Fostering Adolescent Sexual and Reproductive Well-being with Communication for Social Change
Straight Talk Foundation (STF)
This 60-page evaluation report examines a project carried out by Uganda's Straight Talk Foundation (STF) called "Youth Radio for Better Adolescent Reproductive Health" in Kisoro, Uganda. Conducted between July 2007 and August 2009 with funding from Cordaid, this project incorporated a local language youth radio show with complementary information, education, and communication (IEC) materials and face-to-face activities - a package of interventions meant to facilitate sustained and informed conversations amongst adolescents and the adults in their lives about adolescent sexual and reproductive health (ASRH).
In its work throughout Uganda, STF uses radio to usher positive social change. The Uganda Demographic and Health Survey (2006) shows that close to 80% of Ugandans listen to the radio daily. A Population Council-STF survey (2005) found that over 75% of adolescents will have "ever" listened to an STF youth radio show in districts where STF broadcasts in the local language, compared to 13.4% in districts with only an English show. According to this report, until STF began broadcasting its youth radio show in the Lufumbira language in July 2007, Kisoro's young people were largely isolated from STF's "conversation" on growing up and staying safe, had low levels of knowledge on HIV and RH, and held attitudes about condoms and gender which put them at risk.
Specifically, by increasing the quality and frequency of SRH dialogue in Kisoro (a small and remote district in far south-west Uganda), the project aimed to contribute to HIV/AIDS prevention efforts among married and unmarried adolescents and youth (aged 10-24). To that end, STF structured the project interventions around 5 key objectives:
- To give young people a voice and to empower them to manage their sexuality more safely by delaying sexual debut, reducing numbers of sexual partners, treating sexually transmitted infections (STIs), testing for HIV with their partners, and using family planning (older youth).
- To encourage youth to have more gender-equitable relationships, in which boys do not exploit girls and girls do not manipulate boys.
- To encourage all youth to seek protective environments (e.g. such as remaining in school, having dialogue with trusted adults like parents, and becoming socially connected by joining clubs).
- To increase utilisation of health services, including voluntary counselling and testing (VCT), antenatal care, and contraceptive use.
- To seek support among opinion leaders by increasing their understanding of youth SRH-related issues.
The achievement of these objectives required a multifaceted programme with both mass media and face-to-face interventions. At the heart of the programme was the production of 104 episodes of the 30-minute pre-recorded radio show "Tuvuge Rwatu" ("Straight Talk"). Each was broadcast twice, for a total of 208 broadcasts over 24 months. During this time, STF journalists completed a total of 8 field trips to Kisoro, conducting face-to-face interviews, focus group discussions (FGDs), Straight Talk Club visits, and facilitated dialogues in a number of different contexts. Each broadcast featured an average of 4 adolescents sharing their stories and 1 health worker or local opinion leader. Customised, local-language jingles, sweepers, "intros and outros", and popular music tracks were included (accompanied by dedications to individuals or groups in Kisoro selected for their letters - between September 2007 and August 2009, "Tuvuge Rwatu" listeners sent in 2,762 letters, and some received prizes - or participation in another component of the project). To weave these stories and clips together, an STF journalist - himself from Kisoro - narrated each show with an interactive and informed style.
In brief, other project elements included:
- 32 Straight Talk listeners' groups were established to reinforce conversations stimulated by the youth radio show. "As social change agents in Kisoro, ST Club members became on-the-ground representatives of STF, facilitating dialogue and community outreach by and for young people."
- Over the two years, STF sent about 40,350 copies of its newsletter "Straight Talk" and 77,000 copies of "Young Talk" to Kisoro. In addition, the STF team physically handed out 17,000 copies each of "Straight Talk" and "Young Talk" in face-to-face activities.
- Face-to-face outreach and advocacy efforts were undertaken at the community level. For instance, the STF team identified and vetted 6 key health centres to which referrals for youth-friendly services could be made in the radio show. In an effort to seek support among opinion leaders by increasing their understanding of youth SRH-related issues, STF held 2 district meetings attended by a total of 104 leaders. The radio show aired 81 interviews with health workers, which evaluators read as a mark of their support.
STF finds that an estimated 80% of the young people in Kisoro were reached by this project at a cost per person of US$.78 or UGX 1544 per year. Of 14 targets set in the project proposal, STF was able to exceed 8. Reflecting on one objective, evaluators note: "STF resoundingly succeeded in giving young people a voice. Hundreds of young people spoke and heard themselves on the STF radio shows, including members of the deeply marginalized Batwa group." The impact of this "reach" extended to the following: the project was associated with statistically significant changes in several domains of knowledge and attitudes; many fewer young people reported "no one" as a source of reproductive health information; talk greatly increased, particularly between parents and young people, and young and teachers; young people and adult stakeholders, such as health workers, gained a voice on radio to talk about topics of critical importance to them, some of which had not been verbalised in the media before, such as the tradition of marriage by abduction.
Based on the conclusion that STF has "catalysed a process of social change in which young people as well as parents, teachers and health workers have begun to talk about sexuality, HIV and gender," this report urges continuing this project to consolidate and increase the gains achieved. It recommends: paying more attention to areas such as pregnancy, around which there are many misconceptions and more knowledge gaps than HIV; ensuring that scarce airtime and resources focus on the most important "conversations" (for example, HIV-positive youth); working more creatively and intensively on gender norms and beliefs and attitudes about condoms; and constantly renewing and refreshing STF's discourse in Kisoro by listening to and respecting the people that STF works for: young people and important people in the lives of young people.
STF website, accessed January 19 2010.