In the chapters of this document prepared by individuals with expertise in the

Transcription

1 Overview of Chapters In the chapters of this document prepared by individuals with expertise in the particular subject, sector, or subgroup under study we will explore in depth some selected analytic and programmatic issues, offering specific tools and resources where available. These are signed notes often drawn on work done by the individual author. Some pieces, however, draw on information and text developed through long-term program efforts in which many individuals have participated. Where this is the case, and pre-existing narrative, program notes, or protocols are included, their sources are duly noted. Chapter 1 Preparing the Twenty-First Century s First Generation of Adults: Policy and Program Perspectives by Judith Bruce This chapter provides a general orientation to the broad policy rationales, international and national level covenants, and macro-level concerns that necessarily underpin calls for much expanded investment in adolescents. In this chapter and in others, adolescence is defined as years of age using the WHO definition. The second part of this chapter suggests eight operating principles that could be employed in building an adolescent program at the national level. Some program tools, as illustrative first drafts, are also provided. Chapter 2 Steps in Building Evidence-Based Programs for Adolescents by Judith Bruce This chapter lays out proposed steps in building a program at a national or subnational (e.g., regional) level. These steps represent basic analytic and process- 1

2 building blocks for developing a program responsive to a diversity of adolescent subgroups and needs. The steps outlined here do not all need to be carried out, while some can be carried out simultaneously. This chapter includes some illustrative worksheets that might be used to undertake a program inventory. They can be helpful in identifying audiences whose needs are met or notably unmet, and in gauging whether program content is inappropriately concentrated in one or another kind of activity, or whether some areas of concern are unduly neglected. Chapter 3 Data on Adolescents for Program Planning: What We Need, What We Have, and Where to Find It by Carey Meyers This chapter provides an overview of some of the shortfalls in the available data on adolescents and difficulties in interpreting these data. The chapter also presents what data we do have on adolescents living arrangements, schooling, work status, marriage status, and reproductive health knowledge and behavior. It discusses why each of these subjects is so important, and presents some of the unexpected findings that emerge when detailed information about adolescents lives is sought and tabulations are broken down by age, gender, marital status, and schooling status. This chapter introduces tables developed at the Population Council, which present data on adolescents in 47 countries in a highly accessible form, based on the most recent DHS data. The chapter also identifies other data sources providing internationally comparable material that may be relevant to programming for adolescents. 2

3 Chapter 4a The Neglected Ages Between Child Survival and Adolescent Health Programs: Bridging the Policy Gap by Anrudh Jain Chapters 4a and 4b explore, from different perspectives, how investments in schooling may affect the adolescent experience. This chapter offers data on school enrollment and attainment among male and female adolescents in urban and rural settings, and makes a strong argument for giving close attention to the school enrollment and attainment status of children currently aged 5 9. These children constitute a group largely neglected by policy and programs too old to benefit from early childhood initiatives, yet too young to benefit from the current concern with adolescents. The author s analysis suggests that at least in some countries, adolescent policy must be closely allied with, if not founded upon, a commitment to increase the educational opportunities of those aged 5 9 (particularly girls of that age in rural areas) if significant improvements are to be made in the educational status, general empowerment, and skill base of adolescents. This analysis is accompanied by tables providing data from 43 countries. Chapter 4b Increasing the Quality of Adolescent Girls Education: A Vital Development and Reproductive Health Measure by Annabel Erulkar This chapter tackles the subject of gender equity in school environments challenged by shrinking resources. It provides an overall commentary on the issue of school quality (as opposed to quantity) in contributing to reproductive health outcomes. It shows that in Kenya, school drop-out is more often a result of poor school quality than of pregnancy. Those concerned with adolescent reproductive health and development need 3

4 to give their attention to school quality during the adolescent years including, but not limited to, the issues of gender equity in teaching style, educational content, and the safety and security of the school environment for girls as well as boys. Chapter 5 Examining the Gender Dimensions of Popular Adolescent Programming Concepts: What Do They Offer to Adolescent Girls and Boys? by Annabel Erulkar This chapter suggests a need for looking through a critical lens at popular investments in the field of adolescent reproductive health. Noting the strong, current emphasis on four different kinds of investments youth centers, peer education, family life education, and youth-friendly services the author suggests that many of these popular concepts may be less effective than initially anticipated (based in part on her analysis of data on youth centers and peer education). She offers parameters for evaluating programs, some disconcerting but important insights into the failure of youth centers to provide a cost-effective means for meeting both adolescent boys and girls needs, and strong hints that peer education programs may need some rethinking. Chapter 6 Engaging Adolescent Boys and Young Men in Promoting Sexual and Reproductive Health: Lessons, Research, and Programmatic Challenges by Gary Barker This chapter addresses the often ignored question: What can we do about and for adolescent boys? While girls bear the brunt of poor reproductive health outcomes, often with lifetime consequences (in the form of unwanted and unsafe sexual relationships and pregnancy), their situation cannot be improved without efforts to offer boys different ways of viewing what it means to be a man and policy/programmatic initiatives that seek to include young males as supportive partners and peers. The author 4

5 reviews some of the broad issues related to adolescent boys, and draws lessons from particular intervention and research projects (many of them in Latin America) that have sought to engage adolescent boys, or subsets of these boys (for example, those who have fathered children), in pursuing reproductive health and more gender-equitable behaviors. Chapter 7 Safe Spaces for Girls by Martha Brady This chapter explores the meaning and importance of safe and supportive environments for girls. It describes the role that safe spaces apart from home and school play in strengthening girls peer networks, serving as a locus for mentoring support and skill-building activities, and functioning as a base for providing critical health information. The author develops the case for creating such spaces, and lays out key diagnostic questions and considerations for research and programming. The chapter also describes several interventions underway including ones that center around functional skill-building education and sports which offer alternative social roles to girls in highly traditional circumstances. Chapter 8a Offering Adolescents Safe and Appropriate Livelihoods and Economic Skills by Carey Meyers with Jennefer Sebstad Chapters 8a and 8b both explore the benefits of providing older adolescent girls with livelihood opportunities. This chapter reviews some of the policy and programmatic concerns about adolescents, which have generated lively debate in the international arena. Drawing heavily on work that the Population Council and partners have conducted in a number of developing countries, the chapter explores what we know about where and why 5

6 adolescents work, and how they feel about their work experiences. It also describes some relatively well-documented research and intervention efforts focusing on adolescent livelihoods. Chapter 8b Wage Work for Girls and the Transition to Adulthood by Sajeda Amin. This chapter provides a commentary on adolescent girls wage work in developing country settings, and gives special attention to the experience of girls in the garment sector in Bangladesh. It reveals some good news regarding the role of wageearning work in the lives of adolescent girls in highly traditional environments. This analysis is particularly useful for those thinking about adolescent livelihoods and globalization, as a rising number of workers in export-led industries forming a significant component of the new global workforce are female, young, and unmarried. Chapter 9 The Neglected Majority: Married Adolescents by Nicole Haberland This chapter makes the case for why married adolescent girls who make up the majority of sexually active adolescent girls in the developing world comprise a seriously neglected subgroup of adolescents. The author outlines some of the key programmatic and health issues that must be investigated before developing programs. The chapter offers sample diagnostic questions for program research and describes some illustrative interventions targeting newly engaged or newly married adolescent girls, firsttime adolescent mothers, and their partners. 6

7 Chapter 10 Adolescents in the Context of HIV/AIDS: Crisis and Opportunity by Judy Diers This chapter reviews the well-known and tragic data on the global HIV epidemic. About half of new, post-infancy infections worldwide now occur in people younger than 25 years old (UNAIDS 1999). This chapter reviews available data on rates of infection in adolescents, giving special attention to differential rates among boys and girls and married/unmarried adolescents. The author provides a taxonomy of some of the current methods and intervention models almost all unevaluated at this point to deal with the growing HIV epidemic among adolescents. 7