Integrating Reproductive Health Into Livelihood Programs In India

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Author: 
Julia Freed, MSW
Sushmitha Paidi
Affiliation: 

International Youth Foundation (Freed); Youthreach (Paidi)

Publication Date

November 1, 2009

This 8-page report details the implementation and evaluation of a project carried out in 2008 and 2009 to develop and test a sexual and reproductive health (SRH) curriculum for vocational students aged 15-24 from economically poor families in urban and rural areas of India. As part of the yearlong Samriddhi Project ("Samriddhi" is a Hindi term that means well-being and prosperity), the International Youth Foundation (IYF) commissioned Thoughtshop Foundation to develop a curriculum and teaching aids, which Youthreach then used to build the skills of youth educators to teach SRH and family planning (FP) topics. Youthreach worked with 4 partner non-governmental organisations (NGOs) - Sahara, Prerana, Dr. Reddy's Foundation, and Byrraju Foundation - to integrate the Samriddhi curriculum into existing vocational training programmes for youth. The goal was to equip low-income and at-risk youth in Andhra Pradesh and Delhi with accurate, age-appropriate information on how to maintain their reproductive health and prevent risky behaviours that lead to poor health outcomes including sexually transmitted infections (STIs), unplanned pregnancies, and unsafe abortions.

Youthreach staff regularly visited the 4 partners' project sites; the partners reported on a monthly basis to Youthreach and IYF. The monitoring and evaluation plan also included pre- and post-tests for students, focus group discussions with students, and key informant interviews with trainers.

Key findings related to youth knowledge:

  • In post-tests, 90% of male youth and 85% of female youth correctly discussed the changes that occur in their bodies during puberty.
  • In the pre-test, only 39% of male youth correctly responded to the question, "How do girls get pregnant?" This percentage rose to 95% in the post-test.
  • After the course, more than 90% of youth correctly identified pregnancy prevention methods.
  • In the pre-test, only 7% of female youth and 15% of male youth had accurate information on STIs; this percentage jumped to between 80% and 85%, respectively, in the post-test.
  • In the post-test, 85% of youth gave correct and detailed information about HIV/AIDS, including transmission and prevention.

Key findings related to youth attitudes and perceptions:

  • Most youth indicated they were comfortable attending the SRH sessions that were integrated into existing vocational training programmes.
  • 65% of male youth indicated that, after this training, they would not be embarrassed to ask for condoms in a pharmacy.
  • 70% of male youth reported feeling more aware of gender issues and bias.
  • In the pre-test, 50% of female youth and 46% of male youth said that it is bad for a husband to beat his wife. In the post-test, 75% of female youth and 85% male youth said that beating is bad.
  • Most youth reported an increased sense of self-confidence, self-worth, and the ability to understand themselves and others better.
  • More than 90% of participants rated the Samriddhi curriculum as very interesting and useful. Particularly appreciated were the friendly attitude of the trainers, who spent considerable time establishing rapport with students before launching into sessions on sensitive SRH topics, and teaching aids in the form of card games, puzzles, and flip books, which reportedly made the interactions very hands-on, comfortable, and non-threatening.

Key findings related to trainer responses:

  • Most trainers reported being satisfied with the master training that they attended; they felt equipped with adequate skills to deliver the Samriddhi curriculum (and use the teaching aids) in conjunction with vocational training classes.
  • The majority of trainers felt that the Samriddhi curriculum and teaching aids were very effective in garnering youth participation during the trainings; they reported very good attendance.
  • Trainers reported that students took very well to the teaching aids and that the sessions were full of energy and excitement, and that they included discussions and very often debates.

IYF and Youthreach offer a handful of lessons and recommendations for their work as well as the work of others. Some are confirmations of known principles - for example, it is best to teach SRH in sex-segregated classes and with teachers of the same sex as the students; teaching aids help break the ice and encourage interactivity and free discussion; youth vocational training is an appropriate forum for introducing SRH information, given the ages and interests of the students. IYF and Youthreach also share the following specific recommendations:

  1. When the Samriddhi curriculum and teaching aids were introduced in the middle or near the end of vocational training programmes, the results were more satisfactory than when the SRH modules were introduced early. Students were more comfortable with one another and teachers had developed rapport and trust with the students.
  2. It is important to teach life skills alongside the SRH information.
  3. Trainers and school staff must have solid relations and trust within the communities where they work; otherwise, parents may be reluctant to allow their children to attend SRH classes within the vocational curriculum.
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