A Manual for Working with Youth Hands on! on Sexual and Reproductive Health 4320 Health and Population Supraregional Project: Innovative Approaches in Reproductive Health Hands on! A Manual for Working with Youth on Sexual and Reproductive Health Deutsche Gesellschaft für Technische Zusammenarbeit (GTZ) GmbH 4320 Health and Population Supraregional Project: Innovative Approaches in Reproductive Health Hands on! A Manual for Working with Youth on Sexual and Reproductive Health Publisher: Deutsche Gesellschaft für Technische Zusammenarbeit (GTZ) GmbH Dag-Hammarskjöld-Weg 1-5 65760 Eschborn OE 4320 Health and Population Supraregional Sector Project: Innovative Approaches in Reproductive Health Tel.: (+49) 6196-79-4104/5, Fax: (+49) 6196-79-7411 E-Mail: [email protected] [email protected] http://www.gtz.de/srh Editors: Julika Rollin, Annette Gabriel Concept: Cordula Schümer, Annette Gabriel Cover: Stefan Mümpfer Printed by: Universum Verlagsanstalt, Wiesbaden Eschborn, April 2002 List of Contents List of Contents List of Contents ............................................................................................................................I Abbreviations .............................................................................................................................III Introduction: Working with Youth on Sexual and Reproductive Health........................................1 I Methods 1.1 Situation Analysis ......................................................................................................7 1.2 Methods for Baseline Data Collection.......................................................................19 1.3 Participatory Rapid Appraisal in Project Planning .....................................................37 1.4 Action Research Training.........................................................................................51 1.5 Indicators for Monitoring and Evaluation...................................................................59 II Approaches 2.1 Alternative Youth Policies ........................................................................................71 2.2 Inter-sectoral Youth Promotion.................................................................................79 2.3 Youth Organisations: Co-operation – Support – Setting Up ......................................91 2.4 School-based Sexuality Education .........................................................................101 2.5 Health Information Centre for Young People ..........................................................111 2.6 Youth-friendly Health Services ...............................................................................125 2.7 Youth Involvement in IEC Material Production........................................................137 2.8 Peer Education ......................................................................................................147 2.9 Theatre for Development .......................................................................................157 2.10 Sport and Physical Activities ..................................................................................169 2.11 Rural Youth as a Target Group ..............................................................................179 List of Contacts .....................................................................................................................187 Hands On! A Manual for Working with Youth on SRH, GTZ 2002 I Abbreviations Abbreviations AIDS Acquired Immune Deficiency Syndrome BMZ Federal Ministry of Economic Co-operation and Development CIFRA International Course for Action Research Training DHS Demographic and Health Survey FGM Female genital mutilation GTZ Deutsche Gesellschaft für Technische Zusammenarbeit (GTZ) GmbH (German Technical Cooperation) HIV Human Immune-deficiency Virus IEC Information, Education, Communication KAP Knowledge, Attitude, Practice NGO Non-governmental organisation PRA Participatory Rapid Appraisal SRH Sexual and reproductive health STD Sexually transmitted disease UNAIDS Joint United Nations Programme on HIV/AIDS UNICEF United Nations Children’s Fund WHO World Health Organisation Hands On! A Manual for Working with Youth on SRH, GTZ 22002 III Introduction Introduction: Working with Youth on Sexual and Reproductive Health Context1 Today’s generation of young people is the largest in history: 1.7 billion 10-24-year-olds make up more than one-fourth of the world population. In many developing countries the same age group accounts for about 30% of all inhabitants representing an enormous momentum for population growth. But youth2 are not only important as a demographic factor. In the face of widespread poverty, socio-cultural transformation and AIDS-struck families they carry heavy socio-economic responsibilities, too. How well they can perform these socio-economic tasks depends largely on their health and skills. While the spontaneity, enthusiasm, openness and readiness to take risks inherent in adolescent behaviour can represent an important impulse for development processes of the community they live in the very same characteristics frequently result in adverse health outcomes. Among the main courses of mortality and morbidity in young people are violence, accidents and sexual and reproductive ill-health: • More adolescent girls (15-19 years) die from complications of pregnancy, abortion and childbirth than from any other cause • 15-24-year-olds have the highest rates of sexually transmitted infections including HIV (60% of new HIV infections with 2/3 of them in girls) • One to two thirds of rape victims worldwide are age 15 or younger and many first-time sexual experiences in developing countries are non-consensual • Each day an estimated 600 girls are at risk of being genitally mutilated. Adolescence is a crucial phase for the development of behaviours and practices, which greatly affect the health status of adults,3 and thus makes young people the ideal target of health promoting interventions. Attitudes and behaviours formed in the physical and psychological maturation process are crucial to the current and future Sexual and Reproductive Health (SRH) of individuals, and affect the well-being of their families and communities. The importance of addressing young people in particular lies not only in their perceived improved behaviour as future adults. As trained “youth promoters” they are also instrumental in sensitizing adults and peers alike. This is one way of young people being true “agents of change”. The Deutsche Gesellschaft für Technische Zusammenarbeit (GTZ) GmbH has been actively promoting young people’s reproductive health and rights previous to but especially since the 1994 International Conference on Population and Development. This promotion takes the form of support and technical advice to local governmental and non-governmental organisations supplemented by cooperation with international partner organisations. Currently, GTZ is supporting some 40 projects, which address adolescent SRH at different levels and scales in the contexts of health, education or youth promotion and with a special focus on prevention. 1 Figures: The World’s Youth 2000, PRB/Measure 2 International discourse differentiates adolescents (10-19 years), youth (15-24 years), young adults (20-24 years). All of them make up young people (10-24 years) 3 According to WHO, approx. 70% of premature deaths among adults are due to behaviours initiated in adolescence. Hands On! A Manual for Working with Youth on SRH, GTZ 2002 1 Introduction Interventions range from direct distribution of informational materials, capacity building and the provision of comprehensive services to the steering of complex multisectoral networks and policy advice. The challenge lies in marrying up macro and micro level. Some of the experiences drawn from such interventions have been compiled by GTZ’s supraregional project Innovative Approaches in Reproductive Health in this recipe-like manual with a view to disseminating lessons learnt. The publication at hand aims to facilitate the replication and scaling up of successful interventions thereby improving young people’s life perspectives and access to adequate SRH information and services. Content Hands On! A Manual for Working with Youth on Sexual and Reproductive Health lays out useful methods and approaches to support technical co-operation personnel and their partners in the development and implementation of SRH measures with young people in a practical way. It consists of 16 separate yet complementary papers written largely by practicians from the field. Instead of long theoretical discourses, authors use examples and checklists. All methods and approaches described can be adapted to different settings and various topics. Part one, Methods, consists of a step-by-step guide to a situation analysis, description of methods for baseline data collection, tools for participatory rapid appraisal and indicators for monitoring and evaluation. Part two, Approaches, contains among others checklists for peer education, guidelines for the development of IEC material, theatre plays, or sports activities, and how to support youth organisations and cross-sectoral networking. The ensemble of articles is not meant to be exhaustive on the topic. However, they reflect major experiences from technical cooperation projects supported by GTZ. Further contributions are currently being developed which will subsequently be distributed to those who wish to obtain this