Peer educator from BWHC in Narayanganj

Creating a better environment for SRH among the urban adolescents and youth

Project profile. Starting in October 2003, CWFD selected a partner (BWHC) through which project activities were implemented in two sites: Narayongonj and Tangail. Besides, CWFD worked in three more project sites (Bonosree, Gazipur and Khulna). All together five sites were monitored by CWFD to increase the awareness, demand, access and utilization of SRH services o the vulnerable and marginalized population, in particular from the age of 10 to 24.

CWFD took the lead of the RHIYA project for creating an enabling environment and fostering policy support for ARH. For this purpose, it focused on developing a coherent advocacy strategy targeting in particular policy makers, researchers, Government officials, media people at the national level and gatekeepers (parents, teachers, community leaders...) at the local level. CWFD had 100 groups of youths, each containing approximately 20 members.

Other activities included youth rallies and support for partners. 30 rallies were conducted with 2500 adolescents present at each rally. Existing clinics were converted to adolescent youth friendly with support provided from RHIYA partners MSCS and FPAB. The strategies adopted by this project included peer and health education through community mobilizers in organized settings such as scout groups, garment factories and local clubs.

Strategy. CWFD identified problems on the basis of review, experience and lessons learned from earlier, as well as stakeholder consultations occurring as part of the programme planning by UNFPA, UNICEF and WHO. Organizers visited the areas for assessing the ASRH needs:

In particular, young people have identified the following problems to be addressed:
1. The lack of opportunity and freedom of young people to exercise their rights to information and help ASRH, and to obtain the necessary understanding and support from stakeholders.
2. The persistent gender discrimination exiting within the family and the society;
3. The lack of respect, application, protection offered by the legal system for girls especially;
4. The lack of engagement by GoB and/ with NGOs and community groups on ARH issues;
5. The inability to talk confidentially on concerns related to ARH and access the necessary sort of counselling for adolescents girls and boys;
6. Lack of opportunities and resistance of communities to the participation of adolescent girls and boys in planning and decisions on social development.

In the light of the above, the CWFD strategy consisted in:
a) Adequate information and knowledge provided through health communication sessions in the community and in the educational institutes.
b) Necessary coherent advocacy events organized to orient the parent/teachers, community, religious and national leaders on youth oriented SRH through meetings, workshops...
c) Give access to youth-friendly clinical services by establishing 5 RHIYA primary health care clinics and by building referral linkages with non-RHIYA and Government facilities.
d) Development of HRD plan and help for capacity building to the Facilitators, Service Providers, Peer Educators, adolescents on the issues of RH, Life skills, Message development.
e) Establishment of 5 adolescents clubs, commonly known as Resource Centers where the adolescents came on a regularly, and passed their free time enjoying recreational activities.<

Outputs. CWFD programme’s goal was to contribute improving ASRH and the overall well-being of adolescents and youths and develop positive changes and attitudes on these issues. Given the socio-cultural context in Bangladesh, the following outputs were a challenge:

1) Create an enabling and supportive environment, involving gatekeepers for the provision of SRH services and information: provision of life skill training to adolescents, including through peer education. ARH strategy was developed through subcommittees working groups and approved by the GoB. 999 advocacy events with gatekeepers, a round table with parliamentarians, and 5 parents-children workshops were organized. Medias were deeply involved to advocate mass people and disseminate ASRH related information.

2) To improve and expand knowledge on SRH and life skills among the youth to equip them to deal with their SRH needs and concerns: adolescents and schools were provided with ASRH information based on approved curricula in the 5 areas. 46,728 youths benefited adolescent-friendly clinical services. 5 resources centers equipped with books, computers, video materials, and 4 adolescents’ spaces equipped with BCC and educating materials, were created. Peers organized debates, discussions, street dramas on ASRH related topics. 60 adolescent’s forums were organized; 31,000 copies of RHIYA Newsletter were published.
3) To create increased availability and access to quality, gender-sensitive and culturally suitable SRH education, counseling and services through a variety of outlets & means: Talking about SRH to unmarried adolescents within cultural context of Bangladesh is very delicate, even for health preventive reasons. CWFD built special corners with timing for adolescent friendly approach, and medical staff was trained. A counseling manual was published and referral linkages were developed with clinics. 33,000 youths received clinical and counseling services.
4) Improve NGOs capacity to provide youth friendly clinical services through various means: With the help of partners, staff members were trained on different topics (ARH, TOT, Gender, Message Development workshop...), 13 exchange visits were organized to share views on the programme, and different core groups were formed (advocacy, BCC...)

Lessons learned. Involvement of adolescents and youth and adolescent in the project showed that the adolescents are very inquisitive and very much eager to get information and services on SRH. They realized their right to know. Resource centres were their own worlds. However, it is a pity RHIYA Newsletters were not sustained since it was a good way of expressing their thinking and love.
There are huge needs for an integrated approach: RH programme alone will not be sustainable without it. Adolescents should be able to develop their skills and earn money. The targeted young people are vulnerable in terms of skills as well as the financial condition: 1,500 000 garment workers are engaged in industry in Bangladesh and are extremely vulnerable to SRH since rarely counseled or educated.
Despite the cultural taboo on SRH before marriage there is an increasing demand about SRH information from the youth. SRH education should be incorporated in the national curricula without any delay, gender development should be a cross cutting issue, and greater information on HIV/AIDS should be provided, since 35% of Bangladesh population is concerned.
Partnership approach is a very good system: Good linkages and team work with Government (especially Health and Youth Ministries) and NGOs should be maintained to have more impact, develop programmes and strategies at an institutional level and disseminate information, including in schools.

Partner profile. The mission CWFD is to support, promote and protect the interest of women in Bangladesh by providing community based health care, creating economic opportunities, empower under privileged youth of urban and rural population and develop Human Resources for a positive social change. CWFD works in areas of reproductive health since 1976. It first focused on family planning, but realized over time that improvement on health status in Bangladesh was depending on more actions. It thus decided to initiate new programmes for children, women and adolescents encompassing primary health care, life skill development and economic empowerment. CWFD has a long experience on implementing adolescents activities since the early nineties through which they were given like-skill training and shcool sponsorship. CWFD is also a member of NEARS (Network for Ensuring Adolescent Reproductive Rights and Services) in Bangladesh.
Contact: Concerned Women for Family development (CWFD) Email: