Blog

Keeping Young People at the Center of the Development Agenda

By Jenifer DeAtley and Nicole Trevino 

In the wake of the presidential election, we’ve heard from students, many of whom seem fearful and uncertain about the future for themselves and their families. The youth we work with experience the normal challenges associated with being teens, as well as many unique challenges specific to their communities and families.

We would like to take this opportunity to remind our staff, colleagues, and partners about what matters most to us—the youth and communities we serve. It is easy to get caught up in local, state, and national politics, especially at a time when our country seems so challenged in trying to overcome our differences and find common ground. However, one needs only to look to the youth in our communities to find hope and a positive outlook on the future.

The youth who serve as peer educators in our new RE:MIX Sexual Health Education  Program have overcome tremendous challenges as young parents and continue to face new challenges every day. And yet, they have worked tirelessly to provide for their children, to finish their education, to look for new career opportunities, and to continue growing as adults and leaders in their communities.

Many of the youth that we have served in local schools and throughout our community have also shown us what it means to come face to face with challenges and continue to work hard for a better life. We’ve seen youth locate resources in our community for themselves when their own families have let them down. We’ve seen young people push themselves to be involved as leaders in our community while balancing these demands with their roles as students, friends, workers, and family members. The youth we’ve worked with stand up against bullying, unfairness, and exclusion every day in their schools. They participate in gay-straight alliances, they tutor, mentor, and teach each other, and they share their voices and perspectives on important issues in their schools.

Adolescence is arguably one of the most challenging periods of growth and development for young people, and we have had a front row seat to the amazing things they have accomplished in our own communities, despite the challenges they face. This is why, at EngenderHealth’s U.S. Programs Office, we believe wholeheartedly in the values we’ve set forth for our work:

  • Self-determination: We believe in providing opportunities for youth to take ownership over their own sexuality and sexual and reproductive health, because all youth have a right to self-determination.
  • Quality: We deliver high-quality, factual, age-appropriate, and research-driven programs, services, and information, because youth deserve quality work from the adults who serve them.
  • Innovation: We challenge the status quo with innovative approaches and solutions, because young people teach us new things every day and require us to be innovative.
  • Respect: We give respect to every person every time we interact with them, because young people have shown us how important it is to be inclusive and open-minded.

As staff at youth-serving agencies and professionals, we must continue placing youth and the communities we serve front and center. Youth need adults who can be present, focused, and positive role models in their lives. It doesn’t mean ignoring the real concerns that we have for our country, our field, or the work we do. It means being cognizant that the youth we serve are seeing our example, watching how we handle conflict and challenge, and looking to us to be the kind of leaders we ask them to be every day. We must show youth that no problem or challenge is insurmountable.

In our RE:MIX program, we teach young people to maximize their strengths, imagine a healthy future, and explore their identities, because we believe that young people who put their energy into these areas can succeed even while facing many challenges. We as adults can find a way to maximize the strengths of our communities and our nation, imagine a healthy and prosperous future, and continue to explore our identity as a nation that is growing, changing, and developing in much the same way that the youth we serve are. We at EngenderHealth believe that putting our energy into these areas and the youth we serve will ultimately move us all forward.

Three Ways We Have Expanded Youth Access to Contraception in the United States

By Mandy Ackerman, LMSW, MPH & Jenifer DeAtley, LMSW

It’s important on World Contraception Day to reflect on concrete ways in which we’ve expanded access to contraceptives for young people. Access to contraception is vital for ensuring health and for breaking cycles of poverty. In fact, access to a full range of contraceptive methods and education is critical to the well-being of youth and their communities in preventing sexually transmitted infections (STIs) and unplanned pregnancy. In some communities, contraceptive access for youth is also a means of survival, with pregnancy resulting in more deaths of adolescent females aged 15–19 than any other cause (Save the Children Fund, 2012).

Young people often have limited sources of independent income and grapple with high levels of shame in seeking services, so they need supportive policies, direct access to care, and comprehensive education and skill-building opportunities. Therefore, expanding contraceptive access for youth in a meaningful way requires a holistic approach that considers the needs and wants of young people and that focuses on removing longstanding barriers. By listening to youth’s needs, providing education, and increasing access, we help youth become empowered to make informed decisions about how they can protect themselves in a way that is consistent with their own values and in accordance to their future life plans.

Despite having one of the developed world’s highest rates of teen pregnancy, some exciting progress in the United States is worth noting (Sedgh et al., 2015). As a nation, we are beginning to recognize the importance of providing young people with options and information to properly plan out their lives, including one of the most significant decisions—whether and when to become a parent.

Colorado—Eliminating the Cost Barrier

Since 2008, Colorado has successfully increased youth access to family planning services throughout the state by providing low- or no-cost contraceptive methods, particularly the most effective methods, such as intrauterine devices (IUDs) and implants. IUDs and implants can require multiple doctor visits and have up-front costs as high as hundreds of dollars apiece. By providing these methods and others at an affordable cost and with limited doctor visits needed, young people can more easily access contraception.

In 2014, researchers reported significant drops in the birthrate among teens participants. Additionally, the abortion rate among 15–19-year-olds dropped by more than a third, and the rate of high-risk pregnancies decreased by a fourth (Ricketts, Klingler, & Schwalberg, 2014).

 

California—Removing the Need for Prescriptions

California recently passed legislation eliminating the need to obtain a prescription to purchase birth control. The new law allows youth and adults to access certain methods directly from a pharmacist without having to see a doctor. As a result of this law, youth no longer need to find transportation and spend money to visit a doctor during often inconvenient hours of operation to access contraception.

Other states, such as Oregon and Washington, have already implemented similar legislation, and several additional states, such as Hawaii and Tennessee, are proposing comparable bills.

 

Texas—Increasing Knowledge, Awareness, and Skills  

Based in Texas, EngenderHealth’s U.S. Program implements comprehensive and inclusive sexual health education with middle and high school–aged youth, both in and out of school. Evaluations of comprehensive sexual health education programs show that these programs not only help youth delay onset of sexual activity, reduce the frequency of sexual activity, and reduce the number of sexual partners, but they also increase condom and other contraceptive use, a key to delaying pregnancy (Kohler, Manhart, & Lafferty, 2008; Lindberg, Santelli, & Desai, 2016).

Gender Matters (referred to as Gen.M by the youth) and RE:MIX, two comprehensive sexual health programs developed and evaluated by EngenderHealth, support healthy decision making by providing holistic information on pregnancy and contraception, in addition to building skills, such as how to negotiate and communicate contraceptive use with a partner and respect your own and others’ sexual limits. The programs also frame contraception in the broader context of sexuality, gender, and relationships and ask young people to consider their future goals and how the decision to become a parent aligns with those aspirations.

 

World Contraception Day is a global event where lessons learned and best practices in contraceptive access are shared internationally. Beyond this day, it is important to continuously engage in this process and apply successes from countries to inform similar efforts in others. Ultimately, our collective knowledge is essential in increasing access and breaking down the barriers necessary for youth and communities worldwide to live happier, healthier, and more prosperously.

 

References

Kohler, P. K., Manhart, L. E., and Lafferty, W. E. 2008. Abstinence-only and comprehensive sex education and the initiation of sexual activity and teen pregnancy. Journal of Adolescent Health 42(4):344–351. doi: 10.1016/j.jadohealth.2007.08.026.

Lindberg, L., Santelli, J., and Desai, S. 2016. Understanding the decline in adolescent fertility in the United States, 2007–2012. Journal of Adolescent Health in press. doi: 10.1016/j.jadohealth.2016.06.024. Accessed at: http://www.jahonline.org/article/S1054-139X(16)30172-0/pdf.

Ricketts, S., Klingler, G., and Schwalberg, R. 2014. Game change in Colorado: Widespread use of long-acting reversible contraceptives and rapid decline in births among young, low-income women. Perspectives on Sexual and Reproductive Health 46(3):125–132. doi: 10.1363/46e1714. Accessed at: http://obgyn.wisc.edu/documents/Game_Change_in_Colorado_Rickets.pdf.

Save the Children Fund. 2012. Every woman’s right: How family planning saves women’s lives. London. Accessed at: http://www.savethechildren.org/atf/cf/%7B9def2ebe-10ae-432c-9bd0-df91d2eba74a%7D/EVERY_WOMANS_RIGHT_REPORT_JUNE_2012.PDF.

Sedgh, G., Finer, L. B., Bankole, A., et al. 2015. Adolescent pregnancy, birth, and abortion rates across countries: Levels and recent trends. Journal of Adolescent Health 56(2):223–230. doi: 10.1016/j.jadohealth.2014.09.007. Accessed at: http://www.jahonline.org/article/S1054-139X(14)00387-5/pdf.

A Young Woman Gives Back to Help Others

“Giving young people the resources to keep themselves healthy or to keep their children healthy is very important to me.”

Sarah Weaver's Story

Sarah Weaver was only 19 when she realized that she was pregnant. She remembered, “I didn’t know about the options that I had—whether it was birth control before I got pregnant or clinic-based services afterwards to make sure that I stay healthy.” She feels fortunate that her family supported her in every way during this challenging phase of her life. Now, she is happily married again and devoted to raising her two children. In 2015, she went on to graduate from the Texas State University with a bachelor’s degree in psychology, minoring in sociology. She hopes to pursue a PhD in cognitive neuroscience.

Life came back full circle for Sarah when she became a peer educator for the Re:MIX program with EngenderHealth in Austin, Texas. As part of this initiative, Sarah now reaches out to adolescents in schools to talk about issues that no one spoke about when she was in high school. The curriculum covers discussions around healthy relationships, consent, gender, sexually transmitted infections, and contraceptive options for girls and boys. The students are also given information about local health care centers where they can access youth-friendly services.

To connect with adolescents requires both skill and empathy. Sarah explained, “At first, we are the ‘blow off’ class. Most students feel that they don’t need to pay attention to what we have to say. But by the end of these sessions, the response changes. At one school, we were asked to come back for an extra day. At another school, students requested us to visit them again. On the last day of one of our classes, a kid hugged and thanked us for doing what we are doing. So you can see the difference.”

Among the range of topics, consent and birth control are two areas that catch the attention of these teenagers. Sarah shared that there “is a lot of confusion around the issue of ‘consent.’ In our curriculum, we emphasize that if you have consent at one point, it doesn’t mean that you have consent at another point. This usually leads to a deeper discussion. Moreover, many kids don’t know that they have the right to use birth control and the right to choose what kind of birth control they want.”

Once, a school teacher checked with the students to see how many among them had spoken to their parents about any of these issues. Fewer than a third raised their hands. Sarah said, “It was sad to see that parents weren’t talking to their kids about any of this. So many of them were sexually active with no resources or knowledge to keep themselves safe. That moment made this job seem meaningful. Giving young people the resources to keep themselves healthy or to keep their children healthy is very important to me.”

She went on to reflect, “Becoming a parent at 19 was incredibly and unexpectedly difficult. I can see the way this journey has benefited me. The role of a peer educator is to show that if you are a young parent, it can turn out okay, and you can still get where you want to in life. I am grateful for my story. It is nice to be able to tell a young parent that it’s going to be okay.”


1Re:MIX is a comprehensive sexual health program aimed at reducing rates of unplanned pregnancy and sexually transmitted infections among youth in Central Texas. Re:MIX pairs peer educators who are young parents with clinic-based health educators to cofacilitate the Re:MIX health curriculum among a target population of 13–17-year-olds.

World Contraception Day

By Jenifer DeAtley

#WCD2015—#AFriendOfMine

With nearly half of the world’s population under the age of 25, the future holds extraordinary opportunities for the world’s economic growth, reduction in poverty and overall increased quality of life. Despite this promise, young people face significant social and economic barriers to accessing sexual and reproductive health information and services, demonstrated by high levels of unplanned pregnancy and incidence of sexually transmitted infections (STIs), including HIV. In the United States, approximately half of all new STIs occur in young people between the ages of 15 and 24, and roughly a quarter million teens give birth, most of which are unplanned. These outcomes inhibit young people from living up to their full potential and optimally contributing to society.

Read the full post on the EngenderHealth website.

From Tanzania to Texas: Empowering Youth on World Contraception Day

By Pam Barnes and Jenifer DeAtley

“I was 16 years old, a junior in high school, a star athlete, and on the honor roll when I found out my girlfriend was pregnant,” youth advocate Corey Jones of Austin, Texas, told us recently. “I wanted to tell people right away, but she was afraid. It took seven and a half months until she felt ready and saw a doctor.”

Fear of talking about sex can translate into shame at any age, but particularly during the formative years, when young people are just starting to learn about themselves and their bodies.

Read the full post on Huffington Post.