Adolescent Sexual Health in West Africa: Rights, Realities, Responses

This 44-page report, published by Plan International, looks at the sexual health rights and needs of adolescents in West Africa. It is intended for people who work with adolescents in West Africa, such as teachers, nurses, social workers, activists, politicians, and bureaucrats from both national institutions and international organisations. It seeks to draw attention to the rights and needs of adolescents who, the report argues, are often neglected in social development initiatives and national health policies and programmes, despite massive donor investments to combat HIV and other sexually transmitted diseases. This in turn contributes to increased sexual health risks and vulnerability to HIV.

The report examines why it is important to focus on the sexual health and rights of adolescents. It looks at the legal context of adolescent health and rights in West Africa with regards to polygamy, demographics, and gender equality. It then looks at programmatic approaches used in West Africa to promote adolescent sexual health and rights. According to the report, the majority of these kinds of programmes are part of the national or international response to HIV. HIV prevention programmes for adolescents primarily aim to change behaviour - specifically to delay sexual debut, decrease the number of sexual partners, and increase condom use - and are often based within the curriculum of schools and led by adults. However, the report argues that the adolescents in West Africa who are most in need of information about HIV risk and sexual health and rights are the vast majority who are not in school, and who are not reached by these kinds of programmes.

The report includes a number of experiences of Plan programmes in West Africa that represent different approaches to adolescent sexual health education. For example, in Benin, Plan embarked on a process of assisting young people to develop a project that would meet their needs and priorities. A team of youth leaders was selected and in a series of workshops they learned leadership skills, basic principles of sexual health and rights, and research methods. They then conducted their own situational analysis of the factors influencing adolescent sexual health and rights in their community. Following the research, the team formulated a project which had the main objective of empowering adolescents to make choices that positively influence their future health and well-being.

In another project in Togo, Plan worked with a local organisation to support youth clubs for adolescents aged 15 to 19. Each club was led by a female and male volunteer facilitator. According to the report, after three years, the project was found to have contributed to the personal development and confidence of the members. The report states that one of the most important lessons of the project was the realisation that once an opportunity is created for young people to take charge of their own issues, these concerns can no longer be compartmentalised into 'sexual health issues and other problems.' Once the young people felt confident that they were in charge of their own agenda, they expanded the range of discussion to other areas where they felt under-valued and marginalised. The report notes that sexual health is not just being informed about reproductive functions and sexually transmitted infections, it also requires being in charge of ones life and being able to meaningfully contribute to the decisions and standards that prevail in ones family and community.

The report also makes a number of recommendations to governments, the African Union, civil society organisations, the United Nations, international aid agencies, the European Union, and adolescents around supporting adolescent sexual health and rights initiatives, and contributing to the empowerment of young people. For example, the report recommends that governments should provide social services such as youth centres and/or community-based facilities managed with a high level of youth participation, offering a wide range of services and opportunities for the development of adolescent girls and boys. It also suggests that civil society organisations should expand their mobilisation efforts on the issue of HIV to include adolescent sexual health and rights. Specifically, these mobilisation efforts should include advocacy for a government response in the education, health, social service, and criminal justice sectors. The report further adds that international development cooperation should invest in sexual health and rights of youth and give priority to support the development of national plans of sexual health and rights in the country, as well as on programmes that focus on the empowerment of adolescents, providing them with opportunities to access adequate information and to participate in the design, implementation, and monitoring of projects, policies, and services concerning their sexual and reproductive health rights.