Below is a description of an initiative JHPIEGO has launched in Bahia, Brazil, that is
utilizing the existing network of reproductive health clinics to link educational efforts
and service delivery to strengthen the public health sector’s response to the needs
of young people.
Background
Since 1993, JHPIEGO has been providing technical
assistance to the Bahia State Secretariat of Health (SESAB) in the implementation of
reproductive health Clinical Training Centers through the training of service providers in
contraceptive technology, service delivery standardization, clinical training skills
courses, and ongoing mentoring and supervision. Currently, nine Clinical Training Centers
are implemented and activated: three in the state capital and six in the interior. As a
result of “echo” courses conducted by the training centers, close to 400 service
providers have received clinical training in family planning and 170 service delivery
points have begun providing family planning services to the general population.
During 1992–1994, UNFPA provided technical assistance to 40 public schools to
strengthen sexuality education by training primary and secondary school teachers and
including sexuality education materials in the public school curricula.
As a result of the UNFPA assistance, adolescent demand at family planning service
delivery points increased significantly, and service providers reported feeling unprepared
to provide adequate family planning care to the adolescent population. Per SESAB’s
request, JHPIEGO, in collaboration with Odebrecht Foundation in Brazil, designed a
demonstration project aimed at linking health and education through the implementation of
a school-clinic referral system. The strategy built upon the existing training centers and
family planning service providers and focused on 10 select public schools statewide.
Program Results to Date
A supportive policy environment has been created by forming state Reproductive Health
and Sexuality Education Technical Committees. These committees work closely to develop
state reproductive health service guidelines that place special emphasis on the provision
of care for adolescents and also standards for sexuality education in public schools. Both
documents are finalized and will be published in mid-1997.
32 decision-makers and key stakeholders have been sensitized to the RH
needs of adolescents.
147 RH service providers (of an estimated project total of 350
providers) have received updated information about the RH needs of adolescents.
100 teachers from the public sector (of an estimated project total of
200 teachers) have received updated information and have the teaching skills to implement
sexuality education in public schools.
Referral systems have been implemented between 10 participating schools
and 10 nearby service delivery points to document the use of these clinics by adolescents
at the schools.
Next Steps
Evaluation activities began in March 1997. Activities
planned or in progress include: knowledge, attitudes and practices (KAP) surveys of
adolescents and service providers, collection of service statistics, exit interviews with
adolescents and teachers, and use of a teacher logbook to document sex-ed interventions at
schools. These tools will assess changes in knowledge, attitudes and practices regarding
reproductive health among adolescents in public schools and service providers located at
pilot service delivery points. Evaluation activities will also document the ways in which
the linked interventions have affected adolescent access, use and satisfaction with family
planning services.
More
