Building a Better Future for Youth: Learning from Experience and Evidence

This 32-page report offers a summary of the content and discussions that formed part of the Africa Regional Forum on Youth Reproductive Health and HIV which took place in June 6–9, 2006. The event was sponsored by the World Health Organization’s Department of Reproductive Health and Research (RHR), the Frontiers in Reproductive Health (FRONTIERS) Program of the Population Council, and the YouthNet Program (YouthNet) of Family Health International (FHI).

The forum aimed to address critical issues in youth reproductive health and HIV programmes in sub-Saharan Africa. About 90 national, regional, and international researchers, donors, programme managers, youth, and policy-makers from nine African countries and global organisations participated.

The objectives of the Africa Regional Forum on Youth Reproductive Health and HIV were to:

• share the latest research results and programme evidence;
• share findings and methodologies of promising interventions for youth and identify new programmes and techniques;
• identify gaps in existing research, programmes, and policies in youth reproductive health and HIV prevention; and
• explore monitoring and evaluation methodologies and desired outcomes for youth programmes.

Recommendations

The following recommendations with communication implications were derived from the evidence and analysis provided during presentations, group discussions, and working groups at the forum.

Trends in youth behavior and environment

• governments, communities, families, and donors should respond to the needs of young people by creating supportive environments and programmes to prevent and address the causes of vulnerability and their consequences;
• programmes for youth must improve efforts to identify and meet the diverse needs reflected within this growing sector of society;
• messages promoting condom use as a contraceptive should provide women with a more acceptable negotiating stance with partners than disease prevention alone.

Participation of youth

• meaningful participation makes programmes more relevant and sustainable and improves general youth development. Youth should be involved in the design, implementation, and evaluation of programmes;
• given the critical role of youth participation in programme success, there is a need to develop new methods to measure the level and effects of youth participation on programme quality and sustainability.

Services for youth

• programmes should incorporate multisectoral approaches whenever feasible. At a minimum, youth programmes should be linked with other networks concerned with youth, as well as with other efforts to serve the needs of youth in the community;
• to improve quality and accessibility, efforts should be made to train clinic providers and supervisors, remove medical and other access barriers, integrate services (especially reproductive health and HIV), and offer as many services under one roof as possible, while refer­ring people to other youth-friendly providers for services not offered. Also, ensure privacy and confidentiality for youth seeking services.
• documented models of successful and unsuccessful integration experiences are needed to better understand the benefits, processes, and limitations of service integration;
• programmes should prioritize taking repro­ductive health and HIV services directly to youth, rather than building new facili­ties. Stand-alone, multi-purpose youth centers and clubs often fail to attract large numbers of at-risk youth and are expensive to build and operate.

School- and curriculum-based education, and peer education

• keeping youth in school is perhaps the most critical strategy for promoting the successful transition to adulthood. In addition to the academic benefits of schooling, the school environment offers opportunities for social support for the healthy development of youth.
• an annotated database should be created to facilitate the adaptation of school and peer education curricula to support the use and scale-up of evidence-based best practices.
• designers of peer education programmes should be knowledgeable about environ­ments where peer education programmes are likely to be most effective, as well as about why certain programmes have been unsuccessful.

Supportive environments

• researchers need to make the results of analysis and synthesis on youth issues more readily available and more compre­hensible to stakeholders. Similarly, poli­cymakers need to be more aware of best practices and open to applying evidence-based results in decisionmaking;
• programmes should invest greater resources in documenting and sharing experiences related to fostering supportive environ­ments;
• collaboration, regular feedback, and communication are vital to maintaining a positive working relationship with com­munities. All programmes should develop explicit dissemination strategies that include key stakeholders within the com­munity as well as programme beneficiaries.

Monitoring and evaluation

• programmes should include explicit moni­toring and evaluation plans appropri­ate to the level of available funding for services;
• the lack of process data on programme implementation is especially problematic when interpreting impact data, attribut­ing effects to programme investments, and understanding how intervention strate­gies are implemented. Programmes should incorporate process evaluation indictors into monitoring and evaluation plans to ensure measurement of the effectiveness of their interventions;
• the lack of documentation of negative findings or unsuccessful youth programmes limits our understanding of how to improve them. A “safe” forum should be created to allow programme directors, researchers, and youth to share experi­ences of unsuccessful programmes.