“We used to think that if you have given birth, you have no value. You have no use. So when I heard about this project for first-time parents, I was like, ‘Ah, no matter what, I will be a part of this.’”
Queen Esther Peters, a 24-year-old mom from Cross River State Nigeria, sits in a bright blue plastic chair. She’s smiling. Beside her, a circle of empty seats will soon bustle with life—
Young moms will soothe, nurse, and balance their babies on their laps. Pregnant teens and 20-somethings will share their experiences and get lifesaving health advice. First-time mothers will discover strategies to resolve conflicts and make decisions with their male partners.
Queen Esther is proud to lead this small peer group, part of a core package of activities for young first-time parents (FTPs) developed by the Evidence to Action (E2A) Project. E2A’s comprehensive first-time parent program model, implemented with dedicated country partners and funding from USAID, is effectively improving health and gender outcomes for this critical population in multiple countries.
Why FTPs and Why Now
Each year, at least 12 million girls aged 15–19 years give birth in developing countries. And millions more young women like Queen Esther have become mothers by the time they are 25 years old.
These young first-time mothers are at increased risk of poor pregnancy, delivery, and child health outcomes—a situation compounded by multiple factors that limit their access to timely health information and services. Additional life uncertainties, especially those related to their education and economic options, also affect if, when, and how first-time parents are able to take action on their health concerns. Despite these increased risks, traditional reproductive health programs typically do not fully address the needs of FTPs.
Using E2A’s approach, programmers can close this gap and reach FTPs during this pivotal stage in their lives—when they are most receptive to information about their health and futures.
“I learned so many things,” says Queen Esther. “I learned about exclusive breastfeeding…about my health as a mother…about caring for my baby.”
Her face brightens. She is passionate about sharing this knowledge.
“In my peer group…so many of them never knew there was anything like family planning that could help them to space the way they have their children. Before, even I thought there were only two methods,” she laughs and shakes her head. “But I have learned there are so many methods.”
Unique Opportunity for Impact
In designing FTP programs, E2A identified key outcomes important during the FTP lifestage—a 33-month interval that encompasses main health events—from conception through 2 years postpartum. Applying a context-specific life-course lens, which takes into consideration the local epidemiological profile and cultural context of reproductive health-related behaviors, helped E2A identify specific opportunities for reproductive health and related interventions and address family planning; healthy timing and spacing of pregnancies; maternal, newborn, and child health; and gender outcomes through one approach.
Furthermore, this is a formula for influencing multiple generations through one program. E2A’s approach engages diverse stakeholders, including influential male partners and mothers-in-law, and addresses specific moments where interventions can make the greatest impact, not only for the FTP’s health, but also for the wellbeing of the next generation.
“Decision making—I have always thought that it’s only the man of the house that has the final decision,” says Prince Emmanuel, Queen Esther’s partner and a first-time father. “But when [the project] came, they made me to understand family decisions are for the two spouses.”
“Family planning is the best thing that can ever happen to any youth,” says Queen Esther without hesitation. “Because with the knowledge of family planning, it will help you not to give birth to children when you are not ready. It will help you to position your life well and plan for your future.”
Programming That Gets Results
Since 2014, E2A has prioritized improving health outcomes for FTPs and delivered results.
Wherever E2A has implemented our first-time parent programs, voluntary contraceptive use has climbed. For example, look at these significant increases from Nigeria—
Couples communication on family planning also increased significantly in Nigeria, with reported discussions about family planning among first-time mothers doubling from baseline to endline—41% to 80%, respectively—and increasing significantly among male partners—from 69% to 91%.
These results matter. So do the lessons we’ve learned along the way.
Over the course of implementing FTP projects in multiple settings, our team has gained valuable experience in the “how to”—and occasionally, the “how not to”—of FTP programming. Project experience, implementer feedback, and input provided by FTPs like Queen Esther have highlighted several programming elements that are new or distinct from traditional family planning/reproductive health or youth programming when applied to this transitional lifestage.
Now we want to share our most important takeaways with you. We believe, like Queen Esther, that knowledge should be shared.
Key Insights for First-Time Parent Programs
These high-level FTP insights are a compilation of our learnings relevant across multiple contexts and multiple programs—from Francophone West Africa, Anglophone West Africa, and East Africa. They represent learnings from standalone FTP projects, as well as FTP programs implemented within larger projects.
No matter where you plan to implement an FTP program, or in what programmatic context, these insights should provide you with useful information as you design and implement.