Youth

There are 1.2 billion people ages 10–19 in the world today. Nine out of 10 young people live in developing countries, where they face profound challenges, such as high rates of early marriage, unintended pregnancy, HIV and other sexually transmitted infections, and maternal mortality and morbidity. Young people’s sexual behavior, and their resulting sexual and reproductive health (SRH), is influenced by peers, parents, and other adults in the communities in which they live. As a result, it is essential to involve members of the wider community in SRH programs in order to build an enabling environment for young people to improve their well-being and health. Involving communities also increases the potential to reach youth who are not in school or who are otherwise more at risk (for example, orphans and vulnerable children). Advancing Partners & Communities (APC) recognizes the importance of addressing the unique needs of adolescents as part of a comprehensive approach to strengthening community health systems and programs.

Read more about APC's youth activities [PDF, 326 KB]

Photo credit: Simone D. McCourtie/World Bank

Below are select resources related to key issues within youth.

Multisectoral Approaches

Addressing young people’s lives in a broader context may ultimately have a stronger impact on reproductive health behavior than a narrow focus on sexuality.

The Intersection of Economic Empowerment and Youth Sexual and Reproductive Health
May 2013 | Brief

This brief reviews various types of “economic empowerment” approaches, discusses promising programs and talks about next steps for this relatively new topic of the intersection of economic empowerment and youth SRH.

A Framework for Integrating Reproductive Health and Family Planning into Youth Development Programs
December 2011 | Publication

This document, based upon an initial “Planning for Life” Project Launch and Technical Workshop that took place in New Delhi, India in September 2007, provides a strategic framework for youth reproductive health (YRH) and family planning (FP) and its integration into youth development programs.

Married Adolescents

Programs addressing adolescent reproductive health and HIV prevention tend to focus on unmarried youth, but the majority of unprotected sexual activity among adolescent girls in most developing countries occurs within marriage. In some settings, young married girls (ages 15 to 19) have been shown to have higher rates of HIV infection than sexually active unmarried youth of the same ages.

Girls Not Brides
September 2014 | Website

Girls Not Brides is a global partnership of more than 350 civil society organizations from over 60 countries working to address child marriage. Members are based throughout Africa, Asia, the Middle East, Europe and the Americas and are united by a commitment to end child marriage and enable girls to fulfil their potential.

Marrying Too Young: End Child Marriage
July 2012 | Report

International conventions declare that child marriage is a violation of human rights because it denies girls the right to decide when and with whom to marry. This report is intended to help policymakers prevent this violation of girls’ rights. It summarizes available data and evidence, while offering advice on the many issues involved, and suggests prioritized actions to reduce, and eventually eliminate, child marriage.

Addressing Early Marriage of Young and Adolescent Girls
January 2011 | Brief

This brief is a discussion of five approaches for delaying marriage that also can help girls avoid HIV, other STIs, and early or unintended pregnancy.

Long-Acting and Reversible Contraceptives

Long-acting reversible contraception (LARC)—intrauterine devices and contraceptive implants—are safe and appropriate contraceptive methods for most women and adolescents. Expanding access to LARC for young people will drastically reduce the rate of unintended pregnancies, unsafe abortions, and maternal and infant morbidity and mortality across the globe.

Characteristics of Kenyan women in a prospective cohort study who continue using subdermal contraceptive implants at 12 months
November 2013 | Journal Article

This article compares baseline characteristics of Kenyan women who continued to use implanted contraceptives at 12 months to those who did not. Note: A subscription is required to view the full document.

Adolescents and Long-Acting Reversible Contraception: Implants and Intrauterine Devices
October 2012 | Committee Opinion

This committee opinion describes the outcome of a study that found that more than two-thirds of females aged 14-20 years chose long-acting reversible contraception (LARC). It also exhorts professionals to use LARC methods as a first-line recommendation for all women and adolescents.

Peer Education

Peer education is a popular approach for promoting HIV prevention and reproductive health among young people. However, the quality of peer education varies. Difficulty in recruiting and retaining peer educators, lack of community support, and poor training and supervision of peer educators can adversely affect a program’s impact. Effective peer education programs require intensive planning, coordination, supervision, and resources.

Evidence-Based Guidelines for Youth Peer Education
October 2014 | Guide

This guide helps readers to develop new, high-quality peer education programs for young people ages 10-24 years and to improve existing programs. Although the focus is on peers working with young people to improve their sexual and reproductive health, these guidelines can be applied more broadly to other types of peer education programs as well. This second edition of the publication provides updated technical content and incorporates information about addressing gender inequality in peer education programs.

Integrated Services

Young people, especially those who are sexually active, need a variety of services, including contraception, HIV counseling and testing, testing and treatment for other sexually transmitted infections, pre- and postnatal care, and postabortion care. Health facilities serving youth often offer one primary service. As a result, young people’s full range of sexual health needs are not addressed. Research shows that there is a strong need for various services in a single setting.

From Roots to Results: Evidence-Based Practices for Integrating Family Planning in HIV Programs
April 2014 | Video

This video summarizes the evidence from FHI 360’s review of 97 resources. FHI 360 identified evidence pertaining to the rationale for integrating family planning and HIV; facilitators of and barriers to successful integration; the impact of integrated FP/HIV services; and recommendations to advance effective delivery of integrated services.

WHO guidance document on HIV Testing and Counselling and Care for Adolescents Living with HIV
November 2013 | Guide

These guidelines provide specific recommendations and expert suggestions — for national policy-makers and program managers and their partners and stakeholders — on prioritizing, planning and providing HIV testing, counselling, treatment and care services for adolescents.

Service delivery characteristics associated with contraceptive use among youth clients in integrated voluntary counseling and HIV testing clinics in Kenya
March 2012 | Journal Article

This journal article explores the facility- and provider-level characteristics that may be associated with same day uptake or intention to use contraception after a voluntary counseling and testing visit, and contraceptive use three months later among youth clients, controlling for client characteristics. Note: A subscription is required to view the full text.

Linking Sexual and Reproductive Health and Gender Programs and Services with Prevention of HIV/STIs
June 2010 | Proposal

This proposal seeks to make a significant contribution to the efforts already underway in several locations to optimize health care, including sexual and reproductive health promotion and care with a gender perspective that explicitly approaches HIV and other STIs as problems requiring immediate attention. The proposal not only stresses the importance of collaboration among programs, services, providers, and community members to better tackle the challenges posed by these issues, but also proposes actions that can lead to a better quality of life for the individual, the family, and the community.

Pregnancy Prevention and Family Planning for Adolescents Living with HIV

According to several studies, unintended pregnancies occur at a very high rate for adolescents living with HIV. Most contraceptive methods can be used by women who are living with HIV, but condoms are recommended to prevent the spread of HIV or reinfection. People who are living with HIV also have the right to have children when they are ready, but it’s very important that they to talk to a doctor about the safest way to conceive. Taking ARVs as prescribed can lower a woman’s chances of passing HIV to her unborn child.

Resources for Adolescents Living with HIV
March 2014 | Brief

This brief provides a list of resources to support communities and health care providers in meeting the unique physical, social, and psychosocial needs – including sexual and reproductive health – of adolescent HIV.

Adolescents Living with HIV in Zambia: An Examination of HIV Care and Treatment and Family Planning
October 2013 | Brief

This brief summarizes key findings of a study to understand the experiences and concerns of adolescents living with HIV in terms of their HIV care and treatment and their sexual and reproductive health.

Improving Adolescent HIV Treatment, Care, Prevention and Family Planning Services Technical Brief
July 2012 | Brief

This technical brief provides an overview of current literature and an analysis of key informant interviews investigating the key challenges and successful approaches to supporting ALHIV, particularly those who are perinatally infected and living in sub-Saharan Africa.

Postabortion Care

Young women are generally more vulnerable than adults to unintended pregnancy, unsafe abortion, and abortion-related complications. Girls and young women also are more likely to face barriers to receiving vital postabortion care (PAC). PAC for all women should include emergency treatment for potentially critical complications of abortion; family planning counseling and services; evaluation and treatment for sexually transmitted infections; and HIV counseling and testing, or appropriate referrals.

Post-abortion care services for youth and adult clients in Kenya: a comparison of services, client satisfaction and provider attitudes
June 2013 | Journal Article

This journal article documents how the receipt of postabortion care varies by client age. Descriptive data were collected from clients, providers, and eight health facilities in Kenya's Central and Nairobi provinces to examine receipt of PAC services by client age, client satisfaction, and provider attitudes. Note: A subscription is required to view the full text.

Meeting the needs of adolescent post-abortion care patients in the Dominican Republic
March 2010 | Journal Article

This journal article aimed to evaluate an intervention whose goal was to improve the counseling and contraceptive uptake of PAC patients, with special attention given to the needs of adolescent patients, in the four public hospitals in the Dominican Republic where PAC services were not being routinely offered. Note: A subscription is required to view the full text.

Mobile Phones and Other Technology

Global mobile phone use is rapidly increasing and a large percentage of mobile phone users are young people. Many programs are capitalizing on their ubiquity as a way to reach young people with important health information, and research is beginning to demonstrate that mobile phones are a feasible means of mass communication for this population.

Evaluating feasibility, reach and potential impact of a text message family planning information service in Tanzania
January 2012 | Journal Article

This journal article’s objective was to evaluate the feasibility, reach, and potential behavioral impact of providing automated family planning information via mobile phones to the general public in Tanzania.

Very Young Adolescents

Studies show that most very young adolescents (ages 10-14) lack the knowledge and skills to reduce associated risks of puberty, including unplanned pregnancy and sexually transmitted infections. Very young adolescents (VYAs) face additional unique challenges such as early marriage, the increased danger of pregnancy, and high vulnerability to sexual violence and coercion.

Investing in very young adolescents' sexual and reproductive health
March 2014 | Journal Article

Since early adolescence marks a critical transition between childhood and older adolescence and adulthood, setting the stage for future SRH and gendered attitudes and behaviors, targeted investment in VYAs is imperative to lay foundations for healthy future relationships and positive SRH. This article advocates for such investments and identifies roles that policy-makers, donors, program designers and researchers and evaluators can play.

Whose turn to do the dishes? Transforming gender attitudes and behaviours among very young adolescents in Nepal
March 2013 | Journal Article

This article focuses on Choices, Save the Children’s curriculum designed to help VYAs explore alternate views of masculinities and femininities, and its impact in Siraha district, Nepal. Research revealed changes in children's gendered attitudes and behavior relating to discrimination, social image, control and dominance, violence, attitudes to girls' education, and acceptance of traditional gender norms, before and after participating in Choices.

Advancing Promising Program and Research/Evaluation Practices for Evidence-based Programs Reaching Very Young Adolescents: A Review of the Literature
September 2010 | Literature Review

This paper reviews and describes research practices and program interventions addressing the SRH of VYAs and identifies promising program components and research/evaluation practices.

CHSS

Preventing Unintended and Unplanned Pregnancy among In-school Youth: An Acceptability and Feasibility Assessment
December 2016 | Assessment

To better understand the feasibility and acceptability of interventions to reduce unintended pregnancy among in-school youth, APC in Uganda conducted a formative assessment in the Lira, Amuru, Oyam, Pader, Agago, and Dokolo districts. 

Below you will find links to resources created by APC and other organizations.

External Resources

Whose turn to do the dishes? Transforming gender attitudes and behaviours among very young adolescents in Nepal
March 2013 | Journal Article

This article focuses on Choices, Save the Children’s curriculum designed to help VYAs explore alternate views of masculinities and femininities, and its impact in Siraha district, Nepal. Research revealed changes in children's gendered attitudes and behavior relating to discrimination, social image, control and dominance, violence, attitudes to girls' education, and acceptance of traditional gender norms, before and after participating in Choices.

Promoting Partner Reduction: Helping Young People Understand and Avoid HIV Risks from Multiple Partnerships
December 2012 | Guide

This guide is a set of activities created to address multiple partnerships, with an emphasis on those that are overlapping or concurrent (sometimes referred to as “multiple concurrent partnerships” or MCPs). This resource was designed to supplement other programs on sexuality education or HIV prevention.

Adolescents and Long-Acting Reversible Contraception: Implants and Intrauterine Devices
October 2012 | Committee Opinion

This committee opinion describes the outcome of a study that found that more than two-thirds of females aged 14-20 years chose long-acting reversible contraception (LARC). It also exhorts professionals to use LARC methods as a first-line recommendation for all women and adolescents.

Marrying Too Young: End Child Marriage
July 2012 | Report

International conventions declare that child marriage is a violation of human rights because it denies girls the right to decide when and with whom to marry. This report is intended to help policymakers prevent this violation of girls’ rights. It summarizes available data and evidence, while offering advice on the many issues involved, and suggests prioritized actions to reduce, and eventually eliminate, child marriage.

Improving Adolescent HIV Treatment, Care, Prevention and Family Planning Services Technical Brief
July 2012 | Brief

This technical brief provides an overview of current literature and an analysis of key informant interviews investigating the key challenges and successful approaches to supporting ALHIV, particularly those who are perinatally infected and living in sub-Saharan Africa.

Service delivery characteristics associated with contraceptive use among youth clients in integrated voluntary counseling and HIV testing clinics in Kenya
March 2012 | Journal Article

This journal article explores the facility- and provider-level characteristics that may be associated with same day uptake or intention to use contraception after a voluntary counseling and testing visit, and contraceptive use three months later among youth clients, controlling for client characteristics. Note: A subscription is required to view the full text.

Evaluating feasibility, reach and potential impact of a text message family planning information service in Tanzania
January 2012 | Journal Article

This journal article’s objective was to evaluate the feasibility, reach, and potential behavioral impact of providing automated family planning information via mobile phones to the general public in Tanzania.

My Changing Body: Body Literacy and Fertility Awareness for Young People (IRH)
December 2011 | Manual

The purpose of the manual is to teach girls and boys ages 10-14 years about the changes they experience as they approach puberty, and share information in objective and reassuring terms. What youth learn from this intervention can help them become more self-confident, practice good health habits, and gain a positive self-image that contribute to their future sexual and reproductive health.

A Framework for Integrating Reproductive Health and Family Planning into Youth Development Programs
December 2011 | Publication

This document, based upon an initial “Planning for Life” Project Launch and Technical Workshop that took place in New Delhi, India in September 2007, provides a strategic framework for youth reproductive health (YRH) and family planning (FP) and its integration into youth development programs.

Addressing Early Marriage of Young and Adolescent Girls
January 2011 | Brief

This brief is a discussion of five approaches for delaying marriage that also can help girls avoid HIV, other STIs, and early or unintended pregnancy.

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