P2i:Youth-Driven SRHR Policy Transformation

• Background and Context:

Pakistan, a low-middle-income country, with a population of 241 million, is witnessing a substantial youth bulge, with 64% of its population under 30 years. Out of the total population 154.2 million people are youth. Out of these, there is an almost even split between males (13.1%) and females (13.2%). The sheer size of this demographic suggests its significant engagement in both identifying and influencing the national SRH priority agenda. However, a crucial concern arises when the voices of these youths, particularly the young females, remain largely unheard in policy and program design processes. The neglect results in SRH policies misaligned with the actual needs of the youth. This policy-practice disconnect is highlighted by concerning SRH indicators, like high maternal mortality rate (178/100,000 live births), 35.4% contraceptive use, and 20% unmet need for family planning, more pronounced in younger age groups. Of 4‐5 million annual births in Pakistan, only half receive skilled birth attention, and whereas the prevalence of HIV among the population is 0.1% there has been a steady increase in the weighted prevalence of HIV which is a cause for concern.

• Data Disparities and Oversights:

A fundamental issue in many existing research methodologies is the lack of data disaggregation based on age and gender. This broad-brush approach tends to gloss over specific challenges faced by distinct demographic segments. For the youth, especially, it means that their unique obstacles, service preferences, and aspirations in SRH remain shadowed. The need for a granular, youth-focused database becomes evident if the objective is to draw policies and interventions that genuinely resonate with their needs and realities.

• The Gap between Data and Advocacy:

Even when youth-centric data is available, there's a gap between data collection and its translation into actionable advocacy. Young researchers often find themselves distanced from policy dialogues, rendering their findings less impactful. 

The specific problem centers on the underrepresentation and engagement of the youth, especially females, in SRH research, policy design, and advocacy, leading to SRH policies and services that are neither youth-focused nor gender mainstreamed.

• Limited Youth & Female Engagement in SRH Research and Policy:

The prevailing research paradigm largely sidesteps the unique perspectives and requirements of the youth. The limited engagement means that their distinct experiences and challenges, which could substantially inform SRH policy, are often overlooked. It becomes vital, therefore, to recognize and address the existing deficits in their SRH knowledge and understanding, as well as their limited exposure to participating and leading research, advocacy, and policy development. Youth are ill-informed not only on SRH topics but also have limited awareness of the power of their voices which is accentuated through evidence-driven advocacy to guide SRH prioritization, sensitization of the policymakers on the importance of their engagement in the policy process, and as well as on the need of youth and gender focussed design of SRH program and policy formulation for shaking the stagnant and often deteriorating SRH indicators in the country.

Addressing the Underrepresentation & Engagement of Youth in SRH Research, Advocacy and Policy Processes:

Our solution prioritizes capturing the authentic voices and experiences of Pakistan's youth, particularly in the SRH domain.

• Youth Engagement: Emphasizing youth leadership in SRH decision-making, we ensure their active involvement in shaping the project's trajectory.

• Youth-Centric Research Initiative: We've kickstarted a research grant project aimed squarely at Pakistan's youth, emphasizing gender-sensitive and gender-disaggregated data. This ensures balanced participation and representation, particularly of females, in all project stages.

Addressing Data Disparities & Oversights in SRH:

• Our strategy extends beyond mere data collection by focusing on unveiling the unique challenges and aspirations of the youth.

• Data Disaggregation: We stress the importance of breaking data down by age and gender. This reveals specific insights into the unique challenges youth face in SRH, their preferences, and aspirations.

• Research Dissemination: Our initiative creates avenues for young voices to be heard, be it through seminars, online platforms, or direct dialogues with senior policymakers, bolstering their advocacy and policy communication skills.

Bridging the Gap between Data & Advocacy:

To ensure research data becomes actionable, we are committed to robust advocacy efforts:

• Training and Capacity Building: Organizing workshops tailored for young participants, we enhance their skills in areas like research, data analysis, reporting, and project management.

• Mentorship: Connecting young researchers with seasoned SRH experts for guidance throughout their research journey and assistance in the use of evidence for advocacy and developing key messages.

• Policy Advocacy: Through our existing professional linkages and networks, we promote dialogues between young researchers and senior policy and decision-makers, translating findings into actionable policy recommendations and innovations.

Elevating Youth & Female Participation in SRH Research & Policy:

Recognizing that the youth and particularly the young females unique perspectives inform SRH policy, our solution addresses the existing disconnect between their needs/preferences and the existing SRH programs and policies.

• Comprehensive Strategy: Beyond just research, our initiative seeks to embed youth participation in every step of the SRH policy process and program design. They become vital contributors, from Assessment to Accountability.

• Capacity Building: Our goal extends to transforming these young advocates into active SRH policy contributors, ensuring they have a stake in the entire policy development cycle.

• Replication & Expansion: As our model proves effective, coupled by a strong social media campaign again designed and led by youth, we anticipate its adoption by government agencies and development partners, leading to heightened youth and female engagement in policy discussions.

In essence, our project isn't merely about identifying and researching problems; it's about proactive, youth-driven solutions that will reshape the SRH landscape in Pakistan.

Our solution is specifically designed for and serves Pakistan's youth, particularly those between the ages of 18 to 30. With 64% of the nation's population under 30, this vast demographic necessitates deliberate and tailored attention.

The vitality and concerns of the youth, especially during their active reproductive years, often remain unaddressed, making their engagement and insights crucial. So, why emphasize the youth? Beyond their direct experiences, many young professionals also serve as caregivers. We're not just incorporating youth perspectives into SRH policies; we're nurturing a comprehensive pathway for their engagement. As we enhance their capacity, we're preparing them to occupy seats at policy-making tables confidently. Armed with appropriate knowledge and effective advocacy skills, they'll present compelling, needs-driven arguments. Our ambition is to pioneer this pathway, not only recognizing the significance of SRH but emphasizing that in a predominantly young nation like Pakistan, youth engagement isn't just beneficial – it's essential.

This solution will impact their lives through:

1. Unmasking Youth-Centric Issues: Through youth-led research, we aim to disaggregate data within the broader context of SRHR. This will unveil distinct challenges faced by the youth, ensuring they aren't overshadowed by broader trends.

1. Building Research and Advocacy Skills: Our project provides training in research project management, leadership, advocacy skills, mentorship, and research opportunities, equipping the youth with essential skills. This not only aids them in the immediate project but also sets them on a path of lifelong learning and advocacy.

1. Amplifying Youth and Female Voices: Recognizing Pakistan's consistently low ranking on gender parity indices, our approach goes beyond just youth-centric; it's also female-focused. This ensures that young women, a segment traditionally marginalized, have their voices amplified and issues addressed.

1. Youth-driven g Policy Processes: By connecting these young researchers with policymakers, we ensure that their insights, rooted in evidence, inform and influence policy directions. The direct impact is twofold: more youth-centric policies and an empowered youth populace actively participating in policy dialogues.

1. Creating Awareness and Fostering Collaboration: Beyond research, the project serves as an awareness-raising tool. Dissemination of findings, coupled with collaborations between academia, youth, and SRH organizations, ensures a wider reach and greater impact.

1. Gender and Youth-Focused Policy Recommendations: By understanding the barriers faced by the youth, especially young women, in accessing SRH services, our project will provide evidence-based recommendations. This ensures not only youth-focused but also gender-responsive SRH services and policies, addressing Pakistan's long-standing gender parity challenges.

In essence, our solution is a transformative approach, ensuring that the youth, especially young females, are not passive recipients but active shapers of the SRH discourse in Pakistan. 

P2i focus is on assessing the context, engaging the public, decision-makers, and policymakers, rigorously generating quality and relevant evidence, building linkages and effective partnerships, networking with subject matter experts, donors, and development partners, disseminating evidence, and advocating guided policy and practice reforms. 

Senior Advisors at P2i founded the Women in Global Health Pakistan (WGH-P) Chapter in August 2020 with the active presence of two sitting Federal Ministers at that time. It was the first chapter to be established in Asia and ranks as one of the high-impact chapters amongst the WGH network of 51 country chapters. It is actively supported by both senior and young aspiring women leaders in medical universities, research institutions, policy think tanks, government, and key institutions. WGHP focuses on evidence-based advocacy to inform program and policy interventions targeted at promoting gender equity at all levels of the health systems. 

The team at P2i has experience of running an extensive youth leadership program offering internships to students from elite schools and connecting them to students studying in underprivileged areas. They conducted the landmark study on nutrition, SRH of marginalized adolescent girls and in 2020, actively supported the government in conducting a youth survey whereby 44,000 youth submitted what challenges they confronted and what priority policy initiatives they wanted the government to take for them to actualize their potential. 85% of the youth expressed the desire to be engaged in policy-making processes. Following the same, they facilitated extensive engagement of youth in the gender focussed youth policy framework formulation which was presented by them before the senior ministers in March 2021. Our advisor was appointed to lead the national gender, health, and youth portfolios and the P2i team of young professionals actively supported the launch of the country's first-ever national gender policy framework in March 2022. 

The team further supported the Ministry of Health, Government of Pakistan in 2023 conducting an extensive survey around the mental health of youth to guide the development of the mental health policy framework. 

The P2i Team and its growing network of advisors have experience working at the highest policy level and have led portfolios for health, education, and social development. That puts them in a unique position to create this prototype of active engagement of youth in SRH policy discourse and connecting them to the highest policy rooms.

P2i was founded by two senior women leaders, is staffed by all women, and the current youth initiative project lead is also a young highly passionate professional who is hugely passionate about SRHR. 

Our solution initially targets the youth of Punjab, which encompasses a significant number: 30,097,786 individuals from the age of 15 to 29 years. Within this demographic, there's a near-even split between males (14,986,223) and females (15,106,931). While our primary focus is on the youth of Punjab, the broader implications of our initiative are far-reaching. By championing policy modifications that actively incorporate the youth into SRH programs and strategies, the ripple effect of our work could positively influence the entire youth demographic of Pakistan which is 154.2 million. Thus, in terms of policy impact, our solution indirectly serves the expansive youth populace of the nation.

Our solution is innovative because it introduces an unprecedented approach in Pakistan. Despite the youth constituting 64% of the population, their participation in SRH research and policy-making has been negligible. Our innovative pathway challenges the status quo by turning the entire model top-down, adopting a bottom-up approach that brings the youth, and also females, to the forefront of SRH discourse—a paradigm shift that has never been undertaken in such a holistic manner before in the country. Our strong linkages and presence of our advisors in the policy rooms will facilitate linking the youth working under this project to the policy and decision-makers.

Youth and Female Leadership in a Traditional Context: In a nation where the health sector's leadership features less than 2% of females—even when 70% of healthcare workers are female—our project marks a significant departure from the norm. For the first time in the SRH landscape of Pakistan, a project is being designed, steered, and executed by youth, predominantly young women. This not only challenges the prevailing patriarchal structures but also sets up a robust pathway for the next generation of leaders in the health sector.

New Process: Traditionally, research in SRHR has often been led by international experts and senior professionals, with youth voices mainly relegated to the periphery. We've inverted this model. By prioritizing and empowering youth to lead research projects, we've instituted a new process where the very demographic most affected by SRHR issues is at the forefront of investigating and addressing them. This youth-centric research model ensures that findings are more attuned to the lived experiences of the youth, making the resulting solutions more relevant and impactful.

Next Year: Formalize Engagement of Youth in Policy Process

Next Five Years: Youth driven SRH Policy Frameworks in Pakistan

Strategy: Over the next year, we aim to solidify the infrastructure and mechanisms that allow the youth, particularly young women, to be actively engaged in the policy-making process. We will:

1. Initiate Consultations: Begin with a series of consultations and workshops involving diverse youth groups, ensuring a comprehensive representation across various demographics and regions of Pakistan. These sessions will identify the primary challenges faced by the youth regarding SRH and will gather recommendations for policy amendments.

1. Develop Partnerships: Collaborate with key stakeholders, including government agencies, NGOs, and academic institutions, to ensure that the youth perspective is acknowledged and integrated at all decision-making levels.

1. Capacity Building: Organize training sessions and workshops for the youth, aimed at enhancing their knowledge of the policy-making process, equipping them with the skills to contribute effectively.

1. Pilot Initiatives: Implement pilot initiatives based on feedback and recommendations from our consultations, iterating and refining our approach based on real-world outcomes.

Next Five Years:

Goal: Establish Infrastructure for Youth Participation in National and Regional Policy Formulation, with Emphasis on Women and Girls

Strategy: In the longer term, our vision is to have an established and sustainable infrastructure that ensures consistent youth participation in policy-making, especially that of women and girls. Here's how we plan to achieve this:

1. Scale Successful Pilots: Extend and replicate successful pilot initiatives from our first-year activities across different regions of Pakistan.

1. Diversify Representation: While our primary focus is on SRH, we aim to broaden the scope of youth representation to include other pressing issues faced by the youth. This will make our infrastructure versatile and more holistic.

1. Mentorship Programs: Establish mentorship programs where experienced policy-makers guide and train the younger generation, ensuring a constant flow of experienced youth representatives in the policy rooms.

1. Documentation and Research: Continually document our efforts and conduct research to ascertain the effectiveness of youth participation. This will serve as a foundation for future policy recommendations and adjustments.

1. Engage with International Bodies: Partner with regional and international organizations to benchmark our efforts, share best practices, and ensure our approach is aligned with global standards.

By focusing on these strategies, we are confident that we can achieve our impact goals, creating a lasting and positive change for the youth of Pakistan, especially young women and girls, in the realm of SRH and beyond.

Goal: 

Enhance the engagement of Pakistani youth in shaping Sexual and Reproductive Health (SRH) policies and programs to better address their needs and challenges.

Intermediate Outcomes: 

1. Immediate Outputs: 

-        Issue research grants to young scholars for SRH topics.

o   Immediate Outcome 1: Young scholars receive financial support for SRH research projects.

-        Conduct mentorship, training, and skill-building sessions for these young researchers.

o   Immediate Outcome 2: Young scholars receive mentorship and training in research methodologies, advocacy, and policy engagement.

2. Intermediate Outcome 1: 

-        This financial support encourages and facilitates in-depth investigations into critical and often overlooked SRH challenges faced by Pakistan's youth.

o   Intermediate Outcome 1a: Young scholars conduct in-depth research on SRH challenges.

o   Intermediate Outcome 1b: Research findings shed light on critical SRH issues faced by Pakistani youth.

3. Intermediate Outcome 2: 

-        By offering structured guidance, we enhance the quality of research while fostering a new generation of SRH advocates, ensuring a sustainable model for change.

o   Intermediate Outcome 2a: Young researchers acquire advanced research skills.

o   Intermediate Outcome 2b: A network of young SRH advocates is established.

o   Intermediate Outcome 2c: Young scholars are equipped to engage in evidence-based advocacy.

Long-Term Outcomes: 

1. Intermediate Outcome 1: 

-        Research findings are disseminated to policymakers and SRH stakeholders.

o   Long-Term Outcome 1: Policymakers are informed about the specific SRH challenges faced by Pakistani youth.

2. Intermediate Outcome 2: 

-        Engage in targeted policy advocacy based on the research findings.

o   Long-Term Outcome 2: SRH policies and programs are informed by evidence-based research conducted by young scholars.

3. Long-Term Outcome 1:

-        Policymakers consider the evidence-based findings in the development and revision of SRH policies.

o   Long-Term Outcome 1a: Policymakers integrate youth-focused SRH research findings into policies.

o   Long-Term Outcome 1b: SRH policies better address the needs of Pakistani youth.

4. Long-Term Outcome 2: 

-        Improved SRH policies and programs benefit the SRH outcomes of Pakistani youth.

o   Long-Term Outcome 2a: Enhanced SRH programs positively impact the health and well-being of Pakistani youth.

By linking project activities to immediate outputs and intermediate and long-term outcomes, this logical framework provides a clear path for how the project will contribute to the ultimate goal of involving Pakistani youth in shaping SRH policies and programs to better address their specific needs. It also highlights the sustainability of the approach through the creation of a network of SRH advocates among young scholars.

Evaluation: Tracking changes in national SRH policies, surveys gauging youth awareness and attitudes towards SRH, recording trendline for SRH indicators disaggregated by age and gender, and monitoring international citations of our research.

Rationale for Expected Impact:

Our approach is rooted in the belief that direct youth involvement in research yields authentic insights into SRH challenges. This participatory research ensures genuine resonance with ground-level experiences and needs. The training components amplify research quality, leading to findings that can directly influence policies. As policies evolve to reflect these needs, the broader environment becomes more conducive to youth SRH welfare.

There are 3 people full time and 5 part time.

Senior leadership has been operating at the policy level for over 15 years. This particular project focused on youth has been initiated since 2020 (3 years). 

At the core of our initiative is a profound commitment to diversity, equity, and inclusivity (DEI). Our belief is that genuine solutions emerge when all voices are not just heard, but actively incorporated into the decision-making process. Here's how we actualize this commitment:

1. Diverse Representation: We prioritize the inclusion of participants from various ethnic, religious, socioeconomic, gender, and geographical backgrounds. This ensures that our research reflects the vast mosaic of Pakistani youth experiences.

1. Geographical Inclusivity: While Punjab is a significant province, our commitment extends to achieving a nationwide representation. We actively collaborate with universities and institutions in Sindh, Balochistan, and KPK, ensuring that voices from all provinces are robustly represented and that regional SRH challenges and nuances are addressed.

1. Gender Equity: Recognizing Pakistan's gender disparities, our approach is designed to not just be youth-centric but also female-focused. We champion the active participation of young women, ensuring that they're at the forefront of research and policy advocacy. This emphasis addresses and seeks to correct historical marginalization.

1. Inclusive Research Topics: Our research encompasses a vast spectrum of SRH topics, ensuring that even lesser-discussed or taboo issues are illuminated. This inclusive scope guarantees that no aspect of youth SRH experience is left unexplored.

1. Accessible Training: Our training modules are designed to cater to a wide range of educational and experiential backgrounds, ensuring that all participants, regardless of their starting point, have an equal opportunity to learn, grow, and contribute.

1. Community Engagement: We actively solicit feedback from the communities we serve, continually refining our approach to ensure it aligns with their evolving needs and resonates with their lived experiences.

1. Collaborative Policy Dialogues: Our policy advocacy efforts prioritize inclusivity. By engaging youth from diverse backgrounds and regions in direct dialogues with policymakers, we foster policies that are holistic and truly representative. 

In essence, DEI is not an afterthought for us; it's an integral framework that underpins every facet of our work, ensuring that our impact is broad-based, genuine, and transformative.

Value Proposition:

P2i provides a holistic, evidence-based approach to address pressing public health challenges. By integrating expertise from diverse professional fields, including health and academia. We ensure that health is examined in its cultural and social contexts. Our services directly benefit from our team's vast experience in education, social reforms, sustainable development, and global goals, as well as our history of collaborations with international bodies, governments, and NGOs. Our unique position allows us to bridge the gap between technical experts and decision-makers, translating evidence-based insights into actionable policies and strategies.

Key Customers and Beneficiaries:

1. Public and Communities: We serve the broader public, especially in areas of community health, understanding their concerns, and addressing them comprehensively.

2. Youth: As an aspirational voice for the younger generation, we involve and challenge them in public health matters, preparing them for the future.

3. Policymakers and Governments: Our research, advocacy, and policy development services aim at both current and future decision-makers to ensure sustainable and informed policy decisions.

4. Organizations: Both governmental and non-governmental entities benefit from our wide array of services, spanning from research to HR planning.

Services:

1. Research: Comprehensive research activities focused on current public health challenges.

2. Monitoring and Evaluation: Ensuring the effectiveness of health-related initiatives and providing necessary feedback for improvements.

3. Policy and Strategy Development: Creating evidence-based policies and strategies tailored to the present and future needs.

4. Human Resource Planning and Health Information: Helping organizations optimize their workforce for health initiatives and providing accurate health data insights.

5. Communications and Reporting: Effective communication strategies and detailed reporting for stakeholders.

6. Linkages and Partnerships: Bridging the gap between different stakeholders in the health sector for collaborative efforts.

Delivery Mechanism:

Through our established platforms, we connect experts with policymakers, facilitating the flow of valuable insights into actionable strategies and policies. Our service delivery is tailored to the specific needs of organizations, communities, or governments we work with, ensuring targeted and efficient solutions.

In summary, P2i's business model revolves around leveraging our unique expertise and networks to offer evidence-based solutions in the realm of public health. Our diverse range of services caters to a broad spectrum of beneficiaries, from local communities to global entities, ensuring that we not only identify challenges but also provide actionable solutions.

Diversifying Funding Sources: While initial grants are instrumental in setting the stage, it's essential to diversify our funding sources. We plan to explore partnerships with private sector companies, CSR initiatives, and international development agencies interested in SRH and youth engagement.

Providing Paid Services: Building on our expertise, we offer consultancy, training, and capacity-building services to other organizations, NGOs, and governmental bodies. This approach generates revenue while promoting our core objectives.

Local Fundraising: Engaging the local community can be a sustainable source of funding. We plan on organizing awareness events, workshops, and crowd-funding campaigns to rally support and gather micro-donations.

Developing Intellectual Property: Through our research and interventions, we will create tools, methodologies, and training materials. Licensing or selling these assets can become a steady revenue stream.

Collaboration with Universities: Universities often have funding for research initiatives. We can collaborate with academic institutions, offering them access to our data, insights, and field expertise in exchange for financial support or shared grants.

Engaging Alumni and Beneficiaries: Those who have benefited from our programs can become ambassadors. Their testimonials and success stories can be influential in attracting sponsors and donors.