By: Smita Gaith, Women Deliver
In 1994, the International Conference on Population and Development (ICPD) acknowledged that governments should make information and services available to adolescents to increase awareness of adolescent sexual and reproductive health (ASRH), including unwanted pregnancies, sexually transmitted infections, and risks of infertility. According to ICPD, this information should be youth-friendly, and involve multiple stakeholders from diverse sectors, at different levels of government.
In response, Geração Biz, (Portuguese for "Busy Generation") was developed with the intention to improve ASRH, increase gender awareness, reduce unplanned pregnancies, and decrease vulnerability to sexually transmitted infections, HIV, and unsafe abortions. This small-scale program was designed by a multisectoral group made up of several donors and other groups, including Pathfinder, the United Nations Population Fund (UNFPA), the Embassy of Norway, the Swedish International Development Cooperation Agency, and the Danish International Development Agency. The program was mainstreamed into Mozambique’s health program, and today, is widely accepted as well-known and respected program.
Geração Biz had three components, carried out by different parties to reach youth who were in and out of school. Youth friendly clinical services were spearheaded by the Ministry of Health, in-school interventions fell to the Ministry of Education, and community outreach was under the guidance of the Ministry of Youth and Sports.
Phase 1 of the program was the pilot phase, and took place between 1999-2000 in Maputo City and Zambezia Province and the central levels of respective ministries. Between 2000-2005, Phase 2 of the program was completed, and had expanded to four more provinces, to include many more program sites. Finally, by 2009, Phase 3 of the program saw the expansion of the program to another five provinces. Today, the program exists in ten of Mozambique’s 11 provinces, and functions on several levels.
Youth friendly health clinics were designed to increase access to clinical and counseling services. Some clinics are for adolescents only, while others specifically integrated adolescent-friendly services. The importance of involving all stakeholders, including young people, was kept at the forefront of all aspects of program design, including designing, implementing, and evaluating youth friendly health services and a minimum service package.
School-based and community-based interventions included training students in more than 300 schools, enabling these students to advise their peers who may or may not attend school with them, on multiple issues, and to sponsor community events like sports, music or theatre competitions, and radio programming. Both school- and community-based components make use of peer education, further enhancing the youth-friendly aspect.
Finally, support groups for young people living with HIV are hosted every week, in an effort to discuss the challenges of living positively, and finding opportunities for youth development.
In July 2001, two external consultants were charged with evaluating the pilot phase of the program. One area that evaluators saw for improvement was the perception of reproductive health services as a feminized need. This was due in large part to the number of young women coming in for antenatal services and contraceptive resources, and the general perception that women opening up to a health professional is acceptable, but not among men. Despite this, evaluators found that the youth friendly health service facilities were providing relevant information and services that was meeting the needs of youth. Other successful areas of the facilities were knowledgeable staff, goo quality clinical services, and increased condom distribution. In the three years from 1999-2001, there was a spike in use of services from 1173 visits in 1999 to nearly 18,809 visits in 2001, in just one city. Other areas also saw similar increases in both visits, and condom distribution.
Evaluations continue, to assess the quality of knowledge and behavior change and client satisfaction.
For more information on the Geração Biz program, please click here.
Flickr photograph via Rosino.