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Adolescent Sexual & Reproductive Health in
Humanitarian Settings
Zaatari Youth Task Force
27/08/2019
by: Ali Al-Gharabli
1
Photo Credit: Mercy Corps
2
Session ONE
What is adolescent sexual & reproductive health
(ASRH)?
3
What is Adolescence?
Period from 10 – 19 years of age:
• Very Young Adolescence: 10-14
years
• Middle Adolescence: 15-16 years
• Older Adolescence: 17- 19 years
Common references:
- Children under 18
- Young People 10-24
- Youth are generally referred to as 15-
24 years
4
What is Adolescence?
• Period between childhood and
adulthood
• Visible physical, behavioral and
psychological change
• Increase feeling of independence
especially independence from
adults
5
Adolescents are not a homogenous group!
Certain adolescents are always at
high risk, regardless of the situation:
• Pregnant adolescents
• Orphaned adolescents
• Adolescent heads of household
• Marginalized adolescents:
• Adolescents living with HIV
• Adolescents with disabilities
• Adolescents who identify as LGBTI
• Adolescents belonging to
indigenous or migrant groups
6
Why prioritize adolescents and
young people during emergencies?
“Demographic imperative”:
• Today we have the largest generation of young people the world has ever
known
• There are now 17.2 million refugees under UNHCR’s mandate – half of them
under the age of 18 and a large proportion. Youth (aged 15-24) also constitute
a large proportion of populations affected by forced displacement (UNHCR,
2015)
What is sexual & reproductive health?
“A state of complete physical, mental and social well-being and not merely the absence
of disease or infirmity, in all matters relating to the reproductive system and its
functions and processes. This implies that people are able to have a satisfying and safe
sex life and that they have the capability to reproduce and the freedom to decide if,
when and how often to do so.”
International Conference on Population & Development (ICPD), Cairo 1994
“Sexual health requires a positive and respectful approach to sexuality and sexual
relationships, as well as the possibility of having pleasurable and safe sexual
experiences, free of coercion, discrimination and violence. For sexual health to be
attained and maintained, the sexual right of all persons must be respected, protected
and fulfilled”
World Health Organization (WHO), 2006
8
Why is ASRH important?
9
Important Facts about ASRH:
• We start our reproductive life cycle during adolescence with puberty
• Each year about 15 million girls are married before the age of 18 years and 90% of
births to girls aged 15-19 years occur within marriage (UNFPA, 2015)
• AIDS is now the leading cause of death among young people ages 10-24 years in
Africa (AVERT, 2018)
• An estimated 23 million adolescents age 15 to 19 years living in low and middle-
income countries have an unmet need for modern methods of contraception
(Darroch et al., 2016; MacQuarrie, 2014).
Why is ASRH important?
10
• Every year, estimated 21 million girls ages 15-19 years and 2 million girls under 15 years become pregnant in low
income countries. (UNFPA, 2015)
• It is projected that adolescent pregnancies will increase globally by 2030 with the greatest proportional increases
in West & Central Africa. (UNFPA, 2013)
• Complications during pregnancy and childbirth is the leading cause of death for 15-19 years old girls globally.
(WHO, 2016)
• The risk of pregnancy-related death is still twice as high for girls aged 15-19, and five times higher for girls aged
10-14, compared to women in their twenties. (UNFPA)
• Unmet need for family planning is highest amongst 15-19 year-olds, and youth aged 15-24 account for just under
half of all unsafe abortions worldwide (UNFPA, 2012)
• Babies born to adolescent mothers face a much higher risk of dying than those born to women ages 20-24 years,
including 50% higher risk of being still born. Newborns of adolescent mothers also have high risk of low-birth
weight (WHO, 2014)
ASRH Rights are Human Rights
Adolescent
Sexual & Reproductive
Health
Freedom from
Harmful Practices
Equality in
Marriage
Consent to
Marriage
Decide Number
& Spacing of
Children
Freedom from
Discrimination
Privacy
Education &
Information
Freedom from
violence
Health
11
Adolescents’ Human Rights are Protected by International Law
ASRH rights are protected by international law
• Universal Declaration of Human Rights
• Constitution of the World Health Organization
• 1994 Cairo International Conference on Population and Development
• 1995 Beijing Conference
• UN Convention on the Rights of the Child
• UN Convention on the Rights of Persons with Disabilities
During the 2016 Word Humanitarian summit, UN member states signed on
to the 2030 Agenda for Sustainable Development and the Youth Compact,
pledging to reach first those who are furthest behind. (Source: World
Humanitarian Summit. Compact for Young People in Humanitarian Action.
2016.)
12
Questions/Comments
Session TWO
Meeting ASRH Needs in Humanitarian Settings
14
Why focus on ASRH in humanitarian situations?
In humanitarian emergencies
adolescents face:
• losing family, social, educational
and religious structures
• high risk of child-marriage
• high risk for sexual violence
• increased consensual or coerced
sexual activity
• high risk for forced recruitment
to armed groups
• limited access to health services
15
ASRH is seldom addressed in emergencies
Even in “normal” settings,
adolescents face barriers
that prevent them from
accessing health services:
• Individual
• Socio-cultural
• Structural
Vulnerable adolescents in humanitarian situations
Certain adolescents are always at high
risk, regardless of the situation:
• Very Young Adolescents (VYAs)
• Pregnant adolescents
• Orphaned adolescents
• Adolescent heads of household
• Marginalized adolescents:
• Adolescents living with HIV
• Adolescents with disabilities
• Adolescents who identify as LGBTI
• Adolescents belonging to indigenous
or migrant groups
17
Operational research on gaps in ASRH funding
& programming in humanitarian settings
• Conducted in 2011-2012, published in December 2012
• 1) Program Mapping
• Based on >200 responses, 37 programs focused on the SRH needs of
10-19 year-olds in humanitarian settings since 2009
• Among the 37, only 21 offered at least two methods of contraception.
None were from acute emergency settings.
• 2) Funding Analysis
• Between January 2009 – October 2012
• Among a total of 2,638 health only 37 included some element of ASRH
• Proposals for ASRH through humanitarian funding streams constituted
less than 3.5% of all health proposals per year
• Among the 37 programs, only 32% received any funding: 7 programs
were fully funded and five were partially funded.
• Report further shared good practices and recommendations for
donors/governments, organizations and the cluster system.
18
Questions/Comments
Session THREE
Participation Tools
Participation Tools
• Meaningful participation
of adolescents is key to
ensure services are
accessible and
acceptable to them
• Consulting and involving
parents and
communities from the
design phase of ASRH
programs can lead to
long-lasting impact
Photo Credit: UNFPA
Adolescent Participation
(p. 45)
Levels of Participation
22
Adolescent Participation
(p. 45)
Adolescent Participation (pg. 45)
23
Youth Adult Partnership
Integrates creativity and
insights of adolescents with
experience and knowledge
of professional adults
• Equal partnership
• Both groups contribute
• Mutual respect!
Community and Parental Participation Tool
(p. 48)
Community and Parental Participation Tool
(pg. 48)
25
Community and Parental Participation Tool
(p. 48)
Community and Parental Participation Tool
(pg. 48)
26
Partnership Defined Quality for Youth Tool
Planning and Design
Building Support
Youth Defined Exploring Quality Health Worker Defined
Bridging the Gap
Working in
Partnership
ACTION
Other Participatory Techniques
• Participatory Ranking
• Community Scorecard for Young People
• Representation of young-people in decision-making groups, such as
SRH Working Groups
• Creation of youth/adolescent WG
Questions/comments
Thank You
Photo Credit: Relief International

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ASRH in Emergencies_ Slides (3) (1).pptx

  • 1. Adolescent Sexual & Reproductive Health in Humanitarian Settings Zaatari Youth Task Force 27/08/2019 by: Ali Al-Gharabli 1
  • 3. Session ONE What is adolescent sexual & reproductive health (ASRH)? 3
  • 4. What is Adolescence? Period from 10 – 19 years of age: • Very Young Adolescence: 10-14 years • Middle Adolescence: 15-16 years • Older Adolescence: 17- 19 years Common references: - Children under 18 - Young People 10-24 - Youth are generally referred to as 15- 24 years 4
  • 5. What is Adolescence? • Period between childhood and adulthood • Visible physical, behavioral and psychological change • Increase feeling of independence especially independence from adults 5
  • 6. Adolescents are not a homogenous group! Certain adolescents are always at high risk, regardless of the situation: • Pregnant adolescents • Orphaned adolescents • Adolescent heads of household • Marginalized adolescents: • Adolescents living with HIV • Adolescents with disabilities • Adolescents who identify as LGBTI • Adolescents belonging to indigenous or migrant groups 6
  • 7. Why prioritize adolescents and young people during emergencies? “Demographic imperative”: • Today we have the largest generation of young people the world has ever known • There are now 17.2 million refugees under UNHCR’s mandate – half of them under the age of 18 and a large proportion. Youth (aged 15-24) also constitute a large proportion of populations affected by forced displacement (UNHCR, 2015)
  • 8. What is sexual & reproductive health? “A state of complete physical, mental and social well-being and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and its functions and processes. This implies that people are able to have a satisfying and safe sex life and that they have the capability to reproduce and the freedom to decide if, when and how often to do so.” International Conference on Population & Development (ICPD), Cairo 1994 “Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence. For sexual health to be attained and maintained, the sexual right of all persons must be respected, protected and fulfilled” World Health Organization (WHO), 2006 8
  • 9. Why is ASRH important? 9 Important Facts about ASRH: • We start our reproductive life cycle during adolescence with puberty • Each year about 15 million girls are married before the age of 18 years and 90% of births to girls aged 15-19 years occur within marriage (UNFPA, 2015) • AIDS is now the leading cause of death among young people ages 10-24 years in Africa (AVERT, 2018) • An estimated 23 million adolescents age 15 to 19 years living in low and middle- income countries have an unmet need for modern methods of contraception (Darroch et al., 2016; MacQuarrie, 2014).
  • 10. Why is ASRH important? 10 • Every year, estimated 21 million girls ages 15-19 years and 2 million girls under 15 years become pregnant in low income countries. (UNFPA, 2015) • It is projected that adolescent pregnancies will increase globally by 2030 with the greatest proportional increases in West & Central Africa. (UNFPA, 2013) • Complications during pregnancy and childbirth is the leading cause of death for 15-19 years old girls globally. (WHO, 2016) • The risk of pregnancy-related death is still twice as high for girls aged 15-19, and five times higher for girls aged 10-14, compared to women in their twenties. (UNFPA) • Unmet need for family planning is highest amongst 15-19 year-olds, and youth aged 15-24 account for just under half of all unsafe abortions worldwide (UNFPA, 2012) • Babies born to adolescent mothers face a much higher risk of dying than those born to women ages 20-24 years, including 50% higher risk of being still born. Newborns of adolescent mothers also have high risk of low-birth weight (WHO, 2014)
  • 11. ASRH Rights are Human Rights Adolescent Sexual & Reproductive Health Freedom from Harmful Practices Equality in Marriage Consent to Marriage Decide Number & Spacing of Children Freedom from Discrimination Privacy Education & Information Freedom from violence Health 11
  • 12. Adolescents’ Human Rights are Protected by International Law ASRH rights are protected by international law • Universal Declaration of Human Rights • Constitution of the World Health Organization • 1994 Cairo International Conference on Population and Development • 1995 Beijing Conference • UN Convention on the Rights of the Child • UN Convention on the Rights of Persons with Disabilities During the 2016 Word Humanitarian summit, UN member states signed on to the 2030 Agenda for Sustainable Development and the Youth Compact, pledging to reach first those who are furthest behind. (Source: World Humanitarian Summit. Compact for Young People in Humanitarian Action. 2016.) 12
  • 14. Session TWO Meeting ASRH Needs in Humanitarian Settings 14
  • 15. Why focus on ASRH in humanitarian situations? In humanitarian emergencies adolescents face: • losing family, social, educational and religious structures • high risk of child-marriage • high risk for sexual violence • increased consensual or coerced sexual activity • high risk for forced recruitment to armed groups • limited access to health services 15
  • 16. ASRH is seldom addressed in emergencies Even in “normal” settings, adolescents face barriers that prevent them from accessing health services: • Individual • Socio-cultural • Structural
  • 17. Vulnerable adolescents in humanitarian situations Certain adolescents are always at high risk, regardless of the situation: • Very Young Adolescents (VYAs) • Pregnant adolescents • Orphaned adolescents • Adolescent heads of household • Marginalized adolescents: • Adolescents living with HIV • Adolescents with disabilities • Adolescents who identify as LGBTI • Adolescents belonging to indigenous or migrant groups 17
  • 18. Operational research on gaps in ASRH funding & programming in humanitarian settings • Conducted in 2011-2012, published in December 2012 • 1) Program Mapping • Based on >200 responses, 37 programs focused on the SRH needs of 10-19 year-olds in humanitarian settings since 2009 • Among the 37, only 21 offered at least two methods of contraception. None were from acute emergency settings. • 2) Funding Analysis • Between January 2009 – October 2012 • Among a total of 2,638 health only 37 included some element of ASRH • Proposals for ASRH through humanitarian funding streams constituted less than 3.5% of all health proposals per year • Among the 37 programs, only 32% received any funding: 7 programs were fully funded and five were partially funded. • Report further shared good practices and recommendations for donors/governments, organizations and the cluster system. 18
  • 21. Participation Tools • Meaningful participation of adolescents is key to ensure services are accessible and acceptable to them • Consulting and involving parents and communities from the design phase of ASRH programs can lead to long-lasting impact Photo Credit: UNFPA
  • 23. Adolescent Participation (p. 45) Adolescent Participation (pg. 45) 23
  • 24. Youth Adult Partnership Integrates creativity and insights of adolescents with experience and knowledge of professional adults • Equal partnership • Both groups contribute • Mutual respect!
  • 25. Community and Parental Participation Tool (p. 48) Community and Parental Participation Tool (pg. 48) 25
  • 26. Community and Parental Participation Tool (p. 48) Community and Parental Participation Tool (pg. 48) 26
  • 27. Partnership Defined Quality for Youth Tool Planning and Design Building Support Youth Defined Exploring Quality Health Worker Defined Bridging the Gap Working in Partnership ACTION
  • 28. Other Participatory Techniques • Participatory Ranking • Community Scorecard for Young People • Representation of young-people in decision-making groups, such as SRH Working Groups • Creation of youth/adolescent WG
  • 30. Thank You Photo Credit: Relief International