The PROJEUNES program in Benin has developed a model that empowers adolescents to mobilize for their rights to sexual and reproductive health and lives free from violence and the results are remarkable.
The program was funded with a $3M CAD grant from Global Affairs Canada and implemented from April 2018 to March 2021 in Alibori and Borgou Departments of Benin. Through a multi-sectoral approach that worked to create an enabling environment around youth, in addition to supporting their own positive development, PROJEUNES reached 660,525 participants (351,215 females and 309,310 males).
These multi-faceted approaches are often more complex and can require more resources but the impressive results from PROJEUNES are proof that the investment more than pays off in terms of impact. In just three years the project reduced the rate of child, early, and forced marriages from 57% to 23% and the birth rate from 41% to 30% among youth aged 20-24 years.
With the goal of ensuring sexual and reproductive health for adolescents and reducing the practice of child, early, and forced marriage, PROJEUNES set out to facilitate adolescents’ access to youth-friendly health and social protection services, build communities’ understanding and promotion of adolescents’ rights, and strengthen the accountability of government and civil society organizations to uphold existing policies and commitments designed to protect adolescents.
- Young people were able to get the sexual and reproductive health services they needed: Prior to implementation of PROJEUNES many adolescents were hesitant to access family planning services and were not prioritized by community-based health workers. Now, adolescents are working together with health care workers and others in the community to access the services they need. As a result, use of modern contraceptive methods more than doubled from 15% to 38% and 78% of adolescents had their needs for modern contraceptive methods met compared to just 34% at baseline.
"I can go to the Health Center to ask for services without someone's permission" – Female PROJEUNES Project Participant
« Je peux aller au Centre de Santé pour demander des services sans la permission de quelqu’un »
- Health and social protection service providers are better equipped to provide services that respect the rights of adolescents: Across the 12 health centers supported by PROJEUNES, there was a 50% increase in visits from clients aged 15-19 and an 150% increase among clients aged 20-24, the rehabilitation of 10 youth-friendly spaces and corners for youth to feel welcomed, and a reported satisfaction rate of 98%, up from just 66% at the start of the project.
“There has been a change in the way we welcome adolescents and young people (it used to take five minutes to welcome them, but now it is done quickly). When adolescents come for care, we take the opportunity to educate them about sexuality and the adoption of methods. We don't send anyone away, when they come we accept them and give them what they want" –Health Worker PROJEUNES Project Participant
- Communities better understand the rights and protections to which adolescents are entitled and hold each other accountable: While Benin has policies restricting child, early and forced marriage and protecting youths’ access to sexual and reproductive health services, these are not always respected. At the start of the project just 45% of community members could correctly cite the legal age of marriage compared to 92% at endline. As a result, more cases of forced marriage are being reported for investigation and intervention by the Center for Social Protection. In 2018 there were zero cases compared to 99 in 2021.
“A few years ago, a girl who survived a marriage was ignored, rejected, cursed, and misunderstood by her family, which made her feel uncomfortable, but today, thanks to the training received from PROJEUNESS, it is the family itself that encourages the survivor to go for an apprenticeship in order to be autonomous when she wants to get married." – Parent PROJEUNES Project Participant
- Young people have a greater voice in their communities and more support from one another: PROJEUNES’s activities to connect youth together in ways that built their capacity, provided psycho-social support, and facilitated their access to avenues for recourse, contributed to observable gains in their confidence, self-efficacy, and collective action.
“In the past, I was not able to discuss sexuality with my parents. Today, I do so thanks to the training the project has given me and the advice I received from the health workers I see” – Female PROJEUNES Project Participant
How did we get there?
- Let adolescent’s lead: PROJEUNES worked with adolescents to design, implement, and adapt the program. Adolescent’s themselves, whether through the peer-leadership of adolescent groups, their participation in social accountability processes, or their engagement with youth advocates for influencing lead the way in demanding and securing their sexual and reproductive health rights.
- Don’t forget about the importance of norms (and with health workers too!): Focusing on adolescents and health services exclusively neglects the powerful role social and gender norms play in health behavior. PROJEUNES engaged community members and health workers in CARE’s Social Analysis and Action approach, a practice of reflective dialogues and values clarification exercises, to identify and challenge norms that were preventing shared goals like healthy adolescents and youth.
- Hold governments accountable, but provide support: With CARE’s Community Score Card, PROJEUNES facilitated a participatory process through which community members could voice concerns about shortcomings in quality, efficiency, and accountability but PROJEUNES didn’t stop there. The project also provided capacity building and supportive supervision so providers could make the needed improvements.
- Look beyond the numbers to adapt: To supplement more standard routine monitoring data, PROJEUNES used a qualitative monitoring approached called Rolling Profiles to get real-time, longitudinal data for adaptation and improvement along the way.
Where do we go next?
While CARE Benin continues to support PROJEUNES communities through the TEDIJO project which is building feminist and participatory approaches to sexual and reproductive health, we believe that the PROJEUNES model is ripe for adaptation and difussion in other contexts with high rights of child early and forced marriage and low access to adolescent-friendly reproductive health services.
Meaningful engagement of adolescents that facilitates the fulfillment of their rights must be an integral strategy for governments and civil society organizations. We invite those charged with supporting adolescents to invest in PROJEUNES and other holistic adolescent-focused approaches to ensure their healthy futures and multiple our impressive results.
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