Experience Sharing and Learning from Adolescents Development Programmes

Packard Foundation-funded

Youth & Adolescent Reproductive Health Programs

in Pakistan

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Introduction of Adolescents Programme

The Packard Foundation has been supporting Youth/Adolescent RH (YARH) programs in Pakistan since the inception of its country program in 2000.

These programs are being implemented by the organizations: PAVHNA, Aahung, and Rozan.

Informal assessments of these programs have shown that the initiatives have helped these NGOs to strengthen their YARH components within specific organizational strategic frameworks. In addition, these initiatives have leveraged other donor funds for YARH for these grantees.

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Methodology

The Five Year (2000 to 2005) strategy for the Pakistan subprogram was presented to the board in September 2000. Its two main strategies focused on leadership development and access to family planning and reproductive health (FP/RH) services. The Foundation acknowledged that youth and adolescent reproductive health (YARH) was an important component of these strategies, given the highly youthful population of the country, and the poor development of any youth programs focusing on FP/RH.

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Methodology….. Continue

PAVHNA project titled as “Adolescents Reproductive Health” was an originally 36 months project (January 2001 to December 2003) and with a no-cost extension became a 51 months project (extended up to March 2005). The Goal of project was “to contribute to the improvement of the overall Reproductive Health status of adolescents / youth of Pakistan”.

The major components of the project were to establish four youth centers, two each for boys and girls in Karachi (urban) and Larkana (semi-urban). Youth centers provided skills development activities ( Computer, English language, stitching, embroidery etc.), awareness raising sessions, sports and recreation facilities, Peer Education through peer leaders, trainings of peers & teachers, networking and linkages, advocacy, theatre skills and service provision through doctors, LHVs and counselors.

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Methodology….. Continue

Rozan project titled as” Youth Helpline” is a 36 months project and started in November 2003 (Nov. 2003 – Nov.2005). The goal of YHL project is “to improve the reproductive health of adolescents in Islamabad surrounding cities”

The major activity of Rozan is to provide confidential counseling to youth through helpline and refer them to service delivery centre, if there is a need. They have formed partnership to other service delivery NGOs for this purpose, FPAP and MSS.

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Methodology….. Continue

Aahung project is titled as “Reproductive Health in Pakistan” and is a 36 months project from 2001 to 2004. Its goal is “to improve the availability, accessibility and quality of sexual health services”

The project activities included awareness raising to improve health seeking behavior regarding sexual health, capacity building of health service providers (Doctors, LHVs, Nurses, Hakeems, Homeopaths, Counselors, Midwifes & Paramedics) to be able to provide quality and accessible sexual health services, institutional advocacy of sexual health, educational and clinical services into existing services and organizations.

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Outcomes

Discourse around YARH in Pakistan and presenting model of possible youth projects in the country by implementing YARH programs in communities, both urban and peri-urban. (Demonstration model).

Leveraging other donor funds: This is one of the major achievements of Foundation funded projects by these grantees. Aahung has been able to leverage an amount by NOVIB and IWHC for Youth SRHR program. PAVHNA has been able to secure funding from other major programs like EU/UNFPA RHIYA project, GFATM and FHI project.

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Reflective Stories

“I am 13 years old and did not know anything about my body changes until I spoke to a counselor on youth helpline; I can handle this now, thank you very much” (Rozan helpline beneficiary)

“My friend was devastated as her parents had arranged her marriage with a 40-year old man; she did not know what to do. I had heard about the youth centre so went there and spoke to the coordinator about her saga. She consulted my friend’s parents but to no avail. She then got an order from the court that marriage will not take place. My friend was rescued and was able to say no to her parents on these matters.” (PAVHNA beneficiary)

“As a teacher when I am teaching my young students around sexuality issues, I find it challenging but rewarding. I always wonder why we did not have any help when we were growing up; it was like swimming in a black sea.” (Aahung beneficiary)

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Outcomes……….. Continue

Peer leader training model development: As this was a newly introduced activity hence these grantees had not only taken lead in developing this model but train other NGOs on this as well.

Sexuality materials and training curriculum development is now a known expertise of Aahung and this helps them to take a lead in this area and act as a resource centre.

All three NGOs clearly stand out as leaders for other NGOs in YARH programs and accepted both by their fellow NGOs and the Government.

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Lessons Learned

Institutional Arrangements:All three NGOs have set up teams within their organization for

management of these programs. These teams are specifically trained to manage project activities and align them with other ongoing activities in the organization.

Program Sustainability: Aahung has adopted a program rather than a project approach, which

ensured that all donors funding for the organization supports the institution as a whole. Their successful efforts to institutionalize YARH programs among their partner NGOs, and in schools in particular, are examples of sustaining current efforts. However they are not of a scale to ensure sustainable programs within partner’s organizations.

A very strong development in these programs has been their ability to talk about safe sex (rather than abstinence only) with youth. This indicates their maturity in approaching sexual health issues.

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Lessons Learned

Program Challenges:

As can be expected given the Pakistani environment, all three organizations have encountered major challenges in their programs. All had to tread slowly and sensitively to spread the word and have managed successfully to avoid major resistance.

There have been incidences of negative media exposure, community opposition, difficulties in finding appropriate project staff, and linkages with local schools. There has been low receptivity among male teachers (compared to their female counterparts) for SRH teaching, and the program faces the challenge of striking a gender balance in teacher training.

The absence of a national youth policy and SRH programs in the public sector has contributed to these challenges.

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Recommendations

Develop a model that would allow for sustaining key activities in their programs

Undertake institutional strengthening for implementing YARH programs

Develop measures to enhance the outreach for such initiatives

Document good/ best practices in YARH programs to impress upon youth policymakers

Network with other NGOs in the region to share experiences

Prepare IEC and toolkits for youth