Organising adolescent and youth friendly RH services

In order to organise AYFRH services it is important to start with a needs assessment of the adolescent and youth reproductive services at the health post. In the Box below you see the five steps that you can follow to organize AYFRH services at your level.

In the following sections we will show you how you do with each of the above five steps.

Step 1: Conducting a needs assessment of AYFRH services at the health post

At the end of this step, is a needs assessment tool. You use it to collect the required information on the services already provided. It will help you identify existing problems and the people and materials available to provide RH services for young people. In addition, the needs assessment tool will help you collect information on how the health post keeps track of data on AYRH services provided. Overall, the tool will help you determine whether the facility has youth-friendly characteristics.

What are the characteristics of AYFRH services?

The major characteristics of AYFRH services include:

• Convenient hours.
• Convenient location.
• Adequate space and sufficient privacy.
• Availability of peer education and a counseling programme.
• Affordable fees for the service.
• Involves young people in the provision of information and services.
• Informs the community about services for AYFRH.
• Availability of health workers trained in AYFRH service.
• Materials available for AYFRH service provision.

As you see in Figure 9.1., there are about 11 questions related to AYFRH services categorized under the following main headings:

• Materials/supplies and services
• Training of health workers
• Involvement of the young people and the community
• Convenience of the location and service hours

(Source: adolescent and youth RH blended learning module for health extension practitioners)

Step 2: Assess whether the health workers are trained to provide AYFRH services and find out what materials are available in the health facility

How will you carry out step 2?

The information that you want has been gathered using the needs assessment tool (Figure 9.1).

Step 3: Identifying problems related to AYFRH services

Activity 9.1

Figure 9.1 is called an assessment tool because it is used like any other tool to enable you to carry out a task (e.g. a knife is a tool that can be used to cut vegetables in a cooking pot). Use this assessment tool (i.e. Figure 9.1) to collect information about the services that are available at your health post. If you are for the first time to join the health post and there are other health extension workers or practitioners you should talk to them and collect the information jointly.

Based on the information you collected, use the following Table 9.2 to categorize the problems you found. Copy the table into your study diary and show this to your instructor.

List of Problems Identified Under Each Heading

Steps 4: Developing a proposal

Now you should develop a proposal to show how you are going to solve the problems you identified in your assessment. You may not be able to respond to all of the problems you have identified. Therefore you should prioritize the problems based on the importance of the problem and the resources you have or you could acquire. If you can't address the problems at your level, the proposal would help you request support from the health centre or woreda health office. The proposal should have the problems identified. It is good if you have prioritized the problems and put only two or three priority problems in your proposal. You need to include in your proposal, the objective, what you finally want to achieve by addressing the identified problem. It is good also to indicate your strategies (the different ways of achieving your objectives) in your proposal.

You may need to do one or more activities for each of your prioritized problems. You should put the major activity for each problem in your proposal. Addressing some of your identified problems may require resources; if you think you need resources for your priority problems; indicate in your proposal what resources you need. Finally, you should include the time within which you would like to accomplish your proposed activities. Table 9.3 is a form that is suitable for developing a proposal.

Form for Developing a Proposal

Step 5: Developing an action plan

With the proposal it is useful to develop an action plan for each problem that you have identified. The action plan is a very simple tool which will help you organize yourself to respond to the problems to AYFRH service provision at your health post. In the action plan you put very detailed specifications including who will do it and when the specific activity to be carried out. The activities you have put in the proposal may be more general activities. As an example Table 9.4 has been completed for the problem identified in the needs assessment.

Action Plan

Organizing school based AYRH programmes

For successful school-based activities, it is important that you work with the teachers and students themselves in each particular school. Initial discussion with some of the teachers and the students could give you ideas on the issues you need to focus on and the best strategies to employ. Remember that you need to tailor the information that you provide to students according to their age. You can use the various promotional strategies that you learned in the Health Education, Advocacy and Community Mobilization Module to reach young people who are in school. Design some suitable strategies for reaching young people in school. Most schools have clubs organized to respond to selected thematic areas or topics like an environmental health club and anti-AIDS clubs. A suitable strategy would be to visit the anti-AIDS club and work with young people there. If the schools have already established clubs, it is a good opportunity for you to reach the students in the schools through these existing clubs. The anti-AIDS club is appropriate for dealing with AYRH issues. If the schools do not have clubs, you can help them establish a club that can work on AYRH in the school.

How would you help the school establish a club if it doesn't have one? You can do this by holding an initial discussion with the school officials, biology teachers, and student representatives from each grade. They can mobilize the students to be members of the club. Your role will be to educate the club members and they will work on most of the promotional activities.

It is good to assess on a regular basis the changes that have been brought about by your school-based interventions. You can do this assessment by asking questions in the same way that you did when you held your initial discussions with the teachers and the students. Asking the club leaders how frequently they meet, how many of the members are girls, how many are boys, what specific promotional activities they have been doing, what challenges they have faced and what type of support they need from you will help you gain a better understanding of the value of your school-based interventions. It is a good idea to assess the activities every three months because this will give you important information to help you to plan your next activities

Organizing household and community level AYRH programmes

It is at household and community level that you can reach young people who do not go to school including those who are married. From the survey that you conducted, you already have the number of young people in your community. In addition to categorizing them by age (10-14, 15-19, 20-24) it is now advisable to categorize them by marital status in order to tailor your messages to the specific groups. Therefore it is important that you have specific household and community level interventions for this group of young people. At household level, when you plan a household visit for other health activities it is a good opportunity to integrate reproductive health-related activities and address them in each household where there are young people. Once you have the different categories of young people by age and sex, you can form peer groups in each sub-kebele (gotts). First you must train the peer educators. The groups meet for regular sessions, may be every two weeks or every month depending on how often they wish to discuss issues of concern to them. You will be the resource person when needed. As each peer group is likely to require your assistance at some point, it is good idea if you develop a plan for peer education related activities. To be able to plan support activities and assess their effectiveness you may need the following information:

• The number of peer education groups in the kebele.
  
• The number of peer members in each group.
  
• The number of sessions each group conducted during the quarter.
  
• The topics they covered in the peer education sessions.
  

Try to ensure that the peer groups do have similar characteristics, like married girls in one group; unmarried in another group. If you follow the five steps when setting up AYFRH services at your health post you will be able to improve the sexual and reproductive health of the young people in your community with the help of all you have learned in this Module.