About the programme
The Programme, recently completed in 2015, took place in five municipalities in the State of Maranhão in Brazil. Over 40% of the population are under the age of 19 and its poverty rates are the highest in the national Human Development Index. Maranhão has the second highest ranking of child labour, with 240,000 children and adolescents working in the streets.
The Young Health Programme in Brazil was focused on educating young people on sexual and reproductive health, the prevention of non- communicable disease (NCD) behaviours, including tobacco use and alcohol abuse, and broader health issues.
The Programme was implemented by Plan Brazil in partnership with Promundo.
What did we want to achieve through the Programme?
The Programme aimed to reach an estimated 60,000 adolescents in the five municipalities over five years. It also aimed to indirectly influence a population of over 115,000 including policy makers, educators, health professionals and communities where these adolescents live.
- To inform, engage and empower adolescents on health, with a primary focus on gender and sexual reproductive health and rights.
- To influence public policy, engage with key decision makers, and increase public awareness of adolescent health issues.
- To strengthen the existing delivery of health and education services to provide improved quality and access to adolescents.
Key issues for adolescent health include increased HIV cases in younger populations, high rates of unwanted pregnancy, unsafe abortion and increased sexual coercion. Other significant health issues include sexual violence, substance abuse, malnutrition and NCD-related deaths.
What activities took place locally?
Overall the YHP set out to improve the health choices of adolescents within the identified areas with considerable focus placed on driving change through the young people themselves. The Programme targeted adolescents (between 10 - 24 years), their families and communities. Some of the local activities included:
- Training adolescents to become opinion leaders who engage and inform their peers on their rights in terms of health issues. Topics discussed in the Peer Education programme included gender, sexual and reproductive health, sexual diversity, pregnancy and drugs.
- Promoting adolescent participation in public policy campaigns to improve services.
- Ensuring sustainability of initiatives by executing the Programme in very close collaboration with the schools who will ultimately own the project. The Programme also engaged various stakeholders including parents, Community Health Agents and health service providers to ensure community support and engagement.
What has been achieved?
- A total of 724,585 people have been reached: 93,427 young people reached directly, either as Peer Educators or through outreach activities and 631,178 people reached in the wider community through awareness raising activities and mass media campaigns.
- Partnerships with 20 schools facilitating Programme outreach and enhanced collaboration between the YHP and the government - run Health in School Programme.
- 395 Peer Educators trained.
- 431 parents participated in debates and discussions relating to adolescent health ensuring support and understanding is broadened and the important role parents have to play is recognised.
- Partnership with the Technical School of the National Health System to train Community Health Agents (CHAs) across the State about adolescent health. 793 trained over five years. The training sensitised CHAs about the specific health issues affecting adolescent girls and boys, and they are increasingly delivering adolescent friendly activities in their communities.
- Numerous public campaigns have been carried out on specific issues relevant to adolescent health involving media, young people, schools, wider community members and government , for example World Aids Day, International Women's Day. On the ground campaign activities were supported by radio spots and news articles appropriate to the day. Plus YHP successfully launched its own campaign, Adolescent Health Week, in collaboration with government stakeholders and other organisations.
- YHP Brazil successfully worked with the State Department of Health to advocate for changes to the state level guidance on health (PTA) to incorporate gaps relating to gender, sexual and reproductive health and youth participation issues. The PTA has been revised for the whole state of Maranhão.
- YHP Brazil has been recognised for its expertise on adolescent health with the methodology of the Programme now sought by Government to be included in relevant planning forums.
Before YHP: I want to know more, to participate more and have a voice.
My Story: YHP was happening at my school and I saw one of the dramas they did about sexuality. It captured my interest and I decided to join. I had already been very active at school in sports and human rights but, I wanted to learn more through YHP about other topics, so I could discuss them with confidence at school, home or out with friends.
How the Young Health Programme helped me: What motivates me most about YHP is that young people like me spread the word themselves. I was chosen to take part in a consultation process on the statewide health work plan. We saw a need for change. Many things important to adolescents simply weren’t mentioned. We knew no one could understand better what it is like for a young person to go to a health post and not get the help they need. We made many suggestions to improve the health work plan for young people. These were officially approved by the Health Secretariat and the revised plan will be implemented across our whole state. Even though I am young I can still play a role and have a voice within all the spaces that deal with public policy and young people.
Before YHP: Around the age of 12, I started drinking spirits, mainly like vodka, rum and whisky.
My Story: I’ve never met my mother and I don’t know any of her family. To start with I lived with my grandmother but, after she died, I went to live with my father and his current wife. Growing up I have suffered a lot, especially when friends would ask me where my mother was. Some people told me it was my fault my mother left because of my behaviour and when I heard this I would get angry. Around the age of 12, I started drinking spirits, mainly like vodka, rum and whisky. I also started making myself vomit on purpose and I lost a lot of weight. I was also cutting myself on my abdomen and legs with a steel blade.
How the Young Health Programme helped me: When I joined, the YHP group was talking about sexuality and after that we talked about many things: drugs, adolescent friendly health services, non-communicable diseases, health eating and violence. YHP helped me by linking me to a doctor and psychologist. Since I joined the project my friends and family have noticed lots of changes in me. Nowadays I have good dialogue with my father. When I understood that alcohol could not solve my problems I asked my father if he could buy me a guitar. I joined a singing class at the local church and I also started a technical course. I stopped cutting myself as I realised that there were other things I could do with my life. I talked to a nutritionist about my bulimia and now my eating habits have changed and I am eating much more healthy food too. I have learnt a lot in these sessions. I have become a different person.
The Programme was delivered on the ground by Plan Brazil in partnership with Promundo.
Promundo is a Brazilian non-governmental organisation (NGO) that promotes gender equality and seeks to end violence against women, children and youth.