ARFH has designed, pioneered and implemented several adolescent health and development interventions for both in and out of school young people and been at the forefront of providing structures for reproductive health services to meet the needs of adolescents and supporting government at all levels to integrate youth friendly ARH services into Primary Health Care services. Young people in Nigeria, like any other country, are exposed to different sexual and reproductive health challenges. In order to reduce the rate of child trafficking, early marriage, forced marriage, teenage pregnancy, unsafe abortion, drug use & abuse among others, ARFH has designed, pioneered and implemented different sexuality education interventions for both in and out of school young people. This is very remarkable considering the social, sexual and reproductive health burdens of young people in Nigeria; the socio-cultural and religious diversity, and the unfavourable milieu which hinders the provision of sexuality information to young people.
Examples of Youth Programs
Life Planning Education Project:
This adopted the delivery of sexuality information using curricula and co-curricular approaches. This intervention was designed as a response to the ‘call for help’ by parents and teachers of secondary school students in Oyo states because schools girls were dying as a result of septic abortion. The project trained 2422 number of teachers to use the curricular approach to present SRH information. 644 peer educators were trained among the students to reach their peers with information. ARFH also supported the state’s government to establish 40 youth friendly centres across the state with service providers trained in youth friendly service provision to run the centres. At the end of the project, 96,880 in-school young people were reached with information and youth friendly services. The success of this project made government of Borno, Bauchi, Gombe, Yobe, Kogi, Kebbi among others to replicate it and the Federal Ministry of Education to redesign it as Family Life and HIV Education (FLHE) which has been mainstreamed into the Nigerian Education curriculum from the primary to the tertiary levels of Education.
Outreach activities in schools,
Based on needs and requests, ARFH staff visited schools (secondary, tertiary) on regular basis for awareness activities on HIV/AIDS and other reproductive health issues. In addition to the talks are drama presentation, film shows and songs. There exists in ARFH a group of youth volunteers who have been organised as members of Youth Rescue Club (a special drama group comprising of young people using drama to reach out to their peers within and outside the school).
ASRH Among Out-of –School Youths
For about two decade, ARFH worked with the out of school young people population. This is done through targeting apprentices and artisans for trainings that will empower and assist them to be able to make informed decisions on issues of their sexual health. Peer educators were trained among trained trade group like Nigerian Union of Barbers, the National Association of Hairdressers, National Association of Technician on Automobile, Okada riders Association of Nigeria, National Union of Road Transport Workers, Spare Part sellers association among many others. ARFH established a mentoring relationship with the trained peer educators to date.
Mainstreaming Gender & Human Rights Education into Adolescent SRH in Secondary Schools
ARFH has also worked extensively in the area of mainstreaming gender and human right information into the activities of secondary schools in selected local government areas in Kogi, Cross River and Gombe states. This was as a result of gender discrimination and human right abuses of the young Nigerians in schools in the project local government. It is on record that as a result of the initiative, the targeted young people became more aware of their rights and started claiming it from duty bearers especially from parents, school authorities and their immediate communities. Girls also began questioning the tradition of silence on sexual issues that had made them vulnerable to sexual exploitation while standing their ground by refusing sexual coercion
HIV/AIDS Prevention and Care through NYSC-Supported by UNICEF
ARFH also partnered with the National Youth Service Corps (NYSC), UNICEF and the Society for Family Health in conceptualizing and implementing the co-curricular National Reproductive health, HIV/AIDS Prevention and Care Project through the NYSC. This intervention which used the peer education approach aimed at increasing access to sexual, reproductive health and HIV education and life skills for adolescents and young people in order to reduce the spread of HIV in Nigeria. On this initiative, over one million young people and adults aged 10-30 years were reached with accurate RH and HIV information.
The project involved (i) development of 5 training materials and operational guide (ii) HIV/AIDS Orientation seminar for youth corps members in 37 Orientation Camps (36 states and Federal Capital Territory) (iii) Skills Building Training for selected Corps members as trainers of peer educators in their places of primary assignment (iv) Schools and community based HIV/AIDS awareness activities by the trained corps. ARFH is also played a major role in instituting a system for the effective monitoring of the project while an organizational assessment exercise was conducted by ARFH for mainstreaming the project into NYSC activities at all levels (Federal and 36 states).
From the project inception in 2002, ARFH had been a technical partner and from 2007, a financial partner with support from Global Fund. Between 2007 and 2009, ARFH in collaboration with other partners on the project have trained 30,490 young adults as Trainers of Peer Educators. Each Trainer is expected to train and mentor 40 Peer Educators among secondary school students reaching over 12 million youth with empowerment skills.
Massive Awareness Raising Campaign on HIV/AIDS (MARC):-
ARFH secured fund from UNICEF for a 1-day school based HIV/AIDS Education in one of the public secondary schools in Ibadan. Highlights included
- Lecture on roles of youth in the fight against HIV/AIDS
- Drama presentation
- Erection of a HIV/AIDS Education Bill Board within the school premises
- Distribution of IEC materials
- Film Show
Designing Systems and Tools for monitoring and evaluating HIV/AIDS activities
With support from UNICEF, ARFH proposed a system which assisted to design a set of tools for monitoring, documentation and evaluating HIV/AIDS prevention programmes amongst adolescents and young people in Nigeria. This was part of the effort being made at standardizing and improving information gathering on HIV/AIDS activities nationally. These tools went through series of testing at a micro level, and national field testing as part of the process of adoption and use nationally
Promoting HIV Prevention Awareness among Youths and Adolescents (NYSC Project)
The Global Fund supported NYSC HIV prevention project implemented by ARFH in collaboration with Society for Family Health (SFH), United Nations Children Fund (UNICEF) and other strategic stakeholders was a response to growing concern on the vulnerability and susceptibility of youth to STIs and HIV&AIDS. The project provided skills in reproductive health, HIV&AIDS prevention and peer mentoring to fresh graduate from Nigerian tertiary institutions that pass through the NYSC program annually. The project empowered these youth to make informed decisions and choices about their social and sexual and reproductive health.
The involvement of the National Youth Service Corps (NYSC) in creating awareness on HIV pandemic is critical to facilitate its prevention and reduction of stigma and discrimination among young people. To enhance the achievement of project goal, corps members were provided with factual information on HIV&AIDS and prevention strategy through the annual orientation seminars in all the 37 states and FCT orientation camps. In addition, a total of 61,191 were trained as Peer Educator Trainers (PETs) during the NYSC orientation program in NYSC camps in the 36 states and FCT. This enabled each of the PETs trains and mentors forty (40) secondary school students as peer educators who, in turn, reached their peers with factual information on reproductive health (ARH) and HIV prevention. Consequently, the PETs trained and mentored 747,950 students as peer educators. The PEs in turn reached a total of 3,480,000 students with RH prevention messages.
Sexuality Education – Life Planning Education curriculum Among Youth People Living with Disability(YPLD)
Young people with special needs are grossly neglected in spite of their vulnerability to sexual abuse and risky behaviours as most interventions target able bodied youths. Therefore consolidating on our experiences on implementing sexuality education intervention for able bodied young people, ARFH scaled up the sexuality education initiative by targeting young people living with disability (YPLD). This initiative commenced in 2004 with a formative research among YPLD to document their vulnerabilities to HIV infections and other reproductive health morbidities. The research provided an insight into the challenges faced by young people in accessing RH/HIV information and the extent of their vulnerabilities to HIV and RH issues. ARFH therefore mainstream Life Planning Education into the activities of schools of people with disabilities. The organisation also developed and produced a poster and two books (Life Planning Education curriculum and Answers to Questions on HIV/AIDS) in Braille for free distribution to all ministries of education, states library, States Agency on the Control of AIDS, NGOs working with YPWDs, schools of YPWDs throughout Nigeria. This has greatly increased the access of people with visual disabilities to information on adolescent reproductive health and HIV. ARFH went a step further by sourcing for funds from the Rotary club of Appleton to empower selected YPWDs with information technology through computer training programme. The initiative was designed to equip them with vocational skills and consequently with source of livelihood.
Strengthening Family Life And HIV Education Implementation In Six SNR States – Support from FHI/SNR
The intervention sought to increase the capacity of SACA in the project states to respond more actively to coordinating the response of states Ministries of Education to HIV.
This built the capacity of the Ministry of Education staff to implement FLHE and ASRH among lower secondary schools students which invariably increased the access of young people in the six SNR States of Benue, Kaduna , Enugu, Nassarawa, FCT and Cross River to ASRH information and services through a well coordinated Family Life and HIV Education program.
Improving Youth Reproductive Health in Northern Nigeria (Y-ACCESS) project
A four-year (September 1st 2012 to 29th Feb 2016) capacity strengthening and reproductive health improvement project for adolescents and young people (aged 10 – 24 years) funded by DFID under the Global Poverty Action Fund (GPAF) Impact grant. The aim of the project was to address poverty by creating access to sexual health services, providing correct and factual information on adolescents’ sexual health. The project empowered young people through capacity building, skills building & access to make informed decisions by influencing gender roles & stereotypes inhibiting female use of health facilities.
It also scaled up the availability and access to comprehensive reproductive health services for adolescent and young people in four northern Nigerian states to address MDG5b: universal access to reproductive health; MDG3: promoting gender equality and empower women; MDG6a: improving on knowledge and awareness of HIV/AIDS among young persons.
Key activities of the project include:
- Assess, select and implement capacity improvement plans for public, private and community based health delivery service points
- Create or improve referral systems between youth, community, the public and private health systems.
- Identify, select and build the capacity of individual and youth groups and provide incentives to provide SRH information, commodities and referrals to their peers
- Utilize mobile phones to provide SRH information, and refer out-of-school youth and married adolescent girls to facilities to access services
Major output areas and targets of the grant was to reach 900,000 female and male young persons between the ages of 10-24 years, in and out of school young persons, and married female adolescents.
- Trained 1200 health service providers in both private and public sectors (PMVs, TBAs, CHEWS, midwives and PHC staff).
- 16 LGAs Community health facilities’ capacities strengthened to provide quality and comprehensive reproductive health services
Improved social, financial and policy environment that enables young people exercise their rights in accessing sexual and reproductive health services
HIV Prevention including momentum to end Female Genital Cutting in Oyo State
The HIV Prevention project in Oyo State implemented between October 2009 and January 2014 by Association for Reproductive and Family Health was supported by AIDS Prevention Initiative in Nigeria (APIN). The project increased access to HIV&AIDS prevention information and services through capacity development for medical personnel and empowerment of various target groups to adopt social and sexual behavior that protect them and their partners from contracting HIV, as well as to prevent and mitigate the impact of the epidemic.
In October 2009, APIN adopted the Minimum Prevention Package (MPP) introduced by the National Agency for the Control of AIDS (NACA) and its 2 main components namely Abstinence and Be Faithful (AB) and Condom and other Prevention Methods (COP) in line with the National Prevention Plan (NPP). This was done in an effort to reposition all APIN/HARVARD sites for effective implementation. The project utilized the MPP strategy to reach the various target groups with diverse information and services. ARFH through this project demonstrated immense capacity as it was almost the first time a state-wide coverage of the general population, in-and-out of school adolescents, as well as the most at risk population such as uniformed service personnel and members of road transport workers in Oyo State was achieved.
The components of the project were training, community education, and drama, and condom distribution, provision of lubricants, provision of free HIV counseling and testing services, and referral of reactive cases for treatment, (including PMTCT) care and support including economic empowerment for PLHIV. The target groups were Medical Doctors, Uniformed service men (Nigerian Airforce, Road Safety, Customs Service, Immigration Service, Prisons Service, Police and Civil Defense), road transport workers, sex workers, market men and women, Injection Drug Users, hair dressers/beauticians, barbers, footballers and adherents of Christian and Islamic faiths. Out of school youth involved in different vocations and students in select secondary and tertiary institutions in Ibadan, patent medicine vendors and tailors (fashion designers) and inmates at Agodi (Ibadan) prison.
The above targeted groups were strategically selected for the intervention for various reasons including their vulnerability due to the nature of their profession, perceived involvement in risky social and sexual behavior, potentially weak family, marginalization and discrimination, weak financial base and other support systems, and inadequate access to health care services.
On this project, ARFH trained Medical Doctors in HIV&AIDS (prevention, HCT and Treatment) and other groups (Uniformed men, barbers and young FOMWAN members) while community education activity was organized to reach out to the general population. These programs provided the avenues for the distribution of condoms and lubricants to the various groups especially barbers, uniformed service men, IDU, footballers and road transport workers. The interventions were preceded by series of engagements with the leadership of the various groups and authorities of the schools and religious institutions involved.
The HCT services were provided through ARFH HCT centre, two outlets in Ibadan and Ogbomoso, venues for community mobilization and training, and mobile facilities using ARFH tricycle. Though the target agreed with APIN was a coverage of 10,000, however, this target was surpassed as ARFH reached a total of 25,425 excluding the number reached by the trained peer educators for different groups. In addition were 100 PLHIV in Ogbomoso (Oyo State) provided with financial assistance that enabled them set up small scale businesses through their support group: “Positive Action Committee”.
Expanding Access To Emergency Contraceptive Services In Oyo And Ogun States Of Nigeria
ARFH in collaboration with the Centre for Research and Reproductive Health (CRRH) in Sagamu implemented a project titled “Expanding Access to Emergency Contraceptive Services in Oyo and Ogun States, Nigeria.”
The project aimed at increasing the availability of Emergency Contraceptive services (EC pills and information) in 40 patent medicine stores for sexually active young people aged 15-24 years in 2 Local Government Areas (LGA) of Oyo and Ogun states. This was achieved by strengthening the capacity of patent medicine stores and their personnel to provide Emergency contraceptive information and services.
The project started in February, 2008 was a ten (10) months project, and the implementing partners (ARFH and CRRH) worked with 20 patent medicine stores in each state.
Expanding the Frontiers of Adolescent Reproductive Health in Nigeria
The Expanding the Frontiers of ARH project was implemented in collaboration with 4 NGOs from 4 Nigerian states, namely Lagos (South), Bauchi, Gombe and Kebbi (North). Through this initiative, ARFH and the 4 partners increased the access of young people to ASRH/LPE and HIV/AIDS Education in schools and community through schools and community based approaches. Components include training of teachers in the project schools, training of young people as peer educators, provision of clinical services, distribution of educational materials, advocacy/consultation with parents and other behavioural change communication strategies. The project was expanded to 4 (Plateau, Borno, Yobe, and Kogi states) with funding support from Ford Foundation.
Integrating Gender and Human Rights into HIV Programming of 12 Youth Focused CBOs
The Association for Reproductive and Family Health (ARFH) was selected as one of the Principal partners on the Nigeria AIDS Responsive Fund (NARF) phase II project being supported by Canadian International Development Agency (CIDA). The project is aimed at Integrating Gender issues and Human Right into HIV Programming of 12 Youth focused CBOs in the focal state of Cross River, Gombe and Kogi.
Nigerian Youth Initiative
This was later scaled up as West Africa Youth Initiative implemented in Nigeria and Ghana. The project was able to reach 25,994 young people with SRH information and services. This led to remarkable changes in behaviour as the young people were empowered with correct information on the issues of their growth and development.