In the Philippines, there are health and development programs that specifically target children, senior citizens, and adults, said Joan Castro, but adolescents are underserved. Nineteen percent of the population is between the ages of 15 and 19, but “they can’t even go to health centers to get the family planning commodities [they desire],” she said.
Castro is the executive vice president of PATH Foundation Philippines, Inc. (PFPI), which works to improve reproductive health and promote environmentally sustainable development. She was joined at the Wilson Center on April 30 by Leslie Mwinnyaa to talk about youth-focused population, health, and environment (PHE) programs in the Philippines and Ghana.
Relying on Peer Educators
Mwinnyaa, a Peace Corps volunteer, works with the Integrated Coastal Fisheries Governance Initiative – nicknamed Hen Mpoano, or “our coast” – in the Ellembelle district of western Ghana. Ellembelle holds one of the most biologically rich ecosystems in Ghana: the Amanzule wetlands. But the wetlands have no formal protected status and the ecosystem – as well as the people who depend on it – is threatened by degradation, green algae blooms, climate change, and the rapid development of oil and gas extraction.
When Mwinnyaa arrived, she saw the possibility of combining Hen Mpoano’s more traditional focus on coastal resource management with health goals. Ellembelle has higher than average rates of teenage pregnancy – 14 percent of teenage girls become pregnant, compared to 7 percent of girls nationally, Mwinnyaa said – and there are many misconceptions about adolescent sexual and reproductive health. Through the University of Rhode Island’s Coastal Resources Center, she reached out to the BALANCED Project for information about developing a population, health, and environment (PHE) framework for Hen Mpoano, as well as local schools and the nearby Esiama Community Health Nurses Training School, as potential partners.
She found willing partners on all sides. Hen Mpoano began implementing adolescent reproductive health programming in the nurses’ school with the enthusiastic support of its principal, who was “really interested in collaboration on PHE activities,” said Mwinnyaa. Mwinnyaa herself began teaching an adolescent sexual and reproductive health class geared at clearing up misconceptions about contraceptive use.
“In Ghana…they understand that there’s a problem with teenage pregnancy and sexual activity and yet they have a negative idea of adolescents using contraceptives, so we’ve been working to reduce that stigma and those misconceptions,” she said.
The principal of the Esiama nursing school also suggested that “students could act as a conduit to disseminate PHE messages to coastal areas throughout the district.” Over the past year and a half, Mwinnyaa said, 300 nursing students have completed voluntary PHE training and 80 have participated in regular outreach trips to coastal villages. Students try to reach each of the 18 coastal villages in the area at least once a month to educate community members, especially other young people, about PHE issues like natural resource management, sanitation, and reproductive health.
Students in the nursing school also rely on members of PHE clubs in local grade schools to guide them around villages. Hen Mpoano has established clubs in four high schools and 26 junior high schools. Members serve as peer educators trained to talk about PHE issues ranging from HIV/AIDS to natural resource management, taking these messages both to their classmates and other schools.
Through Livelihoods, a Connection to the Environment and Health
The Philippines experiences similar challenges to Ellembelle. Like Ghana, coastal resource management is incredibly important and lack of access to basic health services and contraception is widespread. Like Ghana, more than half the population is under 25.
PFPI decided to survey young people and their parents to find out what they saw as their main challenges to happy and productive lives and build a PHE project that would focus on those concerns, Castro said.
“Despite the fact that education among Filipinos is pretty high – we have above 90 percent literacy rate,” Castro said, “there’s a struggle with unemployment,” especially for “youth that have not finished secondary school and don’t have any skills.” As a result, PFPI developed Project EMPOWER, with “a strong emphasis [on] providing skills and training and linking these youth to livelihood programs, which was found to be a very strong need expressed by the youth and their parents.”
The project trains young people in environmentally sustainable livelihoods, including catering businesses and massage therapy, and also identifies leaders in the community to become peer educators, helping other young people understand and access reproductive health services. With the consent of their parents, Castro said, these peer educators distribute contraceptives when asked for them, but don’t actively promote themselves as distributors.
Castro said the livelihoods component of the program is key to maintaining the interest of young people. “Providing livelihood skills training and opportunities to initiate [environmentally-friendly] micro-enterprises helped to reinforce their commitment to conservation work while enabling the youth to become economically productive members of society,” she said.
Youth As Allies
Family planning is a sensitive issue in the Philippines. Opposition from the Catholic Church has contributed to heavy restrictions on access in some places and the stalled passage of a national reproductive health bill (introduced in 2001, passed in December 2012, implementation temporarily frozenby the Supreme Court in 2013). But addressing the health and development needs of young people necessarily includes reproductive health, especially for those at high risk of teen pregnancy, and Castro said that PFPI finds young people understand this and are very receptive to understanding the links between their own livelihoods and the environment.
The Hen Mpoano program also faces challenges, but of a different variety. Mwinnyaa said the high cost of fuel for transportation of student nurses to coastal communities is a problem, as is the reluctance of adults in communities to volunteer for PHE activities. There are also currently no plans for another Peace Corps volunteer to take her place after her term is completed.
But Mwinnyaa noted that programs targeting young people can take advantage of not only their numbers, but also their enthusiasm. “We have found great success in finding youth who are willing to volunteer,” she said. “These youth are so highly motivated, and they work diligently in their responsibilities as peer educators.”
“These youth will definitely ensure the project’s continuation in this region,” Mwinnyaa said. “I have been amazed and inspired by the youth that I’ve worked with, with their dedication and motivation to help their countrymen and to try to make their communities better places.”
Drafted by Carolyn Lamere, edited by Schuyler Null
- Health/Water and Sanitation Peace Corps Volunteer, Hen Mpoano Project, Coastal Resources Center of the University of Rhode Island