Abstract
This study documents the lessons learned by the Service Expansion and Technical Support (SEATS) project in applying best practices to improve reproductive health (RH) care for young people in eight countries: Albania, Burkina Faso, Cambodia, Eritrea, Russia, Senegal, Zambia, and Zimbabwe. Characteristics of SEATS subprojects included: the use of multiple interventions in multiple settings to address young people's RH problems; clinical services for youth, including contraception, sexually transmitted disease (STD) screening and treatment, and antenatal and delivery care; a focus on urban youth; collaboration among local, national, and international institutions; youth involvement in program design, implementation, management, and evaluation; outreach, including peer education; incorporation of youth RH programming into ongoing program activities; community mobilization and advocacy; and attention to quality and sustainability. Key lessons learned were as follows: (1) Addressing the special needs of young people does not require a separate project or intervention targeting youth. (2) The willingness to pioneer new ventures in RH services for young people is not exclusive to the private sector. (3) Basic human rights -- clients' rights and reproductive rights -- are a compelling rationale for offering RH education and services to young people. (4) Young people and service providers demand integrated RH interventions. (5) Integrated RH services that include STD prevention and screening can attract young men. (6) Health centers can be reconfigured to attract youth seeking information and counseling as well as services. (7) A "champion" for youth within a clinical setting can help maintain a youth-friendly environment. (8) The costs of referral services are a barrier to access. (9) Young people prefer contraceptive method choices. (10) Programs require support, advice, and assistance in addressing community resistance and opposition to youth RH interventions. (11) Identifying a sustainable and appropriate package of compensation and incentives for peer educators is complicated. (12) Peer educators can be very resourceful fundraisers. (13) Adult-friendly programming may be as important as youth-friendly services. (14) Standard family planning and RH monitoring indicators do not capture the results of youth projects. (15) Evidence of sexual activity among girls 12 and younger points to the need to develop appropriate interventions targeting this age group. (16) The sensitivity surrounding RH services for young people is not an insurmountable barrier to demonstrating their feasibility. (Author abstract, modified)