Reproductive health services for teenagers

Summary

Adolescent friendly services

Different survey’s revealed that there is a high rate of teenage pregnancies in Sierra Leone starting at the age of 12. Maternal mortality is very high in the country as a whole, but particularly among young teenage mothers. Teenage pregnancy and loss of educational opportunity is moreover a big factor in perpetuating and exacerbating family poverty and marginalization.

Goals

  • Reduce the level of teenage pregnancies
  • Empower girls in decision-making on Sexual Reproductive Health issues
  • Enhance the educational career/livelihood skills

Background

The population of Sierra Leone is estimated at 5.5 million with around 53% of the population having a daily income below $1,25. The country is still struggling to rebuild health infrastructure and services which were largely destroyed in the civil war a decade ago. 42.1% is under 15 and 19.3% aged between 15 – 24 years.

55% of the youth aged between 15 – 24 years are either not in school or unemployed andeconomically inactive. Early marriage before the age of 18 is common practice especially for those youngsters who are going through the cultural initiation process. This initiation process is still ongoing, despite the fact that it forbidden under the Child Rights Act (2007). In general, we observed that adolescents are ignorant about their sexuality and the use of contraceptives. Also due to a lack of youth-friendly services. Adolescents who become pregnant often drop out of school (and in general, teenage mothers lack the skills to support themselves and their children economically.

Initial situation

The Planned Parenthood Association of Sierra Leone (PPA-SL) was founded as a national organization in the 1970s and became a registered charity in 1982. It is a volunteer-based organization (there are four types of volunteer membership: ordinary members, life members, honorary members and corporate members). Volunteers are the policy makers and usually the implementers of policies and programs.

PPA-SL works closely with the government of Sierra Leone, and with international and local organisations and associations. The relationship with Cordaid started last year.

Goals

This project aims at increasing the number of adolescent girls going to school by reducing the drop-out rate due to pregnancy.

Goals

  • Reduce the level of teenage pregnancies
  • Empower girls in decision-making on Sexual Reproductive Health issues
  • Enhance the educational career/livelihood skills

Target group

7000 adolescent girls in the project communities are targeted, together with 80 teenage mothers and 15 staff members of schools.

Inderectly the families of the adolescents (+/- 35,000 people) and the families of the teenage mothers (+/- 400) will indirectly profit from the interventions.

Project plan

In 2011, Cordaid funded the organization the Planned Parenthood Association of Sierra Leone (PPA-SL) in a small programme designed to address the problems around teenage pregnancies in six communities in the Western Area of Sierra Leone (Goderich, Lumley, Juba, Grafton, Hastings and Rokel). The current project is designed to utilize the lessons learned and to scale up the initiative with new strategies into the existing sites and new communities in Lunsar in the Port Loko District of Northern Province. The original communities were chosen because there were very few community health centres. Lunsar was selected because it is a booming mining town that has attracted migrant teens from various towns to engage in commercial sex. The school dropout rate and rates for STIs/HIV& AIDS are also increasing. Adolescent girls (in and out of school) who had been trained as Peer Educators and advocates on Adolescent Sexual Reproductive Health issues in the previous project will serve as Peer Educators and Advocates in the new project. New Peer Educators, Advocates and Community Based Service providers will be identified and trained in the new communities.

In order to increase access to adolescent -friendly services at community level, we will set up regular mobile outreach clinics to provide back-up services to the Community Based Service Providers. Teenage mothers clubs will be strengthened by supporting their members who may wish to pursue formal or vocational training of their own choice. In order to make them employable or self-reliant a combination of subsidy and microcredit will be used to this end.

A number of other local Cordaid partners have recently become engaged in adolescent sexuality education and awareness. A needs assessment showed the need to increase the knowledge and skills of these local partners in order to implement the project effectively. As part of this project, PPA-SL will train a number of key staff members from three other partners.

Sustainability

Community institutions are established and links are made with government health services.

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