OBJECTIVE
To implement an intervention to improve adolescent RH—through increasing access to both SRH clinic and educational services. A complementary component aimed to increase community sensitisation to the need for youth SRH services, through community education programmes.

BACKGROUND
Senegal is placing a renewed focus on youth SRH needs, as 28% of its population is between 10-19 years of age, and rapid urbanisation has led to societal changes which have contributed to a rise in adolescent sexual activity.

SCOPE
In 1999, FRONTIERS began a three-year collaboration with the World Health Organization (WHO), the Zambian Ministries of Health, Education and Youth, the Center for Research and Training (CEFOREP), and the Population Training Group (GEEP), to test several youth SRH interventions. This intervention was implemented in three urban communities in northern Senegal. In one community, only the community and clinic-based components were implemented, while another included the school-based component, and a third served as a control site. The total project cost for two years was US$100,000.

MAIN ACTIVITIES

Community Intervention
Community sensitisation on the issue of adolescent RH was addressed through educational sessions conducted by peer educators—to community and religious groups and to parents (through women’s groups).

Clinic-Based Intervention
Providers and peer educators were trained to offer youth-friendly services.

School-Based Intervention
Teachers and peer educators were trained to provide RH education through an RH curriculum tailored to both in-school and out-of-school youths.

MANAGEMENT FEATURES

Strategy

The intervention (and lessons learned from it) helped the newly-developed Zambian Office of Adolescent Health (OAH) to develop its strategy. In fact, the OAH and WHO plan to duplicate elements of the clinic and community components in other districts in Senegal.

Capacity-Building

The various educational sessions and trainings increased both knowledge and the ability to conduct SRH education among peer educators, teachers and clinic providers.

Mobilising

Community support for youth SRH issues increased, though an increase in support for youth SRH education (by parents) was mostly for the promotion of abstinence education.

Managerial Leadership

A key lesson learned with applications to similar youth SRH interventions, is that in targeting parents education on youth SRH, an attempt should be made to include fathers, to enable them to play a greater role in their children’s SRH education.

Given the decrease in condom use at both intervention sites, the use of combined interventions-- to include education on the importance of condom use for youths who are sexually active, which emphasises abstinence and fidelity, require further analysis.

EVALUATION FINDINGS

• Among sexually experienced youths, the average reported that the number of sexual partners dropped from 2.1 to 1.5, implying that more youths are choosing to be faithful to one partner.
• Youths’ RH knowledge level had increased overall; the proportion of youth knowing about one or more contraceptive method rose at least 10% at both intervention sites. Knowledge of the consistent and correct use of condoms rose significantly—to nearly 100% at both intervention sites.
• Unfortunately, condom use decreased in the two intervention sites. This may be attributable to ‘abstinence and fidelity being highlighted by providers’, over condom use.
• Youths who reported visiting a health facility rose at least five percentage points at both intervention sites, though only half of the visits were for RH services.