Addressing the needs of young married & unmarried adolescents in rural settings Tekle-Ab Mekbib, Population Council, Addis Ababa, Ethiopia Presentation made at: Early Intervention for Effective Prevention: Timing is Everything! A Consultative Meeting on Appropriate and Targeted Policies and Programs for 10 -14 year olds in Ethiopia Tuesday, October 9, 2007 Desalegn Hotel, Addis Ababa

Background A further analysis of EDHS 2000 by the Population Council revealed that: In Ethiopia, 18% of adolescent girls aged 10-14 live with no parent 17% of rural girls are enrolled in school 86% of adolescents aged 10-14 live in rural areas 50% of Amhara girls get married before they reach age 15

Youth Programs The most popular youth programs in Ethiopia are: School based programs (Family life education, clubs, etc.) Youth centers Youth-friendly services Peer-education

Youth Programs Cont’d Typically, youth programs assume that many adolescents are having premarital sex Focus on premarital pregnancy and school girl drop-out Efforts concentrate on educating on the dangers of premarital sex and modes of HIV transmission Do these efforts take into account local patterns of adolescent sexual activity in particular areas of Ethiopia?

Diagnostic Studies Who are targets of youth programs? A study conducted by the Population Council in 2003 13 Youth Organizations took part in this exercise Critical gaps in their services were identified Majority of beneficiaries were boys (58%), and in school (78%) Girls married and unmarried had limited participation 22% of beneficiaries were aged 10-14 All programs were urban based HIV information included 69% of the contacts, while information on condoms was only 20%

Diagnostic Studies Cont’d Suggested programmatic recommendations: Out-of-school & vulnerable groups were neglected by programs & required rethinking to modify programs Programs were urban based, while majority of young people live in rural areas, & a paradigm shift to address the needs of these groups is needed Adolescent girls were neglected by progams, designing innovative approaches to reach these vulnerable youth was timely

Diagnostic Studies Cont’d In 2003, PC was requested by the Ministry of Youth & Sports to conduct a study The objective was to understand the diversity of adolescent lives in rural areas Relevant programmatic recommendations for programming were put forward In the study, two districts in West Gojam Zone were selected In-depth interviews followed by a large scale survey of over 1800 adolescents aged 10-19 were conducted A range of topics were covered in the questionnaire (education, time use, migration, RH knowledge and pracitce, marriage, pregnancy & childbirth, sexual activity, etc.)

Most girls do not know what is happening to them… Percent of girls who knew about and consented to marriage, by age at marriage Married <10 Married 10 to 15 Married age 16+ All married girls Knew spouse 2.8 4.5 12.9 5.5 Knew about marriage 5.6 17.3 25.8 15.3 Consented to marriage 6.9 20.5 48.4 19.6 Wanted to get married 16.0 41.9 14.9

Sexual initiation was most often unwanted and traumatic 69 percent of girls had first sex before first menstruation Percentage of girls whose sexual initiation was unwanted and forced, by age at marriage Married <10 Married 10 to 15 Married age 16+ All married girls Did not want to have sex when they did 92.3 82.4 66.7 82.0 Were forced against their will to have sex 89.7 83.8 60.0 81.4

Programming for the most vulnerable adolescent girls Principles Broad social change; not individual behavior change Change a generation of girls by mobilizing them and building social assets Berhane Hewan Project “Berhane Hewan” (Amharic for ‘Light for Eve’) in rural Amhara to mobilize and support girls at risk of early marriage or girls who are already married

BERHANE HEWAN Technical support is provided by the Population Council Project targets over 600 unmarried & married adolescent girls (10-19 yrs) Project is located in Yilmanadinsa woreda (Mosebo KA) of west Gojam zone

Project Objectives Objective 1: Reduce the practice of early marriage among 10-15 year olds Objective 2: Increase proportion of married girls’ RH information and service utilization

Key Strategies focusing on Unmarried adolescent girls 1)Promoting functional literacy, life skills, livelihood skills & RH education through girls’ clubs led by adult female mentors 2) Supporting social networks of adolescent girls through mentors that impart life skills, information on RH and legal issues; 3) Livelihood component to address community needs e.g. water points, vegetable gardening, improved stove, and 4) Community Conversations to gain family and community support

Implementation Process Nearly 2 years of implementation in 1 KA yielding in enrolment of 647girls, 77% of whom are unmarried girls. Rapid assessment indicated that girls are happy to attend school & parents supportive Parents are also supportive of livelihood skills Currently, an end-line survey is completed to measure the impact of this intervention

Other Programs Under the PEPFAR Program, the Population Council is: Working in West Gojam and North Gondar to delay child marriage and in the prevention of HIV infection The EOC, EMDA and the Ministry of Youth & Sports are key partners in this program Currently, the expansion of this activity is including urban areas