Community Involvement in Youth Reproductive Health and HIV Prevention

According to this 4-page paper from the Interagency Youth Working Group, projects working with youth are now turning to a more holistic approach that involves community members, in the belief that reproductive health (RH) and HIV outcomes for youth will be better and that programme efforts will be sustained. The paper poses the following questions: "Are RH and HIV outcomes for youth better when a project makes an explicit effort to involve community members? Are communities more able to sustain interventions with youth if they participate in programs?"

Though early research shows promise, questions remain about how to determine the added value and how to design, document, and evaluate interventions seeking to use community involvement to improve youth RH and HIV prevention. In introducing promising findings, the authors note the challenges of finding a common definition of "community" - geographical, shared characteristics, or shared interests - and the degree of involvement or participation (terms used interchangeably). Another challenge is whether to measure youth RH behaviours or to measure increased community strength for more sustainable and long-term outcomes.

Having raised these questions, the paper reviews the results of project evaluations, some showing marginally positive youth RH indicators, but substantial indicators in the broader factors of capacity building, empowerment, and sustainability. Another project showed an increase over a 10-year period in knowledge and use of RH services, particularly in issues related to traditional community beliefs. A third study measured youth knowledge and behaviours regarding RH using pre- and post-intervention surveys and found significantly better knowledge and attitudes but few significant behaviour differences between intervention and control areas studied.

According to the authors, more programmes are seeking community input before implementation and sharing lessons learned from, and evaluations of, their efforts. Some successes of early community participation are: A project in Burkina Faso training and sending peer educators in to villages found a high degree of participation and ownership among the community members; nearly 70% of people had participated in at least one activity. Peer educators were seen as a resource for youth, parents, and people living in neighbouring communities. In Bangladesh, an RH project halted by Muslim religious leaders resumed after relations with key stakeholders in the religious, political, and local communities improved through workshops, advocacy materials, community meetings, meetings with national leaders and ministry officials, and local advisory committees. These committees helped to revise the project materials so they were more acceptable.

In a rural area of Egypt, a community-based project sought to broaden the opportunities available to adolescent girls. A number of organisations collaborated to work with parents, boys, community leaders, and others to change gender norms for girls’ mobility, skills, knowledge, and confidence through interventions addressing life skills, literacy, sports, vocational training, and savings clubs. Parents and community members were allowed to attend classes, and village committees were formed to share and discuss project activities. Of those girls who completed the programme 90% passed a qualifying test to return to school. In Namibia and Tanzania, participatory assessments led by youth and adults resulted in what the article cites as being innovative, community-driven projects being incorporated into the ongoing activities of faith-based organisations (FBOs). Several faith groups in Namibia then developed new sex education curricula and used them to train pastors and parents to work with youth on sexuality issues.

The paper concludes with future directions and key issues including the need to develop better conceptual frameworks and indicators to help researchers and programmers to be clearer in developing goals and outcomes for community involvement - the questions being: when, what types of involvement, and to what degree to involve the community. Issues include:

• strategies to engage vulnerable groups;
• “safe spaces” for youth for sharing issues and accessing information;
• validation of the importance of working on youth RH/HIV by supportive, engaged adults; and
• strategies for community-based programmes to manage or mitigate community conflict, given that youth sexuality involves sensitive issues.

The paper includes a link to resources on community involvement in youth RH/HIV prevention including participatory guides, reports, and a literature review.