There have been
attempts at developing programmes and interventions to address key challenges related
to a lack of adolescent-friendly health services, limited access to
age-appropriate counselling services, promotion of a healthy lifestyle, and
menstrual management facilities at the school, both in the government and
non-state sectors for quite some time. These
programmes have mostly been on a small scale, localised and fragmented. A study has been
done to fill in this knowledge gap by conducting a situation analysis on AH/SRH
and identifying past and present programmes that have been highly effective and
impactful.
The
study adopted multiple methods for collecting data: i) a Scoping review of relevant documents to get a ‘snap shot’ of the current situation;
ii) a Qualitative study including
Key Informant Interviews (KIIs) with stakeholders at district and central levels,
In-depth Interviews (IDIs) with programme participants, and Focus Group
Discussions (FGDs) with members of the beneficiary community; iii)
Observational case studies based on
field visits to selected programme sites, and iv) feedback from a deliberative workshop with the
stakeholders to share and discuss findings.
Data
were collected from 11 purposively selected sub-districts (of eight districts,
one district per division) during Jan. – Mar. 2022. The sub-districts were
selected based upon programme concentration and discussion with DGHS/DGFP of
MoHFW, MoE, and MoWCA. A total of 39 IDIs, 34 KIIs, 9 FGDs, and 18 case
observations were done. Finally, a stakeholder
deliberative dialogue with key stakeholders at the central level was organised
on 30th May 2022 at BRAC Centre Inn Dhaka.
Here
are some glimpses from the findings:
·
In the
study, 28 Adolescent SRH programmes were reviewed by the study team. Findings
reveal that BRAC was a pioneer in implementing programmes for adolescent girls
since the ‘90s as part of its women empowerment mission, e.g., BRAC Adolescent
Development Programme (1993) and APON (1998). This was followed by UNICEF at
the beginning of the millennium (Kishori Abhijan, 2001) and then the government
(Adolescent-friendly Health Corners, DGHS/MoHFW, 2011).
·
An attempt was made to identify
some impactful (and scalable) AH/SRH programmes based on the scoping review and
perspectives of the programme implementers and beneficiaries. For example, child
marriage interventions improved awareness about the problems of early
marriage, including the legal age of marriage for girls and its rationale. Some
interventions positively affected unmarried girls’ preference for marriage at
20 years of age or later and increased their confidence in negotiating with
their parents to delay marriage.
·
Menstrual
hygiene management programmes
helped to improve relevant knowledge and use of health products and services as
intended by the programmes. Findings show that additional
focus on male family members, especially fathers, was helpful to improve the utilisation
of MHM products.
·
Some Nutrition programmes
successfully improved nutrition practices and shifted gender dynamics at
household and community levels, beside improving knowledge of nutrition and its
practical implications in everyday life. Some
·
Programmes focusing on gender-based
violence achieved reasonable awareness of the participants around domestic
and intimate-partner violence, harassment, rape and acid throwing etc.
·
Findings
show that in-school girls developed better gender-equitable attitudes than
their out-of-school peers. Some programmes achieved a higher percentage of
married adolescents using modern contraceptive methods.
·
Educational interventions enhanced
access to AH/SRH knowledge and helped lower the barrier for adolescents to
access information, counselling, and sexual and reproductive health services.
·
