Generating demand and community support for sexual and reproductive health services for young people
A review of the literature and programmes
To support the health sector in identifying and implementing a few strategic, do-able, evidence-based interventions to create demand for sexual and reproductive health services by adolescents who need them and to stimulate community acceptance and support for their provision, a global review of the evidence was compiled.
Using a standard methodology, evidence from thirty studies was reviewed on interventions for generating demand through the provision of information, education and communication via several different channels. This included:
- information on accessibility of health services;
- the use of referral systems;
- and the provision of funds/vouchers/subsidies to cover financial costs of services.
Similarly, assessments were done of the effectiveness of interventions for garnering community acceptance and support. These included interventions such as providing information to influential community members about the need for health services for adolescents through a variety of channels: one-to-one discussions, cultural/social or school events, mass media, and activities to foster community engagement and participation in improving access to health services by adolescents.
The available evidence clearly highlights the importance of engaging parents, adolescents and communities as part of a comprehensive strategy for improving health service use by adolescents. Young people are most likely to use youth-friendly services in those communities that demonstrate most awareness and approval. A supportive social environment (folk, popular, professional) also results in higher utilization rates.
The review also highlights the need for stronger programme design and for the evaluation of projects that work with families and communities on influencing reproductive health behaviour and service use.