Improving the fit: adolescents' needs and future programs for sexual and reproductive health in developing countries

Abstract

Demand is growing in developing countries for sexual and reproductive health programs for young people. However, little scientifically based evidence exists about which program approaches are most effective in shaping healthy behaviors. Careful evaluation and research must be increased, but meanwhile, planners need guidance as they expand programming. Research indicates that current programs often do not match the needs and health-seeking behaviors of young people. Behavioral theories and expert opinion agree that adolescents must be taught generic and health-specific skills necessary for adopting healthy behaviors. Constraints on financial and human resources, coupled with the great size of the youth population, highlight the need to find less costly ways to reach young people. These observations generate six programming principles to help planners and communities experiment with a wide variety of programming approaching.

PIP: Although the demand for sexual and reproductive health programming for young people in developing countries is growing, there is a dearth of evidence on the characteristics of effective programs. In fact, the available literature indicates there is a poor fit between existing programs and the needs of young people. Thus, planners must build upon existing knowledge about adolescents' needs, preferences, and health-seeking behaviors while taking resource constraints into consideration. This paper considers the need for approaches that can help adolescents to obtain information, skills-building opportunities, counseling, and clinical services. A review of the work of the WHO/UNFPA/UNICEF Study Group on Adolescent Health and Development suggests six principles for use in planning expanded sexual and reproductive health programs for young people: 1) recognize and address the fact that the program needs of young people differ according to their sexual experience and other characteristics; 2) begin with what young people want and what they are already doing to obtain information and services; 3) include building skills as a core intervention; 4) engage adults in creating a safer, more supportive environment in which young people can develop and learn to manage their lives; 5) use a greater variety of settings and providers--both public and private, clinical and nonclinical--to provide sexual and reproductive health information and services; and 6) build upon what exists by linking existing programs and services in new ways so that they reach many more young people.