Social biases and a lack of appropriate services can keep teens from getting the support they need to become healthy adults. Yet this support is critical for them as they begin to experience important physical, social, and emotional changes that can significantly affect their lifelong well-being-for better or worse.

More than 20% of the world's population falls between the ages of 10 and 19, ages at which young people usually begin to develop the sexual and reproductive health habits that will last a lifetime.

Reproductive health services, however, have not traditionally addressed the needs of adolescents, married or unmarried.

Where they do exist, programs for adolescents are often designed by adult experts who may be out of touch with the special needs of a community's young people.

Because nearly half of Nepal's population is under 16 years old, it becomes especially important to design services that appeal to adolescents, identify their real needs, and win the support of parents and the community.

When AVSC and its partners set out to design a health program for Nepalese adolescents, it sought the help of the most qualified experts-the young people themselves.

Through discussions, diagrams, and other participatory methods, adolescents from a rural and an urban community gave voice to their concerns and worked with project staff to develop a reproductive health plan that meets their needs.

Most of the young people described concerns about menstruation, wet dreams, and managing sexual feelings, but others identified troubling behaviors.

Some young women talked about taking medicines to lose weight, and others talked of girls who prostitute themselves to earn money to "look nicer."

Project staff also asked service providers and key community members for their perspectives, then reviewed and shared the findings with the young people, parents, community leaders, and other adults through role-plays, drawings, and discussions.

Based on the findings, participants in the two communities decided to address five key areas: information, counseling, services, social and economic development, and social and community norms.

Adolescent task forces formed for each area are currently developing detailed interventions. During the next year, AVSC will work with its partners, community members, teachers, and service providers to implement these interventions.

Evaluation, scheduled 18 months after the interventions are in place, will assess whether these programs-designed by and for young people-can help adolescents successfully manage the sometimes challenging transition from youth to healthy adulthood.

The Nepal project is funded by the Andrew W. Mellon Foundation and implemented with the support of the International Center for Research on Women, the BP Memorial Health Foundation, and New ERA.

Manisha Mehta is a Research Project Coordinator for AVSC's New York office.