E2A Newsletter, March 2015

Niger: Shining the national spotlight on young people’s sexual and reproductive health


E2A has helped to place young Nigerien’s sexual and reproductive health in the national spotlight by convening representatives of Niger’s Ministry of Public Health (MPH), relevant civil society organizations (CSOs), implementing partners, and donors, as well as young people themselves, in two recent meetings, held March 12 and March 17-18 in Niamey.

The first meeting, co-hosted with Pathfinder International, the Youth Health and Rights Coalition, and the Nigerien organization Lafia Matassa, was a technical exchange with local CSOs. During the meeting, participants identified ongoing advocacy initiatives on adolescent and youth sexual and reproductive health (AYSRH), assessed the policy landscape and its impact of CSO-led work on AYSRH and rights, created a space for collaboration toward advocacy, and built participants’ advocacy skills.

The second meeting was a workshop with 70 participants entitled "Prioritization and Dissemination of Adolescent and Youth Sexual and Reproductive Health Best Practices in Niger." Representatives from the MPH and other relevant government ministries, donors, international and local nongovernment organizations, and student representatives from Niamey’s Abdou Moumouni University, where E2A currently supports an AYSRH program, discussed promising practices that could be applied to improve AYSRH. Those practices include increasing access to integrated health services for young people, extending mobile outreach services, expanding community-based services for youth, and building youth leadership. They also identified gaps and opportunities to strengthen support for AYSRH programs, such as bolstering tailored behavior-change strategies for young people, community influencers, and service providers. Participants made plans for accelerating the achievement of Niger’s national family planning goals and scaling up select best practices, and through their dialogue, strengthened national stakeholder collaboration.

E2A also introduced its soon to be released tool—Thinking outside the separate space: A decision-making tool for designing youth-friendly services. Through group work, participants tested the tool, following its steps for strategically selecting and assessing the scalability of appropriate youth-friendly service models and demand-generation strategies.

As a result of the meetings, there are plans to: establish a national AYSRH consultative group that will bring together government and civil society actors to better harmonize and coordinate AYSRH efforts; introduce a new strategy for sharing information between civil society and the government about AYSRH efforts (including new tools and an M&E committee); and launch a participatory process to develop a new national AYSRH strategic plan.

E2A’s work in Niger is part of its robust portfolio of programs for youth described in this fact sheet.

New study on use of text messages to reach youth with sexual and reproductive health information in Mozambique

In Mozambique, contraceptive use among those younger than age 25 is extremely limited, while misconceptions that impede contraceptive use are all too common. It is therefore essential that young people receive accurate information about contraception that will allow them to make evidence-based decisions about their sexual and reproductive health (SRH).

To reach young people with this type of information, Pathfinder International implemented the mCenas! program from September 2013 to June 2014 in Mozambique’s Matola district of Maputo province and Inhambane City district of Inhambane province. mCenas! targeted youth 15-24, with and without children, in an interactive two-way SMS (text message) system, which included story messages, to increase their knowledge about contraceptive methods, dispel common myths around contraception, and address common barriers youth face regarding use of contraception.

E2A assessed use of that SMS system and its effects on the knowledge, attitudes, and self-efficacy related to contraception among young people aged 18-24. The findings from that assessment are published in a comprehensive report and policy brief.

Key findings include:

  • mCenas! contributed to an increase in the number of contraceptive methods the young participants knew about.
  • Perceptions of safety, ease of use, and effectiveness improved significantly among males and females for multiple modern methods.
  • The interventions contributed to some increases in intention to use a method in the future.
  • Youth were better informed about contraception and its effects following exposure to the SMS interventions.
  • Self-efficacy at both baseline and endline was high for males and low for females.
  • Participants were largely satisfied with the intervention, felt comfortable sending and receiving SMS messages about SRH, and expressed willingness to receive SMS messages on SRH in the future.

These findings were presented at a national dissemination event in Maputo on March 27.

E2A offers perspective on scale-up of emergency contraception and reaching first-time parents at annual Global Health Mini University

E2A, in collaboration with Pathfinder International, engaged students and global health professionals at the annual Global Health Mini University, hosted by USAID and the George Washington University Milken Institute School of Public Health, on March 2, in two sessions: one on introducing and scaling up emergency contraception and another on reaching first-time parents with sexual and reproductive health services.

The presentation, "Stop Playing Favorites: Introducing and Scaling-up a Neglected Contraceptive Commodity," focused on the importance of including emergency contraceptive pills (ECPs) in a balanced, rights-based contraceptive method mix and illustrated promising practices and challenges to introducing and scaling up ECPs within national health systems.

The presentation drew on an assessment E2A conducted, Emergency Contraception: Four Country Case Studies on the Introduction and Scale-up of Emergency Contraception, which presents four country case studies that analyze how Mexico, Bangladesh, Senegal, and Kenya introduced and/or scaled up ECP programs using two frameworks: the World Health Organization’s Building Blocks for Health Systems Strengthening and the International Consortium for Emergency Contraception’s 9 Steps. During the presentation, participants were encouraged to note the different components which helped and/or hindered each program and to think about these during the group work session.

The group work focused on how the Government of Mozambique has started to scale up emergency contraception. Participants were asked to divide into two groups to discuss the question: What should Mozambique consider in order to further scale up access to ECP based on the lessons learned from the case studies?

Another presentation from E2A focused on first-time parents: why it is important to reach this population to improve sexual and reproductive health and gender-related outcomes, and potential strategies for reaching them.

The presentation identified first-time parents as young women under the age of 25 who are pregnant or already have one child and their partners, pointing out the inherent diversity of the population and the importance of recognizing that diversity when designing programs for them. During the group work session, participants read different scenarios and identified factors that might prevent first-time parents from spacing their pregnancies in a healthy way or seeking other health services.

The presentation also gave a brief summary of E2A’s literature review on first-time parents and recommendations for designing programs for first-time parents that are based on evidence from that literature review. Participants learned that combining a number of approaches to offer an integrated package of information and services for a woman, her partner, and her support network is likely to be the most effective way to improve reproductive decision-making, increase the use of contraceptives, and promote healthier spacing of additional children.