1. WHAT WORKS? WHAT DOESN’T?
TO EFFECTIVELY IMPROVE THE HEALTH OF
ADOLESCENTS AND YOUTH?
Cate Lane, Youth Advisor, USAID/Washington
July 13 2017

2. Why youth?
• One third of the world’s population is aged 10-24
• Pregnancy and HIV: major causes of youth illness and death
among youth
• 16 million women 15–19 years give birth: 11% of all births, 95% in
LMIC
• 10% of girls are mothers by age 16 years (SSA, SEA)
• 42% of new HIV infections to all people 15 and over are to adolescents
15-24
HEALTH INVESTMENTS IN TODAY’S ADOLESCENTS HAVE
IMMEDIATE AND FUTURE RETURNS

3. What do we want for youth?
PRH focuses on ages 10-19
• Delay first pregnancy to
at least age 18 years
• Ensure birth to
pregnancy intervals of
at least 24 months
USAID’s Youth in Development Policy Goal: Improve the capacities and enable th
e aspirations of youth (aged 10 -29) so that they can contribute to and benefit fro
m more stable, democratic, and prosperous communities and nations.

4. Challenges to Achieving These
Outcomes
• Persistent norms: early marriage and childbearing
• Biases and stigma around adolescent sexuality
• Unmet need for contraception: both married and
unmarried adolescents
• Lack of access to appropriate information and services at
scale
• Negative perceptions of youth and adolescents
• NIMBY attitudes among policy makers
• Poverty and lack of opportunity
• Limited engagement
• And so on………………………..

5. Considerations to achieving
Be clear about your desired outcome and
plan accordingly. Keep the following in
mind:
• program against the diversity of
adolescents;
• ensure adolescent access to all methods;
• forgo separate services and make
services that already serve adolescents
“youth friendly;”
• partner with pharmacies and drug shops
as sources of contraception; and
• support all health workers to provide
“youth friendly” care.

6. Developing Life Skills

7. Key Implementation Needs
• Adolescents have access to full method mix
• Health services are age and developmentally
appropriate and integrated: PPFP, ANC, MCH, PAC,
HTC, PMTCT, ART etc
• The policy and social environment facilitates the
delivery of developmentally appropriate, gender
equitable information about sexuality and health and
addresses barriers to contraceptive and condom use
• Youth programs in other sectors integrate health
information and services

8. Successful programs address the following:
• Value girls and are gender transformative
• Help youth understand benefits of delayed sexual activity
• Increase school enrollment
• Build skills, self efficacy, agency, and confidence
• Promote a sense of future
• Use multiple channels to disseminate information
• Build adult and adolescent comfort with adolescent sexuality,
contraceptive and condom use
• Ensure access to youth friendly services that are accessible,
convenient, affordable, confidential
• Create referral networks
• Involve private sector: vouchers, social franchises.

9. Things NOT to do
• Implement ineffective
interventions and
approaches
• Implement effective
interventions without
fidelity

10. Popular but ineffective interventions
• Youth Centers:
• Don’t change SRH behavior or increase use of services
• Used by older male youth
• Costly
• Peer Education:
• Little impact on intended beneficiaries (e.g. contraceptive
uptake
• Greatest impact on peer educators
• High profile meetings
• No impact on harmful practices

11. Interventions that are delivered ineffectively
• Comprehensive Sexuality Education
• Inadequate attention to factors that ensure success
• Weak content
• Teachers uncomfortable with content
• Little or no linkages to services
• Youth friendly services
• Providers are not trained
• Facilities are not welcoming
• Adolescents lack awareness of services
• Community members are not supportive

12. Little or no systematic and sustained approaches
• Inattention to whole system of youth development:
• Cross-sectoral
• Integrated
• Coordinated
• Inadequate intervention dosage
• Short-term
• Donor driven
• No plan for scale

13. A call to action!
1. Youth as partners
2. Stop doing what doesn’t work.
3. Fidelity. Dosage. Scale.
4. Innovate and evaluate!
 Positive youth development
 Cross-sectoral programming