Adolescent population in Ethiopia remains the most affected by sexual and reproductive health risks such as early marriage, unprotected sex, STIs, early pregnancy and Female genital mutilation (FGM).
According to 2016 EDHS report, 65 percent of women age 15-49 are circumcised: 3 percent of women had cutting with no flesh removed, 79 percent had cutting with flesh removed, and 7 had their genital area sown closed after cutting. In Ethiopia, according to most recent estimates, 41% of women aged 20-24 years old got married by the age of 18, and 16% were married by the age of 15. According to 2016 EDHS report, Girls in Ethiopia enter puberty with knowledge gaps and misconceptions about menstruation, unprepared to cope with it and unsure of when and where to seek help. This is because the adults around them, including parents and teachers are themselves ill-informed and uncomfortable discussing sexuality, reproduction and menstruation (which frequently comes laden with dirty, polluting and shameful connotations).
The most vulnerable groups among these adolescents are found to be girls, youth from rural settings and those who are economically impoverished. Vulnerability is attributed to such factors as: lack of relevant information, access to SRH service, limited open discussion with parents, peer pressure, absence of protection from the legal sector and economic problem.
ODA has strived towards the attainment of improved AYSRH by working on the provision of information, counseling and skills and services through different approach such as school based, health facility based and community based. Moreover, volunteerism activities and collecting best practices for future programing has been some of the project activities.
- School Based Approach
In recognition of the implications of investing early on adolescents to the future of youth and the country, ODA’s AYSRH program targeted adolescents in school. As such, ODA has strived towards the attainment of improved AYSRH by working on the provision of information, counseling and skills through Comprehensive Life skills Education (CLSE). This manual is prepared by ODA that enables children and young people to: Acquire accurate information about SRH, explore and nurture positive values and attitudes and develop life skills that encourage critical thinking, communication and negotiation, decision-making and assertiveness.
- Comprehensive Life Skills Education (CLSE)
CLSE is a club based extra-curricular activity where adolescent students ranging from 40 to 45 students engaged in facilitated game based learning. The guidance manual has been prepared by ODA that has 13 chapters considered as activities. The chapters generally address the issues of SRH, HIV prevention, risk of SRH behaviors, Gender, HTP, menstruation, communication, and decision-making. Two trained teachers from each school (one female & one male totally, 791) facilitate the CLS activities. The CLSE activities take 3 months to be finalized. The trained students organize parent child dialogue events and present what they acquired from CLSE activities to their parents in the form of entertaining activities like games, poem and drama etc… After completing all the activities, participants graduate and serve as role models and they cascade the skills and awareness to other students. They sometimes use mini-media to share what they have learned to the students in the school. Time is dedicated for such an activity before class every week. Thus, a lot of students are reached with education through school mini media by the graduates during the past few years. Moreover, in collaboration with government stakeholders, teachers and the community, a lot of early marriage were rescued. School teachers played a remarkable role in this regard.
1.2 Guidance and Counseling
Individual targeted provision of information, advice, compassion to needy ones and referral to health facility for more support is the objective of this intervention. While both boys and girls benefited from the guidance and counseling service, particularly girls benefited more. In addition to individual counseling services, girls maintain separate sessions with their trained female teacher and discuss in group on menstruation, arranged marriage, GBV as well as how to be successful in their educational activities. In all schools, there are girls club that discuss together, raising resources for menstrual hygiene management and discuss on their role within classes and school. Furthermore, this has given girls an opportunity to learn from each other. ODA’s intervention school guidance and counseling room is also separated.
- Gender Responsive Pedagogy
School teachers are given on the job training on enhancing gender sensitive Academic Environment. The training aims to treat boys and girls as equal partners and provide conducive learning environment for both. More particularly this initiative aims to boost girl’s participation in the classroom and decision making process as regards school matter.
Every teacher is expected to choose teaching methodologies that will ensure equal participation of both girls and boys. As such, ODA encourages such approaches as group work, group discussions, role play, debates, and case studies where girls have no less role than boys if not more. In connection to this, schools have dedicated separate room for menstrual hygiene management. The menstrual hygiene management room has clean water, soap and sanitary pads. Besides, separate toilet for female students is found in all the schools. However, the quality of such facilities was not uniform in all the schools. Taking this in to consideration, ODA has renovated 46 girls menstrual hygiene management corner at 46 schools and equipped with materials like mattress, carpets, shelf, sanitary napkins etc.…
‘Gabi’ Award
During every end of academic year (on parents’ day event), ODA introduced reward to parents of girls who ranked 1-3 in their respective school academic achievement. This is found to have important symbolic value to keep girls in school and support them to succeed. The award for their father and Mother is ‘Gabi’ (Woven cotton Blanket) in addition to awards of dictionary, books etc to the best performing girls. The Parent Teacher Association (PTA) suggested introduction of “Gabi” as reward due to its cultural connotation. In Oromo culture, “Gabi” has symbolic value given to only respect family as represented by father whose daughter has kept the pride of the family. Those who request to marry such daughter would bring Gabi to the father. In order to encourage girl’s participation in education and discourage early marriage, ODA awarded best performing girl students with ‘Gabi’ and reference books. Thus, those best performing girls dressed their parents to maintain the pride of the family through education. This Gabi award ceremony through education encouraged parents to maintain their daughters in school and contribute in reducing dropouts and early marriage.
Saving for school
ODA initiated a unique form of group saving scheme among school attending children (5 – 8 grades), as part of its comprehensive Youth Reproductive Health project designed to address programs on reproductive health services. Saving for school contributes to girls’ school continuation and rescuing them from early marriage. School saving has been done through two ways. The first one is saving in cash while the other is in kind. Saving in cash is through personal account and saving in kind is through permanent property which students’ family has promised for their children. The second form of saving (in kind) is culturally adopted and practiced in Oromo culture as “Handhuura”. In the last few years 3,701,347.35 birr in cash and 8,907,678 birr estimated in kind. Totally, 12,607,727.8 birr has been saved both in cash and in kind.
II Health Facility Based Approach
The long term objective of the AYSRH is to improve the sexual reproductive health status of young people (10-24 age groups) in the project intervention Woredas of Oromia Regional State. In order to meet this broad objective, the ODA AYSRH project has four intervention components. One of the components is to strengthen youth-friendly service delivery at facilities through trainings of facility staff on youth-friendly Health services (YFHS) and comprehensive abortion care (CAC) and the provision of furniture and equipment. The implementation of the project has pursued four strategies:Improve the physical situation of the health facility, Training of service providers on AYFHS provision. Provision of supplies to equip the public health centers and Follow up and supervision to monitor progress and support the continued provision of services
2.1. Improve the physical situation of the health facility
In order to improve the quality of services for the adolescents and young people, ODA-AYSRH project has worked with the health centers to establish a dedicated separate room and waiting area for adolescents and youth. The reasons for dedicating a separate room are to provide services to the youth and adolescents in a confidential and welcoming approach. ODA has played a key facilitation and advocacy role for the allocation and establishment of the YFHS rooms and the waiting area. After the allocation of separate room and establishment of waiting area, ODA has provided various supplies to equip the center including chairs, tables, and other health equipment and supplies.
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