Youth in Action

Sexual and Reproductive Health and Rights of young people play a significant role in a nation's health and are critical in its development.  In Sub Saharan Africa, approximately 70% of the total population falls under the age of 30. Similarly, of Ghana’s 31 million population, only 4 % are above age 65, 35% below age 14 and 38% being young people aged 15 to 35. With such a young and vibrant population, there is the need to ensure that young people have ready access to resources needed to empower them to participate actively in decisions concerning their sexual health. 

Various studies have shown that three primary levels of influence shape young women’s SRH experiences, decision-making, and behaviors. Interpersonal influences were both supportive and unsupportive influences on sexual debut, contraceptive (non) use, and pregnancy resolution. Community influences included perceived norms about acceptability/unacceptability of adolescent sexual activity and its consequences. Macro-social influences involved religion and abstinence and teachings about premarital sex, lack of comprehensive sex education, and limited access to confidential, quality SRH care. This can be partly attributed to their limited involvement in decision-making on their SRH.

Improved youth participation in SRHR activities leads to the acquisition of  appropriate knowledge thus reducing the incidence of unsafe abortions, unplanned pregnancies and STDs. Encouraging participation of young people in decision-making on sexual health is critical in making significant changes in developmental issues in society. Also, active participation gives young people  a voice, empowers them to influence change and improve their leadership skills.   In Ghana, several interventions have been implemented by the government with support from other relevant stakeholders to address the sexual health needs of adolescents and young people. These include provision of SRH information and introduction of ‘safe spaces’ in health centers and schools. However, there is no evidence of the use of participation as a tool to drive change. Instead, participation is measured as an outcome of other  interventions. A global study that sought to assess participation of the youth in sexual and reproductive health decision-making policies found that only 9% of young people had been engaged by decision-making bodies for over five years. Again,  66% of young people had a negative view of participation in SRHR activities. These responses were related to age discrimination, tokenism or failed spaces for participation. Gyampoh (2015), also argues that the extent of youth participation in Ghana is unclear and often driven by the elite. In Ghana, no study, to the best of our knowledge has been conducted to assess the number of  young people who participate in SRHR related activities Based on the information above , it is evident that there is the need to restructure the design and implementation of SRHR interventions by giving young people the opportunity to take part in decision-making from the grassroots. As such, our organization seeks to assess the actual level of participation by the youth in SRHR decision-making and to address the issues that contribute to poor participation of young people in SRHR activities.

Young people are often perceived as vulnerable and inexperienced in decision-making. Nonetheless, it is essential to provide them with opportunities to exercise their rights and take responsibility for their decisions. 

Our organization aims at improving youth participation by

i.  Offering capacity building training sessions and workshops. These initiatives are targeted at empowering young people  to independently and/or collaboratively organize and execute advocacy campaigns. The educational content will prioritize identifying advocacy strategies that align with the cultural context of young individuals, enabling them to drive positive change in the SRHR space and acquire the necessary resources for successful campaign execution.

ii.  Fostering community engagement. Through community engagement sessions, we would create awareness and promote open discussions on harmful gender norms, cultural stigmas, and misconceptions about SRHR that affect young people especially the most vulnerable groups (girls and the disabled). These engagement sessions will be held in partnership with opinion leaders and the youth of various communities. The sessions will provide the opportunity to effectively address generational barriers, fostering direct communication and understanding between leaders and young people, thus bridging the gap between both groups. Unwavering support from leaders will also promote support from community members and encourage the SRHR initiatives by young people. Furthermore, it will endorse the legitimacy of youth-driven initiatives and thus encourage more young people to get actively involved.

iii. Improving youth participation by leveraging on already existing SRHR apps and platforms, such as the UNICEF  U-report and Agoo SHE+, to create a customized platform that provides appropriate information, interactive sessions, and other resources tailored to needs of this age group. This platform will include features of personalized robocalls , giving users the opportunity to opt in for informative calls on topics like contraceptive use and personalized reminders, appointment notifications and general SRHR advice. These calls will be designed with user cultural and language considerations of these young people. This initiative employs a modern approach to informing and empowering young people to get actively  involved in SRHR activities.

iv. Organizing frequent monitoring and evaluation activities to ensure proper assessment of the impact, effectiveness and sustainability of these initiatives. Also, these activities will help young people to become more committed and remain engaged in SRHR activities. Monitoring and evaluation will help identify gaps and potential areas of improvement in our proposed strategies and enable us to fill these gaps and refine strategies, content and approaches to equip young people to participate more actively and effectively..

Our solution will serve young people who live in the Ashanti, Northern, Greater Accra regions of Ghana. These regions according to the Ghana Demographic Health Survey have the highest prevalence of teenage pregnancy, early child marriage, low contraceptive use and HIV infections (GDHS, 2015; GDHS 2023). Young people in these regions encounter so many barriers to SRHR service delivery. These barriers include but are not limited to, limited access to comprehensive information, issues  of non-confidentiality, cultural barriers, gender stigmatization and the lack of youth friendly support systems.  The solution our organization plans to deploy will empower young people with the requisite knowledge and resources to make informed decisions about their sexual rights.  We will also equip these young people with the necessary skills to advocate for their rights and help influence policies and policy revisions on SRHR. 

Our organization seeks to address health related issues through evidence-based research, targeted stakeholder engagements and policy analysis.  We also provide practical solutions to health related issues and engage in advocacy campaigns that address relevant health issues in the country. Our team comprises vibrant young health professionals from different backgrounds that possess the skills and qualifications to design and execute training programs and workshops for young people. With the knowledge and expertise we possess, we are well equipped to provide young people in the selected regions with the needed resources to enable them participate actively in SRHR related issues. Also importantly,  our team has an overwhelmingly good female representation, thus  giving us a great advantage in reaching out to more young  females who are the most vulnerable population in SRHR matters.

Our organization has also in the past collaborated with some groups in various underserved communities to address other related issues such as education on female genital schistosomiasis which is a neglected tropical disease that affects a great number of females in their reproductive age leading to complications affecting the sexual and reproductive health of many young women in these rural areas.

We have engaged many other organizations who are also working on projects related to Adolescent SRH as well as opinion leaders who have provided some great guidance on how some critical pieces of our proposed solutions should be modeled to ensure maximum impact. 

We have had the opportunity of engaging young females during our project on female genital schistosomiasis (FGS) advocacy campaign in 2022. 

In collaboration with the University of Health and Allied Sciences, Ho, Ghana, Bridge to Development, USA and Buyere Hospital, Canada, we conducted some post-evaluation exercise to determine the impact of the FGS campaign, during the time, we collected qualitative information from participants on their level of confidence and involvement in SRH matters.

We have also engaged Savana signatures, an NGO based in Tamale, that have worked extensively on projects bordering on female SRH and gender equity. We plan to leverage expertise from their team as well as utilize some data from them for our advocacy plans.

Firstly, our training and workshop sessions on conducting advocacy campaigns will have interactive sessions where participants are tasked to provide practical solutions to case studies and real-life scenarios. There will also be brainstorming sessions, group discussions, role play activities, quizzes and games that will encourage active engagement of the participants. We will also employ the use of peer to peer learning, where participants will be trained and mentored by their peers. This approach will encourage the acceptability of shared knowledge. 

With regards to community engagement, we will organize sessions with young people and community leaders separately and thereafter bring them together to discuss issues concerning SRHR. We will also ensure a fair representation of young people at community engagement sessions since they are the target population. We will also use role play sessions, case studies that require practical solutions, dramatization and have frequent capacity building sessions for young people to enhance their knowledge in communicating matters pertaining to SRHR. Our  training and capacity building sessions will be jointly facilitated by both young  people and older age groups. This will promote the acceptability of information and influence change in the selected communities.  

Again, instead of building new SRHR platforms from scratch, we will collaborate with organizations like UNICEF who already have existing SRHR platforms to create our customized platform. We will liaise with these organizations to promote the use of these platforms in areas that are unreached, Again, we will also propose the modification of platforms to suit the cultural and language preference of the target group in order to promote acceptability. 

We will create interactive dashboards that will display data that will enable target groups to report progress made and our organization  to track the progress and outcomes of our interventions. We will introduce mobile apps that allow for the consistent collection and transmission of data by fieldworkers  even in areas with poor or no internet connectivity. 

Projections for the next year

Target 1: Organize a total 4 workshops and capacity building training sessions on advocacy campaigns by November 2024 (once every quarter) for young people in the selected communities

Indicator: The total number of young people who lead or are actively involved in SRHR advocacy campaigns either independently or as an organization. 

Target 2: Organize a total 4 community engagement sessions by November 2024 (once every quarter) by November 2024

Indicator: Percent increase in number of SRHR related activities carried out in communities

Target 3: Train a minimum 1000 youth on the use of the U-report and Agoo SHE+ platforms 

Indicator: the number of new monthly subscribers to the platforms from selected communities

Target 4: Organize monthly evaluation and monitoring exercises in selected communities 

Indicator: The total number of implemented strategies with evidence of positive data-driven results

How to achieve targets in the next year 

We aim to achieve these targets in the next year by collaborating with young health professionals who work with the Ghana Health Service. These professionals support the facilitation of capacity building training sessions and workshops as well as community engagement sessions. We will also collaborate with UNICEF to expand the use of their SRHR platforms in our selected communities. Lastly, we would ensure strict adherence to monthly timelines for our monitoring and evaluation activities. In doing so, we will be able to promptly identify areas of our strategies that are not working so well.. We will achieve this  by creating a monitoring dashboard for our team to track our progress with regards to service delivery

Impact goals for the next 5 years

 We aim at training  60 youth groups who can in turn train upcoming  youth groups and individuals from new communities to carry out effective advocacy campaigns. 

 In five years, we hope to have attained a 70 % increase in acceptance rate of SRHR activities in both rural and urban communities.

In the next 5 years, we plan to support 30 young people groups in creating their own SRHR platforms to increase the coverage of SRHR service delivery. 

We plan to train 30 young people groups in creating their own interactive dashboards to track the progress of the SRHR interventions implemented.

How to achieve goals in the next 5 years

In the next five years we will be collaborating with relevant international and local organizations on related projects to grow our network and extend our influence across various communities within the country.

With regards to community engagement, we will work with telecommunication platforms, leverage social media to expand our reach and enhance community awareness advocacy on SRHR for young people in both rural and urban areas.

Our organization will partner with local software development hubs to train young people groups in creating their own platforms to broadcast information on SRHR and keep track of progress. 

Theory of Change for ‘Youth Action: For the youth by the youth’

Activities 

1.  Capacity trainings and workshops on deploying advocacy campaigns
2.  Community engagement 
3.  Utilization of SRHR platforms 
4.  Monitoring and evaluation exercises 

Immediate outputs 

1. Increased awareness and acceptance of SRHR issues
2. Policy change influence  by youth-led advocacy
3. Reduction in the incidence of sexually transmitted diseases and  unwanted or unplanned  pregnancies
4. Increased use of SRHR platforms to address pertinent reproductive health problems
5. Prompt identification of successful strategies

Long term outcomes

1. Enacting and revisions of laws that protect the rights of young people in Ghana
2. Increased number of sexually healthy young people in the country
3. Significant improvement in public confidence in the capabilities of young people in influencing positive change 

Evidence to support the impact of activities 

1. Data provided by reliable surveys on the reduction of unplanned or unwanted pregnancies, increased use of contraception, a reduction in sexually transmitted diseases
2. The amount of positive feedback received from beneficiaries of implemented strategies 
3. The total number of new SRHR young people groups created in the country
4. Number of SRHR service delivery centers created in the target communities 

FULL-TIME STAFF

1. Charity N.F. Anang - Team Lead

2. Dr. Benedicta Bonsu - Technical Advisor

3. Dr. Mariam Wahab - Project Co-ordinator

4. Dr. Samuel Nuamah - Principal Advisor

5. Mark Hammond - Consultant 

PART-TIME STAFF

1. Julliet Johnson - Associate

2. Richard Owusu - Research analyst

Our organization over the past 2 years have been working in collaboration with organizations both local and international on SRHR projects notable among them is an advocacy on Female Genital Schistosomiasis prevention advocacy tied to improving youth participation on SRH activities. While our team has dedicated just over 5 months to developing this particular solution, we are certain that we would be able to improve active participation of the youth in SRHR activities considering our previous engagements. We are committed to bolstering youth participation in SRHR in order to create long-lasting transformations in our country and across Sub-Saharan Africa.

At Public Health Alliance International Ghana, we acknowledge the need for diversity, inclusivity and equity at all levels of our organization and in all programs run. Our team is made up of young people from different genders as well as cultural and educational backgrounds. This diverse mix of expertise and experiences positions us to deliver our solution effectively in the communities we plan to reach 

Our goals for the future include:

1. Organizing capacity building workshops and trainings for all young people groups in the country on diverse public health issues in Ghana and Sub-Saharan Africa which we believe will attract people from diverse educational and social background.

2. We aim at creating an environment where all young people particularly females can freely discuss and address issues that concern them without the fear of being discriminated and with the confidence that their concerns will be addressed. In line with this, we will be creating various communities of practice as well as focus groups that will constitute young women of different age groups and socio-economic background so to ensure a very rich and global set of perspectives to issues relating to SRHR.

3. We aim at creating safe spaces all over that country, in schools, health facilities, communities and religious institutions where every young person can access all the information and support they need to facilitate positive decision making.

Business model: 

Improving youth participation in SRHR activities through capacity building trainings and workshops, community engagement, digital SRHR platforms and frequent monitoring and evaluation exercises

Value proposition: 

1. Empower young people to actively participate in SRHR activities 
2. Provide  comprehensive SRHR knowledge and practical skills 
3. Nurture leadership and advocacy capabilities of young people 

Customer segments: 

Young people aged 15-35 and community members 

Delivery channels: 

1. A combination of in person and online workshops and trainings to cater for those living in both rural and urban areas 
2. Social media platforms
3. Television and radio
4. Robocalls

Customer relationships: 

1. Engagement through workshops, community meetings  and SRHR platforms 2. Frequent monitoring and evaluation 

Revenue streams: 

1. Grants and donations from governmental and non governmental organizations 

2. Partnerships with other organizations to leverage resources

Key resources: 

1. Expert trainers and facilitators in SRHR

2. Training materials such as tool kits 

Key Partners: 

1. International and Non-Governmental organizations 

Cost Structure: 

1. Human resource cost 

2. Cost of acquiring materials 

3. Cost of transportation 

In order to ensure sustainability, we aim at charging a small fee for come back youth organizations that request to take part in our training sessions. This should help us to not rely solely on grants and funding from government and non-governmental organizations

We would also leverage on digital platforms especially for our engagements in urban areas. This would help us reduce the cost of logistics and aid in reaching a larger audience