72 percent of the population reportedly live he country's health system is below the poverty line, that is, earning less anchored by a National than one U.s. dollar a day. According to THealth and Welfare Policy. the Human Resource Development Report Primary Health Care provides the thrust of (United Nations Development Programme, services to the sizable rural population and 2000), Nigeria ranked 151 among 174 is supported by secondary and tertiary countries in the Human Development Index, health care institutions. 62 in the Human Poverty Index among 85 As part of the efforts aimed at countries, and 123 in the Gender-Related managing the anticipated high population Development Index among 143 countries. growth rate and its adverse effect on Having experienced long military national development, a National autocracy since attaining independence in Population Policy for Development Unity, 1960, the country lost huge opportunities Progress, and Self-Reliance (NPP) was for rapid development as a result of weak adopted in 1988. The four cardinal planks governance and a lack of transparency and of the policy were to (1) improve the living accountabili1

Table 1 shows medical and financial information comparing Nigeria to a neighboring country, Ghana,

Life expectancy at birth Infant mortality (per 100 live births) 112 Maternal mortality (per 100,000 live births) 210 980 People living with HIV/AIDS (% of 15-49) 238.0 5.4' No. of doctors (per 100,000 people) 4 21 No. of nurses (per 100,000 people) NA 142 GNP (US$ billion 1998) 7.3 36.4 GNP per capita (US$ 1998) 390 300 Population below the average poverty line (US$ 1 a day) 78.4 70.2

NA = not available; " ::: based on year 2000 Sentinel studies. Source: Unitt:d Nations Development Programme, Human Resources Development Report;., 2000. 11

A. UNDERSTANDING ADOLESCENCE

essions related to 1;his 1;hema1;ic area were designed Sto increase participanw' unders1;anding of adolescence as a developmen1;al process, to provide background informa1;ion on 1;he s1;aws of young adul1; reproduc1;ive heal1;h in Nigeria, and to explore 1;he myriad issues 1;ha1; affec1; sexual and reproduc1;ive healW behaviors and decision making among Nigeria's young people, including our Ol'm percep1;ions of you1;hs and 1;heir right to RH informa1;ion and services.

OUR PERCEPTIONS To se1; 1;he tone for 1;he res1; of We mee1;ing, we divided participanw into 1;1'10 groups: 1;hose under age 25 and Wose over age 25. Each group was asked to brainstorm a lis1; of adjec1;ives Wa1; describe young people. The 1;wo groups derived a to1;al of 86 words. The differences be1;ween the responses of We 1;wo groups were s1;riking. Cleariy We you1;hs saw 1;hemselves in a much more posi1;ive Iigh1; 1;han We adulw did. Young people lisud words such as "inulligen1;," "competen1;," and "inquisi1;ive," vlnereas We 12

adults included adjectives such as By contrast, participants agreed "irresponsible," "mischievous," "confused," that parents should have the right (1) to and "impulsive." Exploring why those censor information (depending on the age differences in perception were so great of their child) and to control access to provided an excellent opportunity for information; (2) to know what services are youths and adults to engage in provided to their children and why; (3) to constructive dialogue that laid the participate in programs that affect their foundation for building a partnership children; (4) to educate their children between the two groups over the next few about sexuality; (5) to monitor and control days. the movement of their children; (6) to give Clearly, our perceptions of young consent to their children's involvement in people and their abilities greatly influence RH services while supporting access to the the rights to which we feel they should be information and services they deem entitled. As a result, many adult appropriate; and (7) to participate in participants were conflicted about the developing policies and programs that reproductive rights of youth. Overall, while affect the reproductive health and rights they agreed that young people should have of youth. The exercise of those rights by certain rights over their reproductive parents and others over youth has largely health, they also felt parents and set the tone for YARH in Nigeria. While significant others should maintain a parental and community involvement is certain amount of control over access to desirable, most of us recognize that these information and decisions about the rights are often reflected in the strong reproductive health of their minor children. and conservative poliCies and programs Most participants felt that young that create an environment that remains people should have the right to receive restrictive and fails to support the rights affordable, accessible, high-quality, of youths so they can access appropriate confidential, and nonjudgmental health information and services about services; to choose love partners, decide reproductive health. when to get married, and determine the number of children to have; to use CURRENT STATE OF AFFAIRS condoms and contraceptives; to choose the outcome of pregnancy; to receive With this information as a backdrop, health education to aid in decision making; the data revealing the status of YARH to participate in designing youth-friendly globally, and in Nigeria specifically, provide programs; to receive family life education a stark contrast between what is desired and life-building skills; to attain education and what is the reality of life for the and protection; and to have an enabling world's youth, including Nigerian youth. environment that supports their overall This contrast has resulted in major development. However, while those rights concerns regarding the sexual and are well reasoned, to a large extent the reproductive health of Nigeria's youth, group felt that they are denied or deprived including sexual behavior and decision to Nigeria's young people because of the making, early marriage, social and health prevailing social and economic conditions, consequences of early child-bearing and and traditional practices. motherhood, unintended pregnancy and 13

abortion, contraceptive practices, sexually contraception, which is estimated to be transmitted diseases (STDs) and HIV/ between 3 and 13 percent (McCauley and AIDS, harmful practices, sexual violence Salter, 1995). and abuse, and gender disparities that By comparison, childbearing begins negatively affect young women and girls. early in Nigeria. About half of women age Worldwide, young people age 10 to 19 25 and older became mothers before the make up about 21 percent of the age of 20, and 18 percent of all women population and are growing in number. age 15-19 gave birth to at least one Virtually all of this growth is occurring in child. The median age of first birth is 20 developing countries, with sub-Saharan years, although educated women, Africa leading the way. In Nigeria, young particularly those with a higher people age 10 to 24 number 36.7 million, education, start bearing children later representing 33 percent of the total than those with only a primary or population (The World'a 'rOuth. 2000). secondary school education. According to the World Health Early childbearing, particularly Organization (WHO), the greatest burden among those under age 20, has negative of maternal mortality (about 50 percent) demographic, SOCioeconomic, and worldwide is borne by young women, sociocultural consequences. Teenage because of their risk behaviors and poor mothers are more likely than older women access to information and services. In sub­ to suffer from complications during Saharan Africa, data on indicators of delivery, which results in high morbidity reproductive health among young people and mortality rates for them and their include, but are not limited to, the age of children. In addition, the socioeconomic sexual debut (average, 17 years); fertility advancement of teenage mothers may be rates above 200 per 1,000 women; curtailed because they tend to drop out contraceptive use that is less than 10 of school and subsequently have fewer percent; and an unmet need for job opportunities. 14

15-19 37.5 36.3 20-24 60.8 58.8 Total 64.4 61.9 Ever Uge Ff' Methodg 15-19 9.2 5.9 20-24 26.3 17.1 Total 27.0 17.8 Current Uge of Ff' Method" 15-19 6.6 3.2 20-24 16.0 7.9 All women 15.0 9.0

Source: National Demographic and Health Survey,

s"tili are using cont.raception currently, as FERTILITY REGULATION shown in Table 2. Presently, 65 percent of women age 15--49 and 82 percent of men age 15-59 HIGH-RISK FERTILITY least one contraceptive know of at BEHAVIOR method. Knowledge of contraceptive Certain patterns of reproductive methods is considerably higher among behaVior also are associated with sexually active unmarried women and men health negative maternal and child health. These than among the married. Among all women, include motherhood before age 18 more than One quarter (277,) have ever patterns or after age 35, short spacing between used a method of contraception and less births, and high parity, especially high birth than a fifth (1770) have used a modern order. Children born to mothers younger method. Currently, few adolescents make than 18 are at particularly high risk of use of family planning (FP) methods. Only dying, with almost twice (1.9) the risk of 9.2 percent of adolescents have ever used those not considered to be high risk. (See any method, and even fewer (5.97,) have Tables 3 and 4.). used a modern contraceptive. Even fewer

15-19 85.0 5.9 20-24 93.8 5.3 62.6 65.5 Total 74.4 5.9

Source: National Demographic and Health Survey, 1999. 15

Use to Avoid Use During For Family Use to Age Group ForFP STDs Last Sexual Planning Avoid STI Intercourse Intercourse 15--19 12.7 18.3 10.3 425 47.8 26.5 20-24 16.7 21.9 95 50.4 52.3 38.3 Total 11.9 14.9 6.5 30.8 32.0 14.8

Source: National Demographic and Health 5urv~. 1999.

Abortion and Young People. Several Gender Issues Affecting AdoleXllnt assessment reports on abortion in Nigeria Girl,;. Violence against women is show that between 24.4 percent and 71.5 increasing, and that violence is embedded percent of induced abortions were among in the socioeconomic and political context single women, usually those younger than of gender power relations. Violence occurs age 20. It is estimated that an additional within patriarchal social relations in which 23.5 percent of those women probably male power dominates and in which sexual have had more than one abortion. Although abuse and child marriages are tolerated, if available data, mostly from urban or health not encouraged. Traditional practices that faCility-based studies, may indicate that specifically affect adolescent giris include abortion is an urban problem, surveys have female genital cutting (FGC) or mutilation, demonstrated that similar situations are forced early marriage, male child found in rural communities as well (Bra bin, preference, detrimental labor and delivery et aI., 1995) practices, and wife inheritance. To begin to HIVIAIDS and Young People. HIV address these practices, it was prevalence in Nigeria has increased from recommended that Nigeria adOpt global 1.8 percent in 1991 to 4.5 percent in 1996 and national poliCies tha!; have been and presently is estimated at 5.4 percent. articulated to protect the right of girls Infection rates vary with age, with the and women, examine laws (both customary highest rate, 8.1 percent, found among and civil) that discriminate agains!; women young adults (age 20-24). However, there and girls, remove policy barriers that is also an alarming prevalence rate of 4.9 impede unmarried adolescen!; females' percent among the adolescent population. access to RH, and modHY penal codes to In view of the size of Nigeria's population, discourage and punish gender-based this rate means that a large segment of violence (Giorgis, 2001). youth have been exposed to HIV infection, Drug Abu6e and Young People. There posing the threat of an increasingly appears to be widespread use of drugs growing AIDS epidemic in the country among young people in Nigeria, including an (National Action Committee on AIDS, estimated lifetime consumption of 2000). cannabis (10.87.), followed by psychotropiC substances (10.6'7.) and, to a lesser 16

Participants degree, heroin (1.6'/') and cocaine (1.4%), in and young adulthood. influences of family and both urban and rural areas. The use of considered the cognitive, identity, volatile organic solvents (0.053%) is society as well as the and physical reportedly becoming popular, especially emotional, psychological, people on RH health among street children, in-school youth, development of young with this information, and women. Overall, the age of first use outcomes. Armed helped to move away and the pattern of abuse show that those participants were programs age 10-29 are the group most vulnerable from more generic "adolescent" a homogeneous group to abusing drugs in Nigeria.' that view youth as to programs that are better suited to meet the needs of more specific groups of MAKING THE TRANSITION young people according to where they are Suffice it to say that all of those developmentally and more targeted to factors conspire to make the transition their life circumstances. from childhood to adulthood a trying time for many of Nigeria's youth. The nature of SUMMARY adolescence as an immense time of growth in Nigeria compose a and development requires a greater Young people of the population. Their understanding of how young people make large segment for building a better this transition within the Nigerian context, potential and promise for themselves is what the factors are that influence this nation and better lives attitudes and beliefs process, and how those in the YARH field often hampered by access to information and can seize this opportunity to promote that limit their and health among these youth. Furthermore, services, traditional practices their risk of the tremendous cultural, ethnic, and customs that increase and disease and religious diversity in Nigeria necessitates exposure to pregnancy against women and girls, an approach that takes those differences that discriminate and economic into account when one designs and and limited educational However, their hope for a develops programs and services. opportunities. Using the FOCUS tool titled better future lies in a better needs as they grow Oevelopmentally 8aged Interventiong and understanding of their various life Strategieg: Promoting Reproductive Health and develop and of their in the SOTA and Reducing Rigk Among Adolegcentg, circumstances. Participants position of making participants identified the characteristics are in the special programs that that define young people during deciSions and designing change the course of life prepuberty, early and middle adolescence, could conceivably for millions of youth.

1 Oruq Control Priority Proqram for Nigeda, 2002- 2005, in support of National Druq Control Master Plan, UNDO; Niqeria. 17

B. RISK AND PROTECTIVE and mi5management of the economy. Unemployment ha5 ri5en in m05t urban FACTORS area5, and down5izing ha5 occurred among m05t private- and public-5ector bU5ine5ses. A weak educational 5y5tem here i5 no doul7t that ha5 led to an increase in the number of socioeconomic,environmental, 5chool dropout5 and to ri5ing illiteracy and cultural factors can and T rates. Furthermore, modernization and do have a negative effect on YARH in urbanization have contributed to a Nigeria. However. they can also be a source breakdown of the traditional mean5 of of hope and promise for supporting young 50cial control and 5UppOrt for many people to make sexual and reproductive Nigerian youth. Needle55 to 5ay, while health (S&RH) decisions that will affect th05e socioeconomic conditions have had their lives in positive ways. Given the a negative effect on YARH, modemization tremendou5 regional, ethnic, religiou5, and and urbanization have al50 opened up cultural differences that exist within opportunitie5 for young people to ol7tain Nigeria, it is necessary to tease apart ~a5ic, profe55ional, and vocational those factors in 5uch a way as to education, and for increa5ed employment capitalize on the protective factor<:; that opportunities for 50me. exi5t within the society. Small groups met to di5CU55 the 50cioeconomic, environmental, and cultural factors that ENVIRONMENTAL FACfORS both p05itively and negatively affect YARH In view of economic downtum5, the in the variOU5 region5 of Nigeria. Th05e government i5 unable to provide the kind of meeting5 were followed by an examination 50cial infra5tructure that will en5ure the of per<:;onal and programmatic experience5 provi5ion of YARH information and and 5trategie5 that have worked to service5. Hence, most young people find minimize or eliminate the negative effect of acce5S to RH information and <:;ervices such factor5 while enhancing the p05itive lacking and, consequently, go to effect. unorthodox facilitie5 where their 5afety i5 compromi5ed, sometime5 leading to SOCIOECONOMIC FACfORS complications, including death. Rural-to-urban migration ha5 One of the m05t important continued, attracting young people with 50cioeconomic factor5 affecting YARH i5 increa5ed acce55 to employment poverty. Nigeria ha5 5een a rapid increa5e opportunitie5 and the modem life5ty1e in th05e living in poverty in recent year<:; found in the urban area5. However, m05t of becau5e of the unbridled devaluation of the migrant5 have little or no education Nigeria'5 currency again5t the U.s. dollar, and lack the vocational skill5 needed for the galloping inflation rate5, and the low employment in the formal 5ector. Hence, earning5 of the working cla5s and rural many young people are forced to engage in farmer<:;. Furthermore, for most of the 40 low-paying job5 or commercial 5ex work year5 5ince Nigeria'5 independence, the (e5pecially girl5) and to live in 5qualid political leader5hip ha5 been dominated by condition5. military rule, with the attendant in5tability 18

CULTURAL FACTORS groups continue to depend on moral persuasion to control sexual behavior, despite Nigeria's primarily patriarchal culture its apparent ineffectiveness in successfully encourages males to have multiple sexual countering the appeal of a more permissive partners, to marry early, and to practice lifestyle. As a result, most young people have polygamy. Girls are subjected to traditional limited access to reproductive health practices such as FGC, wife inheritance, and services and are exposed to inaccurate widowhood rites and are prohibited from information when they are available. owning land, property, and other forms of Unfortunately, all too often the result is wealth. Nonetheless, in some rural negative RH outcomes. Nonetheless, there communities, chastity before marriage is are examples of effective partnerships with encouraged, thereby protecting girls from the religious community whereby religiOUS unwanted pregnancies and sexually leaders recognize and support the provision transmitted infections. Cultural norms also of information so youth can make more prohibit parents and other adults from informed, responsible sexual and reproductive discussing issues related to sex and health (S&RH) decisions that do not sexuality with their youth, thus failing to necessarily lead increased sexual activity. prepare young people for sexual relationships to and the resulting consequences. SUMMARY THE MEDIA Young people appear besieged and trapped in a milieu of socioeconomic, The media have had both positive and environmental, media, and religious forces negative influences on young people's that are, at the same time, both risk and reproductive behavior. Print and electronic protective factors for their reproductive media are increasingly more accessible to health. Public policies, traditional practices, youth in urban and rural areas, and they and available resources are out of sync with provide information on a range of topics. In the needs and realities facing young people. some cases, the media have been used to Such conditions have resulted in youth having promote sexuality education and youth poor access to RH information and services reproductive health services. However, those and have led to a depressing picture of YARH efforts are limited in their coverage and have in Nigeria. Conversely, programs and services not been sustained because of poor levels of that take those factors into account can funding. In addition, without censorship, and do go a long way toward meeting the some information found in media outlets is needs of youth. As a result, programs are pornographic in nature and glamorizes increasingly involving young people in their spontaneous, unsafe sexual intercourse. design and implementation and are working with families, communities, and religiOUS RELIGION leaders to change attitudes and perceptions The major religious groups in Nigeria and to engender support for S&RH programs, prohibit premarital sexual relationships, including services for youth. In addition, more discourage contraceptive use by unmarried and more RH programs link with income people, and restrict access to reproductive generating, vocational training, and health information and services. ReligiOUS educational activities. 19

C. CREATING AN progressively adopted integrated approaches to achieving growth in all ENABLING ENVIRONMENT sectors. Since the 1970s, landmark policies have been developed in education, health and population, reproductive health, uch of YARH funding, and HIV/AIDS. Those poliCies have had a programming, and services positive effect on young people's is driven by national and M reproductive health, even though such local policies. Those policies provide an policies have not been dedicated to youth operational framework for organizations and their unique needs. However, more and to a large extent, determine the recent poliCies have begun to deal more allocation of resources. In many ways, explicitly with youth. In addition to formal Nigeria is in its genesis with respect to RH policies, Nigeria, like other countries, has policies for youth. As a result, Nigeria has unwritten, informal poliCies that shape the an opportunity to bring the lessons of lives and futures of young people. Those others, including some of its neighbors, to informal poliCies, though not universal, bear on shaping the public policy debate. operate at the individual, family, and RH and other youth-serving organizations community levels and are passed on in the recognize the importance of mobilizing folklore and traditions of the people. community support for effective policies Needless to say, those poliCies are harder for youth, but they also recognize that to grasp and change. advocacy and policy development are areas Education. The education poliCies sorely needing increased capacity. recognize the importance of education as Sessions in this thematic area a positive predictor of delayed marriage, explored existing formal and informal delayed sexual initiation, prevention of policies in RH and related areas, including pregnancy, acquisition of professional and education and HIV/AIDS, as well as the vocational skills, access to formal extent to which they enhance or restrict employment, and access to economic YARH. Participants also discussed how to viability. Hence, the government has move from policy development to continued to pursue a universal, free implementation and how to involve youth, primary and basic education program, as it parents and communities, donors, religious is encouraged by government scholarships groups, governments, NGOs, community­ and other schemes favoring the education based organizations, civil society of young people, especially girls. organizations, and the private sector in National Adolescent Health Policy. this process. Consistent with the Nigerian National Health Policy, 1988) and the Cairo CURRENT POUCIES International Conference on Population and AFFECTING YOUNG PEOPLE Development Plan of Action, 1994), the government developed the NaUonal m NIGERIA Adole!3cent Health fblicy in 1995). Among Beginning in 1946, Nigeria created other things, the policy facilitated five-year development plans that set the providing effective and accessible framework for policy formulations. It has information, guidance, and services for 20

promoting health, preventing problems, and situation and to incrementally bring about treating and rehabilitating those in need. equal opportunities for males and females In line with this policy is the Adolescent alike, especially in terms of reproductive Reproductive Health Policy currently under health. development. Harmful Traditional Practice". Marriage Law". At present, Reports and surveys reveal that harmful customary laws, penal codes, and criminal traditional practices such as female codes guide marriage in Nigeria. Under genital cutting (FGC) and other social those laws, it is an offense to gain carnal rites persist. Those cultural practices have knowledge of a minor under the age of 14, a negative effect on the reproductive to cause her pregnancy, or both. However, health of young people. The Nigerian federal early marriage is customary in most ethnic legislative chambers have passed a bill groups in Nigeria, and parents and families that outlaws FGC and is now awaiting the give girls (sometimes under age 9) in president's signature to become law. This marriage to older men or bequeath them landmark development will contribute to to other families. In this persisting reducing or eradicating this harmful tradition, formal laws are rendered practice in Nigeria, or both. However, inadequate. Therefore, consideration of the despite the change in formal laws, informal factors and conditions that sustain those practices will reqUire additiona I work to practices-such as poverty, parental change attitudes, beliefs, and values that ignorance, and traditions-shows that perpetuate such practices. laws and policies are needed that will HIVIAIDS. The Nigerian government discourage and regulate early marriage. has developed an HIVI AIDS Emergency Gender Policy. At the moment, Action Plan (HEAP), "A Strategy to Deal Nigeria has no specific policy on gender. with HIVI AIDS in Nigeria," a three-year However, the Nigerian constitution strategy for dealing with the HIV/AIDS recognizes the fundamental human rights epidemic. The HEAP is to be used to guide of all Nigerians, irrespective of gender, age, the implementation of activities and the ethnic origin, level of education, or position appropriate assignment of available in society. Implicit in the constitution is resources. HEAP is also intended to serve that all people, male or female, shall have as an expression of the government's equal access to opportunities for self­ interest in and commitment to a dynamic expression, preservation, protection, and and proactive response to the threat of prosperity. Beyond this statutory the H IVI AIDS epidemic. It is expected that provision, women and young people are HEAP's strategies and activities will raise especially vulnerable to discrimination and awareness, lead to changes in behavior, deprivation in achieving those rights, mitigate the effects of AIDS, provide care because of the ascendant traditional and support to people living with AIDS, and practices and the huge gap in social, encourage research and data economic, and infrastructure development. management. As the group with the Gender inequality in Nigeria puts women at greatest burden of HIV/AIDS, young people a vast disadvantage, and a gender policy will reap the greatest benefit of HEAP if it may be imperative to redress the current is implemented at an optimum level. 21

National Population Policy. The Therefore, overall improvement in the current population policy was written in economy and family income will 1988 and thus predates the International encourage stronger family life and Conference on Population and Development values, and it will support young people's (ICPD). The POLICY Project, in concert with education. the United Nations Population Fund and • Poor funding of health and education the Ministry of Health (MOH), currently is programs. Despite government poliCies working to revise the policy. The new policy on education and health, the weak will address specific YARH issues and will economy and poor government funding include a policy to integrate youth into the have reduced the program's development effort and to recognize the effectiveness and the attainment of the particular reproductive health needs of improvements envisaged. To fill this gap, adolescents and young adults. most programs and services are provided by NGOs and community­ based organizations through FROM POLICY TO PRACTICE international and foundation support. As noted, a number of poliCies, However, this funding tends to be for guidelines, and plans are already in place short cycles (from one to three years), and are designed to create an enabling which makes sustainability a constant environment for YARH, even while the policy threat. Corporate and private-sector on adolescent reproductive health is being funding is still largely an untapped developed. In spite of the statutory resource. provisions, the achievement of reasonable • Weak advocacy for policy refonn. There progress in YARH has been constrained by is a weak base of support and poor myriad socioeconomic and political mobilization for advocating for policy factors, namely the following: reforms. Most stakeholders lack • Pove~. As a developing country with a accurate and reliable data to help them weak economy, Nigeria has increasing galvanize support and sustain advocacy poverty among its urban and rural efforts. This newly democratic society populations. Family earnings are low and also needs capacity building for cannot sustain the competing needs for effective advocacy strategies. nurturing, education, and enterprise. • Lack of infonnation. A general lack of Consequently, children's education knowledge exists, even among key YARH (especially that of girls) beyond the stakeholders, about existing poliCies basic level is usually terminated so the that can provide some measure of child can assist in generating family support for YARH issues. Furthel111ore, income. Many engage in petty trading there is a need to harmonize such that often sustains them at a mere policies. subsistence level. Because of permissive • Weak intersectoral collaboration. parental attitudes, their own Despite the motivation for greater desperation, or both, some young people intersectoral collaboration, resort to commercial sex work, drug abuse, and, sometimes, violent crime. 22

partnerships have been difficult tc population resources in a manner sustain. The lack of human and financial consistent with the ultimate objective of support makes coordination extremely accelerating the pace of economic difficult, and funding mechanisms lack modernization and of improving the quality the flexibility required to work across of life of all Ghanaians. sectors. To facilitate a coordinated process, • In@ufficlent inve@tment in women'@ the National Population Council (NPC) was education. Although the importance of established with a secretariat and a girls' education is acknowledged and coordinator. The NPC was composed of supported by available data, few policies representatives from various groups and minimal resources reflect an throughout Ghana, including young people. insufficient investment in education. Following the revision of the population Consequently, most young women lack policy, a draft Adult Reproductive Health the professional or vocational skills (ARH) policy document was produced and required for access to formal disseminated nationally. This document employment and well-paying positions. was followed by an ARH summit held in 1996. The national summit and local • Religion and culture. The major religious meetings provided a forum for community groups in Nigeria largely hold views that input and dialogue. New initiatives were oppose policies that provide RH launched and the policy was formally information and services. In addition, adopted in October 2000. the largely rural environment in which many Nigerians live allows the persistence of conservative cultural SUMMARY practices and values that negate Progress has been made tcward reforms in reproductive health policies. creating an enabling environment for YARH in Nigeria, and other policy reforms are anticipated in the near future. However, THE GHANAIAN EXPERIENCE realizing such policies in practice has been Dr. Kwame Ampomah, United Nations hindered by poverty, poor funding, weak Advisor, SAAYP advocacy for policy implementation or The impetus for Ghana's YARH policy reforms, poor information, poor advocacy was drawn from the Cairo ICPD intersectcral collaboration, and the and subsequent Plan of Action, 1994), the conservatism entrenched in the dominant BeUing International Conference on Women religions and cultures. Increased capacity (1995) and a recognition that the health in advocacy strategies is needed to of young people needed to be a priority. In remedy some of these barriers, as is addition, Ghana's National Population better coordination across sectors with Policy (1969 and 1994) first defines the clear lines of authority and responsibility. government's policy on population. Then it Fortunately, there are lessons tc be affirms the government's commitment to learned from Nigeria's neighbors and adopt and implement appropriate others, and tools are available to assist in strategies and programs that will manage those efforts. 23

D. SERVICES administrative procedures, and without psychosocial barriers that might prevent youth from seeking services." This rking in small groups, definition can be applied in a variety of participants defined gaps settings including educational and health Win meeting the needs of facility programs. young adults and identified strategies for A number of NGOs and public-sector bridging those gaps. Although access to programs have established YFS through information is of major concern, there is integrating the services into existing growing recognition that information alone development centers, into general health is not sufficient to meet the needs of facilities, or into specially designed clinics youth or to change behavior. YARH for young people. This integration has led services, including the provision of to only a marginal increase in utilization, contraceptives, are sorely lacking in Nigeria reportedly caused by the restrictive social and are highly controversial. Many and religiOUS milieu that discourages youth programs provide information and from using reproductive health services. education although the accuracy of the Furthermore, the perceived high cost of content of some of this information is services--especially for clinica[ tests, questionable. A few services are availab[e drugs, and condoms--deters many young through the private sector and NGOs, but people from using the clinics. what does exist seems to be concentrated To address these shortcomings, the in the urban areas of southern Nigeria. In participants recommended that ongoing principle, youth can access services assessments (invo[ving data collection, through the public sector, but government including in-depth interviews and focus­ services lack sufficient resources and are group discussions with staff members and of generally poor quality. In addition, with current and potential clients) be cultural and provider biases pose a conducted and that indicators be selected significant barrier to access for youth. and measured to identifY where improvements are needed to achieve desired goals. Strategies recommended to YOUTH-FRIENDLY SERVICES increase and improve services for youth The establishment of Youth-Friendly include improving the training for providers Services (YFS) has been touted as one and volunteers on the special needs of strategy for increasing young people's youth; integrating RH into other youth access to reproductive health. However, programs and services; providing multiple this concept takes on different meanings venues through which information and for different people. Therefore, for the services can be accessed; supporting purposes of this course, YFS was defined other priority needs of youth such as the as "the provision of a range of reproductive need for vocational and educational health services that meet the specific training and income generation; and needs of young persons, provided by youth­ involving young people in the design, friendly staff, under youth-friendly implementation, and evaluation of services. 24

MEETING THE NEEDS OF tend tc lack knowledge and access to services. Poor roads and difficult access SPECIFIC YOUNG ADULTS IN routes discourage NGOs and the private NIGERIA sector from establishing programs and With the growing recognition that services in rural communities. Because youth are not a homogeneous group, rural youth tend not to participate in participants explored some of the various formal groups that could be targeted segments of the adolescent population readily, their needs are neither easily and began tc identify young people's needs identified nor integrated into existing and suggest strategies for reaching and services. In the rural areas, strong serving youth. attachments to culture and tradition also Children Living on the Streets and in create additional barriers to providing Refugee Camps. Participants report that services tc young people. there is no conscious plan for meeting the ihe group that discussed rural youth reproductive health needs of children living suggested that strategies to reach and on the streets or in refugee camps. serve those young people begin with Furthermore, there is reportedly scanty assessing their needs and identifying RH information available to them. Most of potential entry points for reaching them. those youth come from very poor homes or ihis step can be followed by strengthening are orphans and have no income tc pay for exis1;ing facilities and by providing outreach services. ihey often live in open, squalid and capacity building to form strategic conditions, thereby increasing their partnerships through community vulnerability to such health and mobilization and advocacy, increasing the environmental hazards as rape, sexually number of service pOints, and producing transmitted infections, drugs, unwanted materials in local languages. pregnancy, and induced abortion. In Homosexual, Lesbian, and Bisexual addition, those young people lack access Youth. Generally, the numbers of Nigerian to formal education and are generally at young people with same-sex orientation great risk of physical, economic, and social appear to be increasing, especially in the exploitation. urban areas. However, there is a dearth of Some strategies that may help to information for determining to what extent mitigate the situation of those youth homosexual, lesbian, and bisexual youth include increasing awareness of their plight are present in Nigerian society, or what tc make more resources available to them this dearth means for the health and and advocating for an inclusive policy; social dynamiCS of those young people. establishing comprehensive rehabilitation Generally, Nigerians abhor such sexual centers tc provide housing, vocational orientations, and many deny the existence training, and integrated health and RH of such behaviors and lifestyles within services, as well as mobile schools and Nigerian society. Many young people do not health clinics; and sensitizing and training expose their sexual preference for fear of service providers to their special needs. being ostracized or even harmed. Rural Youth. Young people living in Consequently, there are no known services rural areas constitute more than 50 targeting this group. Most health workers percent of Nigeria's youth population. ihey have limited understanding of this group's 25

needB, and for the mOBt part, reproductive childbearing, and forced labor. Advocacy health "championB" have not taken their and awareneBB raiBing are needed among needB BeriouBly. DeBpite a pervaBive denial community leaderB, the education BeGtcr. that thiB population of youth exiBtB, many parentB, and health-care providerB tc participantB were able tc identify improve their attitudeB tcward married individualB and even communitieB of youth. SpeCial interventionB Bhould be homoBexual youth. purBued tc enBure male involvement in Therefore, SOTA participantB Buch effOrtB. BuggeBted that more reBearch be Out-of-School Youth. In Nigeria, mOBt conducted tc underBtand homoBexuality young people who do not attend Bchool and tc create awareneBB about the life have limited or no education and are circumBtanceB and needB of thiB illiterate. Although many are forced tc population in Nigeria. In addition, health work out of economic neceBBity, they often workerB and RH championB Bhould be lack acceBB tc vocational training trained tc work effectively with homoBexual opportunitieB. There iB general agreement youth. Finally, advocacy iB needed tc that the information, education, and broaden the policy baBe tc accommodate communication (IEC) materialB targeting homoBexualB, leBbianB, and biBexualB in youth are neither appropriate nor effective Bervice proviBion. for meeting the needB of thiB population. In Married Youth. At the moment, addition, many organizationB lack the BerviceB do not diBtinguiBh married reBourceB tc provide theBe young people adoleBCentB from married adultB and, with vocational and life-building BkillB, and conBequently, BerviceB are not deBigned tc tc help them Becure employment. However, meet their Bpecial developmental needB. Bome effOrtB are under way tc fill thiB gap. Nigeria haB not yet implemented the StrategieB recommended tc bridge exiBting legal protectionB of minorB, Buch Buch gapB include reorienting youth­ aB the prohibition of child marriage (forced Berving NGOB tc deBign appropriate or otherwiBe). In addition, there tend tc be programB for thiB BubBet of youth; discriminatory attitudes toward married developing low-literacy IEC materials youth in the educational Bectcr and in involving thoBe youth tc optimize the acceBB tc formal education. Therefore, benefit of their experience; increaBing the thoBe young people fit neither exiBting program'B BUBtainability by developing programB and BerviceB deBigned for youth fund-raiBing, and credit BChemeB; involving nor thoBe programB deBigned for adultB. parentB, community leaderB, and religiouB The participantB recommended that leaderB in planning, implementing, and a review of exiBting legiBlation be appraiBing program BucceBB; and forging conducted and policieB be broadened tc partnerBhipB with other organizationB tc BUppOrt the education, health, and Bafety aBBiBt in pOBttraining integration intc needB of married youth. They alBo community life and enterpri5e. recommended that programB and BerviceB VictimB of Rape or Ince5t. Rape iB a be enhanced for thiB population. The review known Bocietal problem that OCCUrB among of legiBlation Bhould pay particular a crOBB-Bection of the population. In part, attention tc giving further protection tc becauBe of gender diBcrimination, the minorB againBt early marriage, early community BhowB little or no concem for 26

victims of rape and incest. Rape and guidance, and they tend to engage in sex incest are underreported, and laws put the work to generate income for survival. There burden of proof on the victims. The lack of is a huge gap in meeting the RH needs of forensic equipment to confirm rape and sex workers. the negative attitudes toward rape victims To make services available to this have further complicated this problem. In population, the following was deemed most cases, the victims are poor and may necessary; advocacy for strengthening the not feel they can compel the authorities to legal system to protect young adults from conduct a thorough investigation and sex work, human trafficking, and rape; successfu I prosecution of offenders. providing special services to sex workers; Likewise, incest is shrouded in secrecy, and and sensitizing the community, family members often threaten the policymakers, and health workers. To victims. Most incest victims are unaware forestall an increasing trend in young of the channels for reporting or seeking people's engaging in sex work, participants redress. Existing programs for young recommended that life-planning skills be people do not include counseling services integrated into the curricula of primary, for victims of rape or incest. secondary, and tertiary educational Participants suggested a number of institutions. In addition, vocational strategies, such as raising awareness of training centers should be established for the prevalence of rape and incest; out-of-school youth. strengthening the legal instruments to Phye;/cally and Mentally Challenged. facilitate prosecution, conviction, and Young people who are physically and incarceration of offenders; improving DNA mentally challenged are vulnerable to testing facilities; and training the police to abuse, partly because of the prevalent effectively investigate and prosecute rape social attitudes that discriminate against and incest cases. Other suggested them. This vulnerability arises from the strategies included teaching women and belief that their disabilities are the result girls self-defense, providing counseling of a punishment, a curse, or bad luck. As a services to the victims of rape and incest, result, there are no concerted efforts to establishing reporting centers to provide ensure that they achieve their full legal support, and establishing an potential. Government policies do not take information database to provide data on them into consideration and, as a result, the incidence of rape and incest in the health services are not designed to meet community. their needs. A number of traditional beliefs Commercial Sex Worker,;. Prostitution encourage exploiting the disabled for or commercial sex work is illegal in Nigeria. personal gain. For example, women who are However, the weak legal and judicial mentally challenged have been raped and systems have made arrests and their body parts removed and sold. Blind prosecutions nearly impossible. Most sex young people have been formed into workers are young people who have little musical bands for profit. Most youth­ formal education and who lack serving organizations do not generally work professional, vocational, and business with this target population because of the skills. They often lack parental care and lack of trained staff members, the need for 27

specialized and oiten expensive equipment, Dieadvantaged Areas. Young people I'lno and the lack of government interest. reside in the riverine and arid areas of The perceived gaps may be bridged Nigeria will experience problems related to through creating awareness and access to RH because of the difficult sensitizing all stakeholders to the needs natural terrain and the hostility of the and issues affecting youth who are local communities. The rural nature of physically and mentally challenged. those settings gives rise to economic Advocacy for policy and legislative reforms concerns about the productive to support integrated RH and engagement of young people in both rehabilitation programs for challenged modern agriculture and other micro­ youth may lead to adapting existing enterprises. Poverty, low literacy levels, and services to include the handicapped. This weak traditional leadership institutions change can be achieved only when qualified are generally found in such areas. personnel are r!"cruited and trained. Currently, YARH programs are not available Youth Involved in Drugs. Drug abuse is to most needy youth in these believed to be common among young people disadvantaged areas. age 10-25 in Nigeria. Factors that SOTA participants' recommendations contribute to this problem include for improvement include initiating income­ frustration, stress, experimentation, generating activities, building the capacity poverty, unemployment or of young people through vocational skills underemployment, and peer influences. training, and supporting peace-making While under the influence of drugs, young efforts and conflict resolution. people may have unprotected sex, thereby HIVIAIDS Effect Among Adolexent6. increasing their risk of contracting STDs The HIV/AIDS epidemic poses a significant and HIV/AIDS. Those involved with drugs threat to Nigeria. The HIV prevalence of 5.4 are also more likely to be involved in percent is lower than that of many accidents and violent crime. A number of Eastern and Southern African countries NGOs have integrated drug rehabilitation but, because of the large population size, into their services. but those services are the effect of the epidemic is felt more poorly used and follow-up support is broadly than in countries with smaller lacking. population sizes. In 1999 it is estimated SOTA participants recommended that some 2.6 million Nigerians were that youth-serving organizations integrate infected with HIV. counseling and rehabilitation services for Although the true number of AIDS drug abusers into their programs. Media cases in Nigeria is unknown, it is estimated interventions should include creating that almost 600,000 adults and children awareness of the problems of drug abuse had developed AIDS by 1999. Many more and developing culturally sensitive and are HIV-positive. A Significant portion of youth-sensitive IEC materials. The NGO both groups--those who are HIV-positive community should advocate that the and those who have AID5-is adoleecente. government improve socioeconomic There is considerable variation acr05e conditions and should develop appropriate zones and states, ranging from 3.2 infrastructures in the rural areas. percent in the Northwest zone to 8 Youth in Riverine, Arid, and percent in the North Central zone. Young 28

adults have the highest infection rate at SUMMARY 8.2 percent. As the social, economic, and The paucity of services for youth is a psychological needs of young people major shortcoming within the Nigerian increase, many do not feel they are health system. Conservative religious and accepted by adults or viewed as integral cultural beliefs, plus provider bias, are key members of society. In the face of factors in need of change to reduce increasing isolation and disapproval by barriers to access to information and adults, many young people make decisions services. The specific needs of various that have deleterious consequences for subsets of the adolescent population­ their health and future. including children living on the streets and Participants identified an absence of in refugee camps, rural youth, accurate information about HIVIAIDS and homosexuals, and married youth-pose a limited availability of quality condoms so special challenges for which there is little youth can prevent HIVI AIDS. Some of the currently being done. Often little is known information and materials that are about such groups. Even where there is available contain inaccurate information community support and political will, that i5 sometimes grounded in myths and government organizations lack adequate fear. Treatment and services for people human and financial resources, and living with AIDS are almost nonexistent. anything being provided is done primarily The HEAP does recognize the particular through NGOs. However, such programs effect of the epidemic on young people and and services have shown only a marginal attempts to addreBS their needs. NGOs increase in usage, and they are perceived and others also playa prominent role in as expensive, with weak managerial and counseling and preventing HIV/AIDS, operational capacity to meet the needs of although clearly more needs to be done. young people. Nonetheless, the potential Multimedia campaigns to increase exists for greater coverage by integrating awareness, communicate abstinence HIV/AIDS and RH services into other messages, address the stigma toward programs and services for youth, as well people living with AIDS, and increase as by prOViding more comprehensive condom use are all suggested strategies services, including life-skills planning, for preventing the spread of the disease. vocational training, and micro-enterprise. Integrating behavior-change strategies into other existing services should also be part of the mix. 29

E. COMMUNICATION need to balance the positions of heal",J, professionals, communities, and religious institutions on the value and use of rint, radio, and television contraceptives, the media have resisted media are the major vehicles promoting the use of condoms, which Pfor making people aware of leaves a huge gap in public education on social issues, Undoul7tedly, modern condoms. technology has opened new avenues of Gender issues are slightly easier to communication and of increased access to discuss, especially with the creation of the information. This occurrence has brought Ministry of Women's Affairs, the United with it new ideas about the role and Nations Development Fund for Women, and responsibility of journalists and other the NGOs, as well as the effort of all of guardians of information. Recognizing the those who tackle women's issues and critical partnership between RH and the rights. However; even efforts in this area media, organizers designed sessions under have faced resistance from some men, the communication theme to examine the irrespective of their social standing or messages that youth derive from the professional status. media; the role that journalists play in Concerns about fiscal viability have advancing the status of YARH; the also contributed to RH coverage-or the media's perception of YARH issues and, lack thereof-and have led to the "brm'm consequently, of how they deal with issues envelope" syndrome. This syndrome is related to sexuality, HIV/AIDS, described as an unwritten rule in which contraceptive use, and gender; and the journalists expect to receive financial ways to develop stronger partnerships. incentives to ensure coverage of certain topiCS. Although there was some disagreement as to whether this ROLE OF THE MEDIA IN expectation is appropriate or necessary, REPRODUCTIVE HEALTH there was agreement about the COMMlThTJCATION importance of strengthening partnerships For the most part, the media in with the media. Nigeria reflect society. They are The media have a profound effect on constrained by the prevailing reluctance to the development of sexual information, openly discuss sexuality. They are also values, and behaviors and are often the relatively uninformed about issues related primary source of information for youth. to RH, including HIV/AIDS. The advent of However, they often present an unrealistic HIV/AIDS has, however; led to spirited image of courtShip, marriage, and attempts by the media to create parenthood. The global nature of the media awareness about contraceptives and HIVI industry has introduced values from other AIDS. Abstinence has been the major cultures that are different and varied and thrust of protective measures advocated that are sometimes in direct confiict y.... ,J, by religious institutions and by some more traditional Nigerian society. health professionals. Because they feel a Furthermore. decisions about who, what, where, when, why. and how to publish are 30

made by proprietors of media outlets who lessons learned, to involve youth and pursue specific objectives that sometimes communities, to share information and result in competing interests. strategies with others, and to evaluate Participants made recommendations efforts and make modifications based on for enhancing the partnership between RH those evaluations. and the media. including advocating for programming that does not glamorize sex SOCIAL MARKETING AND and irresponsible sexual practices; BEHAVIOR-CHANGE increasing coverage of YARH issues and events; cosponsoring programs and media COMMUNICATION campaigns; and providing regular ARH One approach to providing training and workshops for journalists. information and increasing demand for and editors, and other principal officers. access to condoms is social marketing and behavior-change communications. The DEVELOPING EFFECTIVE principles of social marketing involve studying the needs and wants of the COMMUNICATION target population to design products to STRATEGIES meet its desires. It then promotes those Well-planned communication products so they become familiar, strategies with weli-thought-out acceptable, and available in the most messages that are supported by each appropriate places and at an affordable organization are critical to successful use cost. In the RH context, this process of the media. The communications means applying commercial marketing strategy should define current attitudes, techniques to promote social ideals and to actions, and changes that are desired, and facilitate behavior change. This concept appropriate communications channels and calls for planning message and materials approaches that are needed. Messages development based on market research should be strongly stated, direct and and well-conceived market plans. It also forceful, simple and clear. The strategy requires ongoing testing, plus evaluation should also include establishing and and feedback. Social marketing has been maintaining productive dialogue with the linked with behavior-change communication groups who can, will, and do influence with the purpose of changing S&RH media programs, as well as with the behaviors to lead to more desired RH targets or recipients of the messages. The outcomes. To this end, social marketing messages should also appeal to emotion seeks to increase awareness and help as well as to logic, should focus on one or young people perceive risk and be two key points, and, to the extent pOSSible, motivated not only to change behaviors should be stated positively. but also to sustain this behavior change. The use of high-tech and low-tech strategies was also discussed. Those SUMMARY techniques ranged from mailing lists and community theater to Web sites and Given the general conservatism listservs. Important to all of those efforts perpetuated by religion, culture, and is the need to document experiences and tradition, the media in Nigeria have not 31

actively engaged the public in open F. YARH STRATEGIES discussions on sexuality. Touting the challenge of the burden of financial AND ,ApPROACHES sustainability. the media are advocating for mutually beneficial partnerships that he lack of rigorous evaluation increase and sustain YARH program continues to be a major momentum, while at the same time keeping Tshortcoming of YARH the media financially viable. An effective programs. This problem has limited the partnership with the media has to involve a ability either to stop doing what does not well-planned communication strategy with work or to better identify promising the input of media managers and message program approaches that do work. reCipients and should be broad in its reach. However, research has shown programs to Various forms of the media can be be more effective in influencing knowledge effectively used to facilitate behavior and attitudes than in influencing behavior. change through the application of social Some evidence suggests that multiple­ marketing techniques. In addition to work component and community-based YARH with the media, low-tech and high-tech programs that target multiple risk and methods are valuable, as are old and new protective factors appear to be more methods of communication. However, effective than single-component programs. ongoing evaluation and modification are Workplace-based programs seem to affect crucial to keeping messages and knowledge and attitudes, although they do information relevant. not appear to increase service utilization. Although there is uncertainty about the effectiveness of peer programs on those reached by such programs, it is felt that peer networks are an important means for ensuring greater outreach to young pecple with appropriate information, counseling, and referrals.

PROGRAt"l APPROACHES At'\'D LESSONS LEARNED IN NIGERIA The increase in YARH activity in Nigeria is driven by a rise in unintended pregnancies among young adults and by increased risks for pregnancy and disease associated with S&RH behaviors, among other factors. Although RH, including HIVI AIDS knowledge, remains an issue, access to programs and services seems to be a bigger problem. Where there is access, 32

young people need to be empowered to use pulse on the needs of their peers. As a the services and to change the behaviors result, the program is well used, although that put them at risk. Furthermore, ways its reach is limited to the surrounding of communicating RH information that community. Duplicating those strategies in targets youth need to be more interactive, other communities is a challenge in an appealing, and dynamic. environment in which resources are scarce The experiences of programs in and capacity is lacking. Nigeria suggest the necessity of a mix of Mlcro-Enterprie;e. High rates of high reproductive health IEC programs and school dropouts, increasing trends in services, clinical care and support, youth unwanted pregnancy and unsafe abortions, mentoring and leadership development, early marriage, and widespread poverty advocacy for civil and policy engagement, have caused many organizations, including and livelihood programs that include those offering YARH programs, to explore access to credit and other supports. Also links with income-generating activities. The needed is an expansion of services to meet Family Health and Population Action the needs of noneducated and out-of­ Committee (FAHPAC) has introduced a school youth, enhanced partnerships with micro-enterprise intervention that the private sector, and an improved combines community mobilization and connection to Web-based information. sensitization, peer education, and Along those lines, a number of vocational training activities. Young men approaches are being used in YARH and women learn skills in soap-making, programs in Nigeria. A few of them are tailoring, tie-dye, batik, arts and crafts, described here. and carpentry. Literacy skills building, Youth Involvement. Many programs small business development, and RH have attempted to involve young people in education and services are also a part of the design, implementation, and evaluation the service mix. The FAHPAC experience of YARH programs. Thus, it is felt that suggests that young people are likely to young people have a greater commitment succeed with proper guidance, acquisition to and ownership of programs; activities of skills, and an entrepreneurial spirit. Hope are also more relevant to their needs and for a more promising future, as well as are more credible. Challenges to greater access to information and services, gives youth involvement, however, include rise to greater motivation to make wise inadequate or insufficient training and high S&RH decisions. levels of mobility and attrition among School-Bae;ed Life Planning those who are trained. The lack of Education (LPE). The LPE approach incentives, especially financial ones, is also integrates life-planning education into the a major factor in an environment in which school curricu lum; esta blishes peer youth increasingly need an income. education activities; and promotes RH Action Health Inc. has demonstrated communication through magazines and the value of involving youth in many ways. newsletters, drama, debates, and radio Young people serve as paid staff members programs and advertisements. Despite the in clinical and educational programs and fact that school-based programs provide services. They play an integral part in an avenue to reach large numbers of youth organizational planning and keep their on a consistent basis, school principals 33

continue to have lukewarm attitudes toward markets are accessible and provide an LPE. Teachers also tend to have poor unrestricted environment. Those factors attitudes about providing RH information have led to the development of market­ to youth. to be poorly trained, and to lack based strategies to reach and serve young commitment. people. Market-based services bring The Association for Family and services closer to youth; provide an Reproductive Health, in collaboration with informal atmosphere where they are not the State Government Ministries of Health stigmatized; avoid parental restrictions and Education, Science, and Technology, is against visiting a health facility; are piloting an integration of an expanded LPE effective in reaching out-of-school youth; curriculum into the Oyo State's public and increase service utilization. secondary schools. The curriculum includes Working with community members, information about human development, FAHPAG has implemented youth-friendly relationships, sexuality, family life, and services in an area market, developed and personal skills development. This initiative distributed lEG materials, and made includes establishing 40 youth-friendly referrals to collaborating clinics and clinics designed to increase access to hospitals. Services are available from 8:00 information and services for male and a.m. to 7:00 p.m. on Monday through female students, advocacy, lEG, networking, Saturday. Youth volunteers assist in peer education, and community involvement, providing a range of lEG materials, while a as well as to evaluate operations research nurse provides contraceptives and early and capacity building. The recent approval detection of disease and a counselor is of national guidelines has given rise to available on-site for counseling services. greater support for school-based initiatives. More than 8,000 young adults use the Work with Religious Institutions. The services annually, with an average of Nigerian Youth AIDS Program has tried an 3,500 receiving contraceptives. ambitious approach to working with Youth Involvement in Advocacy. Youth religious institutions. Activities have been are involved in RH programs and services in conducted to sensitize church leaders to many ways. Advocacy seems to be an area help provide legitimate access to project in which their skills and expertise can be activities for youth. A needs assessment used effectively. As dependable partners was carried out and formed the basis for and active players in RH programs, youth developing both training curricula and lEG have the capacity to mobilize their peers materials in collaboration with church and the community through meetings, members. Progress with churches has thus media activities, and regular consultation. far outpaced that with mosques, and the Through a sustained program of advocacy latter relationships will take longer to skills bUilding, participation in national and nurture and build. However, using religion as international workshops and conferences, the foundation for RH information is seen exchange visits and study tours, and as an effective way to gain community improved knowledge and attitudes in support and minimize resistance. reproductive health, youth are now rising Market-Based Approach. Many young to the challenge of advocating for and people frequent local markets, and the influencing policy reforms. 34

The Nort:hern Strategy: Working with Adolescents are at particular risk, given Youth in Rural Nort:hern Nigeria. The rural the high rates of unwanted pregnancy and northern region of Nigeria is a conservative the low contraceptive prevalence. society where the mix of tradition and Postabortion care addresses the problem Islam has suppressed the adoption of of unsafe abortion through emergency modernization, including expanded treatment of abortion complications, education, especially for girls, and other postabortion family planning counseling societal improvements. Boys are often and services, and the linking of abortion sent off to the cities while girls as young treatment with other reproductive health as age 11 move from their parents' home to services. their husband's home, with little of the The Post-Abortion Care Network in transition time that others have between Nigeria is a membership organization that childhood and adolescence. mobilizes its members to advocate for AHIP is one of the few organizations more liberal abortion policies and laws, working in YARH in this region. AHIP has strengthened postabortion care services, developed and applied an integrated RH and public awareness of the dangers of program to reach young people with abortion and the value of contraceptive vocational training, micro-enterprise technology in preventing unwanted activities, and recreational programs linked pregnancies. to RH education and services. Working within the Islamic culture, AHIP has gained SUMMARY the support of many religious leaders in the area as a result of building and Even though most YARH programs in nurturing relationships over time. Nigeria-and indeed in much of the Postabort:ion Care. Nigeria has one of world-have not been rigorously evaluated, the highest maternal mortality rates in a number of NGOs use promising the world, with as much as 50 percent of strategies and approaches. Youth that mortality attributed to unsafe involvement, micro-enterprise, school­ abortion. Despite national program efforts based life-planning education, market­ to reduce maternal mortality, an based programs, and the like are all making estimated 20,000 Nigerian women still die important strides in stemming the tide of of complications related to unsafe or unwanted pregnancies and sexually clandestine abortions each year. transmitted infections, and promoting healthy development for young people. 35

G. MONITORING AND EVALUATION (M&E) any SOTA participants had been involved in M developing the 1999 his session provided only a national strategic framework. That cursory overview of M&E, framework focused on seven key areas: Tbecause it was followed by a advocacy; lEe; education and skills three-day skills-building course. development; training; services; legal rights Nonetheless, this session did attempt to and protection; and research, monitoring, explore the importance of M&E programs, and evaluation. Using this framework, how this information could be used, and partiCipants examined where they were what tools and resources are available. with respect to the goals, objectives, and Process evaluations measure how a activities outlined; the challenges and program is working, whereas outcome and barriers to achievements, and the next impact evaluations measure what a steps. The results of those discussions program's results and effects are. All are are reflected in Table 5. deemed to be vital management activities that can assist an organization in showing how the program is working to improve interventions, shape decisions of funding agencies and policymakers, mobilize communities to support YARH, and contribute to the global understanding of "what works." Process evaluation activities can include the use of checklists, inventories of facilities and services, interviews with key informants, staff surveys, exit interviews, focus-group discussions, and mapping. Outcome and impact evaluations are conducted through the use of population and community surveys. H. NEXT STEPS 36

AbV6iiACY . • Limited advocacy activities • ARH policy not passed • Strengthen capacity of NGOs with stakeholders-includ­ into law. to carry out an advocacy ing political, religious, and campaign. traditional1eaders-have • Strengthen coordination bod­ been carried out by NGOs ies, such as NAPHAD. and international organiza­ • Conduct a national assess­ tions. ment of what has been ac­ • Some youth advocates complished. have been trained. • Advocacy kits have been produced. • A needs assessment on intergenerational commu­ nication was initiated and resulted in a bill on female genital mutilation in a state legislature.

• Additional IEC messages • Lack of research on the • Conduct training for IEC re­ on HIV/AIDS issues have needs of out-of-school source people. been developed for radio. youth. • Increase collaboration with lo­ • Some IEC materials have • IEC materials for physically cal, indigenous groups. been developed in local lan­ challenged youth. • Use scenarios that will guages. • Materials using more ap­ stimulate response from the • Some efforts have been propriate terms and local target audience. made to encourage youth languages to present is­ • Focus on behavior-change to be screened for H IV be­ sues and ideas. messages. fore marriage. • Lack of more innovative IEC • Use concrete images and • Music has been used as a materials such as pictori­ real-life examples. means of disseminating in­ als. • Monitor and evaluate IEC formation on HIV/AIDS. • Sociocultural attitudes messages on a regular basis. • Road shows also have been and values that hinder pro­ • Revive NAHFAD. used to disseminate infor­ gram efforts. mation. • Bureaucratic bottlenecks • People living with HIV/AIDS in RH. have been helped by organi­ • Difficulty integrating enter­ zations that want to popu­ tainment into lEe mes­ larize care for AIDS victims sages in "Sharia" states. and to reduce the stigma. • Lack of skills to develOp • Newsletters, pamphlets, quality IEC materials. and publications have been produced and distributed. 37

EEIUCAUONAND SKlllS DEVELOPNENT _ There has been limited _ Lack of political will. _ Educate policymakers and ad­ achievement in integrating • Ignorance of the issues vocate for the need for in­ sexuality education into the at stake. creased funding for YARH. school curricula. _ Religious and cultural _ Strengthen NGO and csa net- values restricting works. progress and integration. _ Work with tradrtional and reli- _ Lack of ownership by the gious leaders. people. _ Create pressure groups to con- • Policies and resource a[- sistently monitor impIeme:ntaVoo. location ha6 not recog- • Conduct public education cam- nized the integration. paigns on YARH.

TRAJNING _ The capacity of some stake­ _ Inadequate information • Establish a more effective holders has been built on the strategiC frame­ NGO netVlork. through training, situation work. _ Lobby for adoption of the analysis, and advocacy. _ Weak networking among strategic framework by state • Training materials have been NGOs. health councils. developed, such as manuals, _ "Female teachers" issue. _ Better define the NGO-gov­ curricula, handbooks, illus­ _ "Lack of parental involve­ ernment organization rela­ trated materials for stu­ ment in YARH. tionship. dents, guidelines for peer _ A donor-driven agenda _ Define and determine the educators, an ARH counsel­ that is sometimes out of minimum YARH and advocacy ing manual, and an HIV/AIDS sync with needs. packages. counseling manual. _ Inadequate number of _ Advocate for proper funding. • Training on program manage­ trained staff members. _ Phase in the training of ment for primary health-care • Poor selection of trainees teachers. coordinators, school princi­ _ Negotiate with and convince pals, and area inspectors of donors to adopt the fra_'lo,l,- education has been conducted.

• Some YFS centers have _ Frequent and irrational _ IntenSify training of all cadres been established through transfer of trained person- of health workers. the efforts of NGOs and do­ nel. _ Advocate that government nor agencies. _ Mass retrenchment of establish YFS clinics. _ Pockets of research have workers. _ Have government operate been funded by donors on _ Multiple reporting systems. HMIS at all levels. YARH needs. _ Contraceptive logistics _ Increase collaboration and problems. support between the govern- _ Government not support- ment and NGOs. ive of the work of NGOs. _ Increase media invoivement in _ Inadequate information on YARH. ARH policy. _ Cultural barriers. _ Inadequate funding. 38

• No legal or policy reforms • Lack of expertise or • Galvanize YARH stakeholders have been achieved. commitment among RH to draft a bill on ARH rights. activists, • Lobby the Senate and House • Cumbersome drafting health committees for YARH and passing of laws. reforms. • Lack of identification of • Help NGOs develop the capac­ adolescent rights need­ ity for protecting YARH legal ing protection. rights. • Lack of awa reness of • Involve the media, the judiciary, the right to RH, includ­ and the allied stakeholders in a ing RH violations such roundtable discussion to form as rape and incest. strategic partnerships. • Persistence of stigma • Sensitize the public on ARH of victims of YARH vio­ rights. lations and unrespon­ • Strengthen NGOs' monitoring sive lega! system, and evaluation of ARH rights • Limited M&E on ARH through training. rights violations. • Facilitate building networks on ARH.

• There have been limited • Lack of appreciation of • Make a conscious effort to YARH activities at the local the use of data. conduct research on YARH and government and community • A number of donors who to develop a research plan. levels. don't consider research • Create awareness of ARH re­ • Some research has been and M&E as priority search. sponsored by international program areas. • Build the capacity for a man­ organizations and donors. • Weak capacity at local agement information system in • Information on research and levels and in some both government and NGOs. national data has been NGOs to cond uct re­ • Establish a research data maintained by some interna­ search and carry out monitoring institution. tional agencies and donors, activity monitoring. II Increase donor funding for re­ although it is scarce. • Inadequate funds to search. • No legal or policy reforms support an M&E sys­ II Facilitate information sharing have been achieved. tem. on research findings through networking. 39

COMJ'1ITMENT AND Sill1HARY A REVIEW OF THE 1999 National Strategic Framework for Adolescent Reproductive Health in Nigeria (1999) revealed that a modest increase in programming has occurred, but huge gaps remain to be bridged. Policy and legal reforms, capacity building, data gathering, and information management are areas of immediate need. In addition, the framework should be used more often in program efforts among all organizations with periodic assessments of gains made and challenges faced. 40

y the end of the SOTA course, participants were Bchallenged to explore their next steps by completing a "Statement of Commitment Form," in which each person wrote what he or she would do to advance the status of YARH in Nigeria over the next six months. A total of 56 responses was received. After six months, FOCUS agreed to dispatch the forms back to the individuals to enable them to measure their level of success in implementing the strategies and reaching their targets. As a result of the perceived success of the course, the participants suggested that another SOTA be held in Nigeria for the burgeoning NGO community.

A. EVALUATION

verall, the partners, presenters, and O participants agreed that the SOTA and subsequent skills-building courses were a success. Despite the limited funding available to sponsor large numbers of participants, many were able tc secure their own funding. Although there were many whom we were not able to accommodate, those who did attend felt they benefited greatly from their participation. The ability to provide resource information and copies of papers and presentations shortly after each 41

presentation was greatly appreciated by B . PARTNER AsSESS~1E~rr participants. Small-group meetings that followed the plenary sessions gave his course represented one of participants an opportunity to process the most successful the information and to develop partnerships experienced by relationships and network as a result of T the FOCUS training team. The efficient use working with a group of people over time. of and access to modern technology, namely Bringing people together from different e-mail and the Internet, made regular parts of Nigeria provided an opportunity communication with partners possible. The for those from different regions, religions, course also allowed partners to participate and cultures to work together in a way in shaping the agenda and in making that ma ny seldom experience. decisions. Clearly defined roles and Despite the 'course's success, responsibilities in relation to planning and to participants felt that some areas could be contacting presenters and participants, as improved, such as the need to establish a well as in the actual training course itself, more organized plan for working with the gave each organization equal visibility in the press in advance. Although attempts were SOrA and made it easier for people to fulfill made, a great degree of stress could have expectations. been alleviated by our better preparing for Overall, partners felt the following: contacts with the press. Fortunately, • The workshop was "very nicely organized, several members of the partner and exceeded expectations." organizations were interviewed by print and television, giving greater exposure to YARH • "The coordinators were in constant touch issues. However, much of the work with the with us via e-mail and telephone to press occurred on an ad hoc basis. provide updates as was necessary." Organizing a press conference, preparing Furthermore, the way in which each day's press releases and press packets, and proceedings flowed was an important designating press contacts would also indicator of the level of thought and have been helpful. detailed planning that went into the Several other levels of evaluation and process. assessment of the training were • "The outcome was really fantastic, and conducted. Participants were asked to the debriefing with the youth who evaluate the SOrA course and each of the attended the flrst workshop proved this." skills-building courses in terms of content, rhe strengths of the partnership were format, and delivery. In addition, partner identifled as flexibility, responsiveness, organizations were asked to assess the tolerance, friendliness, trust and the ease of effectiveness of the partnership and to communication. Weaknesses included the identify areas for improvement. competing demands on some staff members that limited their participation in planning. In addition, the number of last-minute changes was seen as a negative in scme case while refiecting flexibility in others. 42

C. SOTA COURSE EVALUATION

n a scale of1 to 6, with 6 being excellent, the O overwhelming majority of participants rated the sessions of the SOTA 4 and above for content, format, and presentation. Small-group work was ranked highest across all sessions, because it provided the greatest opportunity to process information and interact with colleagues. The time allotted for sessions was the most frequently expressed area for improvement, and one participant suggested setting aside time for prayer for Muslims. Nonetheless, participants worked beyond the designated end time on most days, and one day they worked well into the evening. Although participants identified dealing with youth street hawkers, working on proposal development, meeting donor reqUirements, examining counseling techniques, and learning more strategies for influencing behavior change as areas they would like to have covered, the participants each found something that appealed to them. Policy and communication issues are foremost in participants' minds given the current climate in Nigeria, and it is positive that numerous organizations will assist in this area in the coming months and years. There was a strong desire for a follow-up to the SOTA, which did, in fact, take place in August of the same year. Participants also desired periodic updates and materials on YARH issues, as well as other forums for maintaining contact with colleagues. 43

A. COURSE DESCRIPTION

n February 26-28, 2001, the course on "Monitoring O and Evaluating Adolescent Reproductive Health Programs" was conducted. It had been designed to familiarize participants with the technical tool of the same name, which was developed by the FOCUS on Young Adult5 program. This three-day course introduced basic concepts of monitoring and evaluation (M&E), described the steps involved in evaluation planning, reviewed techniques for data collection and analysis, and presented various means of data dissemination. The course also was intended to provide a comprehensive introduction to the M&E guide and to cover its three main sections: the text instructions on how to carry out M&E, the indicator tables, and the data collection tools. The course materials included: • A Guide to Monitoring and Evaluating Adolescent Reproductive Health Programs, which was distributed to all participants; • a trainer's manual, prepared using the PowerPoint notes page format; • a participant's manual, which included a spiral-bound copy of the PowerPoint slides in handout format; 44

"' four diskettes with PowerPoint slides for B. GOALS AND OBJECTIVES all material covered; "' color transparencies of all slides; he goal of the M&E training was to familiarize "' several handouts and worksheets for course with the FOCUS small-group activities, including four Tparticipants titled A Guide to case studies of YARH programs; and on Young Adults tool Monitoring and Evaluating Adolescent "' miscellaneous supplies including Reproductive Health Programs and to flipcharts, markers, and performance strengthen participants' understanding of incentives (candy, stickers, etc.). and commitment to evaluation as a tool Because of the technical nature of for improving YARH programs. The M&E the course content, an interactive lecture training course had five key objectives. format was used to introduce most Following the training, participants would topics. The instructor presented material be able to using PowerPoint slides, while soliciting "' use the M&E gUide as an evaluation input and questions from participants. resource, Several exercises were carried out using M&E within their own four small working groups of about seven "' identify the role of participants each. In addition, on days 1 program, and 2, participants were asked to II understand the elements of the M&E complete brief self-evaluating exercises. process, Nigeria, The course was held in Abuja, o identify potential indicators for their from February 26 to 28. Course own program, and facilitators were Susan Adamchak, an o implement at least three dissemination author of the M&E guide; Emily Zielinski, a formats. graduate student at Tulane University and FOCUS team member; and Chris Onyejekwe, a local trainer. 45

c. DESCRIPTION OF the United Nations Population Fund, and four were employed by U.S.-based PARTICIPANTS AND cooperating agencies (Pathfinder International, the Center for Development ORGANIZATIONS and Population Activities, and International Projects Assistance wenty-nine participants Services). One participant worked for the attended the M&E training Oyo State MOH. Tcourse. Of those, Participants were highly attentive approximately three had carried out more and motivated. They adhered to the course than one M&E exercise, another six had schedule and for the most part were participated in at least one M&E exercise, conscientious about starting the morning and the remaining 20 had no prior and afl;ernoon sessions promptly. They evaluation experience. The more­ continued work until late in the day, with experienced participants were active in most sessions concluding between 5:00 discussions, but they did not dominate the and 5:30 p.m. Only one participant was class or distort the level at which the absent for significant periods of time, course was presented. They appeared because she had to attend meetings with interested in the systematic review of a major foundation on behalf of her stages of M&E and in consolidating their organization. knowledge. The participants with less The majority of the participants (22) experience appeared comfortable asking provided e-mail addresses as part of their questions for clarification and elaboration contact information, although many cited of selected topics. the high cost of using the Internet in Most participants represented local Nigeria. Nevertheless, the Internet may be NGOs, with program emphases on youth a useful means of communication to development, reproductive health, or HIVI maintain a network of course partiCipants AIDS. Two participants were employed by and to provide course follow-up. 46

D. HIGHLIGHTS AND • "We have photocopied some of the tools and plan to adapt them for our use." EMERGING ISSUES • "I like the image of the three young people dancing on the cover. It is highlight of the course was cheerful and makes me think of my feedback from the children being happy." )Jarticipants about the M&E • "I would have liked seeing the book in gUide itself. Several of the participants' three volumes." organizations had received copies of the • "We are glad to have so many manual as part of its postpublication instruments available. In particular, the dissemination, and they reported having mystery clients example is very useful." already put it to use. Among the comments offered were the following: • "Don't reinvent the wheel. It is good to have such a comprehensive source of • "While the M&E gUide appears information." intimidating, the language is simple and instructional so that the book can be a An emerging issue identified by the self-tutorial." group concerned ways to provide ongoing support to participants after the training • 'We have reviewed the indicators and course ended. Several participants plan to use some in our program." requested that the instructors be • "The sequencing of topicS is good and available to comment on M&E plans as builds on prior information." they were being developed (and one had • 'We have used the M&E guide in already e-mailed a paper on poverty and developing a baseline study for youth­ sexual activity of Nigerian girls for friendly services." comments from the instructors before their arrival back in the United States). 47

E. RECOMMENDATIONS environment. With respect to the course content and its relevance to their work, an AND COURSE EVALUATION overwhelming majority felt that the content was relevant, useful, and of articularly because so many interest to them. They found it useful in participants are able to the systematic identification of goals. Pcorrespond by e-mail, time objectives, and indicators. The course also should be allocated for course instructors reinforced the importance of conducting to carry out remote follow-up through M&E from the start, the role it can play in technical reviews. advocacy, and the need to allocate Although a fair number of resourceS to M&E activities. However, represented organizations are doing little depending on their level of skill, some or no M&E, many are doing something. people thought the material waS too However, what they are doing is not always technical. Many suggested making well grounded in M&E principles. In sessions more participatory, providing addition, the results yielded are often not more practical examples relevant to the used to assist in program planning and context, having participants provide case improvements. Therefore, participants felt studies, or including more experiential that more should be done within their learning exercises to enhance learning. organizations to make their M&E efforts Most participants felt that the course more meaningful. was far too short and recommended a Several participants noted the minimum of five days. They also identified a collegial atmosphere and warmth of the need for follow-up and retraining to ensure facilitators, who created a fertile learning sustainability. 48

A. COURSE DESCRIPTION

LY he YFS training course took place over three days T(February 26-28, 2001) and included a variety of interactive teaching REPORT methods including small-group exercises, lectures using PowerPoint slides, large­ group discussions, visualized discussions, role-play exercises, and a field exercise. Participants were first oriented to the YFS tool and then trained to carry out the essential steps of a YFS assessment study. They were also exposed to the results of applications of the YFS tool in other African countries. The last day of the training consisted of an actual "field exercise" in which participants conducted an assessment and synthesized their findings. Participants were divided into groups of three (with eight in each group) and visited three family planning clinics in Abuja. At each clinic, partiCipants were assigned to measure the degree of youth friendliness by conducting focus-group discussions among fathers, mothers, and young people, as well as exit interviews of youth clients and in-depth interviews among nursing staff members. After the group processed and analyzed its data, it made presentations about its assessment and B. GOALS AND suggested strategies of how a higher degree of youth friendliness could be OBJECTIVES achieved at each clinic site. Two health­ care providers from the sites visited were he overall goal of the YFS present to listen to each group's training course was to have assessment findings, as well as to Teach participant feel participate in an open discussion following comfortable in planning a study to assess each group's presentations. the degree of "youth friendliness" at a health facility. Specifically, the YFS training course's objectives were to enable each participant to plan an assessment by (1) selecting appropriate youth-friendly indicators, (2) selecting the appropriate sources of information and data collection tools, and (3) planning how to improve the service environment for youth.

c. DESCRIPTION OF PARTICIPANTS AND ORGANIZATIONS

total of 24 participants from USAID cooperating ~gencies and Nigerian NGOs attended the YFS training course. Participant introductions revealed that the majority of the participants either were in the process of designing a yo.r-<-h­ friendly service program or were learning how to monitor and evaluate such a program. In addition, most were keenly aware of the barriers and key issues associated with providing RH services to adolescents. 50

D. HIGHLIGHTS AND E. RECOMMENDATIONS EMERGING ISSUES AND COURSE EVALUATION

ne of the most interesting ourse evaluations revealed discussions that took that many people felt the O place at the training was Ctraining should be expanded during a visualized discussion about the to five days. Participants also felt that "health needs of adolescents." more local case studies were needed to Participants became divided over the issue make the situations and discussions more of "housing" and whether or not it was relevant to the circumstances under which actually a reproductive health need or a the participants work. As always, the field factor for other health needs of visit was the highlight of the course. Having adolescents. Many participants felt that providers from the site available when the because of the lack of appropriate housing, assessment findings were presented was many adolescents are exposed to more seen as an important follow-up measure to health risks. Another important discussion assist that site in making improvements related to the future of youth-friendly and addressing the challenges it faces. service programs for Nigeria given the Participants in the YFS course found uninviting climate for YARH in Nigeria, the the course to be highly useful in learning cultural taboos, and the provider bias. about data collection tools and Participants shared that parents were methodologies, about data analysis and strongly against providing young people scoring, and about planning for with family planning services and that improvement. The content was viewed as nurses did not fully support providing comprehensive because it covered all key youth with contraceptives. Therefore, the aspects of youth-friendly services and was group discussed other possible strategies helpful in enhancing communication with for moving forward in this area. Some youth. PartiCipants felt that good visual participants felt that more community aids and materials supported their learning outreach activities were needed, whereas and that small-group work and other others emphasized the need to clearly activities provided good opportunities for define "reproductive health" in its broader participation. Suggested areas of context. Finally, partiCipants felt that improvement included additional days in more innovative approaches were reqUired which to cover the course content and to to reach the young people, such as going provide additional clarification of key to libraries and other centers where they concepts. Participants also suggested spend their free time. further training enhancements such as involving youth in the training, including more experiences from other African countries as well as from Nigeria, and prOViding additional field work. PartiCipants recommended that the course be used as an orientation for front-line workers and that additional follow-up be added. 51

A. COURSE DESCRIPTION

n February 26-28, 2001, the advocacy course was O presented. It had been developed te assist in building capacity among organizations te advocate for changes in YARH policy in Nigeria. All planning meetings held throughout Nigeria revealed that advocacy was a much­ needed skill among YARH organizations. To this end, a three-day course was developed using a variety of participatery approaches te transfer knolYledge and share information. DralYlng on the day-to­ day experiences of participants, the course content was flexible and was adapted to meet participants' needs in the context within which they were working. Challenges te advocacy efforts \'Iere also addressed and strategies for overcoming them explored. 52

B. GOALS AND C. DESCRIPTION OF OBJECTIVES PARTICIPANTS AND ORGANIZATIONS he objective of the course was to enhance advocacy skills among participants T articipants were drawn to create an enabling environment for . from various states in the family planning, reproductive health, and federation and were HIV/ AIDS programs. The purpose of the P composed of top government officials from workshop was to provide participants the MOH, executive officers of NGOs, and with basic advocacy knowledge and multinational donors. Of the 29 skills. The objectives of the workshop participants, 10 were executives, project included: directors, or coordinators from NGOs; 8 • introducing participants to the were program officers or facilitators; 3 concept and practice of advocacy as were from the MOH (the director of the a strategy for influencing policy; FMOH and two staff members from Lagos • reviewing the steps involved in and River States MOH); 3 were program designing and implementing a officers from multinational donor agencies strategic advocacy campaign; and (the United Nations Population Fund, the • examining and applying tools for Center for Development and Population effective advocacy, including Activities, Pathfinder); and the remaining 5 networking, advocacy issues were youth volunteers and other staff identification, policy audience members from NGOs. analysis, and advocacy message development. The course content focused on D. HIGHLIGHTS AND developing policies and plans that EMERGING ISSUES sustain access to high-quality services for youth. Furthermore, the skills though a number of acquired during the course would be participants stated that used to raise awareness among key hey were involved in policymakers of the pressing issues to Al advocacy activities, many were not clear advocate for, to develop policies that about what advocacy entailed. Some support sustainable programs, and to confessed that although they were plan for their implementation. mandated by their organizations to advocate for YARH, they did not have the skills and knowledge to do so. In addition, participants stated that their organizations confused IEC with advocacy, leading to a need to reexamine 53

organizational activities and to reshape E. RECOMMENDATIONS them to fit the principles of advocacy. Interactions with participants revealed AND COURSE that YARH advocacy skills were highly EVALUATION needed but that capacity on the ground was very low. The workshop was, therefore, he enthusiasm and designed to meet this need, with the motivation that expectation that the participants transfer participants showed the skills and knowledge to their T throughout the workshop was an colleagues. Together they hoped to indication that they appreciated the improve, reshape, and sharpen the course and recognized its importance to advocacy activities of their organizations. their work. There is clearly a need for well­ In addition, small-group work planned and systematic advocacy identified a number of key issues that activities. It is, therefore, critical that could form the basis of an advocacy capacity be built in advocacy to eqUip campaign. Those issues included the lack participants with skills to design and of youth-friendly services; the hostile legal implement advocacy strategies in ARH, environment, particularly to victims of especially for NGOs that are viewed as a sexual violence such as rape; and the lack driving force for advancing YARH. of sexuality education for youth in Nigeria. The participants recommended that The issues were used as case studies to the training devote more time to identify key advocacy strategies. designing and presenting advocacy messages. Because advocacy is a skill needed by many NGOs dealing with YARH, there is a need, therefore, to build capacity in every state for that purpose. To achieve this, a master trainer's course is recommended to transfer capacity to different states. Finally, participants expressed a desire for follow-up in the form of an advocacy network to spearhead the issues of youth reproductive health, and they pledged their support for such a network. The POLICY Project was requested to assist in and facilitate the establishment of this networik. The network would provide a forum for strategizing about how to mobilize funds to maintain and sustain the netl'lorik and its work. 54

At the beginning of the workshop, a pretest questionnaire was administered to assess participants' level of knowledge. This pretest was followed by a posttest assessment that showed an increase in knowledge. Nine participants scored the workshop as an A (excellent) grade, and 17 awarded it a B (good) grade. Only two participants awarded the workshop a C (fairly good) grade. It was gratifying to note that even those who gave the workshop a B grade stated that the workshop was very good and that they benefted from their participation. 55

IX 1: COURSE 56

6:30-7:00 p.m. 30 min. Welcom&--TUuana A. James-Traore. FOCUS on Young Adults Introduction of Partners Lynn Gorton-USAID Mike Egboh-Pathfinder International Scott Moreland-The POLICY Project Babatunde Ahonsi-Ford Foundation Kole Shettima-MacArthur Foundation Nike Esiet-Action Health Incorporated Mairo Bello--Adolescent Health Information Project

7:00-7:30 p.m. 30 min. Adolescent Health Information Project Youth Forum Presentation

8:30-9:00 a.m. 30 min. Introduction • Introduction to SOTA Facili1Oator • Review course objectives • TUuana A. James-Traore • Discussion of participan1; FOCUS on Young Adul1;s goals and objectives • Review of agenda and format • Ground rules

9:00-9:30 a.m. 30 min. Official • Host welcome Presenters Opening • Introduction of gues1;s • Mike Egboh • Official opening Pathfinder International • TUuana A. James-Traore FOCUS on Young Adults • Scott Moreland The POLICY Project • Lynn Gorton-USAID • Amina Ndalolo-- Minister of S1;ate for Health, Federal Ministry of Health

9:30-10:00 a.m. 30 min. I Wanna' Know • Introduction of participants Facili1;ators Your Name • Mike Egboh- Pathfinder International • Holo Hachonda- Johns Hopkins Universi1y 57

,Moderatoro-Mike EgI7oh, Pathfinder InternationallNlgeria, and Holo Hachonda, John,,; Hopkin,,; Unlver6lt1f 10:00-11:00 a.m. 1 hr. Do You Su • Participants will be divided Facilitators What I see? Do into small groups separat­ • Holo Hachonda- You Hear What ing older adults and youth. Johns Hopkins University I Hear? • Each group will be asked to • Vanessa CarroU­ brainstorm the following: FOCUS on Young Adul.... s 1. What adjectives describe • Moji Oyelami-Network youth? List as many as • Bimbo Jide-Aremo­ you can in 15 minutes on Action Health Inc. newsprint. (Some • Charity Ibeawuchi-­ discussion may follow.) The POLICY Project 2. What rights should young • BahUatu Bello­ people have over their Adolescent Health and reproductive health? Information Project 3. What rights and controls • Leah Wanjama­ should parents and The POLICY Project others have over access to information and services for their minor (under-18) children?

11:00-11:15 a.m. 15 min. Break

M,)dt!l'»t<>,.".-'-t.~ike Egl7oh,filthffnder IntemationallNlgeria, and Holo Hachonda, John,,; Hopki/16 Unlver6lt1f 11:15 a.m.-noon 45 min. I Can See • 5mall groups will report back Facilitators Clearly Now! on their work. .Mike~boh- • The large group will discuss Pathfinder Interr~onal the similarities and differ- • Holo Hachonda- ences between the two lists Johns Hopkins Universrty and what they mean. noon-1:00 p.m 1 hr Lunch 58

on _ M.O.T. Odunjinrin­ 1:00-2:00 p.m 1 hr. This Is My _ Data will be presented Story YARH issues affecting The World Health youth around the world and Organization youth in sub-Saharan Af­ rica, including indicators of _ Scott Moreland­ contraceptive use, abortion, The POLICY Project STls. and HIV prevalence and variation by age, gender, re­ gion. and knowledge of ser­ vices. _ Profile of Nigerian youth with respect to the YARH data and issues presented above will be described.

2:00-3:00 p.m. 1 hr. Adults Are _ Issues specific to Nigerian Presenters _ Belkis Weide Giorgis­ from Mars: youth will be discussed. in- Adolescents cluding the effect of war Management Sciences Are from Venus and civil unrest, democracy, for Health gender. tradition. and cul­ ture. _ TUuana A. James-Traore­ • Participants will discuss FOCUS on Young Adults adolescence as a psychoso­ cial development process. _ They will discuss the stages of adolescent development, characteristics of young people as they move through the process, plus its rel­ evance to YARH. _ The FOCUS Adolescent De­ velopment Tool will be shared and applied . • Questions and Answers.

3:00-3:20 p.m. 20 min. Break 59

3:2D-4:30 p.m. 1 hr., Adults Are • In small groups, participants Facilitators 10 min. from Mars; will be guided through the • Holo Hachonda- Adolescents application of the Adoles- Johns Hopkins Unr,erSity Are from Venus cent Development Tool. • Vanessa Carroll- Ccontinued) • Small groups will discuss FOCUS on Young Adults characteristics that define • Moji Oyelami-Network adolescents at various • Bimbo Jide-Aremo- stages in their growth and Action Health, Incorporated development. • Charity Ibeawl1chi- • This activity will be followed The POLICY Project by a discussion of program • Bahliatu Bello- goals and interventions ap- Adolescent Health aria propriate to youth at each Information Project stage of development. • Leah Wanjama- The POLICY Project 4:30-5:15 p.m. 45 min. Adults Are • Feedback will be given to the from Mars; larger group. Facilitator Adolescents • Tijuana A. James-Traore- Are from Venus FOCUS on Young Adults Ccontinued)

5:15-5:30 p.m. 15 min. Wrap-up and Homework 60

45 min. Jungle City Facilitators socioeconomic, environmen­ • Holo Hachonda- tal, and cultural factors af­ Johns Hopkins University fecting RH (including sexua I • Vanessa Carroll­ growth and development, FOCUS on Young Adults sexual activity, and rates of • Moji Oyelami-Network STI and HIV infection) of • Bimbo Jide-Aremo­ youth today. Action Health Incorporated • This list will be grouped ac­ • Charity Ibeawuchi­ cording to those that affect The POLICY Project youth positively and those • BahUatu Bello­ that affect youth negatively. Adolescent Health and • Groups will then discuss the Information Project impact of those factcrs ac­ • Leah Wanjama­ cording to personal and pro­ The POLICY Project grammatic experience and strategies that have worked in minimizing or eliminating negative effects and en­ hancing positive effects.

9:45-10:30 a.m. 45 min. Jungle City • Feedback will be given tc (cont... ) larger group.

10:30-10:50 a.m. 20 min. Break 61

Mc>t!e,m<,r--Le,.h Wanjama. The POLICY Project

10:50 a.m.- 1 hr. What's Going • Participants will learn from Presenters 12:30 p.m. 40 min. On? the latest data and re­ • Kristin Nel60!1- search about what does and FOCUS on Young Adults! does not work in reaching Tulane University and serving youth. • They will also examine the • Lola Dare- effects of sexuality educa­ Centre for Health Sciences tion. What is it designed to Training, Research ana do? What can realistically be Development irr'"~matio!1af achieved? • Participants will hear case studies of developing and implementing curricula. • Que5tions and answers.

12:30-1:30 p.m. 1 hr. Lunch 62

se- Areas with Presenters 1:30-3:15 p.m. 1 hr., Part I-Ain't • Participants will hear a Topic 45 min. Nothing but ries of 5- to 7-minute pre- • Youth Involvement: Service the Real Thing sentations on program ap- Delivery- proaches to reaching and Adeola Olunloyo, serving youth . Action Health Incorporated • These presentations will be • Micro-Enterprise: Ebun followed by roundtable dis- Omotosho-- cussions with presenters to Family Health and Popula- learn more about their pro- tion Action Committee grams and services. • School-Based: Temitope Adekunle- Association for Reproduc- tive and Family Health • faith-Based: Edem Effiong- Nigerian Youth AIDS Project • Rural: Hajara Mohammed- Adolescent Health Informa- tion Project • Marlret-Based: Bola Omotosho-- Family Health and Popula- tion Action Committee .Youth Involvement, Advocacy: Emmanuel Etim- Adolescents in Nigeria

3:15-3:30 p.m. 15 min. Break- Move into Roundtable discussions 63

Moderator-IJr. Od/ako5a. Action Health Incorponated

3:30-5:00 p.m. 1 hr.• Part II-Let;'5 Thi5 5ession is a repeat of Topic Areas \'lith Presenters 30 min. Do It Again! the previou5 5e55ion. but with • Community-Based: five different presenters and Charity U5ifoh-- new topiC5. Women'5 Heal>..h OrganizaUon of Nigeria • Media: OmolDlu Falubi- Joumali5w Again5t AIDS • Commercial Sex W",*""", Soji Akinleye-Sagamu Community Cen-!.oCf • Fsmlti; Wale Odutolu-- Life Vanguard5 • f!>6ta1>ortlon Cam: Bomi Ogeaegbe- P05t-Abortion Care Network 5:00-5:15 p.m. 15 min. Wrap-up and Homework 64

8:30-9:30 a.m.

youth Presenters 9:00-10:15 a.m. 1 hr.• Last Night a • What messages do 15 min. DJ Saved my derive from the media? • Adeola Olunloyo- Incorporated Life! • What role do journalists Action Health play in advancing the status • Hajara Mohammed- ofYARH? Adolescent Health Informa- • How do the media perceive tion Project YARH issues? • Iwalola Akirl-Jimoh- • How do the media deal with Youth Empowerment sexuality. HIV/AIDS. Foundation contraceptive use, and • Lanre Arogundade- gender? International Press Center • How can we strengthen our • National Association of partnership? Women Journalists • Questions and answers. • Teresa Esien- Channels Television

Presenter 10:15-11:15 a.m. 1 hr. I Heard It • Participants will develop Through the effective communication • Vanessa Carroll- Young Adults Grapevine strategies using local case FOCUS on studies, such as creating 1. messages with the audience in mind, 2. market segmentation, and 3. audience input using appropriate methodology for communicating with different audiences. • Questions and answers 11:15-11:30 a.m. 15 min. Break 65

M,>de'"'tor--~Iolo Hachonda, John!; Hopkin,;; Unlveroity

11:30 a.m.- 1 hr. Reach Out • Participant5 will examine Presenters 12:30 p.m and Touch social marketing for youth, • Bernard Edet- Somebody including branding, pricing, Society for Family Health and learning the per5pective • Holo Hachond.a- of pharmaci5t5 and other Johns Hopkins Universrty "nontraditionar distribution channels. • Then they will examine behavior-change communica­ tion strategies

12:30-1:30 p.m. 1 hr. Lunch

M,'de,mtor--C'r.O'IOII'lJ, Center for Development: and Population ActIvitiee

1:30-2:45 p.m. 1 hr., Tty a Little • Participant!> will define • Kristin Nelson- 15 min. Tenderne55 youth-friendly 5ervice5 FOCUS on Young Muit5! (YFS) and examine charac­ Tulane University teri5tic5 of youth-friendly 5taff member,;, the phY5icai layout of facilities, accessi­ bility of programs and ser­ vice5, privacy. and confiden­ tiality. • They will identify character­ i5tic5 of ciinic-ba5ed and community-ba5ed YFS. • They will alw be expo5ed to the FOCUS A55e55ing and Planning for YFS tool and it5 application to their VlOrk. 66

2:45-3:45 p.m. 1 hr. Search for • Providers of clinical and • Mary Bawa- Tomorrow contraceptive setvices wi!! Planned Parenthood share their experiences in- Federation of Nigeria eluding what challenges and • Bernard Edet- barriers they faced and how Socie1;y for Family Health they overcame them, what • Funmi Doherty- lessons they learned, and Society for Women and what effective implementa- AIDS in Africa tion strategies were. • Grace De!ano- • They will also discuss how Association for they involve youth, males, Reproductive and and families. Family Health • Questions and answers,

3:45-4:00 p.m. 15 min. Break

4:00-5:00 p.m. 1 hr. Where Were You • Participants will define gaps Facilitators When I Needed in meeting the needs of • Holo Hachonda- You Most? young adults. Johns Hopkins University • They will also engage in a • Vanessa Carroll- discussion about strategies FOCUS on Young Adults to bridge the gap. • Moji Oyelami- • The discussion will focus on Ne1;work the specific needs of sub- • Bimbo Jide-Aremo- se1;s of youth including com- Action Health Incorporated mercial sex workers; homo- • Charity Ibeawuchi- sexual, lesbian, and bisexual The POLICY Project youth; victims of rape and • BahUatu Bello- incest; married youth; rural Adolescent Health youth; stree1; kids; and out- Information Project of-school youth • Leah Wanjama- The POLICY Project

5:00-5:30 p.m. 30 min. Review and • Small groups will give feed- Facilitator Complete feed- back on their discussion of • Leah Wanjama-The POLICY back gaps in mee1;ing the needs Project of youth.

5:30-5:45 15 min. 67

'N,>t;e-<':Ia<;,; i,; limited to 15 participants from NGO,;. t:ach on a f/t»1;-come. f/r5t--urved 17a,;i,;

7:00-9:00 p.m. CIa,;,; l-Efft:Ctive Communication

Objective: fllrticipants will have an opportunity to create their Oi','l1 communications prod­ uct that incorporates the §tr:ateqieG reviewed earlier in the day. Participants will be helped to (1) identifY and involve target audiences; (2) explore sources of appropriate and accurate information on YARH; (3) develop quality control standards for communication including consistent imaging. punctuation and grammar. review processes. reproduction. and distribution; (4) develop appropriate budgets; and (5) evaluate effectiveness. (Participants should bring the most popular and widely distributed materials for an individualized review and analysis.)

Class 2-Promotlng Your Program,; and Service,;

Objective: Participants will learn about innovative strategies for promoting programs and services including those used in the private sector. This class will include (1) learning steps to access radio. television. technology. and traditional modes of communication; (2) developing press release5 and fact sheets; (3) developing and cultivating relationships with the media; (4) acquiring media training including developing public-speaking skills; and (5) evaluating resuits.

Cis,;,. 5-Low-Tech verr;u,; High-Tech Method,. of D/5I:rl/>u1;/on

017jective: Participants will examine effective strategies for distributing materials in various settings. This class will include (1) developing and maintaining a mailing li5t. (2) u5ing tp..chnol~ such as Web 5iteS and listsetvs. and (3) evaluating success and leaming from failures. 68

Theme VI-Greating arrEnafAingEnvirdnment Moderatol'-Jerome Mafeni,The fOLICYProjeot

8:30-9:30 a.m. 1 hr. Review/ _ Small groups will give Facilitators Complete feedback on their _ Ho[o Hachonda- Feedback discussion of gaps in Johns Hopkins University meeting the needs of _ Vanessa Carro[[- youth. FOCUS on Young Adu[ts _ Moji Oye[ami-Network _ Bimbo Jide-Aremo-­ Action Health Incorporated _ Charity [beawuchi- The POLICY Project _ BahUatu Be[lo-­ Adolescent Hea[th [nformation Project _ Leah Wanjama- The POLICY Project

9:00-9:30 a.m. 30 min. What Have You _ Participants will be led Presenter Done for Me by The POLICY Prcject _ Scott Moreland­ Late[y? through a di13cw313ion of The POLICY Project the following: 1. Why do we need policies? 2. What do they or can they do for me? 3. How can [ use them? 4. How do they affect YARH, HIVIAIOS, gender, and parental involvement? 11Y!('4e.rat'9r:'-O'lIko'YeRaI~so',,:," Kutl,.·l1lf)tjib(jndai;!()n·Oft.aqo13

• How are policies made? Discussants 9:30-11:00 p.m. 1 hr., You Got Me How are they changed? _ Khairat Gwadabe- 30 min. Going in Circles _ Do they work? Ministry of Women and Youth _ How do we evaluate and _ A. Akinsete--Nationa[ Action modify policies'? Committee on A[DS • What are the barriers to _ Nike Adeyemi- policy change? Federa[ Ministry of Health _ How can they be _ Ngozi N. Odu-Ministry of overcome? Health, Rivers Stete

11:00-11:15 a.m. 15 min. Break 69

Mode,:at<,r--Ernm.anl,el Etim, Adoleecent6 in Nigeria

11:15 a.m.- 1 hr., I've Got A New _ The POLICY PrtJject p.ill §hare and Presenter 12:30 p.m. 15 min. Attitude di5Cu9.3 ~ie5, == • Scott Moreland­ and av,gilable tool!; that can be The POliCY Project uf3ed to advocate for change. They WIll dnaw on !3Ome ofthe recommentf.ation5 from the 5171811 qroup5 a5 examp1e5. _ Questior1,; and answers.

12:30-1:30 p.m. 1 hr. Lunch

Mode,:at<'r--Ni,~e E5ict, Action Health Incorporated 1:30-2:15 p.m 45 min. Here',; a Way _ Case 5tudit:5 will be ,;hared of Presenter hON YARH poIicie5 have been • Kwame Ampomah­ 5UCCt:55fuIIY advocated for in Ghana various countries including Ghana and South Africa . • Questions and answer'S.

2:15-3:15 p.m 1 hr. If You Don't _ Small group,; will addnt:55 the Facilitators Know Me by folioNing: _ HolD Hachonda- Now 1. What formallinformal poIicie5 Johns Hopkins Universfty exist in Nigeria in the aroas of • Vanessa Carrol~ education, RH, Hi'llAIDS, FOCUS on Young Mul"ts maniage, gender, harmful tn.­ • Moji OyeJami---,'..Jetwork ditiOl1al practict:5, etc.? • Bimbo Jide-Aremo-­ 2. What poIicie5 enhance YARH, Action Heaith ~l1wrp!lrated including HIV/AlDS? • Charity Ibeai.'1L1chi-­ 3. What poIicie5 pose barrier!; to The POliCY Project YARHf _ BahU"'-"" Bello­ 4. HON have the poIicie5 af­ Adolescent. Heafth fected YARH positivelY or Infonnavon Proje...--t negativelY? _ Leah Wanjama­ 5. HaN do we move from policy The POLlCY Project development to implementa­ tion? 6. Wnat role can youth, parent5, communities, donors, religiou5 group,;, govemment, NG051 CBOsICS05, and the private sector play? _ Small group,; report; back. 70

3:15-3:30 p.m. 15 min. Break

3:30-5:00 p.m. 1 hr., Do You Know • Why monitor and Presenter 30 min. Where You're evaluate? • Susan Adamchak- Going? • How can you monitor FOCUS on Young Adults/ and evaluate your Tulane University programs and services? • Emily Zilenski- • What tools are FOCUS on Young Adults/ available? Tulane University • How can you eva!uate your commitments and progress?

5:00-5:15 p.m. 15 min. Wrap-up and • Participants will review Homework draft of the National Strategic Framework for Adolescent Reproductive Health in Nigeria, 1999. 71

8:30-9:00 a.m. 30 min. Review

9:00-10:30 a.m. 1 hr., People Get • Participants will meet in Facilitator5 30 min. Ready; There'!> !>mall group!> to begin to • Ho!o Hachonda- a Change a develop a plan of action for John!> Hopkin!> Univer5rty Com in'! moving forward to advance • Vanessa CarroH­ the !>tatu!> of YARH in FOCUS on Your.g MUtts Nigeria. • Moji Oyelami-Network • Bimbo Jide-Aremo­ Action Health Incorporated • Charity Ibeawuchi­ The POLICY Project. • BahUatu Bello­ Mole<>een!; Health Information Project. • Leah Wanjama­ The POLICY Project. 10:30-10:45 a.m. 15 min. Break

10:45 a.m.- 1 hr. People Get Continuation of previous 12:30 p.m. 45 min. Ready; There'!> section. a Change a Comin'! (cont ... )

12:30 a.m.- 1 hr. Lunch 1:30 p.m. 72

1:30-3:00 p.m. 1 hr., People Get • Report back Facilitators 30 min. Ready; There's • Holo Hachonda- a Change a Johns Hopkins University Com in'! (cont.. ) • Vanessa Carroll- FOCUS on Young Adults • Moji Oyelami-Network • Bimbo Jide-Aremo- Action Health Incorporated • Charity Ibeawuchi- The POLICY Project • Ba hUatu Bello- Adolescent Health Information Project • Leah Wanjama- The POLICY Project 3:00-3:15 p.m. 15 min. Break

3:15-4:00 p.m. 45 min. Closing • Remarks from cosponsors • TUuana A. James-Traore-- • Presentation of certificates FOCUS on Young Adults • Mike Egboh- Pathfinder International • Jerome Mafeni- The POLICY Project 73 74

Training Centero

African PO Box 47495 254-2-27043 Council on Nairobi, Kenya Communica- Education (ACCE)

Center for Pamstech House 254-2-448618 http://www.cafs.org/ • Capacity building of organi­ African Woodvale Grove 254-2-448621 (fax) zations and individuals pro­ Family Westlands viding sexual, reproductive, Studies PO Box 60054 and family health services. Nairobi, Kenya • Training topics include lEe materials design, RH coun­ seling, youth sexual and RH program management, and supervision of community­ based RH programs.

Ipas: Improving PO Box 999 919-967-7052 http://www.ipas.org Ipas works globally to improve Reproductive Carrboro, NC 919-929-0258 (fax) women's lives through a focus Health 27510 on reproductive health. Ipas Worldwide USA concentrate on preventing un­ safe abortion, improving treat­ ment of its complications, and reducing its consequences.

ReproLine@: JHPIEGO 410-955-8558 http:// Sexually active adolescents Reprod uctive Corporation 1615 www.reprolineJhu.edu are in need of safe and effec­ Health Online Thames Street, tive contraception because Suite 200 studies show that large num­ Brown's Wharf bers of teens are sexually ac­ Baltimore, MD tive, at least occasionally. This 21231-3430 section provides an overview of USA the key issues involved with teens and contraception and provides guidelines for provid­ ing contraception to adoles­ cents. • Service delivery • Sample role play • Articles 75

The Affinity [email protected] http:// The Affinity Group is a network Group 301-270-4302 (fax) www.affinitygroup.orgl of grantmakers ~,;t10 address issues of populaUon. reproduc­ tive health, and reprodu~Jve right", both domestically and internationally.

The Ford Ford Foundation 234-1-262-3971 http:// The Ford Foundation is a re­ Foundation AlB Plaza, Level 6 234-1-262-3973 www.fordfound.orgl source for innovative people Akin Mesola (fax) and institution5 '.... ona'.'Ade. Our St;reet goals are to Vict;oria Island • strengthen democratic val­ PO Box 2368 ues, Lagos, Nigeria • reduce povert.yand injustice, • promote international coop­ eration, and • advance human achievement.

The MacArthur 234-9-413-2919 http:// The Foundation seeks respon­ MacArthur Foundation- 234-9-413-2920 www.macfound.orgl sible choices about human re­ Foundation Nigeria production and a global eco­ Plot No.2 system capable of suppomng Ontario healthy human societ·i'es. The Crescent off Foundation pursues this mis­ Mississippi St. sion by supporting research, Mait;ama A6 policy aevelopment. dissemina­ Abuja, Nigeria tion, education and trail'iir~. and p"'ctiGe.

United 2 United Nations 800-253-9646 http:// Nations Plaza YI'NW.un.orgIPub51 Publications New York, NY 10017 index.html USA 76

UNAIDS 20, avenue Appia 4122-791-3666 hnp://www.unaids.org/ "Expanding the Global CH-1211 4122-791-4187 (fax) Response to HIV/AIDS Geneva 27 through Focused Action" Switzerland "HIV Testing Methods" "Community Mobilization and AIDS" "Learning and Teaching about AIDS at School" "Integrating HIV/STD Prevention in the School Setting: A Position Paper" "Report on the Global HIV/ AIDS epidemic"

UNFPA UNFPA http://www.unfpa.org/ UNFPA, the United Nations Representative Population fund, helps United Nations developing countries find Development solutions to their population Programme problems. It is the largest PO Box 2075 international 50urce of Lagos, Nigeria population assistance. The Fund has three main programme areas: Reproductive Health including Family Planning and Sexual Health, Population and DJelopment Strategies, a nd A vocacy.

UNICEF PO Box 1282 234-1-269-0276 http://www.unicef.org/ UNICEF is mandated by the Lagos, Nigeria to 269-0280 United Nations General 234-1-774-0761 Assembly to advocate for to 774-0763 the protection of children's rights, to help meet their basic needs, and to expand their opportunities to reach their full 77

Donoro (cont.. .)

UNICEF United Nations 234-9-413-5671 http://www.unicef.org/ UNICEF i5 mad.ated by the Office 234-9-413-5673 UnitP...d Nations General As- Coope~ve Hou5e sembty to advoca"'...e for the Ibrahim Babangida protxUcn of chi!drel1"s Way rights, to help meet their ba- Maitama, Abuja sic need5, and to expand FCT, Nigeria their oppor""wniUes to reach their full pate,.,...;"I.

UNICEF PMB038 234-77-543-573 http://WIWI.unicef.org/ UNICEf i5 maru:!a..ed by the Bauchi, Nigeria 234-77-542-954 United NaD.On5 General As- 234-77-5410-12 sembly to advxa""~ for the protection of children's riglT"v.;, to help meet their ba- sic needs, and to expand. their opportunities to reach their full po'"..er;t;.al.

UNICEF PMBl644 234-43-256-390 wMv.unicef.orgl UNICEF is mar";.ated by the Enugu, Nigeria 234-43-252-373 Unrted Nations Genera! As- semblY to advocat"..e for the protection of chi~ren"s right5. to help me.....""C their ba- sic need5. and to expand their opporl;tmitie5 to reach their full po-.entlal.

UNICEF PO Box 581 234-62-234-243 WIWI.unicef.orgl UNICEF is rmmd.ated by the Kaduna, Nigeria 234-62-240-114 United Nations Genera! As- 234-62-240-115 sembly to advx:a'"~ for the protP...ctioo of chi0:-en's rig~~. to help mut their ba- Sic needs. and to expand their opportAJr.itf-~ to reach their full pot.e-rrD..aL

UNICEF PO Box 1282 234-1-269-2481 http://wl'A'I.unicef.org/ UNICEF i5 mandated by the Lagos 234-1-774-0764 United NaUOIls General A5- Lagos State, sembly to advocate for the Nigeria protection of children's rights, to he!p meet their ba- sic need5, and to expand their opportuniUe5 to reach their full 78

Inn,.n'" (cant .. :)

USAID http://ww.usaid.gov/ USAID has been the principal U.S. agency to extend assis­ tance to countries recovering from disaster, trying to es­ cape poverty, and engaging in democratic reforms. The agency works in six principal areas crucial to achieving both sustainable development and to advancing U.s. foreign policy objectives: • economic growth and agri­ cultural development; • population, health, and nu- trition; • environment; • democracy and governance; • education and training; and • humanitarian assistance. 11"""1-"81>10/,,,1 O;qa~iz~tion;' CARE 151 Ellis Street NE 1-800-521-2273 Promoting Quality Maternal Atlanta, GA x 999 and Newborn Care: A Refer­ 30303-2439 ence for Health Managers USA

Global 1701 K 5treet, NW, 202-833-5900 (tel) http:// The Council is an umbrella or­ Health Suite 600 202-833-0075 (fax) www.globalhealth.org! ganization composed of pro­ Council Washington, DC fessionals in the health-care 20006-1503 field, nongovernmental and USA governmental organizations, academic institutions, foun­ dations, and corporations. The Council's priorities reflect the major contributors to the global burden of ill health: • Child health • HIV!AID5 • reproductive and maternal health • infectious diseases • emerging global health threats 79

Planned 234-1-497-5254(1001) http:// IPPF and r-c6 member a6SOCia Parenthood 234-1-820-526(fax) lWNI.globalhealth.orgl tions are commiWA to promot­ Federation of ing the right of wom!m and men Nigeria (PPFN) to decide freely the number ana Family Planning spacing of their children and the House right to the highes<; pD5sible level 224 Ikorodu Road of sexual and reproductive health. Palm Grove. The six major cha!!enges agreed Somolu by IPpF and r-c6 member FPA6 are Lagos. Nigeria • to meet the demand and PMB 12657 unmet need for qu.alfty services; Lagos. Nigeria • to promote sexual ana repro­ duc'"oive health for ali: • to eliminate unsafe abortion; • to take affirmative action to gain eo~uity. eotua!rty. 8r-td em­ powerment for women; • to help young !",vOpie under­ stand their sexuality and to provide services trrat meet their demands: and • to maintain the highest 5'"...and..ards of care throughout the Federation.

Johns 111 Market Place. 410-659-6300 http://wwJhuccp.org/ CCP l'Ias esta!>H5hed at the Hopkins Suite 310 410-659-6266 (fax) Johns Hopkins University School University Baltimore. MD of Hygiene and PU7.[.c He.atth in Center for 21202 1988 in recognition of the pr,,,,,,". Communica- USA importance of communication tn Programs public health programs arrd in (JHU/CCP) keeping ','lith the !eadersh[p ro1e the Johns Hopkins UI1~lersfty has played in this field. HUlCCP is part of the Depart­ ment of Population and Famify Health Sciences "rod co!la",ora~;I closely "nth the Dep",..."",ents of Intemational Health and Health Policy and Mana,gement. Center staff and facufty mBmbers teach health communic.ati.o'!1 courses in several depa,..."".ents. 80

/nternlatlion,'/ Drgi3tiizatiCJn;;.(COl1t .. :) The Packard 300 Second S1O, 650-948-7658 hnp:11 The mission of 10he Popula1Oion Founda1Oion Sui10e 200 www.packfound.org/ Program is 100 slow 10he ra10e of Los Al1Oos, CA gromh of1Ohe world's P01'U,,".lc'n 94022 and 100 expand reproduc1Oive USA heal10h oplOions among the world's poor. To a1010ain 10his goal, grants are made in five key ar­ easto • expand family planning op- 1Oions and reprodUc1Oive heal10h services to women and men; • prevent childbearing and to promo1Oe safe sex 100 young people; • support efforts to mobilise interest, commitment, and resources 100 address popula­ tion gr.owth in developing countries; • preserve and enhance repro­ duc10ive righ1Os, bo1Oh in 10he Uni10ed S1Oa1Oes and in1Oerna- 1Oionally; and • develop 10he next genera1Oion of popula1Oion and reproduc- 10ive heal10h experU. Its international work is mr" ,e,M in E1Ohiopia, India, Mexico, Myanmar, Nigeria, Pakis1Oan, 10he Philippines, and Sudan.

Popula1Oion One Dag 212-339-0514 hnp:11 Journals and publications on Council Hammarskjold (voice) www.popcouncil.org • adol8!3Centg Plaza • communlty-ba5ed dl5trlbu- New York, NY tion 10017 • emergency contraception USA • female qenital cuttlnq • integration • male involvement in PH ' • post-abortion care • quali10y of family planning services 81

InternationalOrqanizatlon6 (con!;... )

Population 1120 19th Street 202-785-0072 http://www.PSl.org PSI develops and imp!ements Services NW, Suite 600 programs ','lorid,vide to encour­ International Washington, DC age healthful behavior and to (PSI) 20036 increase the 8'1ailabiirty of USA health products and services at prices iO'N-income people can afford.

Reproductive http://w.wl.rho.org RHO website prO"";des up-to­ Health date summaries of re5-"'..-arcn Outlook findings, program experience, (RHO) and clinical gutdeHnes re!ated to key reproductive health top­ ics, a5 well 85 analys-es of policy and program impli~a­ tions.

Save the 54 Wilton Road 203-221-4000 http:// Save the Children's health pro- Children PO Box 950 MYrV.savethechildren.org grams continue to cerr...er Westport, cr around child survival, matema! 06881 hear-vh care, and AIDS a.·.. are­ USA ne5S, as well as ntr~on. dean \'later. and sanitation.

World Health http://www.who.int '!he Implication of Anti­ Organization retroviral Treatmel&""..5: An in­ fonnal Consultation"

U6UervC6 Africa http://catalog.com/This conference 15 for the dis- Cinema dsrlafcin.htm cus-sion of African Cinema. Conference

AFRO-NETS http:// The main purp05t: of the con.- users.harore.iafiica.coml ference is ex.chan.ge of itrLfortrLE- -gtz-hsrl tion between t:.he differerot net­ wod::s act')'!!: in Health Re­ search for Development [!6 We Eastern and 50~.,hem AfrfeaM Region. 82

IListselve,; (cont.. :;

The 5148 Polson 1-250-658-6372 http:// Communications Terrace 1-250-658-1728 (fax) www.comminit.com Initiative Victoria, British Columbia, Canada V8Y 2C4 ----""""-

Fahamu 38 Western 44-0-1865-436446 http:// Fahamu produces and pub­ Road, www.fahamu.org lishes CDROM-based learning Oxford OX1 4LG materials especially for this United Kingdom sector. deSigns and manages websites, runs training courses (including on-line courses), and provides support for Internet­ related work.

Family http:// Its mission is to improve the Planning www.popcouncil.org/ well-being and reproductive Operations health of current and future Research: generations and to help A Book of achieve a humane, eqUitable, Readings and sustainable balance be­ tween people and resources.

Global PCI 212-687-3366 http:// pel's mission is to work cre­ Intersections mUnited 212-661-4188 (fax) www.population.org atively with the media and Nations Plaza other organizations to moti­ New York, NY vate individuals and communi­ 10017-3521 ties to make choices that in­ USA fluence population trends en­ couraging sustainable develop­ ment and environmental pro­ tection.

Global Global Knowledge 202-473-6442 http:// GKP is an evolving, informal Knowledge for Partnership 202-676-0858 (fax) www.globalknowledge. partnership of public, private, Development Secretariat org and not-for-profit organiza­ (GKP) World Bank tions committed to sharing in­ Institute formation, experiences, and re­ 1818 H St., NW sources to promote broad ac­ Washington, cess to, a nd effective use of, DC 20433 knowledge and information as USA tools of sustainable, eqUitable development. 83

Li6teerve6 (cont.. ')

Global http:// GP-NET is an e!ww--onic dis­ Participation www.info.usaid.gov/ cussion board that. provides Network about!part_devel! an opport.-unity for USAID (GP-NET) gpnet.html staff members (in \VashingtDn and in the field) ana deve[op­ ment practitioners around the Vlorld to exchange inforrr~Uon> share ideas, and discuss 15- sues related to participatot:)' development.

Kabissa 98-100 44-0-20-82-08-20-77 http:// Kabissa seeks to support Af­ Fleetwood Rd 44-0-20-82-08-20-79 www.kabi6sa.org rican non profits in their effort Dollis Hill (fax) to take advantage of ICT and London NW10 Intemet as a means for 1NN achieving their humanitarian United Kingdom objectives.

Journlal6 and Publication6

African Women's Health 234-52-600151 http:// The African Journal of Repro­ Journal of and Action 234-52-602334 WNW.inasp.org.ukJ ductive Health is a muftJ.di5- Reproductive Re6earch Centre ajol!journals!ajrh! ciplinary and international Health 4 Alofoje Avenue, index.html journal that pJ.Jf;Ji!3hc5 otigir£5! Off Uwasota rCGeorch compMhen§ive re­ Street view article§~ !Short reF0rt~ PO Box 10231, and commcnt:aric5 on repro-­ Ugbowo ductive health in Ami:a. Benin City, Edo State, Nigeria 84

IJo'u""a/,; and Publication,; ,(cant.. .)

African 27 Park End 44-1865-249909 http://www.inasp.org.u kl African Journals Online Journals Street 44-1865-251060 ajolljou rna lsia j rhl (AJOL) began in May 1998 Online Oxford OX1 1H U (fax) index.html as a pilot project managed by United Kingdom INASP. At its re-Iaunch in Au­ gust 2000, AJOL features • up to fift;; African-pub- lished journals (for the time-being in English and excluding journals pub­ lished in South Africa) in agricultural sciences, sci­ ence and technology, health and tiocial sciences; • TOGs and abstracts (where the latter are avail­ able), with back files main­ tained for up to five years; • a key word search service; • a photocopy document de­ livery service for all titles; • a link to full text of an ar­ ticle/journal (if available on the Web).

Free Medical http:// The Free Medical Journals Journals v.wN.freemedicalioumals.com site was created to promote the free availability of full text medical journals on the Internet. We welcome your comments and suggestions.

Journal of Academic Press http:// The Journal of Adolescence is Adolescence Limited www.academicpress.com/ an international. broad 24-28 Oval Road adolescence based, cror3r3-dir3ciplinaty London NW1 7DX journal that addrer3r3er3 ir3- United Kingdom f3Ue5 ofprOfeG51onai and ?!ca­ demic importance concerning development between puberty and the attainment ofadult statu5 within society. 85

Journal" and Publication" (cant.. .}

Pathfinder Pathfinder 234+262-4034 (tel) http:// Module 1: ItTtroductionilNer­ International International 234-1-262-1779 (fax) www.pathfind.org! view-Training Objeaive: In­ Medical Plot 248, Muri htmllPublications! creases the a~'lareness of Services Okunola Street mod_links.htm participants of the value of Off Ajose child spacing for the health of Adeogun Street women and children. and the Victoria Island contribution of private practi­ Lagos, Nigeria tioners in prO'l'idin,g FP ser­ vice5 to the commu!1rty. ['t also provides an overv-;'~I"" of contraGefTtAve me""..hoas. in­ cluding, hormonal me""~ods. IUDs. surgical methods, bar­ rier methods, and. the lacta­ tional amenorrhea me-'"vhod. Module 2: Infection Preven­ tion-Training Objeaive: Pre­ pares providers to practice appropriate infectiOtl preven­ tion procedure:::. in order to re­ duce the risk of disease transmiss:on during the pro­ viSion of reproduct!ve hearth services. it includes ir.rorma­ 'Cion on prot.ec'"t..fJt: barriers such as hana.... ashlng. gloving, and skin preparauon. as '.... en a5 the proce5S~rig of trtstro­ ments and gloves. Module 3: Coun5eling--Train­ ing ObjeG"CWe: Prepares ~rvfce providers to FroMe eIT&"'t{ve genera!. m~Jtod-sp-"'...crri;::;. and. follow-up Gour'l8e~ir,.g to FP cU­ ents and t.he~r fam~~[~5. 86

Journ"l,;andPubiication6(corit.,;)

Pa1;hfinder Pa1;hfinder 234-1-262-4034 (1;el) hUp:1I (Cont. from page 86) International International 234-1-262-1779 (fax) www.pa1;hfind.org/ 11; helps par1:icipan1;s iden1;ify Medical Plot 248. Muri html/Publica1;ionsl their own attitudes, feelings, Services Okunola S1;ree1; modJinks.h1;m and values and 1;heir signifi­ Off Ajose cance and effect on the coun­ Adeogun S1;ree1: seling process. 11; explains the Victoria Island factors that influence counsel­ Lagos, Nigeria ing outcomes, describes the principles and elemen1;s of counseling, and enables coun­ selors 1;0 respond 1;0 1;he myths and rumors raised by counselors and their families. The module places special em­ phasis on communication skills, and par1:icipan1;s prac­ tice their communication skills in an actual clinical sett.ing. Module 5: Emergency Contra­ ceptive Pill,; (ECP,;)-Tralnlng Objective,;: Prepares providers 1;0 offer ECP services to clients in ap­ propriate situations, accompa­ nied by clear and correc1; information and explanations. It includes information on the mechanism of action, effective­ ness, characteristiCS, and appropriate uses for ECPs. It in­ structs partiCipants on the screening of clients for the use of ECPs and management of side ef­ fects and complications. 87

JOI,rna15 and Publication5 (cont... )

Pathfinder Pathfinder 234-1-262-4034 (tel) http:// Module 6: DMPA-Training International International 234-1-262-1779 (fax www.pathftnd.org/ Objectives: Prepares providers Medical Plot 248. Muri htmllPublicationsl to safely provide Depot Services Okunola Street modules_2.htm Medroxyprogesterone A.cC"~te Off Ajose (DMPA) in a clinic or commu­ Adeogun Street. nity-based service delivery set­ Victoria Island ting. The module include5 infor­ Lagos. Nigeria mation on mechanism of ac­ tion. effec'tlveness. advantages and disadvantages. indications for use. and eligibHrty crit..-eria for the use of DMPA. Partici­ pants are trained in client screening and in the manage­ ment of side effects and com­ plications re!a'V"A to the use of DMPA. Module 7: IUD5-Training 01>­ jectives: Prepares providers to safely provide IUDs for cHel'itG vmo chost: this method. The module includes complete in­ formation on the method. By the end of training. partici­ pants are ab!e to counsel. screen, and provide safe 8C1d competent in5ert.ion arrd re­ moval services for iUD ditmt5. They can then mara..age skie-ef'­ fects and prov'.de foHo,.... -up care for IUD acceptors. Module 8: Lactational Amenor­ rhea and Breast Feeding Sup­ port-Training Objectives: Up­ dates the participants on LAM as a ne"N, effective, irr-w-oauc­ tory method of child spacing. 88

J()urnals and Publication; (COl1t ..;)

Pathfinder Pathfinder 234-1-262-4034 (tel) http:// (Cont. from page 86) International International 234-1-262-1779 (fax) www.pathfind.org/ and improves their counseling skills in Medical Plot 248. Muri htmllPublications/ the promotion of LAM and Services Okunola Street modules_2.htm breastfeeding among their clients. Off Ajose The module also orients reproductive Adeogun Street health care providers to promote Victoria Island successful breastfeeding. Lagos, Nigeria Module 9: Condoms and Spermicides-Training Objectives: Reviews with the participants the im­ portance of the condom not only as an effective contraceptive method but also as a method that can pro­ tect against the transmission of sexually transmitted diseases (in­ cluding HIV/AIDS). It prepares par­ ticipants to provide spermicides to enhance the protective effect of condoms and other barrier methods.

Pathfinder Pathfinder 234-1-262-4034 http:// Module 13: PostpartumlPostabortion International International (tel) www.pathfind.org/ Contraception-Training Objectives: Medical Plot 248, Muri 234-1-262-1779 (fax) html/Publications/ Prepares participants to provide con­ Services Okunola Street modules_3.htm traceptive services immediately Off Ajose partum and immediately Adeogun Street postabortion. The module provides i Victoria Island formation on the essential compo­ Lagos, Nigeria nents of postpartum and postabortion contraceptive services and prepares participants in counsel­ ing and in provision of appropriate methods. Module 14: Training of Trainers-­ Training Objective: Prepares service providers to fulfill the role of health care trainers in public sector service delivery systems or nongovernmental family planning organizations. It in­ cludes information on adult learning, facilitation skills, training methodolo­ gies, visual aides, conducting a train­ ing needs assessment, and planning and evaluating training. 89

Journal" and Publication.. (wITt... )

The Popu lation 212-339-0514 (voice) hUp:11 Population and Deve!opment Council 212-755-6052 (fax) WWN.popcouncil.orgl Review Gats to advance Development One Dag pdr knoJwedge of the interrefa­ Review Hammarskjold tionships betwun populaCiO.'1 Plaza and 50cioeconomic develop­ New York, NY ment and prO'Ades a forum for 10017 di5Cu55ion of re!a~ i5!3U8S USA ofpuMic policy.

http:// Studies in Family Planning i5 a Studies in www.popcouncil.orgl peer-reviewed inUmatfonaJ Family sfpl quarterly concerned "'4th aff Planning 95Pect§ of reproductive health ferti/iCY regulation. and famjly planning program:; in both developing and devel­ oped countriC!3.

The http:// The Gender, Family. and Dew::l­ Uncharted www.popcouncil.orgl opment (GFD) program ex­ Passage: gfdlgfd.html plores hoi'! social, economic, Girl's and cultural fac;""!.-Or5. such as Adolescence gender roles. 'Nomen's and in the girls' nondomes.ti'G actMties.. Developing and male partners' roies and World responsibilities, affect inai­ vidual:;' reproduc""J.vs and 5exual health. 90

USAID http:// The PHMWG is a group of orga­ Population www,medjhu,edu/ccp nizations that work with the and Health Population, Health, and Nutri­ Materials tion Center of USAID, Its pur­ Working pose is to encourage coopera­ Group tion among organizations. to (PHMWG) eliminate duplication of materi­ als, and to promote the dis­ semination and the use of each organization's materials.

Demographic Macro Interna- 301-572-0456 http:// MEASURE DHS+ aGGi!3t!3 de­ and Health tiona I Inc, 301-572-0999 (fax) www,measuredhs,com vdoping countrie!3 worldwide in Surveys 11785 Beltsville the collection and USe ofdata (DHS) Drive, Suite 300 to monitor and evaluate popu­ Calverton, MD lation, health, and nutrition 20705 programG. Oemographic and U5A health GurveYG provide informa­ tion on family planning, mater­ nal and child health, child !3ur­ vival, HIVIAIOSISTIG (Gexually tranemitted infectlon5) and reproductive health,

Development 202-473-7824 http:// The World Bank is the world's Data 202-522-1498 (fax) www,worldbank,orgl largest source of development data assistance. providing nearly $16 bUlion in loans annually to its client countries. It uses its financial resources, highly trained staff, and extensive knowledge base to help each developing country onto a path of stable, sustainable, and eq­ uitable growth in the fight against poverty, 91

Databa$C6

International http://wv.w.idrc.ca/ The IDR i6 a public corporation Development library/ddb6/ created by the Parliament of Re6earch index.html Canada to help researchers Centre (IDRC) and communfties in the devel­ Development oping world find 6OIution5 to Databa6e6 their social. economic. ana en­ vironmental problems.

~arch Eng;n",.

International http://www.indix.org Network for Development Information Exchange (lNDIX)

PamphlCiI:5 and P06ten;

Advocates 1025 Vermont 202-347-5700 http://wv.w. Advocates for Youth is dedi­ for Youth Avenue, NW, Suite 202.347.2263 (fax) advocate6foryouth. cated to creating programs 200 org and promoting poEcics that Wa6hington, DC help young people make in­ 20005 formed and responsible dxf­ USA siam:; about their 5e>::ua~ health. It provides info:-matfo!1. training. and advocacy to youth-serving organrzatrO:is. policy makers. and the media in i the United St.ates and internationally.

Family Care 588 Broadway, 212-941-5300 http://www. FCI i6 o.edicated to improvinq International Suite 503 familycareintl.org women's s-exual ana reproduc­ (FCI) New York, NY tive health and rieh""~ in ae"lel­ 10012 oping countries, with a spec~! USA emphasis on making pr~n.ancy and childbirt..h 6afer. 93

AP~!3.~~ 3: p ~T~~i~~ LIST

f-iREVIOUS PAGE BlANK 94

Nongovermenta{Organlz$,ti6m;", . .' , -. ". Adeola Olunloyo, Action Health Plot 54, Somorin Street 7743745 (phone) Youth Volunteer Incorporated Off Ket;u-Oworonsoki Expressway 863198 (fax) Ifako, Gbagada ahi@linkserve,com,ng PO Box 803 Yaba, Lagos, Nigeria

Bimbo Jide-Aremo, Action Health Plot 54, Somorin Street; 7743745 (phone) Senior Incorporated Off Ketu-Oworonsoki Expressway 863198 (fax) Programme Officer Ifako, Gbagada [email protected] PO Box 803 Yaba, Lagos, Nigeria

Bunmi Odiakosa, Action Health Plot 54, Somorin Street 7743745 (phone) Adolescent Health Incorporated Off Ketu-Oworonsoki Expressway 863198 (fax) Services Advisor Ifako, Gbagada [email protected] PO Box 803 Yaba, Lagos, Nigeria

Chiemezie Ndukwe, Action Health Plot 54, Somorin Street; 7743745 (phone) Program Officer Incorporated Off Ketu-Oworonsoki Expressway 863198 (fax) Ifako, Gbagada [email protected] PO Box 803 Yaba, Lagos, Nigeria

Nike O. ESiet, Action Health Plot 54, Somorin Street; 7743745 (phone) Project Director Incorporated Off Ketu-Oworonsoki Expressway 863198 (fax) Ifako, Gbagada [email protected] PO Box 803 Yaba, Lagos, Nigeria 95

Nongovcrmcntaf Organization" (cont;... ) Olapeju Fau5at Action Health Plot 54, Somorin Street 7743745 (phone) 05unkayode, Incorporated Off Ketu-Oworonsoki Expressway 863198 (fax) Program Officer Ifako, Gbagada [email protected]~ (IEC) PO Box 803 Yaba, Lago5, Nigeria

Olubunmi Adeniyi. Ac1Oion Health Plot 54, Somorin Strea 7743745 (phone) Program Officer Incorporated Off Ketu-Oworonsoki Expressway 863198 (fax) (Mvocacy and Ifako, Gbagada [email protected] Documentation) PO Box 803 Yaba, Lag05, Nigeria

Abdul-Rahman Mole5cen1O Heal10h PIo1O 9, Tarauni Marke10 Road 064-667286 (off. phone) Abdul, Member, and Information PO Box 12846 064-663193 (fax) AHIP You1Oh Forum Projec1O (AHIP) Kano, Nigeria [email protected]

BahUatu Bello, Mole5cent Health Plo1O 9, Tarauni Marke10 Road 064-667286 (off. phone) Facili1Oa1Oor and Information PO Box 12846 064-663193 (fax) Project Kana, Nigeria ahip@gc!online.net

Hajara Jummai Mole5cen1O Heal10h Plo1O 9, Tarauni Marke10 Road 064-667286 (off. phone) Mohammed, and Information PO Box 12846 064-663193 (fax) Member, AHIP Project Kano, Nigeria ahip@gc!onHne.net Youth Forum

Magaji Shu'aibu Mole5cen1O Health Plot 9, Tarauni Marke10 Road lf04-667206 (off. p:-to!ie) Ga5akole, Member, and Information PO Box 12846 064-663193 (fax) AHIP Youth Forum Project Kano, Nigeria [email protected] ahip@gc!on!ine.f1ct

Mairo V. Bello, Mole5cen1O Heal10h Plo1O 9, Tarauni Marke10 Road 064-667286 (off. p~one) Project Coordinator and Information PO Box 12846 064-66.0185 (offiu @ Project Kana, Nigeria home) 064-663i93 (fax) ahip@gc!online.net ahip@gc!online.com [email protected] 96

NonqovermentaIOi-qanization5(Cont ... ) Mamman Sani, Adolescent Health Plot 9, Tarauni Market Road 064-667286 (off. phone) ) Member, and Information PO Box 12846 064-663193 (fax) AHIP Youth Forum Project Kana, Nigeria [email protected]

064-667286 (off. phone) Maryam Osman Adolescent Health Plot 9, Tarauni Market Road Bala, Member, and Information PO Box 12846 ) 064-663193 (fax) AHIP Youth Forum Project Kano, Nigeria [email protected]

Mathias Achimi Adolescent Health Plot 9, Tarauni Market Road 064.667286 (off. phone) Okpanachi, and Information PO Box 12846 064.663193 (fax) ahip@gc!online.net Head of Depart- Kano, Nigeria ment, In-School Outreach

064.667286 (off. phone) Nuhu KhadUah Project Plot 9, Tarauni Market Road Kubura Ibrahim, IEC Adolescent Health PO Box 12846 064.663193 (fax) [email protected] Officer, HOD Youth a nd Information Kano, Nigeria Center/Unit Project

064-667286 (offce Safiya Adolescent Health Plot 9, Tarauni Market Road Abdulmumini Sani, and Information PO Box 12846 phone) 064-665185 (home office) Member, AHIP Project Kano, Nigeria Youth Forum 064-663193 (fax) [email protected]

064-667286 (offce) Shafi'u lIiyasu Adolescent Health Plot 9, Tarauni Market Road and Information PO Box 12846 064-663193 (fax) Project Kana, Nigeria

Suleiman Garba Adolescent Health Plot 9, Tarauni Market Road 064-667286 (off. phone) Muhammed, and Information PO Box 12846 064-663193 (fax) [email protected] Member, Project Kana, Nigeria AHIP Youth Forum

064-667286 (off. phone) Umar Adamu, Adolescent Health Plot 9, Tarauni Market Road Member, AHIP and Information PO Box 12846 064-663193 (fax) [email protected] Youth Forum Project Kano, Nigeria 97

Organfzation5(corn;... )

Usman Garko Bello, Adolescent Health Plot 9, Tarauni Markel; Road 064-667286 (off. phon!:) Program Assistant, and Information PO Box 12846 064-663193 (fax) AHIP Youth Forum Project Kana. Nigeria ahip@gclon!ine.net.

Wilson Osigbemeh Adolescent Health Plot 9, Tarauni Market Road 064-667286 (off. pho"e) Idanwekhai, and Information PO Box 12846 064-663193 (fax) Member, Project Kano, Nigeria [email protected] AHIP Youth Forum

Yetunde Awe, Adolescent Health Plot 9, Tarauni Markel; Road 064-667286 (off. rhOtt-e) Member. and Information PO Box 12846 064-663193 (fax) AHIP Youth Forum Project Kano, Nigeria [email protected]

Yusif Yakubu Yusif, Adolescent Health Plot 9, Tarauni Markel; Road 064-667286 (off. pnone) Member, AHIP and Information PO Box 12846 064-663193 (fax) Youth Forum Project Kana. Nigeria [email protected].

Adama Zakari Adolescent Health Plot 9, Tarauni Markel; Road 064-667286 (off. phor.e) and Information PO Box 12846 064-663193 (fax) Project-Youth Kana, Nigeria [email protected] Forum

Adamu Umar Adolescent Health Plot 9, Tarauni Markel; Road 064-667286 (off. phone) and Information PO Box 12846 064-663193 (fax) Project-Youth Kana. Nigeria ahip@gcofilir:e.net Forum

Badriya Shehu Bala Adolescent Health Plot 9, Tarauni Market Road CY04-665321 (home) and Information PO Box 12846 [email protected]. Project-Youth Kana, Nigeria Forum

Fatima I. Bello Adolescent Health Plot 9, Taraun; Markel; Road 064-667286 (off. phone) and Information PO Box 12846 064-663193 (fax) Project-Youth Kano, Nigeria [email protected] Forum 98

Victoria Boma West Adolescent Health Plot 9, Tarauni Market Road 064-667286 (off. phone) and Information PO Box 12846 064-663193 (fax) Project-Youth Kano, Nigeria [email protected] Forum

Zuwaira Abdulsalam Adolescent Health Plot 9, Tarauni Market Road 064-667286 (off phone) and Information PO Box 12846 064-663193 (fax) Project-Youth Kano, Nigeria [email protected] Forum

Emmanuel Etim, Adolescents in Legico Postal Agency [email protected] Executive Nigeria Legico Flats ainnlavsa.net Director Block A, Ahmadu Bello Road Victoria Island, Lagos, Nigeria

Grace Ebun Delano, Association for ARFH HOUSE 02-8100164 (phone) Vice Reproductive and 815A Army Officer's Mess 02-8101669 (fax) President/Executive Family Health Road [email protected] Director Ikolaba GRA, PO Box 30259 (Secretariat) Ibadan, Nigeria

Temitope Adekunle, Association for ARFH HOUSE 02-8100164 (phone) Member Reproductive and 815A Army Offcer's Mess 02-8101669 (fax) Family Health Road [email protected] Ikolaba GRA, PO Box 30259 (Secretariat) Ibadan, Nigeria

Lola Dare, Chief Centre for Hea Ith 29, Aare Avenue 02-8102401 (phone) Executive Officer Sciences Training, New Bod Ua Estate 02-8102405 (fax) Research and Ibadan,Oyo State, Nigeria [email protected] Development International

Joline Van Lier, Community Health Dass Road 077-544163 Health Educator Agency Yelwa Tudu, Bauchi [email protected] (VSO Volunteer) Bauchi State, Nigeria 99

N0I7goVertne •• tel Drgsnizatlom>(cont... )

Face-It c/o GPI Benin Office 052-252497 (phone/fax) 2 Hudson Lane 052-255762, Off 85 Akpakpava 5t;reet;, By 052-250668 (fax) Dawson Junction PO Box 7400 Benin-City, Nigeria

Bola Omotosho, Family Healt;h and Ode-Aje Iwajowa Cooperat;ive Actoion Populat;ion Ogbere-Oloba, Gbaremu Actoion Commit;t;ee Ibadan, Nigeria

Ebun Omotosho, Family Health and Ode-Aje Iwajowa Cooperative 02-8106950 (phone) Yout;h Volunteer Actoion Populat;ion Ogbere-Oloba, Gbaremu bosmat:ii>yahoo.com Action Committee Ibadan, Nigeria

Global Health and S/34 Chief Edward Nnaji Paek 042-258078 (phone) Awareness Research New Haven, Enugu, Nigeria onwaorgu@irrl'oNet>.ab'5.net Foundat;ion

Girls' Power Initiat;ive 44 Ekpo Abasi Street; [email protected]~5erve.com Programme Calabar, Cross Rivers State, Facilit;ator Nigeria

Joy Abieyuwa Girls' Power Initiative 2 Hudson Lane 052-252497 (phone/fax) Ogbomo, Facilit;ator/ Off 95 Akpakpava Street;, By 052-255762, Research Assistant. Dawson Junction 052-250668 (fax) PO Box 7400 [email protected] Benin-City, Nigeria

Okojion lsi Eituajie Girls' Power Initiative 2 Hudson Lane 052-252497 (pi-.o17e!fax) Off 95 Akpakpava St;reet;, By 052-255162, 052- Dawson Junction 250668 (fax) PO Box 7400 Benin-City, Nigeria 100

Organiiatiorl,,(cont.:.) Joy Onyebuenyi. Human Development 8. Fola Agoro Stree1; 82S398 (phone) Program Officer Initiatives Somolu, Lagos, Nigeria 4706643 (phone) PO Box 127, Unilag Post Office [email protected] Akoka, Lagos, Nigeria

Cesnabnuhilo INCRESE PO Box 904 [email protected] Dorothy Aken' ova, Minna, Niger State, Executive Di rector Nigeria

Adeniyi Kazeem Inter-African Com- 14A Akin Adesola Street 615627, 614912 616887 Adeneye mittee PO Box 71607 (phone) Victoria Island. Lagos, Nigeria 2637547, 2631231 (fax)

Omololu Falobi, Journalists Against 42, uaye Road 01-4921292 Project Director AIDS Ogba Lagos, Nigeria [email protected]

Dupe Oluworin, Konars Operations A5 Ahmadu Bello Way 062-238782 (phone) Principal Consult- Consultants PO BoxS47 214729 (fax) ant Kaduna, Nigeria

Oluwole Odutolu, Life Vanguards Opposite Osogbo Grammar 035-243552 (phone) Project Director School 035-242738, PO Box 2182 035.242092 (fax) Osogbo, Osun State, Nigeria livanig@skannet,com

Eden Effiong, Head, Nigeria Youth AIDS 9 Adebola Street 01-5455268 Research and Programme Surulere, Lagos, 01-5840622 Training Nigeria

Florence Porobunu, Ogoni Youth Develop- 45 Kenule Stree1; 084-870192 (phone) Program Officer ment Project Bori. Rivers State, Nigeria 101

NOl'!10Venne,.tal Organization§(com;... )

Uji Inalegwu, Field Flanned Farenthood clo LATH STD/HIV Project Office 044-662777 Officer (LATH) for Nigeria Otukpa General Hospital 662436 Otukpo, Benue State, Nigeria 090-800365 Abdul M. Abdallah, Flanned Farenthood Federal Capital Territory [email protected] Head of Branch for Nigeria Association Room 226, Block A Open University Complex Garki Area 3 Abuja, Nigeria

Mary N. Bawa Flanned Farenthood Niger State Association 066~224855 (phorldfax) for Nigeria BaylClInic Road FO Box 2501 Minna Niger State, Nigeria

Bomi Ogedenbge, Fost-Abortion Care College of Medicine Strategic Network University of Lagos Management Team Idi-Araba, Lagos, Nigeria

Bolanle Somoye, Sagamu Community lA Baruwa Road 037-641902 Youth Volunteer Center Sagamu, Ogun State, Nigeria 037-641368

Olusoji Akinleye Sagamu Community lA Baruwa Road 037-641902 Center Sagamu. Ogun State, Nigeria 037-641368

Yelwa H. Alkasim, Social Support Orga- clo Army Day Sec. Sch. Project Coordinator nization Dukku Barrack, Birnin Kebbi Kebbi State, Nigeria

Funmi Doherty, Society for Women 28 Moleye Street 5837618 (phone) Treasurer and AIDS in Africa Alagomeji, Lagos, Nigeria 863530 (fox) 5,,' .. ann@~0!!rs?ac~.~~.na 102

Oihi Ejoganu, Society for Women clo LATH S TD IH IV Project Office 044-662m (phone) Field Offcer and AIDS in Africa Otukpo General Hospital Otukpo, 662436 (fax) Benue State,Nigeria

Maimuna Y Society for Women Plot 2, Badawa New Layout, 064-667316 (phone) Mohammed, Development and Phase II 090-81957 (fax) Project Director Empowerment of Kano, Nigeria Nigeria

Bernard Nwabuko, STOPAIDS 95, Suite A&B East Pavilion 263-5219 (phone/fax) Secretary Organisation Tafawa Balewa Square Complex stopakis@fon:lwa.linkserve.org General PO Box 5052, Murtala Muhammed Airport Ikeja, Lagos, Nigeria

Charity USifoh, Women's Health Lofom House 234-1-4937937 (phonel Program Officer Organization of 21 Mobolaki Bank, Anthony Way, fax) Nigeria, Lagos Maryland [email protected] PMB 21178 [email protected] Ikeja, Lagos, Nigeria

Adesola Young Men's 111 Borno Way 01-860583 Adebamgbe Christian Ebute Metta, Lagos, [email protected] Afuye, Deputy Na- Association, Nigeria Nigeria tiona I Secretary General

Fiwashade Youth Empowerment 40 Johnson Street 234-01-7748397 Onifade, Foundation, Lagos Off Bode Thomas Street (phonelfax) Program Offcer Surulere, Lagos, Nigeria [email protected] [email protected]

Iwalowa Akin- Youth Empowerment 40 Johnson Street 234-01-7748397 Jimoh, Executive Foundation, Lagos Off Bode Thomas Street (phonelfax) Secretary Surulere, Lagos, Nigeria [email protected],ng [email protected]

Yahaya Ibrahim AI Youth Society for No, 13, First Floor, Lamuya Shop- 064-664118 (phonelfax) Yakub, Program Prevention of ping Complex [email protected] Officer Infections, BUK Road, PO Box 11406 Diseases, and Kano, Nigeria Social Vices 103

Coc'per-ati,"g Aqencie5

Sydney Lorraine Mvocates for Youth 1025 Vermont Avenue. NW. West, Interregional Suite 200 Project Manager Washington. DC 20005 USA

Asiwa Obishai. AVSC AVSC Secretariat. 2nd Floor 234-1-4707477 (phone) Program Assistant Elephant Cement House. [email protected] Alausa Ikeja. Lagos. Nigeria

Aisha Abubakar. Center for A5 Tukur Road by Muktar 234-64-633626 (phone) Program Officer Development and Moh'd Link [email protected] Population Activities Nasarraw, Kana, Nigeria

Angela Odiachi. Center for Develop­ 18 Temple Road. Ikoyi 2600020 (phone) Assistant Program ment and Population PO Box 53373. Falomo 2600022 (fax) Officer (Reproduc­ Activities Ikoy. Lagos. Nigeria tive Health)

Dr.Olowu. Center for Develop­ 18 Temple Road. Ikoyi 260020 (phone) Senior Program ment and Population PO Box 53373. Falomo 2670359 (phone) Officer (Reproduc­ Activities Ikoy. Lagos. Nigeria 2600022 (fax) tive Health)

Kolawole Oyediran, Center for 18 Temple Road. Ikoyi 2600020 (phone) Assistant Program Development and PO Box 53373 Falomo 3205273.2670359 Officer (MIS/Evalua- Population Activities Ikay. Lagos. Nigeria (phone) tion) 2600022 (fax)

Mary Mujomba. Centre for African PO Box 60054. 12th Floor 254-2-440618 (pho;roe) Program Officer Family Studies Nairobi, Kenya 254-2-448621 (fax) rnmujomba@cz;.fs.Grg

Femi Faweya, Family Health Inter­ 18 Temple Road 2670361 (phone) Program Officer national. Nigeria Ikoyi. Lagos. Nigeria 646353. 260021 (fax) [email protected]!"g 104

Ag~",;lel';(cont. .. )

Susan Adamchak, FOCUS on Young 1201 Connecticut Avenue, NW, 202-835-0718 (phone) FOCUS Adults, Pathfinder Suite 501 104043- Consultant International Washington, DC 20036 [email protected] USA

TUuana A. James- FOCUS on Young 1201 Connecticut Avenue, NW, 202-835-0818 (phone) Traore, Adults, Pathfinder In- Suite 501 202-835-0212 (fax) Program and Traiing ternational Washington, DC 20036 [email protected] Advisor USA

Vanessa Carroli, FOCUS on Young 1201 Connecticut Avenue, NW, 202-835-0818 (phone) Communication Ad- Adults, Pathfinder In- Suite 501 202-835-0212 (fax) visor ternational Washington, DC 20036 [email protected] USA

Emily Zielinski- FOCUS on Young School of Public Health and 504-587-7331 (phone) Gutierrez Adults, Tulane Tropical Medicine [email protected] University 1440 Canal Street, Suite 2200 New Orleans, LA 70112 USA

Kristen Nelson FOCUS on Young School of Public Health and 504-587-7331 (phone) Adults, Tulane Tropical Medicine [email protected] University 1440 Canal Street, Suite 2200 New Orleans, LA 70112 USA

Florence Nyamu, Forum for African International House 254-2-226890 (phone) Programmes Man- Women Mama Ngina Street 254-2-210709 (fax) ager Educationalists PO Box 53168 knyamu@fawe,org Nairobi, Kenya i

Fatima Bello Aliyu, Johns Hopkins A5 Tukur Road, By Muktar 234-64-633626 (phone) Assistant Program University Center for Moh'd Link [email protected] Officer (Reproduc- Communication Nasarraw, Kana, tive Health and Programs Nigeria Development) 105

Cpc'pet'atlin!iJ Agenciee (cant.")

Pathfinder Plot 248. Muri Okunola Street 2624034 (phone) International Off Aj05e Adeogun 2621779 (fax) Representative Victoria 15land. Lag05. Nigeria [email protected]

Pathfinderlnterna- clo Plot 248. Muri Okunola 2624034 (phone) tional (Field Office Street (Off Aj05e Adeogun) 2621779 (fax) Kaduna) Victoria 15land. Lag05. Nigeria

Charity Ibeawuchi. The POLICY Project. 2A Lake Chad Cre5Cent [email protected] Senior Program The Future5 Group Maitama. Abuja. Nigeria cibea"'lUchin#hotmaiLcom Officer International

Jerome Mafeni. The POLICY Project. 2A Lake Chad Cre5cent 09-4135944-5 Resident Advisor The Future5 Group Maitama. Abuja. Nigeria [email protected] International

Leah Wanjana. The POLICY Project. Box 50027 [email protected] Con5ultant The Future5 Group Nairobi. Kenya International

Scott Moreland. The POLICY Project. 4309 Emperor Boulevard. 919-941-9295. ext. 100 Country Manager The Future5 Group Suite 350 919-941-9134 (fax) International Durham. NC 27703 [email protected] USA

Bernard Edet. The Society for Awaye HOU5e 774Zl45 (phone) Head. Marketing Family Health 2nd Floor, Suite 6 7747045 (phone) Department Lag05/Badagry 5850539 (pilDne) Expressway 7744522 (fax) Orile Iganmu. Lag05. mfonede-,Ailyahoo.com Nigeria PO Box 71323 Victoria 15land. Lag05, Nigeria 106

Christain Haruna The Socie1Oy for Awaye House 7742745 (phone) Enenche, Field Op­ Family Health 2nd Floor, Suite 6 7747045 (phone) erations Manager­ Lagos/Badagry 5850539 (phone) North Expressway 7744522 (fax) Orile Iganmu, Lagos, Nigeria PO Box 71323 Victoria Island, Lagos, Nigeria

Ifeoma Charles­ The Society for Awaye House 7742745 (phone) Monwuba. Senior Family Health 2nd Floor, Suite 6 7747045 (phone) Communications Lagos/Badagry 5850539 (phone) Coordinator Expressway 7744522 (fax) Orile Iganmu, Lagos, Nigeria PO Box 71323

Angel Pariola, The Ford Foundation, AlB Plaza 234-1-2623971 (phone) Program Assistant Office for West Level 6, Akin Adesola Street, 234-1-2623972 (phone) (Human Africa Victoria Island 234-1-2623973 (fax) Development and PO Box 2368 [email protected] Reproductive Lagos, Nigeria Health)

Adesegun Fatusi, United Nations 11, Oyinkan Abayomi Drive, Ikoy 234-1-2693108 (phone) Advisor, National Population Fund PO Box 2075 234-1-2692141 (phone) Reprodutive Health Lagos, Nigeria 234-1-2692143 (phone) Sub-Program, 234-1-2690531 (fax) Lagos

Samaila Bala Baba, United Nations Ministry of Budge10 and Planning 076-235158 (fax) Sub-Program Population Fund Maiduguri, Nigeria Advisor, Barno State 107

Prosper Ifeanacho United Nations Popu- State Planning Bureau. 056-280008 (phone) Okonkwo. Sub- lation Fund New Secretariat ngobro5@infa.... eb.abs.ne:t Program Advisor, Asaba, Nigeria Delta State

Elias Dalington United Nations Popu- UNFPA Programme Advisory Unit 72-=476 (phone) Anzaku. Sub-Pro- lation Fund clo Planning and Budget Bureau gram Advisor Gombe. Nigeria

Titilayo Omobola United Nations Popu- Bureau of Budget and Planning 39-243428 (phone) Odutolu. Sub-Pro- lation Fund Ministry of Finance gram Advisor, Ogun Abeaokuta. Nigeria State

Olubunmi O. USAID Global House. Plot 1612 614412. 2614621 (phone! Dosumu, Senior Adeola Hopewell Street fax) Program Victoria Island. Lagos. Nigeria Manager

Babatunde Sequn. Federal Ministry of 7B Olatlunde Ayoola Avenue 1-4966448 Senior Medical Of- Health Obanikoro. Lagos. fleer, Lagos Nigeria

Olapeju Oreofe Federal Ministry of 8 Harvey Road 1-7745455 Adenusi. Family Health Yaba. Lago. Nigeria Planning Program Manager

Romanus Nriagu. Federal Ministry of Ministry of Health. 056-280052 Project Director, Health State Secretariat Awka. Anambra Awka. Anambra State. Nigeria

Tosan Luck Popo. Federal Ministry of Ministry of Health. 056-280052 Project Director. Health State Secretariat Avl

Govermeni·(conj;".) Nike Adeyemi, Federal Ministry of Department of Community Deputy Director of Health, Abuja Development and Population Primary Health Activities Care and Disease Federal Ministry of Health Control Federal Secretariat Complex New Shehu Shagari Way Abuja, Nigeria

Lanre Arogundade, International Press 42 Ijaye Road by Ceterpillar 238242 (phone) Coordinator Center Bus Stop 230279 (phone) Oregun, Ikeja, Lagos, Nigeria

Jacob Akintola, Ministry of Ministry of Education, 2-8104466 Director, Imple- Education State Secretariat mentation Task Ibadan, Oyo State, Force, Oyo State Nigeria

Ngozi N. Odu, Per- Ministry of Health, Secretariat Complex, 084-231073 (phone/fax) manent Secretary Rivers State Ministry of Health 084-234389 (phonelfax) Block C 084-331522 (res) Port Harcourt, Nigeria [email protected]'.

Kwame Ampumah, 50uth African National Department of Health 27-82537688 UN Advisor Adolescent Youth Pretoria, Republic of South [email protected] Program Africa

Abubakar Mu'azu, State Ministry of Ministry of Health 77-542911 Project Director, Health PMB065 Primary Health Bauchi, Nigeria Care and DC, Bauchi State

Agbata Krukrubo, State Ministry of Ministry of Health, 084-232079, Director, Primary Health State Secretariat 084-238886 (phone) Health Care, Port Harcourt, Rivers State, 084-234073 (fax) Rivers state Nigeria 109

(cont... ) State Ministry of Ministry of Health. 088·221632 (phone) Chidorondu Origa. Health State Secretariat Director, Primary Umuahia. Abia State. Nigeria Health Care

Musibau Oladepo State Ministry of Ministry of Heatlh. 035-204117 (phoneffax) Adelasoye. Project Health State Secretariat fet,,[email protected] Director. Oshogbo. Osogbo. Osun State. Nigeria Osun State

Theresa Essien, ChannelsTelevision Kresta Laurel 234-9-2342046 (phone) Journalist 376 Ikorodu Road 234-9-2342860 (fax) Maryland. Lagos. [email protected] Nigeria

Jonathan A. EDNA Evangel Zaria Bye Pass Karshima, Hospital Jos. Plateau State. Director. Family Nigeria Health Program

Chris Onyejekwe. 19 Lawani Street 2624034 (phone) Network Onitiri. Yaba 2621779 (fax) Consultant Lagos. Nigeria

Lanre Arogundade, International Press 42 Uaye Road. By Ceterpillar 238242 (phone) Coordinator Center Bus Stop 2302:79 (phone) Oregun. Ikeja Lagos. Nigeria

Moji Oyelami. Otyl Consultants 9B Bodajoko Office Complex 2624034 (phone) Network Consultant Idi Ape/Bashorun Road. Idi Ape 2621779 (fax) Ibadan. Oyo State. Nigeria 02-711736

Kwame Ampomah. South African National Department of Health 27-82537688 UN Advisor Adolescent Youth Pretoria. [email protected] Program Republic of South Africa 110

234-1-5455268 (phone) Off Adeniran Ogunsanya Street 234-1-5840371 (fax) Building Unit Surulere, Lagos, Nigeria [email protected]

Iwalola Akin-Jimoh, Youth Empowerment 40 Johnson Street 234-1-7748397 (phone) Executive Secretary Foundation Off Bode Thomas [email protected] Surulere, Lagos, Nigeria

Emmanuel Etim, Adolescents in Legco Posta I Agency ainn[@usa.net Executive Director Nigeria Legco Flats, Block A [email protected] Ahmadu Bello Way Victoria Island, Lagos, Nigeria

Eka Bassey Girls' Power Initiative 44 Ekpo Abasi Street 087-230920 Calabar, Cross River State, [email protected] Nigeria

Abubakar Center for Develop- USAID Field Office 064-633626 ment and Population A5 Tukur Road, By Muktar Moh'd 646353 Activities/United Link States Agency for In- Kana, Nigeria ternational Develop- ment, Kana

K.Onwuka, Care for Life/Center Suite 6, Moh'd Farm Mem 072-46000 Project Coordinator for Development and Shopping Complex Population Activities Billiri, Gombe State, Nigeria

Kolawole Ojo Centre for Health Sci- 2A Aare Avenue 02-8102401 encee Training, Re- Bodija, Ibadan Oyo, search and Develop- Nigeria ment International

Funmi Doherty Society for Women 28, Moleye Street 01-863530 and AIDS in Africa/ Alagomeji, Yaba, Lagos, Nigeria LUTH

Dr. Moji Aderonke Family Ministry of 8 Harvey Road 01-4705692 Odeku Health, Safe Mother- Yaba, Lagos, Nigeria [email protected] hood/Reproductive Health 111

Jigawa, Nigeria

Calmday Ombo, Nembe Creek Nembe Creek, Nembe West Youth Chairman, Progressive Youths Bayelsa State, Nigeria

Bashiru A. Lasisi, Family Health and 94, Shittu Street 02-8106950 Program Officer Population Action Beere-Adeoyo Road Committee Ibadan, Oyo State, Nigeria

Asmau Ahmed, Adolescent Health Plot 9, Tarauni Market Road 064-667286 and Information Tarauni, Kano, Nigeria cacy Manager Project

Bunmi Adeniyi, Action Health Plot 5,4 50morin Street 01-7743745 Programme Officer Incorporated Ifako, Gbagada, Lagos, Nigeria

Ikechi Ugwa, Rural Health No.7 Amaram Street 083-234794- Programme Officer Foundation Owerri, Imo State, Nigeria

Bisi Tugbobo, Senior Pathfinder 248 Muri Okunola Street 01-2621779 Programme Officer Internat.ional Victoria Island, Lagos, Nigeria

Biola LawaI Adolescents in Legico Postal Agency Nigeria Victoria [slana, Lagos, Nigeria

Stella lwuagwu Center for the Right 3 Obanle Aro Avenue 01-7743816 to Health lIupeju, Lagos, Nigeria

Chidi Odu Ministry of Health, 7 Wokoma Street, Rivers State Port Harcourt, Nigeria 112

Auzaku Population Fund do Bureau for Budget and Planning Gombe, Nigeria

Bimpe Ojikutu CMULILUTH, ARH Lagos University Teaching ojixba@usa,net Committee, Hospital AGAN PMB12003 Idi-Araba, Lagos, Nigeria

Dorothy Akaen'ova INCRESE 1007 Bosso Road [email protected] Minna, Niger State, Nigeria

Hadiza Mohammed Grassroot Hea Ith 3 Abdu Sambo Street 064-669223 Organization, Kano, Nigeria Kana

Baba Smaia Bala United Nations Ministry of Budget and Planning 076-235158 Population Fund Maiduguri. Barno State, Nigeria

Tunde Aremu International Press 42, Ijaye Road 01-4921292 Centre Ogba, Lagos State, 4925568 Nigeria ipc@micor,com,ng taremu@nigeriapress,net

Pearl I. Osakue. Face-It 2 Hudson Lane 052-255162 (phone/fax) Program Director Off Akpakpava Street [email protected] PO Box 7400 Benin City, Nigeria

Mohammed Farouk Nigerian AIDS 24/26 MacArthur Street 01-2600047 Auwalu Alliance Onikan. Lagos, Nigeria 2600029 [email protected]

Estella Mbanugo The Adolescent 5 Elelenwo Street 084-235889 Project, Port Harcourt GRA Port Harcourt Rivers State, Nigeria

Omololu Falobi Port Harcourt 42 Ijakpo Road 234-1-4927292 Journalists Against Ogba. Lagos, Nigeria omololuf@micro,com,ng AIDS 113

i Udonsi, Nigerian Youth AIDS 9 Mebola Street 234+5455268 Project Coordinator Programme Off Meniran Ogunsanya Street 5840622 Surulere, Lagos, Nigeria [email protected]

Fiwasade Onifade. Youth Empowerment # 40 Johnson Street 01-7748397 Programme Officer Foundation Off Bode Thomas [email protected] Surulere, Lagos, Nigeria

Ibifri, Field Of- StopAIDS 95 Suite A & B 01-2635219 Organisation Tafawa Balewa Square 01-2621779 Lagos, Nigeria 4706064 [email protected]

Onyejekl'le, Pathfinder 248 Muri Okunola Street 01-825398 Develop- International Victoria Island, Lagos, 4706643 Officer Nigeria [email protected]

Onyebuenyi, Human Development 8 Fola Agoro Street 035-243552 Officer Initiatives Somolu, Lagos, Nigeria

Baruwa Olatunde, Life Vanguards, Lordship Avenue [email protected] Research Officer Osogbo Osogbo, Nigeria

Akinwale Olaoluwa NIMR, Yaba, Lagos NIMR 02-8100292 Phebian, Yaba, Lagos, Nigeria Senior Research Officer

Oyelakin Oluwatoyin, Ministry of Health, PHC, Ministry of Health 037-641902 Reproductive Health OyO State Secretariat Programme Officer Ibada, Oyo State, Nigeria

Gabriel Sagamu Community Sagamu Community Centre 037-641902 Youth Centre lA Baruwa Street Officer Sagamu Ogun State Sagamu, Ogun State, Nigeria 114

Joseph Okeibunor Global Health and S/34 Chief Edward Nnaji Park 042-2S8078 Awareness New Haven Research Enugu, Nigeria Foundation,

Ajao Bayo Family Health and PO Box 28351 02-8106950 Population Action Agodi [email protected] Committee Ibadan, Oyo State, Nigeria

Gbenga Ishola Association for Army Officers' Mess 02-8102760 Family and Repro- Ikoloba, Ibadan Box 30259 ductive Health (Sect) Ibadan, Oyo, State, Nigeria

Charity K. Usifoh Women's Health Lofom House [email protected] Organisation of 21 Mobolaji Bank Anthony Way [email protected] Nigeria PMB 21178 Ikeja, Lagos, Nigeria 18, Temple Road Ikoyi, Lagos, Nigeria

Kolawole Oyediran Center for 54 Somorin Street 01-3205273 Development and Ifako Gbagada, Lagos, [email protected] Population Activities Nigeria

Chiemezie Ndukwe Action Health 9 Tarauni Market Road 01-7743745 Incorporated Tarauni, PO Box 12846 [email protected] Kana, Nigeria

Mairo V. Bello, Direc- Adolescent Health 248 Muri Okunola 064-667286 (phone) tor/Project Coordi- and Information Victoria Island, Lagos, 064-663193 )fax) nator Project Nigeria [email protected]; [email protected]

Dr. Kechi Anah, As- Pathftnderlnterna- State Running Bureau 01-2621779 sistant tiona I, Lagos New Secretariat, Asaba, kechian@cmpmail,com Program Officer Nigeria

Dr. Prosper Okonkwo, United Nations 056-28008 Sub-Programme Population Fund ngobros@infoweb,abs.net Advisor, UNFPA, (UNFPA), Delta Delta State 115

Joline Van Lier, Community Health PO Box 1136 jolinevan!!cr@hotmaiLcom Health Educator Agency, Bauchi Yelwa Tudu, Bauchi, Nigeria

Dr. Margaret Stepwise 22, Abeokuta Road 234-31-224877 (phone) Araoye, Programme Organisation Mewole Estate 234-31-224090 Director PO Box 5565 [email protected] [lorin, Nigeria

Nnenna Mba Human Rights Union PO Box 54664 01-8044015 for Medical Action in Ikoyi, Lagos, Nigeria [email protected] Africa [email protected]

Toyin Jolayemi International Projects AlIA2 Bensima Plaza [email protected] Assistance Services Maitama, Abuja, Nigeria

Ojemen Odion Girls' Power Initiative 2 Hudson Lane 052-255162 95 Akpakpava, Benin City Edo, Nigeria

Daini Oluwole Nigerian AIDS Alli- 24/26 MacArthur Street 01-2600047 (phone) ance Onikan, Lagos, Nigeria 01-2600029 (fax) [email protected]

Ladi Luka Dusu Halt AIDS Group 28/30 Bukuru Bye-Pass 073-460380 United Nations Jos, Nigeria haltaid5@jnfo:.... eb..abs.net Population Fund

Adesegun EDNA Evangel Hospi- 11 Oyinkan Abayomi Dr. 01-269189012693108 Olayiwola, Fatusi tal, Family Health Ikoyi, Lagos. Nigeria (phone) aareegunfa'"[email protected]

Jonathan A. Orogrma, Jos EDNA Evangel Hospital 073-451755; 073- Kan;hima CDFON, Child Develop- Zaria Bye-Pass 455323 ment Focus of Nigeria, PMB 2238 jkashima@info.... c9.Zi'bs.net Jos Plateau State, Nigeria

Shem Shehu Kano, Nigeria Ahmadu Dantata House [email protected] 3rd Floor Left Wing PO Box 10976 Kano, Nigeria

Dibor Emeka, Field Adolescents in Legco Postal Af,ency [email protected] Advisor Nigeria Legco Flats, Block A [email protected] Ahmadu Bello Way Victoria Island, Lagos, Nigeria 116

Mercy Omolade Adolescents in Legico Postal Agency [email protected]; Olaleye, Program Nigeria Legico Flats, Block A [email protected] Assistant, Gender Ahmadu Bello Way and Reproductive Victoria Island, Lagos, Nigeria Health

DUe Gimba, Project Pathfinder Interna- 248 Muri Okunola Street 01-2621779 Officer tiona I Victoria Island, Lagos, Nigeria

Juliana Nathaniel, Community Health Yelwa Tudu Dass Road 077-544168 Project Director Agency, Bauchi, Nigeria [email protected] Northern Nigeria Project, Bauchi

Ezekiel Inala F.M.C. Nembe Creek Nembe West, Bayelsa, Nigeria

Rasaq K. Awosola, Life Link Organisation 13, Commercial Road [email protected] Field Officer Apapa, Lagos, Nigeria

Dr. A. C. Origa, State Ministry of Ministry of Health 088-221632 Project Director, Health and United PO Box 579 Community Repro- Nations Populaton Umuahia, Aba State, ductive Health Fund Nigeria

Remi Faiola, Sagamu Community 1A Baruwa Street Program Center Sagamu, Ogun State, Nigeria Offjcer

Shem Shehu, Coor- Child Development Fo- 3rd Floor Ahmadu Dantata [email protected] dinator cus of Nigeria House PO Box 10976, Kano, Nigeria

Nike Etta, Federal Ministry of c/o Dr. A. A. Adeyemi DD (RH) Programme Officer, Health, Department of CDPA Adolescent Repro- Reproductive Health Federal Ministry of Health ductive Health Division, Abuja, Nigeria Abuja 117

Plot 9. Tarauni Market Road and Information PO Box 12846 064-667286 (office phone) Project. Kano Kano. Nigeria 064-663193 (fax) [email protected] [email protected]

Action Health Incor- Plot 54 Somorin Street porated Ifako Gbagada. Lagos. Nigeria

Ebun Omotcsho Family Health and Ode-Aje Iwajowa Coop Building 02-8106950 Population Action Ogbere-Oloba. Ibadan. Nigeria [email protected] Committee

Omobola T. Odutolu United Nations Popu- Bureau of Budget and Planning 039-243428 lation Fund. Ogun Ministry of Finance 245311 State Governors Office [email protected] Abeokuta. Ogun State. Nigeria

Dr. Tunde Segun Federal Ministry of 3. Harvey Road. 01-0043219 Health Yaba. Lagos. Nigeria [email protected]

Vulasi Barinem Ogoni Youth Develop- 45. Kenule Street 064-870192 ment Project PO Box 102 [email protected] Bori. Ogoni Rivers State. Nigeria

Dr. Tajudeen Human Rights Union College of Medicine 01-5851432 (fax) Oyeyemi Oyewale. For Medical Action in University of Lagos yemioye:[email protected] Vice President Africa PMB 12003 (HURUMA) Lagos. Nigeria

Folashade Popoola Society for Women 12 Apena Street. off Cole 01-5837617 and AIDS in Africa Street [email protected] Surulere. Lagos. Nigeria

Olaosebikan StopAIDS 95 Suite A and B 01-2635219 Adenike East Pavilion TBS Lagos. Nigeria --

118

Angela Odiachi, Center for Develop- 18 Temple Road 01-2600022 Assistant ment and Population Ikayi, Lagos, Nigeria [email protected] Programme Officer Activities

Alero Bolanle Halt AIDS Group 28/30 Bukuru Bye-Pass 073-460380 Mokonogho, Jos, Plateau State, Nigeria PO [email protected] Programme Officer Box 1031 Jos, Plateau State, Nigeria

Bolanle Oyebola, Centre for the Right 3 Obanle Aro Street 01-7743816 Programme Officer to Health Off Coker Road Roundabout [email protected] Ilupeju, Lagos, Nigeria

Stanley I. Wowo, Youth PRO-FILE # 29 Okiya Street [email protected] Programme Officer Mile 2 Diobu Port Harcourt, Nigeria

Chinwe Nwokedi, In- Youth PRO-FILE # 29 Okiya Street [email protected] formation Officer Mile 2 Diobu Port Harcourt, Nigeria

Godwin D. U. Dike, Health Matters Inc. Bloke 1, Suite 314 01-4931737 Youth Mobilisation LSDPC Building Officer lIupeju, Lagos, Nigeria

Ngozi Ukauwa, Ex- Public Enlightenment 15D Civic Centre Road 064-645842 ecutive Director Project PO Box 10197 635152 Kano, Nigeria [email protected] 119

ollowing are the pre5entation aterial5 5ubmitted by the Hre50urce people and gue5t 5peaker5 during the SOTA work5hop.

1- Monday, February 19, 2001, "Do You See What I See'? Do You Hear What I Hear?" (Group5 1-7) 2. Belki5 Weide Giorgi5, "Gender and Adole5cent Reproductive Health Agenda" 3. Scott Moreland, "Adole5cent5 and Young Adult5 in Nigeria Fertility and Reproductive Health" 4. Monday, February 19, 2001, "Adulw Are from Mar5; Adole5cenw Are from Venu5" S. Tue5day, February 20, 2001, "Jungle City" 6. Kri5tin Ne150n, "Preliminary Re..earch and Evaluation Finding5 on Program Effectivene55 for Youth Program5" 7. Lola Dare, "Improving Sexual and Reproductive Health of Young Perwn5 in Nigeria: What Work5?" Total Youth Empowerment, Center for Health Science5 Training, Re5earch and Development International, Ibadan, Nigeria (CHESTRAD) 8. Adeola Olunloyo, "Youth Involvement," Action Health Inccrporated, Nigeria 9. Ebun Omotc5ho, "Micro-Enterpri5e," Family Health and Population Action Committee, Ibadan, Nigeria 120

10. Temitope Adekunle, "School-Based 19. Scott Moreland, "Adolescent Strategies for Sexuality Education: My Reproductive Health Policy," The Experience of ELPE," Association for POLICY Project Reproductive and Family Health, 20. Ngozi Odu, "Creating an Enabling Ibadan, Nigeria EnVironment-Using Policies," Ministry 11. Edem Effiong, "Concepts and Practices of Health, River State, Nigeria in Addressing Adolescent 21. "National Emergency Action Plan-A Reproductive Health in Religious Strategy to Deal with HIVIAIDS in Institutions," Nigerian Youth AIDS Nigeria," National Action Committee Project, Lagos, Nigeria on AIDS 12. Bola Omotosho, "Program Approach to 22. Scott Moreland, "Advocacy Skills-An Reaching and Serving Youth: Market­ Overview," The Focus Project Based," Family Health and Population 23. Kwame Ampomah, ''YARH Policies Action Committee, Ibadan, Nigeria Advocacy-The Ghana Case Study" 13. Emmanuel Etim, "Youth Involvement in 24. Tuesday, February 20, 2001 Advocacy," Adolescents in Nigeria, (afternoon), "Jungle City" Lagos, Nigeria 25. Kristin Nelson, "Preliminary Research 14. Charity Usifoh, "Community-Based and Evaluation Findings on Program Approach to Youth-Friendly Effectiveness," FOCUS on Young Reproductive Health Services," Youth Adults/Tulane University Action Project, Women Health of 26. Lola Dare, "Improving Sexual and Nigeria, Lagos, Nigeria Reproductive Hea Ith of Young Persons 15. Omololu Falobi (compiled), "What in Nigeria: What Works?" Total Youth Nigerian Youths Think About Coverage Empowerment Initiative, Center for of Youth Issues in the Nigerian Media," Health Sciences Training, Research Journalists Against AIDS, Lagos, and Development International, Ibadan, Nigeria Nigeria. 16. O. B. Akinleye, "Program Approaches to 27. Mary N. Bawa, "Provision of Clinical and Reaching and Serving Youth­ Contraceptive Services," Planned Commercial Sex Workers," Sagamu Parenthood Federation of Nigeria, Community Centre, Sagamu, Ogun Zonal Office, Abuja, Nigeria State, Nigeria 28. Bernard Edet, "Social Marketing and 17. Odutolu Wole, "(Re )creating Social Behavior Change Communication Space for the Family in Provision of Strategies for Youth," Society for Sexua lity Education for the Young Family Health, Lagos, Nigeria People," Life Vanguard Osogbo, Ondo 29. Funmi Doherty, "Providing Clinical State, Nigeria Services on HIVI AIDS for Young 18. Hajara Mohammed, "Youth People," Society for Women and AIDS in Development in Rural Northern Africa, Lagos, Nigeria Nigeria," Adolescent Health and Information Project, Kano, Nigeria 121

30. Grace Delano, "Provision of Clinical and Contraceptive Services to Adolescents and Young Adult5," A550ciation for Reproductive and Family Health, Ibadan, Nigeria 31. Wednesday, February 21, 2001 (afternoon), "Where Were You When I Needed You Most?" (Groups 1-7) 32. Wednesday, February 21, 2001, Issues Discussion Over Lunch (Groups 1-4) 33. Teresa Essein, "The Media in Health Communications," Channels Television, Lagos, Nigeria 34. Vanessa Carroll, Communications Strategy Development Worksheet, FOCUS on Young Adults 35. Susan Adamchak and Emily Zeilvinski, "Monitoring and Evaluating Adolescent Reproduction Program5," FOCUS on Young AdultslTulane University 36. Friday, February 23, 2001, "Ain't No Stoppin' Us Now" (Groups 1-8)

123

Beijing International Conference on Women, 1995. Brabin et aI., 1995. Cairo International Conference on Population and Development Plan of AND Action, 1994. Drug Control Priority Program for Nigeria 2002-2005, in Support of the National Drug Control Master Plan, UNDCP, Nigeria. Federal Ministry of Health. The National Population Policy for Development, Unity, Progress, and Self-Reliance (NPP), 1988. Federal Ministry of Health. "Time for Action." Report of the National Conference on Adolescent Reproductive Health in Nigeria, January 22-29, 1999, Abuja, Nigeria. Ghana's National Population Policy, 1969 and 1994. Giorgis, Belkis Weide. "Gender and Adolescent Reproductive Health." Paper presented at SOTNNigeria, 2001. Heise, L., M. Ellsberg, and Modler M. Gotte. "Ending Violence Against Women." Population Reports, December 1999. Human Resource Development Report. United Nations Development Programme, 2000. Jogunosimi, Tawa. "The HIV/AIDS PandemiC among Youth in Sub-Saharan Africa." The Facts, Advocate5 for 'rOuth, February 2001. 124

McCauley, A. P., and C. Salter. "Meeting the National Strategic Framework for Needs of Young Adults." Population Adolescent Reproductive Health in Reports, October 1995. Nigeria, 1999. Monitoring and Evaluating Adolescent NDHS Report. National Population Reproductive Health Programs. FOCUS Commission/Macro, 1999. on Young Adults, 2000. Nigeria Demographic and Health Survey, National Action Committee on AIDS, 1999. 2000. Post-Abortion Care Network. "Addressing National Adolescent Health Policy, the Problem of Unsafe Abortion in Department of PHC and Disease Nigeria; A Strategic Plan of Action." Control, FMOH, Federal Republic of Nigeria, 1997. Nigeria, 1995. The World's Youth, 2000 National HIV/AIDS Program in Nigeria, United Nations Development Programme, NACA, Nigeria, 2000 Human Resources Development Report, 2000.