Adolescent Reproductive Health Campaign

• Project Overview
• Objectives and Strategies
• Activities and Highlights
• Publications and Reports
• Research

PROJECT OVERVIEW

The adolescent reproductive health campaign aimed to prevent STIs, HIV/AIDS, and unintended pregnancies through a combination of youth-driven, community-based, and mass-media interventions. Intended audiences included young people, leaders of young people, community groups, and service providers.

These district-based programs in rural Guinea were organized and supervised by the Regional IEC Working Groups (GRIEC) and the Prefectoral IEC Working Groups (GPIEC). The GPIEC established a "steering committee" in each prefecture to execute the campaign for that prefecture, and subcommittees within the steering committee were responsible for local logistics. The steering committees were composed of members of youth associations, members of social clubs ("sérés") or associations of people with common interests, members of women's associations, and people working in the government, particularly the local health department. Government ministries and local NGOs were represented on the GPIEC. These included the Guinean Family Welfare Association (AGBEF), Save the Children, Africare, PSI, Adventist Development Relief Agency (ADRA), the Ministry of Health, the Ministry of Youth, the Ministry of Education, the Association of Parents of Students and Friends of the School (APEAE), and Committees for the Defense of the Revolution (CRD).

OBJECTIVES/STRATEGIES

The adolescent reproductive health campaign aimed to increase the percentage of:

• youth who know that a person in good health could have the AIDS virus;
• youth who know that condoms protect against HIV;
• youth who used condoms during last intercourse;
• youth who were encouraged to practice abstinence as a result of the campaign;
• girls who use modern FP methods to avoid unintended pregnancy;
• girls who intend to use modern FP methods in the future.

Abstinence was the campaign's first line of defense, out of respect for the strong influence of Muslim teachings regarding marriage and the family. Condom use (as dual protection against both pregnancy and STIs) was encouraged among sexually active young people.

A key strategy of the campaign was to reach youth in places where they like to hang out, such as hair cutting salons, sewing shops, and at football (soccer) tournaments. The owners of these salons and shops, and the commentators at the sports events were trained to use these establishments and occasions as message dissemination points.

ACTIVITIES AND HIGHLIGHTS

Regional Campaign Launches. Preparatory meetings were organized by the Regional IEC Working Groups to unite community leaders, parents and service providers around discussions and plans for their involvement in these launches as well as other campaign activities. Young people, prominent leaders, parents and service providers received recognition for the work they had done to promote HIV/AIDS prevention, shared information on and advocated for specific HIV/AIDS prevention measures. Launch events typically included a parade, street theater, music and dance concerts, and a soccer match, as well as talks and group discussions illustrated by slides and video.

Peer Educator Training. In each community, the Prefectoral IEC working group approached the Sub Prefect, the representative from the Ministry of Youth, the Health Worker assigned to that community, and the President of the Committee for Rural Development, and asked them to recommend young people to participate in the campaign as Peer Educators. Criteria for selection included: 15-24 years of age, dynamism, willingness to volunteer, availability, reputation, and, for those at the prefecture level, literacy. After talking to the young people, the IEC group then went to the parents to explain the campaign and get permission for their sons and daughters involvement. Care was taken to enlist an equal number of young men and young women.

Two hundred young men and women were trained in a curriculum designed to strengthen the skills and increase the knowledge of Peer Educators. Trained Peer Educators returned to their community to organize meetings with other youth at school and through sérés – traditional organized groups of friends of the same age – and grains-smaller, informal groups of boys who gather every day for tea.

Service Provider Training. Twenty-two service providers were trained in a curriculum designed to strengthen their ability to deliver services and facilitate discussion with youth. Regional training of trainers workshops explored values, youth-friendly services, key HIV/AIDS information. The workshops helped develop and coordinate community-based outreach, counseling, and action plans.

Action Plan Development. Regional and individual action plans were developed in the workshops for peer educators and service providers to assist in organizing, monitoring and evaluating the impact of interventions.

Youth Competitions. A series of youth-driven community mobilization events included theater, sports, dance, and song competitions, together with speakers and messages disseminated at schools and during Guinean celebrations such as Baradossa (Harvest Day celebration).

Orientations for Local Businesses and Vendors. In an innovative twist on community mobilization, 150 vendors of youth services, such as hair cutting salons, sewing houses, and bars/restaurants were gathered in eight prefectures to orient them to project objectives and enable them to share key campaign messages, pass on project materials, and refer young people to health centers.

Question and Answer Programs in Schools. In-school youth participated in a question and answer program with trained service providers. During a given month, they were invited to anonymously put health-related questions into a box. These questions were then passed on to service providers who came to speak at the schools so that they could address their audience's specific concerns. The questions were also used to develop content for radio programs and print materials. Student Peer Educators reported that their fellow students often asked them questions between classes while they waited for the teacher to arrive, providing them with an opportunity to give mini-talks and distribute print materials.

Community Theater Groups. Eight theater groups were trained in health issues and performed in their communities under the supervision of regional working groups. Dramas were based on themes such as RH, sexuality, abstinence, and condom use. Three trained adult theater groups also tourned the region, advocating dialogue between parents and children.

Community Radio Program. A rural radio program was designed to air the voices of young people and to publicize and cover community events. The interactive format provided a forum for youth and other public health and community leaders to discuss and share information about HIV/AIDS and unintended pregnancies through public broadcasts and spots. Youth friendly service providers, young peer educators, parents, and appropriate community leaders were also recognized. A catchy audio slogan was developed for this program. Sixteen programs were produced in the local language (Malinke) and aired twice a week.

Radio Spots. Five 30-second spots were produced and aired in local languages on rural radio stations.

Print Materials. Three brochures and two posters were developed in collaboration with Peer Educators. They were distributed by Peer Educators, service providers and during community mobilization events. Although materials were designed to reach literate youth, they were illustrated with a low-literate audience in mind. Materials featured the campaign logo and slogan, "My right – information; my duty – abstinence or the condom."

Promotional Materials. For wider message dissemination, promotional materials featuring the campaign logo and slogan were distributed during community mobilization events and awarded as "prizes" during contests. Materials included t-shirts, shirts, caps, pens, combs, bags, balloons, stickers, commemorative clothes (pagnes), and banners.

PUBLICATIONS AND REPORTS

Fonseca-Becker F, Bakadi G, Sow A. Mobilizing Communities for Behavior Change: HIV/AIDS and Pregnancy Prevention Among Youth in Upper Guinea. Center Publication. Baltimore, Johns Hopkins Bloomberg School of Public Health/Center for Communication Programs. May 2005. (Français)

"Guinea’s Youth-Driven Campaign Promotes Right to Abstain or Use Condoms," Communication Impact!, June 2003. (PDF | French PDF)

RESEARCH

CCP conducted a post-intervention survey among young people aged 15-24 twelve months after the conclusion of the campaign. Data were collected from a random sample of youth in the intervention area and a comparison area.

• Over 90% of young men and 80% of young women were exposed to the campaign.
• 83% of males and 63% of females participated in one or more community-based activity.
• 83% of males and 56% of females reported having taken steps toward changing their behavior as a result of the campaign.
• Condom use at last sex was significantly higher (p < 0.01) among youth in the intervention area (47.6% of the males, and 27% for the females) compared to the control area (24.1% of the males, and 2.7% of the females), and to the DHS 1999 results for Haute Guinea for this age group (24% of males and 2.3% of females).
• There were significant differences in perception of community openness to discussing youth sexuality issues for the intervention area as compared to the control area: 60.4 % males and 41% females in the intervention area as compared to 32.7% and 13.3% males and females respectively in the control area.
• Knowledge of condom use for dual protection was significantly higher (p < 0.01) for the intervention area (64.3% of the males and 35.7% of the females) as compared to 14.3% of the males and none of the females in the control area.
• A significant association was found between level of campaign exposure and condom use at last sex (p < 0.01). On the other hand, once a respondent had participated in two campaign activities there was a "diminishing return" effect on behavior change associated with participation in a larger number of activities.