Key Programs: Adolescent Sexual & Reproductive Health (ASRH) 

Delivering Adolescent Sexual & Reproductive Health in Sierra Leone

In Sierra Leone, teenage pregnancy rates are estimated at 21%, with 45% of 19-year-olds having started childbearing and 20% of all deaths among girls and young women are pregnancy related (DHS, 2020). We address some of these challenges through a diverse range of programs that prioritize meaningful adolescent engagement and partnership. We engage adolescents in the design, implementation, evaluation, learning, and partnering with youth-led organizations. We also work within communities through health workers and champions, at the district and national levels, to improve access to quality adolescent-friendly, gender transformative sexual, reproductive and child health services, and reduce adolescent pregnancy.

Connect

Connect (2019-2023), a 4.5-year project funded by the Bill & Melinda Gates Foundation, enhances large-scale health and development projects to improve health outcomes among young first-time parents (FTPs). Connect integrates postpartum family planning (PPFP) for FTPs into the community-based nutrition Lishe Endelevu project in Tanzania; in Bangladesh, Connect enhances the MaMoni Maternal and Newborn Survival Project to improve coverage, timing, and quality of postnatal care, inclusive of PPFP, for FTMs. By leveraging existing projects with light-touch facility- and community-level approaches, Connect effectively and efficiently supports this population.

Growing Up GREAT!

Growing Up GREAT!, implemented under the USAID-funded Passages Project (2015-2021), is a scalable, multi-level intervention designed to improve sexual and reproductive health (SRH) and gender equity among very young adolescents (VYA) and the important adults in their lives. It supports VYAs and their caregivers, teachers, health providers, and communities to question and break down social barriers that prevent access to health information and services. Growing Up GREAT! was piloted in the Democratic Republic of the Congo in 2017-2018. An evaluation by the Global Early Adolescent Study found that the intervention improved SRH knowledge and VYA relationships with caregivers, and also shifted key SRH attitudes and behaviors.

Healthy Transitions for Nepali Youth

In 2019, Save the Children launched the Healthy Transitions for Nepali Youth Project (HTNYP) in four districts of Karnali Pradesh Province in the hill region of Nepal to support unmarried and married adolescent girls and young women (AGYW) aged 15–24 years as they transition to marriage and parenthood. HTNYP engages young women, their husbands when applicable, their parents or in-laws, and the community in interventions to improve reproductive, maternal, and newborn health (RMNH) knowledge and practices, as well as increase gender equality in household decision making. HTNYP also supports quality improvement of RMNH services to ensure they are available and responsive to the needs of youth. Evidence from the first cohort of AGYW who participated in HTNYP demonstrates that reaching them using a robust socio-ecological approach has potential for short- and long-term positive outcomes for RMNH behaviors. Our findings show that women’s attitudes towards RMNH care-seeking behavior, as well as their knowledge, significantly increased for several key indicators. Details from the evaluation may be found on the Healthy Newborn Network.  

USAID Kulawa & Tipping Point

USAID Kulawa (2020-2025) is the USAID Resilience in the Sahel Enhanced II (RISE II) Health Services Delivery activity in Niger, which works to improve access to and use of quality health services, strengthening ownership and management by communities, local government, and service providers. Kulawa—meaning “care” in Hausa—strives to close the equity gap in maternal, newborn, and child health (MNCH), family planning/reproductive health (FP/RH), and nutrition service access and use, with a special focus on youth. USAID Kulawa will also provide an implementation platform for Tipping Point, a 4.5-year research study funded by the Bill & Melinda Gates Foundation and led by the University of California San Diego. Tipping Point will use a three-arm study to explore whether a social network-based intervention is more effective and more scalable than traditional approaches to improving family planning uptake among married adolescents and youth 15-24. Save the Children will implement Tipping Point’s innovative social network-informed intervention as part of Kulawa’s youth and family planning interventions.