1. Ulrike Neubert
Deutsche Stiftung Weltbevoelkerung (DSW)

2. “The Young Adolescents Project - Improving the Sexual and Reproductive Health of Young Adolescents (10-14) in Uganda”
For over a decade DSW has been working with youth aged addressing their special needs regarding SRHR including FP information, education and services. The Young Adolescents Project, in short “YAP” was designed based on the realisation that the needs and rights of years old are mostly not addressed.
It started in 2009 as a 3 years pilot project implemented by DSW in 10 schools and 3 districts in Uganda. It is supported by BAYER Healthcare Pharma
and is implemented in 10 schools in 3 different districts in Uganda (Tororo, Eastern UG, Wakiso, Central UG and Masindi Western UG)

3. Why addressing 10-14 years old adolescents with family planning education?
Early adolescence marks a critical time of development for young people
Many societies perceive 14 years old as young adults, ready for work, marriage and child bearing
It is an opportune time to positively influence choices and lifestyles - as attitudes are formed that can last into adulthood
In Uganda 49.9% of the population is under 14 years.
It is a period of dramatic physical, hormonal, cognitive and social changes which form identities.
Even though most adolescents between years may not yet be sexually active they are on the threshold of becoming engaged .
Early adolescence: is the stage where children develop to youth
Bodies start changing, reproductive system gets ready
they start moving towards independence and continue developing decision making skills, start looking more to peers and not anymore parents
they become more self-conscious and experience feelings of insecurity and begin to doubt self-concept and previous self-confidence
- They start feeling conscious of their sexuality and how they choose to express it
- And they become attractive to the other gender
But what is happening in reality:
-Many adolescents in societies where 14 years old are perceived as young adults, ready for work, marriage and child bearing have to jump this stage, going from childhood straight to adulthood
E.g. In some societies in Uganda at 14 years girls are perceived as young women ready for marriages and childbearing, while boys have to support their families

4. How are young people prepared?
Among 12–14-year-olds, only 33.8% of females and 22% of males have received sex education in school
71% of females and 64% of males have never talked with their parents about sex-related matters
Many adolescents have an early sexual debut: 22.6 % of females have had sexual intercourse by age 15
THOUGH: 60-90% of all year old attending school
Boys have sex by the age of 17
Secondly, 46% of all of HIV/AIDS cases occur among young people. MOH, adolescent health strategy survey 2006 – 2010
1.(Darabi L. et al., Protecting the Next Generation in Uganda: New Evidence on Adolescent Sexual and Reproductive Health Needs, New York: Guttmacher Institute, 2008, p.16)
2. (National Survey of Adolescents, 2004)

5. Uganda’s high teenage pregnancy rate of 32%
Consequences
Uganda’s high teenage pregnancy rate of 32%
46% of all of HIV/AIDS cases occur among young people.

6. Why??
10-14 years olds are often considered as too young for sexuality education and hence left out in SRHR projects for young people
Teachers and parents do not have comprehensive understanding of SRHR issues, and do not talk about SRHR issues with their pupils and children
It is culturally taboo to talk about sex with children and youth
As a consequence: The knowledge of young adolescents about changes in puberty, risk of pregnancies and family planning as well as ways of HIV/AIDS transmissions is poor and based on misconceptions
This age group is often referred to as the neglected group when it comes to SRHR and FP interventions. Mainly because the age of sexual engagement is on average 16 years and there is a common fear that talking about sexuality with adolescents is more encouraging for early engagement than can protect them. – Which is not true, evidence shows the opposite, early prevention interventions are very crucial.
- In addition the adults where young adolescents should be able to get information from (teachers, parents in particular) are not at all prepared and in position to answer questions regarding the reproductive systems, family planning and HIV/AIDS. The often have wrong information and their knowledge is based on misconceptions as well as they do not know HOW to talk to their pupils and children about sexuality

7. Objectives of YAP
To increase sexual and reproductive health knowledge of young adolescents in primary schools
To create support of parents/guardians, teachers and community leaders for reproductive and sexual health of young adolescents.
To increase access to, utilization and referral of quality youth friendly reproductive health services for young adolescents
The YAP project was therefore designed to address
A total of 5,074 young adolescents and 2000 parents and teachers participated in the project to achieve the following objectives:
The knowledge gathered during this pilot project is documented as toolkit, which supports parents, teachers and communities how to deal with sex education of this age group

8. Outcomes
The knowledge level of young adolescents regarding pregnancy prevention increased by 87%
92% responded positively on what family planning is, who uses family planning methods and what a well planned family means.
98% knew at least 2 methods to prevent unwanted pregnancy for boys and girls.
60% were more confident to discuss opposite sex attraction, HIV/AIDS, and sexual health freely with their parents.
An interim evaluation and a qualitative study done after year 1 and 2 found a significant increase in knowledge about RH and life skills among pupils, teachers and parents
Up to 80% of the target pupils showed a remarkable improvement in general knowledge of SRHR and its importance in young adolescents. There has also been an increase in knowledge of modes of transmission of HIV/AIDS and how it can be prevented.
About
98% mentioned at least 2 methods to prevent unwanted pregnancy for boys and girls.
60% more were confident to discuss opposite sex attraction, HIV/AIDS, and sexual health freely with their parents.

9. Outcomes …. Continued
75% of students expressed willingness to share SRH information and knowledge with their teachers in school.
80% of the parents expressed willingness to openly talk about SRH information needs with the adolescents.
Teachers increased information about SRHR issues in class by 38%
Six schools reported a reduced drop out rate of 34% for girls

10. Lessons Learnt
To address young adolescents’ SRHR needs in a sustainable manners means to engage parents, schools and communities
Adolescents will tend to follow youth-friendly communication methods to comprehend reproductive health issues
Capacity building of existing reproductive health efforts at the school, community and family is vital for new approaches to address the role of reproductive health in family planning.
Addressing adolescents’ SRHR needs in a sustainable manner, school systems, the communities and the parents must be engaged. Lessons from the project indicate that:
. Such can be delivered at school assemblies, parades, debates, discussions and community gatherings through Music, Dance, Drama, games, drawings and role plays, which are interactive methods to draw their attentions.
Living adolescents out of reproductive health issues and family planning is counter productive. The cultural norms on sexuality have influenced a number of choices between families and communities. Equipping teachers, pupils, parents and community leaders alike with information and knowledge will eventually undo the cultural rigidities that exist.

11. there is need to strengthen youth-friendly health service delivery
Lessons ……. Continued
Addressing sexual harassment of young people needs to be an integrative part of SRHR projects
there is need to strengthen youth-friendly health service delivery
one strategy can be to involve parents as allies – especially if the harassment takes place in schools

12. Conclusion
Leaving young adolescents out of the SRHR and family planning discussions is counter productive - if we want to truly address the challenges of reproductive health in the next decade.
Show the toolkit – will be launched and online from end July
Thank You!

13. WHAT to Do??? HOW to prepare them???
Start preparing young people early enough to enable them to make informed decisions and healthy life choices!
Use a holistic approach, consider their influential environment!
Equip young people with life skills and knowledge about their changing bodies, dangers of teenage pregnancies and advantages of planning for your family
Use methods that are attractive to young people
Build a supportive surrounding, where young people have access to adequate and correct information and services
HOW to prepare them???
We designed the project in a way that looked at working with the young adolescents directly but also create a supportive environment for the “real” decision makers in their lifes. The aim is to equip young adolescents with knowledge and skills early enough to be able to make informed decision regarding their sexual life and health.
Primary target group are pupils year old in 10 selected primary schools in 3 districts, because school is the place where to reach this age group best
Secondary target groups are adults (teachers, parents, community members and leaders, health workers, local government officials)
The project uses creative, interactive approaches and methods like games, drawing, drama, youth camps, parent-child dialogue, peer education, life skills education, family VCT, film shows etc. and is implemented by the DSW Youth Truck, a mobile multi-skilled team of social workers.

14. Intervention Strategies and Activities for Adults
Capacity building
Beneficiaries active involvement
Awareness creation and grass root advocacy
Beneficiaries
active involvement
Training for teachers were conducted to provide them with comprehensive knowledge about SRHR.
The trained teachers not only passed on information to the young Adolescents but also conducted workshops for fellow teachers.
The teachers were part of the District review meetings to discuss implemented activities and plan next activities.
The teachers supported the school clubs during the in-school programmes and outreach activities and mentored the club leaders
Community meetings and film shows were held in order to create awareness for SRHR needs of young adolescents
Parent – child - dialogues workshops were facilitated at school
The parents participated in district review meetings to discuss implemented activities and plan for next activities
Parent counselors were trained to provide additional counselling to the pupils and were involved in monitoring school SRHR programmes
Parent-with-Child Dialogue workshop

15. Intervention Strategies and Activities for Pupils
Peer education
Youth Participation
Youth-friendly environment, methods and materials
Young Adolescents during a training camp
70 Peer Educators and 67 Club leaders were trained on how design and implement awareness programmes in schools using youth friendly methods, as well as in leadership skills.
SRHR school clubs where established and supported with IEC materials and sports & MDD equipment. Peer Educators then conducted peer learning sessions in their schools, attended parent- child dialogues, participated in MDD and sports tournament with the themes.
The young adolescents were always part of the District review meetings to discuss implemented activities and plan next activities. Major decisions on activities content were left to the pupils.
A drawing and a drama competition was organized in each district to give space for different ways of expression, all trainings and activities followed the principles of creative facilitation
Youth-friendly education materials were developed, grants given to schools to a create healthy environment and sanitary pads for the girl child distributed.