Sexual and reproductive health: “Adolescents and young girls need specific support”

Can you tell us a bit more about comprehensive sexuality education (CSE)? How important is it and what issues does it address?

Anne Boutin – Comprehensive sexuality education is a way of teaching sexuality without discrimination, depending on the age, without making value judgements and based on science. It’s a key issue, both in and out of school: all young people need it. It addresses issues related to the health of young people and adolescents, the prevention of unwanted pregnancies and the fight against gender-based violence.

What do you think are the main issues of projects related to sexual and reproductive health (SRH), particularly in West Africa?

Anne Boutin – In West Africa, over half the population is under 25. This young population suffers from a lack of access to reliable information and suitable, easy-to-access services. These shortcomings are related to the persistence of taboos, religious beliefs and certain cultural practices. It involves combating STIs (including HIV), early pregnancies, unsafe abortions and gender-based violence: risks which girls are more exposed to.
 

Adolescents and young girls need specific support 

Furthermore, adolescents and young girls need specific support, because they are no longer children, but are not yet adults. It should also be emphasised that although the countries have ratified the international treaties on sexual and reproductive rights and health, they don’t necessarily fully apply them. Public authorities responsible for policies don’t take these issues on board sufficiently. They tend to shift their responsibilities to the partners.

What difficulties have you seen on the ground?

Anne Boutin – The health crisis has seriously disrupted the implementation of activities. In Senegal, it has also come up against a more specific difficulty: controversy over the very concept of CSE which led to this theme being dropped and replaced by another, the fight against school-related violence. Consequently, the issue of gender equality has been somewhat “clouded”, as we weren’t directly dealing with improving the situation of girls.

What is the interest of an evaluation for a project like this?

Anne Boutin – The interest of an evaluation is that it provides an external viewpoint, reports on the programme’s performance, draws lessons and makes recommendations to the stakeholders.

What did the evaluation of this project focus on?

Anne Boutin – The evaluation focused on the community component, on all the activities implemented under this project by the partners on the ground: ATBEF in Togo and ENDA Health in Senegal. It also concerned the achievements of the institutional component led by UNESCO.

How was the evaluation actually conducted on the ground?

Anne Boutin – Prior to the mission, a reference framework was developed to structure the approach and determine the investigations to be conducted in order to answer the evaluation questions.
 

I was able to conduct the field investigations thanks to the facilitation and availability of the stakeholders

I was able to conduct the field investigations thanks to the facilitation and availability of the stakeholders and partners, both in Senegal and Togo. In the current health context, and respecting the protective measures, I conducted certain interviews remotely. But I was able to attend activities such as the focus groups (community dialogue sessions), classroom lessons and community healthcare services and advice provided by the mobile clinics.

What are your main observations from your evaluation in the two countries?

Anne Boutin – For me, the main point is the highly relevant nature of the project, which provides concrete responses to the needs of young people for SRH. But in view of the difficulties encountered in Senegal, the operational strategy could have benefited from taking better account of the context in each country. For the implementation, the implementing partners were able to take advantage of their knowledge of the context and their local roots to work in synergy with all the stakeholders, which proved to be very effective.

What do you think of the synergies between the institutional and community components of the project?

Anne Boutin – There were interesting synergies in each component. For the institutional component, we can see that efforts were made to include the community through actions towards parents and non-teaching staff. Similarly, the activities conducted under the community component also reached the school environment through a dialogue with the teachers, the outreach in the Koranic schools and the strengthening of peer educators in schools. Peer educators are young people selected for their commitment and the way in which they act as role models, on a voluntary basis. They are channels of information and communication with their peers who trust them, are more ready to confide in them and listen to them. However, there is little synergy between the two components.

What is the main good practice identified by the project evaluation?

Anne Boutin – The “cascade” training system of the “School-related gender-based violence” module, which was facilitated by the education inspectors, made it possible to include other stakeholders that were not necessarily present when the process started. The concept of non-violence was therefore disseminated more widely through teaching and non-teaching stakeholders. I also note that the concepts learned during the training courses have really been taken on board.
 

The ‘cascade’ training system made it possible to include other stakeholders

Have the measures implemented had an impact?

Anne Boutin – Most of the quantitative results have been achieved or even exceeded. Following the mission, we see that there has been a great deal of effectiveness and a high level of ownership. The young people themselves, as well as the parents, religious leaders and local authorities, say that they’ve become aware of the importance of certain values, such as mutual respect between men and women. There also seems to be a shared interest in the intergenerational dialogue. The teachers, for their part, support active teaching. They all say that they’ve changed their behaviour and/or worked to bring about these changes, in particular at the community level.

But the scope of the project is restricted to a very limited geographical area. It’s not sure whether it will be possible to scale up and the sustainability of the results remains fragile due to the end of the financing. The continuation of the activities depends on whether the stakeholders can find new funds, their commitment and involvement, as well as on the support of institutional stakeholders.

What recommendations would you make in terms of scaling up this type of project?

Anne Boutin – I think it’s important to prepare the sustainability of the measures well in advance with exit strategies. I would also recommend that the financial partners demand or request a national counterpart in order to anticipate the endorsement of these subjects. Finally, it’s important to mobilise and rely on national civil society organisations that are present, active and able to continue all or part of the activities.

In your opinion, what is a “good SRH project”?

Anne Boutin – A “good SRH” project in West Africa should address the issue in terms of health and integrate the education sector. The State should take these issues into account in  school curricula and recognise the community component.
 

Move away from the project approach and place the stakeholders at the centre of processes

More generally, it’s important to work on all fronts and over time, meaning move away from the project approach and place the stakeholders at the centre of the targeted change processes. The first thing would be to give a voice to young people, so that they can take part in the development of the measures that concern them.

   

Financed by the French Ministry for Europe and Foreign Affairs, the FSP-I – DSSR Senegal and Togo project was coordinated by Expertise France and implemented by UNESCO and the International Planned Parenthood Federation (IPPF). UNESCO worked on component 2, concerning the institutional aspect. Component 1, which was based on the community aspect, was deployed by IPPF, with support from two partner NGOs in the field: the Togolese Association for Family Well-Being (ATBEF) in Togo and ENDA Health in Senegal
 

Find out more about the FSP-I – DSSR Senegal and Togo project