She knows best: engaging girls in adolescent programming  

With the support of the David & Lucile Packard Foundation, the International Rescue Committee piloted a new approach to increase access to sexual and reproductive health (SRH) care for adolescents in Goma, Democratic Republic of Congo. The report “She knows best: Engaging girls in adolescent programming” highlights the strategy developed to address foundational facility and community-level barriers that prevent adolescents from accessing and receiving quality SRH services.
 
Our approach

Increased provider capacity: The IRC conducted a series of activities including ASRH training, Values Clarification and Attitude Transformation Activities (VCAT) and targeted supportive supervision.
Improved facility readiness: Baseline and endline facility assessment helped measure facility readiness and recognize areas for improvement. Reorganization to ensure confidentiality and privacy of services and monthly adolescent SRH data review meetings were key.
Meaningfully engaged adolescents: The IRC’s success can be credited to the direct involvement of adolescents in participatory workshops, monthly meetings, joint supportive supervision and data review visits and innovative outreach and mobilization activities led by the adolescents themselves.

Results
 
As a result, the number of adolescents who adopted new methods for contraception increased from 67 in March 2017 to 156 in December 2017, totaling 1,176 adolescents in a 10-month period. By the second month of the project, over one-third of contraception clients were adolescent girls and 89% of adolescent clients accepted long-acting methods during this 10-month period.
 
Lessons learned
 
• STI care can serve as a key entry point for adolescents in Goma.
Adolescents reported that discussing STI care with their peers is at times easier and more acceptable than discussing the need for other SRH services.

• Engaging adolescent boys, parents of adolescents and other influential adults may strengthen the approach.
Data from the participatory assessments indicate that these key stakeholders strongly influence adolescent access and use of services.

• There is a latent demand for comprehensive abortion care services.
Adolescents reported that girls in their community sought abortions through existing, informal networks.

Authors: Rita Nehme, Nathaly Spilotros - International Rescue Committee