EVALUATION OF PILOT YOUTH FRIENDLY SERVICES DEBRIEFING EVALUATION OF PILOT YOUTH FRIENDLY SERVICES

Outline Project Overview Objectives of evaluation Methodologies of evaluation Key Findings Conclusions and Discussions Recommendations

Youth Counselling Service | Youth Friendly services 1. Project Overview Youth Counselling Service | Youth Friendly services Project Objective Project Period: 27 months Feb 2010- Apr 2012 To promote access to reliable SRH information sources and related basic services, targeting young people and women living in rural villages, working in garment factories or studying in secondary schools. Interventions Demand Side Supply Side Intense community demand creation work Supporting the public health provider in consolidating SRH‐related skills and introducing a pilot SRH service for youth. Target Populations Target HCs 50,000 of young people women living in rural villages, working in garment factories and in schools. HC Pong Ro HC Kg. Hao HC Akpiwat HC Ponley Outreach, PE & VHV/VHSG

2. Objective of Evaluation Objective of the evaluation is to evaluate relevance, efficiency, effectiveness, sustainability and impact of the pilot Youth Counseling Services established by the Project in 4 Health Centers, and to identify lesson learned and best practices. Particular focus shall be put on sustainability, with an in‐depth evaluation of the impact of free consultations for youth in improving access to services.

3. Methodologies KII Desk Study FGD Staff Consultation Desk Review Evaluation Tools Development Project Overview meeting Data collection Key Informants Interview Focus Group Discussion Secondary Data Analysis (HIS data) Report writing Feedback on First draft Second Draft Final draft of evaluation Final Report Staff Consultation Preliminary Findings Final Report FGD Desk Study KII

3. Methodologies FGDs KII: A group of school youth in Tekphos Commune A group of female Garment Workers (MV) A group of young people in Koh Krabey village A group of HCMC at Kampong Hao HC A group of VHSG at Pong Ro HC Cesvi staffs KII: Interview with service providers in Akphivat, Kampong Hao, Pong Ro and Ponley HC OD 1 Chief together with MCH representative Debriefing with Cesvi country Representative and Management team

3. Methodologies Timeline of the Evaluation of YFS Overall agreement between Cesvi and ART Final Report submision Data Collection Evaluation Tools development and agreement & Desk Study Preliminary findings Consultation Confirmation with KII and FGD Contract Sign Data Collection Tolls Approved Field work KII, FGD and Staff Meeting Field work Preparation Document Collection 3-7 April 2012 9-12 April 2012 19-20 Apr 26 Apr 2 May

4. Key findings Significant increased access of young population across youth friendly services Specially trained staff on VCCT, STI, ANC, Delivery, Birth Spacing and Counseling Great HCMC and Feedback Committee involved in youth friendly services Appropriate IEC materials and Well recorded book ( Registration Book) Significant increased awareness of targeted youth on sexual and reproductive health Good coordination between MCMC, HC, OD, PHD, Local Authority and Cesvi staff

4. Key findings Increased user fee as evidence of increased access of youth to youth friendly services Increased satisfaction Targeted Youth Peer Educators Health Centre Staff Stakeholders Local Authority

4. Key findings Improved quality of youth friendly services Increased accessibility of youth and general population Availability Reduced waiting time Specially trained staff Availability of drugs and equipments Increased satisfaction among interviewed youth and peers

Rapid Assessment Findings

4. Findings Access to YFS Services by Type of Service

4. Findings Access to YFS Services by HC

5. Key Challenges Lack of meaningful involvement of youth in particular aspects (eg Youth Peer Counselors Youth friendly services need more time and resources Stakeholders' involvement has room for improvement Lack of exit strategy Users fee can not make cover all needed activities

5. Key Challenges Very limited time for completing different steps of counseling Lack of innovative health financing schemes for staff motivation Imbalance benefits among health Centre Staff especially midwife and NGO supported staff There is no community resource mobilization

6. Recommendation1 Meaningful Participation of Youth Village based youth club (Club Moderators and Club Equipments, Materials, Plan…) Youth Peer Educators (One Peer Educator per 10 to 15 peer beneficiaries or targeted youth Youth Peers play critical roles in youth friendly service providers as youth counselor Youth Saving Group Involvement in Community Coordination Bodies ( CCWC, HCMC, VHSG, EFC, School MC… ) as full membership

6. Recommendation 2 Youth Friendly Services at HC Convenient hours for consultation and counseling Convenient room Respect for young people Privacy and confidentiality honored Adequate space and sufficient privacy Comfortable surroundings Youth Peer Counselors available IEC Materials and Edutainment

6. Recommendation 3 Stakeholders' involvement Coordination Bodies (CCWC, HCMC, VHSG, ….) Advocate for full membership of those coordination bodies Project Design and Project implementation and Monitoring

6. Recommendation 4 Exit Strategy Mainstreaming main activities within Commune Development Plan-CDP, Commune Investment Plan-CIP and Plan of CCWC Integrate core indicators (STI, ANC, BS and Consoling ) into monitoring checklist of CCWC Full membership of Youth Peer in Community Coordination Bodies (CCWC, HCMC, VHSG, EFC, School MC…) Simple Proposal Writing Skills and Planning Technical Skills building for HCMC …)

6. Recommendation 5 HC Health Financing All sources of income should be collected and shared based on revised guideline or agreement Innovative approach for increased income should be happened Community Resource Mobilization Community Based Health Insurance Commune Budget Plan Government Budget General User Fee…

6. Recommendation 6 Efficiency and Sustainability Full package of Health Equity Fund for P1 and partial package for P2-Youth Initiate community based health insurance for non poor youth Community Resource Mobilization – Pagoda based Fund Raising and Saving Group among youth Youth Peer Counseling