Report of the external and evaluation of the youth incentives programme 2009-2010 by Plan Nederland

Report of the External End Evaluation of the Youth Incentives Programme 2009-2010

Meera Pillai & Coumba Toure

With Support From Young Evaluators Mr. Boubacar Sidibe, Mali Mr. Chikondi Liwonde, Malawi Mr. Joshua, Rwanda Ms. Mahfouza Rahman, Bangladesh

Utrecht, December 2010 Youth Incentives Contact Point: Gudule Boland: g.boland@rutgerswpf.nl Project Number: Youth Incentives 740 ÂŠ 2010, Youth Incentives www.rutgerswpf.nl

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List of Acronyms and Abbreviations AMPPF Association Malienne pour la Promotion et la Protection de la Famille (Family Planning Association of Mali) ARBEF Association Rwandaise pour le Bien-Ă&#x160;tre Familial (Family Planning Association of Rwanda) ARVs

Anti-Retrovirals

ARO

Africa Regional Office

CDLS Committee de district de Lutte contre le SIDA CHH

Child-Headed Households

IPPF Central Office

HIV

Human Immunodeficiency Virus

ICPD

International Conference on Population and Development

IPPF

International Planned Parenthood Federation

FPAB

Family Planning Association of Bangladesh

FPAM Family Planning Association of Malawi MAs

Member Associations

MFS

Co-Financing System

NGO

Non-Governmental Organisation

PMC

Project Monitoring Committee

PSI

Population Services International

RAP

Rights-Based Approach, Acceptance of young people's sexuality

RNG

Rutgers Nisso Groep

and Youth Participation SARO South Asia Regional Office SRHR Sexual and Reproductive Health and Rights STIs

Sexually Transmitted Disease

Traditional Authority

TMF

Dutch Thematic Co-Financing Programme

UFBR Unite for Body Rights UMATI Uzazi na Malezi Bora Tanzania (Family Planning Association of Tanzania) VCT

Voluntary Counselling and Testing

WPF

World Population Foundation

YAG

Youth Advisory Group

YAM

Youth Action Movement

Youth Incentives

YIF

Youth Incentives Fund

YPLHA Young People Living with HIV/Aids

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Acknowledgements The evaluation team would like to place on record the support provided by the senior management and staff of RNG-Youth Incentives to carry out the evaluation of the MFS Phase of the Youth Incentives Programme. In particular, we are grateful for the attention to detail shown by Ms. Gudule Boland, Monitoring and Evaluation Officer, Youth Incentives, to make our task easier by providing ready and comprehensive access to all relevant documents and assistance with setting up interviews with the different stakeholders. We would also like to thank the senior managements of the four member associations, namely, Family Planning Association of Bangladesh, Family Planning Association of Malawi, Association Malienne pour la Promotion et la Protection de la Famille, and Association Rwandaise pour le Bien-Ă&#x160;tre Familial, for assistance with setting up interviews with local government officials, primary stakeholders and community leaders, in addition to freeing up their own time to provide information necessary to carry out this evaluation. We are also grateful to team members of the senior management of the International Planned Parenthood Federationâ&#x20AC;&#x2122;s CO and ARO for consenting to telephonic interviews to understand their perspectives on the impact of the YIF MFS Programme. -

Evaluation Team

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Table of Contents List of Acronyms and Abbreviations

Acknowledgements

Chapter 1 Executive Summary

1.1 Brief Project Description and Context

1.2 Purpose and Expected Use of the Evaluation

1.3 Objectives of the Evaluation

1.4 Summary of the Evaluation Methodology

1.5 Principal Findings and Conclusions, especially relating to project goals/targets

1.6 Key recommendations

1.7 Summary of Lessons Learned

Chapter 2 Evaluation of the MFS Phase of the Youth Incentive Programme Aims and Methodologies

2.1 Introduction

2.2 Purpose of the Evaluation

2.3 Audience for and Use of the Evaluation

2.4 Objectives of the Evaluation

2.5 Evaluation methodology

2.6 Data Sources, Methods of Data Collection and Analysis, Participatory Techniques and Rationale for Choice of Methodologies 18 2.7 Ethical and Equity Considerations

2.8 Major Limitations of the Methodology

2.9 Composition of the Evaluation Team

Chapter 3 The MFS Phase of the YI Programme Context, Key Concepts and Processes

3.1 Introduction and Context

3.2 Rationale

3.3 Stakeholders and Beneficiaries

3.4 Conceptual Model

3.5 Project Monitoring System

Chapter 4 Evaluation Findings

4.1 Design: Quality and Relevance

4.2 Effectivenes

4.2.1 Gains in Knowledge

4.2.2 Internalisation and Application of Information

4.2.3 Contact with the project has given young people an alternative source of trusted health information

4.2.4 Gains in Knowledge of Rights

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4.2.5 Gains in Skills

4.2.6 Gains in Space

4.2.7 Gains in Exposure

4.2.8 Gains in Opportunities

4.2.9: Gains in uptake of services

4.2.10 Gains in support

4.2.11 Reduction in stigma

4.2.12 Positive changes in MAs in terms of providing non-stigmatising services for young people

4.2.13 Foregrounding gender

4.2.14 Changes in MAsâ&#x20AC;&#x2122; perceptions towards sensitive issues

4.2.15 Favourable comparisons with other SRHR interventions for young people

4.3 Contributions of Stakeholders

4.4 Constraints and Problems Encountered

4.6 Impact: Progress towards Vision and Goals

4.7 Sustainability and Replicability of the project/programme impacts

4.8 Capacity Built

4.9 Institutional and Stakeholder Issues

Chapter 5 Conclusions and Recommendations

5.1 Insights into the findings

5.2 Reasons for Successes and Less than Optimal Performances

5.3 Innovations

5.4 Recommendations (based on evidence and insights)

5.5 Lessons learned with wider relevance that can be generalised beyond the project 79 Annexure 1

Annexure 2

1 Youth Incentives-project background and context

2 Objectives of the evaluation

3 Evaluation issues and key questions

4 Methodology

5 Profile of the evaluation team

6 Output and deliverables

7 Evaluation time table

8 Cost

9 Logistical support

List of Individuals Interviewed and Stakeholder Groups and Communities Consulted

List of Supporting Documentation Reviewed

105

Short biographies of the evaluators

107

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Chapter 1 Executive Summary 1.1 Brief Project Description and Context The Youth Incentives Fund (YIF) was set up as a collaborative undertaking by Youth Incentives (YI), the International Planned Parenthood Federation (IPPF) and four of its Member Associations (MAs) to explore the relevance of the Dutch approach of working proactively and in a participatory manner with young people to promote their sexual and reproductive health and rights (SRHR). The first phase of this programme, funded by the Thematic Co-financing System (TMF), came to an end at the end of 2008. The next phase of the programme, from 2009-2010, was funded by the Co-Financing System (MFS). An evaluation of the MFS phase of the programme was undertaken in the last quarter of the project, and the following is a summary of the evaluation process and its major findings. In the TMF phase, the Family Planning Associations of Bangladesh, Malawi, Mali and Rwanda partnered with YI, developing innovative interventions or addressing new target groups and themes, incorporating all the elements of the RAP approach, namely a Rights-Based Approach, Acceptance of Young Peopleâ&#x20AC;&#x2122;s Sexuality and Participation of Young People, together with one or more elements of the five Aâ&#x20AC;&#x2122;s of IPPF (Adolescents, Access, Abortion, HIV/AIDS and Advocacy). The programme was an outcome of three elements: the commitment of the Dutch government to the agreements of ICPD + 5 and MDGs 3.4.5 and 6, the expertise built by Youth Incentives on working on the sensitive issue of sexual and reproductive health with young people, and the recognition of the MAs of the need for work on SRHR issues with young people in their countries, and their capacity to provide clinical services to back up the increased demand for SRH services by young people, that the implementation of the programme anticipated. The Family Planning Associations of Bangladesh and Malawi worked to promote SRHR among in-school and out-of-school young people, including young labourers, and increase their access to SRH services, in four districts, and one Traditional Authority (TA) area of one district respectively. ARBEF Rwanda provided these services for Child-Headed Households (CHH) and Young People Living with HIV/AIDS (YPLHA) in three districts. Unlike the other three partners, who had been associated with YI in the TMF phase, Mali was a new entrant in the MFS phase, and implemented a youth-led and youth-targeted initiative to promote SRHR and access to SRH services called Youth to Youth. UMATI Tanzania, a partner during the TMF phase, was officially dropped from the programme at the end of 2009 due to poor performances. 1.2 Purpose and Expected Use of the Evaluation The external evaluation at the end of the TMF phase of the project had pinpointed certain gaps and suggested several areas for increased attention, for example, the need for an increased focus on the areas of young people's right to make decisions on sexual and reproductive health issues, sensitization of service providers to provide youth-friendly services, local advocacy with parents and community leaders and increased collaboration with other NGOs. The evaluation was to look at the steps taken by YI and the partner MAs to address these shortcomings and meet the objectives of the programme, as reflected by the results achieved by the individual projects in the community and within the organisations. The findings of the evaluation would assist the YI team at Rutgers WPF to determine whether their technical and programme management support had been

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timely and relevant to help achieve programme objectives, and to the MAs to understand if implementing processes and mechanisms had been effective and efficient. The success or otherwise of the corrective steps taken on the basis of the learnings of the TMF phase could be determined, and the extent to which the whole programme had furthered the Dutch government's efforts to contribute to the promotion of young people's SRHR assessed. Some of the relevant findings could also be of interest to the IPPF, for wider sharing with other member organisations. 1.3 Objectives of the Evaluation The evaluation was to analyse the extent to which the project funds had been used for the intended objectives, as reflected in the results achieved, make recommendations that would be relevant beyond the YI division, and help integrate the RAP approach and its strategies to the larger Rutgers WPF organisation, the Unite for Body Rights Alliance and the IPPF, as well as inputs for the organisational learning of YI and the MAs. 1.4 Summary of the Evaluation Methodology The terms of reference asked that the evaluation should concentrate on "higher level results", assess current and potential achievements, especially in terms of their strategic importance, and consider quantitative data from partner's reports and qualitative information from interviews with multiple stakeholders. A two member team, consisting of evaluators from South Asia and Africa were contracted to carry out the evaluation. The evaluators conducted extended interviews with the YI team in the Netherlands, members of the senior managements and project staff of the partner MAs, members of the YAM or Youth Parliaments, and representatives of the IPPF. A couple of these were telephonic interviews. Data was also obtained from focus group discussions and interviews with peer educators and other young people supported by the programme, parents, local leaders, traditional counselors. Where possible and relevant, meetings were also held with officials of local governments. Participatory methodologies, including art and theatre exercises and small group work were used with the young people. Data was also collected through field observations, observations of training sessions and document reviews. 1.5 Principal goals/targets

Findings

and

Conclusions,

especially

relating

project

The evaluation found that the RAP approach was the keystone of the design and the most important factor of the programme. Within RAP, acceptance of young people's sexuality was key to determining whether their sexual and reproductive rights were respected and they received access to services, and their participation was not only allowed, but actively promoted. An active effort had been made to address shortcomings and concerns identified in the evaluation after the TMF phase, in particular, advocacy at the local level, with parents, local leaders and traditional arbiters of culture and religion within the context of the project areas, and this paid rich dividends, in terms of stakeholder contributions towards acceptance of the projects, and young people's ability to access services. Youth Incentives designed trainings and IEC materials designed to overcome specific capacity building needs identified in the previous evaluation, including communicating about sexuality related issues, monitoring and evaluation, and advocacy. Consequently, there were observable differences in programme implementation and monitoring.

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The involvement of young people in the programme was a key strength. As capacity was built and they gained in skills, they proved able and enthusiastic partners in implementing the programme, relaying information from the community to feed into design aspects at the project level, programme monitoring and research on youth sexuality issues. The new Mali project, Youth to Youth, introduced several innovative features like the telephone hotline, which took into account the realities of the young people's lives in that context, including their need for privacy and confidential support, lack of access to resources, and their comfort with digital media. Skill building, opportunities and exposure provided by the projects also improved their status within the MAs, their local communities, and in some cases, at the national and international level. The project was able to achieve three objectives creditably, namely, increasing the number of young people who recognise and realise their sexual and reproductive rights, including the number accessing SRH services, improving conditions for young people to exercise their SRHR within their local contexts, and increasing youth participation in MAs. Field visits also revealed that young people had received more information about their SRHR through the programme, internalise that information, reflect on and challenge current practices which compromised SRHR, and convert knowledge into health-seeking behaviour and rights realisation, in the project areas. The success of the programme's philosophy and strategies is evident from important developments resulting from the project. To name just one from each country for the purposes of the summary,

Bangladesh has upscaled strategies from the project to 21 districts from the original 4 agreed to, using creative funding strategies involving inter-project collaboration;

TA Kachindamoto in Malawi has passed by laws making early forced marriage of children illegal;

The success of the innovative Youth-to-Youth project in Sikasso and Koulikoro created a demand for similar youth-friendly services from the other districts in Mali;

A young person who is an active YAM member has been appointed to a national committee to work on a policy on young people's SRH in Rwanda.

A creditable beginning has also been made with addressing the fourth objective addressing sensitive issues of youth sexuality - given the often hostile context within which this was attempted. Interestingly, while all the issues were challenging in all the countries, certain issues were particularly difficult given the current legal and cultural contexts prevailing in each country. For example, abortion was viewed pragmatically in Bangladesh, but was punishable by imprisonment in Rwanda; sexual diversity was held as an anathema, even to the extent of decrees of capital punishment in Malawi, and very difficult to uphold in principle and practice in Bangladesh; gender-based violence was a major challenge in Mali. It is also noteworthy that young people were willing to be more creative and flexible with respect to challenging the norms related to these sensitive issues compared to the MAs, which, for obvious institutional reasons, are treading very cautiously with these. The Youth Incentives programme must be lauded for putting these issues firmly on the agenda, even while the more mainstream SRH issues continue to dominate attention for very good reasons. Also, the decision to partner with IPPF MAs was an excellent strategic and ethical choice, as they have the clinical services to back up the sensitisation and demand creation approach of the Youth Incentives programme.

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A major challenge within the programme included limited youth participation in RNG, which diluted the success of the fourth objective of the programme. Other challenges included:

Constraints (especially cultural and religious) related to local contexts

Resistance to addressing sensitive issues

Work related tension between older staff and young people

Operation of traditional hierarchies and economic hardship

Locations of the clinics and limitations in availability of health services and products.

Challenges related to retention and turnover of trained staff, and the loss of trained young people after the age of 24

Addressing increasing aspirations and needs created in young people with the empowerment caused by the programme

While local advocacy has been very successful, advocacy at the national level using learnings from the programme has not received adequate attention.

Building collaborative alliances with other NGOs continues to be a challenge from the TMF through the MFS phases

Deepening the levels of gender analysis beyond increased participation by girls and young women in the programme.

1.6 Key recommendations Some of the key recommendations, based on the learnings from the project are as follows:

The programme should supplement sensitisation on SRHR issues with empowerment training and the life skills needed (e.g. decision making, conflict resolution, stress reduction) needed to negotiate strong prevailing socio-cultural norms and systemic and structural barriers faced by the individual young person in realising SRHR.

There is need for a much deeper analysis into how gender norms should be addressed by the project, and to engage with masculinities-related issues in ways that make men part of the solutions generated for gender-based inequalities that affect realisation of SRHR by young people.

The levels of knowledge of the peer educators need to be monitored more consistently.

Creating a trained pool of local consultants, to support the technical assistance provided by the Dutch consultants, would contribute to cost-reduction in the medium term and sustainability in the longer term.

The results and learnings from the YI programme must be shared with broader networks of organisations that work with young people, for upscaling beyond the resources available with YI.

Linkages with organisations which work on poverty alleviation solutions will contribute to the sustainability of the programme.

Transition planning support should be provided for peer educators as necessary.

There is need for consistent and sustained advocacy in country's whose prevailing socio-cultural and sexuality-related norms run counter to YI's liberal perception of young people's sexual rights, to increase congruence and decrease resistance.

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There is need to work more explicitly on religion and sexuality, as the former continues to exercise emotional, institutional and strategic influence on the implementation and outputs of the programme.

There is need to build on the momentum generated by the study tour and regional events on sensitive themes.

RNG needs to develop a Child Protection Policy and make the HIV Workplace Policy a living document. MAs also need to pay attention to these aspects.

The extent of youth participation in RNG needs to be increased.

1.7 Summary of Lessons Learned The important lessons learned from the project include the following:

Working on the acceptance of youth sexuality is critical to the success of any SRHR programme that targets youth.

Young people receive SRHR information more easily from their peers than adults.

Building adult allies is another key element which contributes to the success of programmes on young people's SRHR.

Buttressing international norms, as promoted by rights-related agreements and multilateral organisations like the UN, with strong and consistently updated local information on the SRH realities and risks faced by young people within each local context, is essential to counter resistance to programmes on young people's SRHR.

Empowerment through SRHR projects appears to empower young people more generally to have improved aspirations and increase the likelihood of their acting as change agents within their communities.

Organisations working on SRHR need to engage with the enduring power that religion continues to exercise on sexual norms for young people, and seek out resources and allies to help engage constructively with this aspect, with the aim of improving sexual and reproductive rights realisation and access to SRH services for young people.

Programmes on individual empowerment with respect to young people's SRHR must be supplemented by work to address structural and systemic barriers in the contexts within which they function.

Linkages of SRHR programmes with (other organisationsâ&#x20AC;&#x2122;) programmes on poverty alleviation, education and income generation will help in their sustainability and continued relevance.

Issues of gender and masculinities must be constantly analysed and addressed during the programme.

Special efforts are necessary by organisations working on SRHR to engage with issues related to sexuality minorities, people with disabilities, and conflicts between dominant cultures and sub-cultures related to sexuality, in order to achieve social justice.

Addressing young peopleâ&#x20AC;&#x2122;s sexual health issues from the lens of positive sexuality, rather than that of disease and death, is of major value and needs to be propagated far more widely.

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the

Youth

Incentives

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Chapter 2 Evaluation of the MFS Phase of the Youth Incentive Programme Aims and Methodologies 2.1 Introduction The Youth Incentives Fund, was established within the Youth Incentives (YI) division of the Rutgers Nisso Groep in 2005, with support from the Dutch Ministry of Foreign Affairs to provide financial and technical support for innovative projects in support of informed sexual and reproductive health seeking behaviour in young people. The first phase of the project involved four countries: Bangladesh, Malawi, Rwanda and Tanzania, where the Family Planning Associations of the respective countries, who are also the member associations (MAs) of the International Planned Parenthood Federation (IPPF), implemented the projects. The first phase of the programme was completed in 20081, after which a mid-project evaluation was carried out. The project was then extended for two more years, 2009-2010, with support from the Dutch Ministry of Development Cooperation/MFS 1. During this period, Tanzania was discontinued from the programme, and Mali joined the project.2 The following is a report of the end evaluation of the project. 2.2 Purpose of the Evaluation The current evaluation was undertaken to assess the MFS phase of the Youth Incentives Trust Fund Programme between 2009 and 2010. At the end of the TMF phase, an external evaluation was undertaken, gaps identified and recommendations made. Some of the key observations of the mid-term report were as follows: 1.

The baseline information and design did not lead to “strategic choices and/or setting priorities”3 in the projects.

2. The rights-based approach focused largely on “transfer of knowledge” and very little on the promotion of young people’s right to decide on sexuality and reproduction issues. 3. The peer educator approach was found to be an effective means of linking young people to services. 4. While some sensitisation of service providers had taken place, this was not of sufficient impact to change their attitudes and service provision to young people. 5. Advocacy potential of meetings with relevant stakeholders was not used sufficiently. In particular “parents are not systematically approached yet” and collaboration with other NGOs was seen as poor. 6. Issues of gender were not being given enough prominence. 1

Youth Incentives (2009). Youth Incentives Fund: Plan of Operation User Guide. 2009-2010 Second Phase. The Netherlands: Utrecht. 2 ibid. 3 Zuidberg, L. (2008) External Evaluation: Youth Incentives Trust Fund [-] Rutgers Nisso Groep TMF Funded Programme 2005-2008. Utrecht: EOS Consult.

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7. Innovation was evident in the production of appropriate IEC materials. 8. Work with young sex workers in Bangladesh was ineffective because peer educators had not been recruited from within the targeted community. 9. The partnerships between member associations (MAs) and youth organisations required further development. 10. Other concerns that emerged from the mid-term evaluation related to where the project coordinators functioned from (head office or field office), under-utilisation of budgets, limited influence of YI staff on the MAs, the relative inexperience and questionable commitment of some project staff, questions about quality and ownership of the programme, inadequate monitoring and reporting, and technical support not being linked to the needs of the MAs. Against this background, this external end evaluation aimed at studying and analysing the adjustments that had been made to the programme, as reflected in the results on the ground in the projects. Consequently, the evaluation would look at both the countryspecific impacts, as well as comparisons and contrasts that were possible across country experiences. 2.3 Audience for and Use of the Evaluation The findings of the evaluation can potentially be used by a number of stakeholders.

The immediate audience for the findings of the evaluation would be the Youth Incentives team at RNG (now Rutgers WPF) to have the additional support of the observations and insights of two external personnel with experience in both SRHR issues of young people and monitoring and evaluation experience. This would assist them in their effort to determine whether the designed YIF programme and the technical support provided had had the desired impact in achieving the stated objectives of the programme.

The findings of the evaluation would also be relevant to the leadership and project staff at the partner MAs, to determine whether the modes of implementation were effective and efficient in reaching the intended target audiences and providing the kinds of support envisaged by the project.

The findings of the evaluation would also contribute to the YIF programme leadership and staff and the leadership and project staff of the partner MAs to understand to what extent they have been able to use the insights of the midterm evaluation to modify their project in the second phase to best achieve the objectives of the project.

The findings of the evaluation may also be of interest to the back donor, the Dutch Ministry of Development Cooperation, to determine the extent to which the mandate provided to RNG through this project was validated, and whether the overall effort of the Dutch government to further human development has been extended by this programme.

Youth Incentives may also choose to share certain learnings that emerge from the evaluation about elements of programmes on SRHR for young people that are likely to work in particular conditions, with the regional and central offices of IPPF, if they so choose, for wider sharing with and support of other MAs of IPPF.

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Likewise, there may be certain learnings from the evaluation, which YI might choose to share more generally with organisations working with the SRHR issues of young people.

YI will also have to determine which sections of this evaluation report they wish to share with young people and how.

2.4 Objectives of the Evaluation According to the Terms of Reference (see Annexure 1), the external evaluation “serves the following objectives: a)

The external evaluation should provide an analysis of accountability with respect to the use of project funds for the backdonor(s), principally the Ministry of Development Cooperation/MFS1. The evaluation should provide recommendations that serve as input for the new programmes in the field of SRHR for the new Rutgers WPF organisation4, the SRHR Alliance5 and IPPF. The evaluation should provide recommended strategies to integrate the RAPapproach and activities from Youth Incentives into other programmes of the Member Associations, Rutgers WPF and the SRHR Alliance. The evaluation should provide input (experiences, strategies and methodologies) for organisational learning of both Member Associations and YI itself.6”

2.5 Evaluation methodology The Terms of Reference specified that in terms of the methodology, the evaluation should:

“Focus on the higher level results. Assess what has been achieved, the likelihood of future achievements, and the significance/ strategic importance of the achievements Use the quantitative and qualitative assessments from reports of partners Include qualitative evidence e.g. opinions on the project’s effectiveness based on impressions and interviews with target groups, partners, government, etc.”

Based on the suggestions in the Terms of Reference, as well as on discussions with the Monitoring and Evaluation Officer at RNG and Programme Coordinators in the MAs, as well as between the two consultants involved in the evaluation, the evaluation made use of a range of methodologies, described in the next section.

On January 1 2011 Rutgers Nisso Groep and the World Population Foundation will merge into a new organisation called Rutgers WPF. 5 The SRHR Alliance Unite for Body Rights consists of Rutgers Nisso Groep, World Population Foundation, Simavi, Dance4Life, Choice and AMREF Flying Doctors. This Alliance has made a joint MFS II proposal. 6 Youth Incentives (2010). Terms of Reference for the External End Evaluation of the Youth Incentives Programme 2009-2010. The Netherlands: Utrecht.

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2.6 Data Sources, Methods of Data Collection and Analysis, Participatory Techniques and Rationale for Choice of Methodologies

The data sources, methods of data collection and participatory techniques included: 1.

Field visits to Bangladesh, Malawi and Rwanda and Mali. a.

In Bangladesh, apart from interviews conducted at the FPAB head office in the capital, Dhaka, field visits were made to the FPAB clinics and Tarar Melas in Jessore and Khulna. At Jessore, interviews and focus group discussions were held with multiple stakeholders. In Khulna, in addition to focus group discussions held in the FPAB clinic with stakeholders including peer educators and youth organisers, Youth Parliament members, PMC members, health service providers, teachers, religious leaders, parents, etc., visits were also made to a local secondary school and a community-based organisation with which FPAB was partnering to implement the programme.

In Malawi, apart from interviews conducted at the FPAM Head Office in Lilongwe, a field visit was made to an FPAM clinic and youth club. Field visits were also made to TAs Kachindamoto and Tambala, where interviews and focus group discussions were conducted with local government officials, the District Medical and Youth Officers, service providers at the Dedza District Hospital and in the local health clinic, the Chief of TA Kachindamoto, parents, traditional counselors, church counselors, local leaders, peer educators, youth club members and other young people who had benefited from the programme.

In Rwanda, interviews with YIF staff, young people who were supported, local leaders, partners, and members of the youth volunteer wing promoted by IPPFâ&#x20AC;&#x2122;s MAs in Africa, the Youth Action Movement ( YAM) were carried out in the Kigembe, Karama, Mukingo and Kansi sectors, and with ARBEF staff in Kigali and Butare.

In Mali, interviews with AMPPF staff, beneficiaries, local leaders, partners, and YAM members were carried out in Sikasso and Koulikoro.

Focus group discussions, with a.

Young people participating in and receiving support and access to resources through the programme

Young people acting as implementers of the programme as peer educators and trainers

Young people who serve as representatives of young peopleâ&#x20AC;&#x2122;s organisations at the national and community level

Parents

Local community leaders

Teachers

Traditional healers

Local government officials and health workers

Religious leaders

Interviews with key informants including a.

Staff of the YIF, including the leadership, and consultants responsible for providing guidance and support to the four partner organisations

Staff at the MAs

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Representatives of regional and central offices of the IPPF

Representatives from the leadership of young people’s organisations

Local government officials

Telephonic interviews with representatives of IPPF Central Office and the Africa Regional Office

Participatory methodologies, including theatre and art exercises and small group work, to understand the views and perspectives of young people. To give an example of the participatory methodologies that were used, a theatre exercise was used in Bangladesh, to get an understanding of how the Youth Incentives project was trying to counter some of the messages related to gender and sexuality that young people traditionally received, which came from a paradigm which sought to focus sexual and reproductive health seeking behaviour on abstinencerelated approaches and was not supportive of the expression of the rights of young people in the area of gender and sexuality, as defined by international agreements like ICPD+5, and the Declaration of Sexual Rights. Young people were seated in a circle. At the centre of the circle, a chair was placed. Young people were told to imagine that sitting in the chair was a young person, either male or female, of any age from 3 to 24. They were then asked to come up and look at the ‘person’ in the chair, and convey a traditional message related to gender or sexuality that they had heard themselves or heard being used with young people. The evaluator- facilitator provided a couple of common examples from the subcontinent like “Keep your legs together when you sit down. Don’t you have any shame?” and “Why are you crying? Are you a boy or a girl?” Young people came up with several such examples related to gender and sexuality. In the second part of the exercise, young people were asked to come up and look at the ‘person’ in the chair, and this time, convey a message related to gender and sexuality that they had learnt through the YIF project. The stark differences in the messages, and the impact of the project were clearly revealed.

Other participatory methodologies used included:

Role-play in a theatre piece presenting the views and interactions of young beneficiaries, former young beneficiaries playing the role of YIF, ARBEF staff and parents

Discussions on a specific situation before and after participation in the YIF project: e.g., “A friend of yours is not interested in using condoms, how would you talk to them before and after YIF program”

Drawings and writing by beneficiaries on their ideas about sexual rights before and after the YIF program

Storytelling

The rationale for using such methodologies was to try and obtain the perspectives of the insiders and other relevant actors involved in the project at different levels, so that decisions regarding project design, implementation, and monitoring could be understood

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from as much of an insider’s perspective as possible, while equally trying to understand the impact of these decisions from the perspective of those affected. In order to triangulate the information obtained in this manner, data was also collected through: 6.

Field observations (e.g., of the functioning of FPAM clinics, of the Tarar Melas in Bangladesh, of Youth Clubs in Rwanda, etc)

Observation of training sessions (e.g., of the Communication Training provided by the consultant from YI for peer educators in Bangladesh)

Document reviews. Documents reviewed included: a.

Partnership agreements and contracts, Annual Work Plans and Reports at periodic intervals from MAs, and feedback from YI consultants

YI External Evaluation Report 2005-2008 Phase

YI Research Reports (e.g., on young people’s access to SRH services in Bangladesh)

YI publications including brochures, presented at conferences, etc.

toolkits,

training

manuals,

papers

Data was recorded through multiple methods including note-taking, photography, videography, drawing, etc. The data so collected was analysed for patterns and themes, to determine findings related to the research questions. One of the most critical elements of the evaluation methodology was the decision to include youth evaluators to support the evaluation in each country. The youth evaluators played valuable roles, including establishing rapport with the community, helping with the ‘insider-outsider’ perspective of the evaluation methodology, translations and provision of a young person’s perspective on the project and the evaluation process. This also helped to maintain the youth participation aspect, a critical part of the RAP rule, in the evaluation. Young people were much more inclined to open up and share their views frankly in the presence of one of their peers. Older people were pleased that a young person from their country was involved in the evaluation of the programme, and it served to further underline the philosophical approach of including young people. 2.7 Ethical and Equity Considerations The primary ethical and equity consideration was that young people constituted a very essential and valuable source of data for the evaluation, and it was important for evaluators to keep in mind the power differential between them and the young people being interviewed, and carry out interviews and focus group discussions after providing full information related to the purposes of the evaluation and the use to which data collected would be put. Evaluators planned the evaluation methodologies with YI representatives and programme managers to ensure that young people would be comfortable, and further, checked directly with them whether they were willing to participate in the process, and gave them the option to pass questions that they were uncomfortable with. Participatory techniques were used to increase comfort levels. A second major equity consideration was that in every project area, there was an obvious and felt need for the resources being provided by the project and the member associations. The resulting gratitude made it difficult for communities to refuse to be part of the evaluation. In Malawi, participants in the focus group discussions came across great distances, sometimes walking over 10 kilometers to participate in the evaluation. Hence, the onus was on the evaluators to be very aware of these equity issues and be respectful and participatory in their approach.

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2.8 Major Limitations of the Methodology The major limitations of the methodology were:

The paucity of time. The evaluation team felt that there was insufficient time built in for field visits, data analysis and report writing, less in terms of number of days allotted as in terms of the duration of the evaluation period. This made prolonged engagement impossible, which affects the validity and reliability of the data generated. It also made cross-verification of certain facts, post-data analysis, more difficult.

Given the limited time available for the evaluation, the evaluators were dependent on the cooperation of the MAs to plan the logistics of the evaluation visits to the field. This compromises to a certain extent the reliability of the methodology, and increases the need for triangulation.

By far, the most important limitation of the evaluation was the extreme need felt by most of the project beneficiaries for the project. This makes it difficult for them to be objective about the project, especially as they know that in many cases, the continuation of the project depends on a positive evaluation report.

The evaluators tried to counter these limitations by using a range of methodologies, described above, and a range of informants, to triangulate data that was gathered. Both evaluators are also seasoned professionals and relied on their instincts to probe areas where they felt required more attention. For instance, one evaluator noticed that the programme manager of the YI project at FPAB was very reluctant to organise a field visit to the Dhaka district project. Without indicating to him that she had noticed this, she sought information on the functioning of the project in Dhaka from several of the senior officials at FPAB. The enquiries revealed certain management and administrative issues, as well as certain field issues which were hampering the optimal functioning of the project in this district. Among the issues were the following:

There are several NGOs working in Dhaka slums, which has made the community expect a quid pro quo in cash or kind for participation in projects, making it difficult to work in the Dhaka slums.

Though alternative target areas were identified in the outskirts of Dhaka district, the FPAB Dhaka clinic continued to be attached to the headquarters, so that the awareness that was raised could not be translated into access to services at the clinic. At the same time, attendance at the Dhaka clinic was less than optimal.

The District Officer in Dhaka district was perceived to be comparatively less effective and showing less initiative for the implementation of the project.

However, this issue had come up for discussion within the larger organisation7, and after much debate and overcoming the opposition of those staff at HQ who felt the Dhaka clinic should remain at the headquarters, it had been decided that the Dhaka clinic would be shifted closer to the project area where it would benefit more vulnerable people, and assist in the effective functioning of the project. During the evaluation visit, the first steps towards shifting the clinic were underway.

With this insider information, the evaluator again confronted the programme manager about his reluctance to organise a field visit to the Dhaka project area. He then admitted that he had been trying to deflect the evaluatorâ&#x20AC;&#x2122;s attention, and that the information that she had gathered from other sources was indeed correct. The evaluator 7

FPAB (February 2010). Report on Annual Project Review Workshop 2009. Bangladesh: Dhaka.

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suggested that given that, firstly, the overall performance of the FPAB project went far beyond the agreement with YI, and secondly, FPAB had been willing to face the problematic issue and take steps to solve it, the sharing of this issue would not be perceived negatively by the donor or the evaluator. Rather than presenting a uniformly rosy picture, sharing the problems and the steps taken to solve them would help to present FPAB as a resilient organisation that was willing and able to confront difficult issues. In another example, at one of the focus group discussions with local community leaders, including traditional counselors at TA Tambala in Malawi, the evaluator noticed that one of the traditional counselors, who was much older than many of the other participants, was listening intently to the discussion but not participating. After a while, she respectfully invited her to share her views. It turned out that this older participant felt much less constrained about decorum, and was willing to discuss many local cultural practices related to sexual mores much more explicitly, compared to the younger participants who were much more restrained and polite in discussing these, probably because they did not want to present their culture in a negative light to an outsider. While some participants were initially uncomfortable with the elderâ&#x20AC;&#x2122;s openness, they then joined in to talk about practices that were no longer regarded as politically correct, but which nevertheless continued to be practised and hence were relevant. It thus became possible to take the conversation to a whole new level as a result, and the evaluator got a greater understanding of some of the really significant changes that had been wrought by the project, like winning the support of these traditional counselors. 2.9 Composition of the Evaluation Team The lead evaluation team consisted of two consultants from Africa and South Asia. The consultant from Africa was responsible for the field visits to the two Francophone African countries, Mali and Rwanda, and the consultant from South Asia was responsible for the field visits to the two Anglophone countries, Bangladesh and Mali, and to the Netherlands. The consultants were assisted by young evaluators in each country. They included:

Ms. Mahfouza Rahman in Bangladesh

Mr. Chikondi Liwonde in Malawi

Mr. Boubacar Sidibe in Mali

Mr. Joshua in Rwanda.

The evaluation also benefited from the support of Ms. Chantal Muhoza, a YAM member, who assisted with translation in Rwanda. All of these young people, except Mr. Boubacar Sidibe, had been trained by YI on M&E and Research.

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Programme 2009-2010

Chapter 3 The MFS Phase of the YI Programme Context, Key Concepts and Processes 3.1 Introduction and Context The Youth Incentives Trust Fund (YIF) was established in 2005 to work with member associations of the International Planned Parenthood Federation8 which were working together with at least one youth organisation, to share the Dutch approach which proactively addresses young people’s sexual and reproductive health in partnership with them9. Members of the YIF included Youth Incentives, the IPPF and four IPPF member associations. The IPPF member associations who were part of the project were encouraged to develop interventions that were innovative or addressed new target groups, themes, methods and strategies. These were to incorporate all three elements of the RAP Rule10, which advocates a Rights-Based Approach, Acceptance of Young People’s Sexuality and Participation of Young People in programmes and policy initiatives related to sexuality, as well as one or more elements of the five A’s of IPPF (Adolescents, Access, Abortion, HIV/AIDS and Advocacy). The four member associations considered first were Bangladesh, Tanzania, Rwanda and Eritrea. As the proposal was met with political objections in Eritrea, the fourth country was changed to Malawi. An initial needs assessment was carried out using a tool developed for the purpose, the RAP tool, together with focus group discussions, interviews, a self-administered questionnaire, etc. Based on the information generated by the tool, proposals were prepared to support the four member associations.

FPAB, Bangladesh was to promote SRHR of students, casual and employed labourers including rickshaw pullers, sex workers and intravenous drug users in the 10-24 age group in Dhaka, Chittagong, Jessore and Faridpur through youth participation.

FPAM, Malawi was to promote SRHR, acceptance of young people’s sexuality and access and use of SRH services among young people, their partners and parents in TAs Kachindamoto and Tambala in Dedza District.

ARBEF, Rwanda was to improve the SRHR of child-headed households (CHH) and young people living with HIV/AIDS (YPLHA) in the districts of Gisagara, Huye, and Nyanza.

UMATI, Tanzania was to promote sexuality education in schools, targeting young people between the ages of 9 and 19 in primary and secondary schools in Kibaha Town and Rural regions. This phase of the programme, funded by the Thematic Co-financing Fund (TMF) of the Dutch Ministry of Foreign Affairs lasted from 2005-2008.

Youth Incentives (2009). Youth Incentives Fund: Plan of Operation User Guide. 2009-2010 Second Phase. The Netherlands: Utrecht. 9 The Dutch approach emphasises evidence-based pragmatism with respect to young people's sexuality, and is its results are reflected in a comparatively low prevalence of teenage pregnancies, abortions and STIs in the Netherlands. 10 ibid.

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The final phase of the programme, funded by the Co-financing System (MFS) of the Ministry of Development Cooperation lasted from 2009-201011. In addition to the countries which were part of the TMF Phase, AMPPF, the member association of Mali included in the MFS phase of the programme12. Following an unsatisfactory performance, the partnership agreement with Tanzania was brought to an end in 2009.

The Mali project was to be a youth-led and youth-targeted initiative called Youth to Youth to promote acceptance and promotion of SRHR and access to SRH services for young people in Koulikoro and Sikasso.

This phase of the project was also designed to put special effort into addressing difficult themes related to young people and sexuality, namely, gender-based and sexual violence, abortion and sexual diversity13. 3.2 Rationale The support for this programme comes from the commitment of the Dutch government to the agreements of ICPD+5 and MDGs 3, 4, 5 and 6, which led to the recognition of a need for specialised programmes targeting the sexual and reproductive health of young people in particular. Partnering with Rutgers Nisso Groep and Youth Incentives in this process justified itself by the expertise that this integrated organisation has developed in comprehensive sexuality education, and in particular, in working on this sensitive issue with young people. Significant underachievement of goals led to discontinuation of the project in Tanzania in the MFS phase. In the other three countries from the TMF phase, namely, Bangladesh, Malawi and Rwanda, the rationale for the MFS phase of the project was to build on the work done in the TMF phase, given that the objectives of the programme were to be achieved against the force of cultural traditions that did not easily recognise young peopleâ&#x20AC;&#x2122;s sexual and reproductive rights, accept their sexuality or allow their participation in programmes and policy development affecting these aspects of their lives. As such, these were objectives that could not be achieved in a few years, but needed to be worked on long-term. Also, given the needs that were established in the needs assessment conducted in the TMF phase, there was a greater chance of sustainability if the projects could be continued in the MAs long enough for their learnings to become institutionalised, and for the important elements to become part of the core programme. The rationales for the YI projects in Bangladesh, Malawi and Rwanda have been addressed at length in the evaluation report for the TMF phase, and in the MFS phase, the three projects, tried to build on the achievements of the TMF phase, and essentially represented a continuation. For example, young people constitute a third of the population in Bangladesh, and while Bangladeshi social customs discourage premarital sexual activity, information from the ground showed that young students constituted the second largest group of clients of sex workers in the country14. The YI project in Mali was part of a larger project on SRHR of the Royal Dutch Embassy of the Netherlands. 11

Youth Incentives (2008). Workplan 2009. MFS-YIProgramme. 2009-2010. The Netherlands: Utrecht.

Youth Incentives (2009). Annual Report 2008. The Netherlands: Utrecht.

Youth Incentives (2008). Workplan 2009. MFS-YIProgramme. 2009-2010. The Netherlands: Utrecht. FPAB (2008). 2nd Phase YIF Project: FPAB Proposal. Bangladesh: Dhaka.

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The larger rationale for such a project was on the one hand the poor access, especially for the poor, to SRH services in Mali; a high maternal mortality rate of 1,200, and a high proportion of young people with over 65% of the population being under the age of 25. Of the young population, about 60% have initial sexual intercourse before 18 and 70% are sexually active. The fertility rate of the 15-19 age group was 188 per 1000 women and the maternal mortality for this age group was .763%. In addition to the strong arguments in favour of the project generated by the secondary data, the specific needs assessment conducted prior to the project suggested that sexual violence and unwanted pregnancies were major issues for young people. These were also linked to other issues such as limited opportunities for economic development, illegal and unsafe abortions, physical and mental stress, etc15. The project chose to work in two areas, Sikasso and Koulikoro, which were very vulnerable. For instance, one school in Sikasso revealed that up to 50% of its girl students were pregnant by the time they reached high school. The closure of the main employer in Koulikoro, coupled with the inward temporary migration of male workers in the sand mining industry who had greater economic power, increased the susceptibility of the local population to imbalances in power and rights related to sexuality, and the ability to make informed and empowered choices which safeguarded their sexual and reproductive health. In this MFS phase, the rationale was also to build on the trust and the experience developed in the TMF phase of the project specifically to address the third objective, namely to reduce resistance to sensitive youth sexuality issues. As the first work plan for the MFS phase explained:

â&#x20AC;˘ â&#x20AC;˘ â&#x20AC;˘

YI believes that, as a Dutch organization, it has a responsibility to help put or keep sensitive issues on the agenda. Crucial to the success of prevention programmes is a thorough fit to the realities and needs as experienced by the specific target groups, not a moral judgement of their sexual behaviour or orientation. Especially in a context of strong conservative influences that prefer an abstinence-only-until-marriage approach to sexuality, there is an urgent need to advocate for sexual and reproductive health and rights as agreed in Cairo (ICPD) and to promote comprehensive sexuality education programmes. From this conceptual framework YI and its partners will target some sexual taboos in 2009 and 2010, in order to advocate SRHR for youth. Special effort will be put into addressing three specific themes: sexual violence abortion sexual diversity (Youth Incentives, 2009)

3.3 Stakeholders and Beneficiaries The primary beneficiaries of and contributors to the projects were the young people in the target areas of the four projects in Bangladesh, Malawi, Mali and Rwanda, including more empowered members of this group like Youth Club members, Youth Action Movement and Youth Parliament members, peer educators and youth organisers. The focus on youth participation in design, implementation and monitoring meant that this group also formed the most important stakeholders of the programme. Other beneficiaries and stakeholders included: 15

Youth Incentives (2010). Youth Incentives Fund Project: Partner Description and Qualitative Results 2009. The Netherlands: Utrecht.

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The local community, which benefited from increased resources, including economic, human and knowledge resources, apart from improved service provision. The project also represented an opportunity for local communities to critically analyse and, if necessary, modify social practices which they felt compromised the sexual and reproductive health and rights of young people. In turn, advocates from within the community provided the necessary local support and insider knowledge necessary to make the project successful and sustainable.

Among the local community, the stake and roles of traditional arbiters of norms related to young people’s sexual health and rights, including the family, teachers, traditional counselors and healers and religious leaders and institutions needs to be specially acknowledged. To the extent that the project was able to build bridges and enlist the backing of these stakeholders, it became more viable.

The local governments, whose resources were extended and supplemented by those of the project, and who, in turn, provided institutional support and possibilities of upscaling for the project;

Service providers and staff of the MAs, who benefited from increases in built capacity, and were critical for the implementation of the project;

The member associations, which were able to both contribute to and benefit from the philosophies, strategies and resources from the project;

Youth Incentives, which received opportunities to contribute its resources and learn from the realities of young people’s sexual and reproductive health and rights issues in different countries, and be challenged to respond to them in essential and creative ways;

The IPPF, which could collaborate with, contribute to, and learn from the programme, and find new and interesting ways of building on the resources and learnings from the programme, and potentially extend these to more member organisations, and was consequently, critical for the potential sustainability and replicability of the project.

In Malawi, the project is co-financed by the organization Simavi, which partners with YI.

Hence, the project was a well-balanced one, with opportunities for giving and taking on the part of all stakeholders, which contributes to the long-term strength and sustainability of project objectives and strategies. 3.4 Conceptual Model The conceptual model underlying the programme is that of the “RAP Rule”, which underlies all YI youth programmes, and all partnerships for youth programmes is predicated on the assent of both partners to commitment to this rule. The core concepts of the RAP Rule are

Acknowledgement of, and commitment towards, recognizing and realizing young people’s sexual and reproductive Rights

Acceptance of young people’s sexuality

Participation of young people

These concepts are derived from international human rights standards, ratified by countries in which partner organisations are located. Since all the partners of the YIF project are members of IPPF, this basic conceptual model links with that of the five A’s of the IPPF, namely, taking into account Adolescents, Access, Abortion, HIV/AIDS and

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Advocacy16. Another element in the conceptual model is that of a participatory approach, which feeds into practices like needs assessments, project design and monitoring undertaken in a participatory way. Since raising awareness on rights-based issues and needs, without creating the environment and human, physical and technical infrastructure necessary to meet those needs and realise those rights would fundamentally undermine the ethical base of this conceptual model, the model also recognises the importance of building the necessary capacity, and carry out improvement of health services, and undertaking advocacy to create a more suitable environment in which SRHR can be realized. 3.5 Project Monitoring System Special attention was paid to project monitoring in this phase of the programme17. Accordingly, each organisation received technical visits on monitoring and evaluation and a detailed training on the topic to build capacity of the MAs. In addition, a handbook and a trainer’s manual were prepared to serve as longer term resources for the partner organisations. Both qualitative and quantitative indicators were developed for the project in a participatory way, which were developed and refined using the SMART (Specific, Measurable, Achievable, Relevant, Time-Bound) principle. A matrix was developed which specified Outputs and Outcomes for each Specific Objective of the programme, and asked for clear delineations of the interventions that led to these Outputs and Outcomes. Because MAs had showed a tendency to focus on outputs (e.g., x number of trainings conducted in this particular half-year), special attention was paid in this phase to building capacity of MAs on a variety of data collection methods, and in particular, qualitative data collection methods, including methods for checking validity and reliability like triangulation, analysis of qualitative data generated, and qualitative research reporting. Consequently, in this phase, the project was better able to capture the voices of people whose lives had been impacted by the programme, and present case studies and learnings in the reporting. The programme was monitored at several different levels: Level Monitoring Field

Examples Monitored

Elements

•

Field level building conducted

capacity trainings

•

Youth Club meetings facilitated/organised/ attended

•

Contacts leaders

•

School

with

Persons Responsible

Examples Sources

Data

Peer educators/ Youth organisers

•

Daily registers

•

Interviews/ Focus group discussions with stakeholders

activity

local

meetings

Retrieved at www.ippf.org/en/What-we-do on January 31,2011. Youth Incentives. (2009). Workplan 2010: MFS YI Programme. 2009-2010. Ther Netherlands: Utrecht.

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Field

MA Project Field Office/ District Head Office

MA Head Office

•

Number of calls received on hotline

•

Number of referrals to health service professionals

•

Work plans educators/ organisers

•

Actual out

•

Contacts leaders

•

Support services provided to peer educators/ youth organisers

•

Congruence of planned and executed activities

•

Necessity for handholding support for effective functioning of peer educators

activities

with

peer youth

Field coordinators/ Project Monitoring Committees/ Steering Committees

•

Daily registers

•

Interviews/ Focus group discussions with stakeholders

•

Daily activity registers of peer educators and monthly reports of field coordinators

•

Interviews/ Focus group discussions with stakeholders

•

Quarterly/Half yearly/ Annual reports of Project Coordinators at district levels

•

Meetings with PMC Members, District Level Project Coordinators, etc.

•

Field

carried

activity

local

•

Necessity of advocacy with local leaders to ensure smooth functioning of project or institutional support

•

Identification of potential capacity building needs

•

Periodic balancing of allocated budget and actual expenditure

•

Congruence of Annual Work plan with Completed Field Activities

•

Identification of Potential Problem Areas

•

Identification of Learnings from Project

•

Identification of areas for advocacy at national level

Project Monitoring Committees/ Steering Committees/ Project Coordinators at district level/ District Officers

Programme Manager/Project Coordinator at national level/Finance Manager/Executive Director

visits

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IPPF Regional offices and Central Office

•

Identification of potential course correction needs

•

Identification of potential capacity building needs

•

Project management

•

Congruence of Annual Work plan with Completed Field Activities

•

Identification of Potential Problem Areas

•

Identification of Learnings from Project

•

Identification of areas for advocacy at national level

•

Identification of potential course correction needs

•

Identification of potential capacity building needs

•

Project financial management, including fund flows and maintenance of accounting standards

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Programme Manager •

Interviews with relevant stakeholders

•

Half-yearly and annual programmatic and financial reports from MAs

•

Field visits by Consultants and Technical Experts

•

Interviews/ Correspondence with relevant stakeholders

•

Research reports (commissioned by IPPF)

•

Reports of sharing and learning days

•

Extra reports

•

Half-yearly and annual programmatic and financial reports from MAs

•

Reports of Annual Meetings YI Fund

•

Programmatic reports shared by YI

•

Correspondence and meetings with

financial

•

Sharing of learnings across project sites

•

Identification of Potential Problem Areas

•

Review of stated capacity building needs and planning of capacity building events and materials

•

Review of project and financial management at MA and YI levels

•

Identification of Learnings from Project

•

Identification of areas for potential further collaboration

Consultants responsible for particular country/ Finance Department/ Programme Head

YI Programme Manager and Senior Management Team

ARO and SARO Youth Officers, Central Office staff

activity

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â&#x20AC;˘

Identification of concepts, strategies, practices to be upscaled to other MAs

YI consultants and MA programme managers and executive directors

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Chapter 4 Evaluation Findings The findings of the evaluation have been grouped in terms of the quality and relevance of the design of the programme, and the effectiveness of the programme as indicated by progress towards the objectives and results, both quantitative and qualitative. This section also explores the contributions of the various stakeholders in the programme, and the constraints and obstacles faced. The relative efficiency of planning and implementation is analysed and an attempt made to determine the impact in terms of progress towards the vision and goals of the programme. The findings related to the sustainability and replicability of the impacts of the programme, which are also related to the capacity that has been built in the programme are also presented. Relevant institutional and stakeholder issues have been highlighted. The evaluators also share some of their insights into the findings, flag some innovations, and make recommendations, based on their findings in this section. 4.1 Design: Quality and Relevance Across the board, different stakeholders, whether within YI, the MAs, local communities, or young people, felt that the keystone of the design, the RAP approach, had been the most significant factor in the programme. The three elements of Rights, Acceptance and Participation, formed a virtuous cycle that both supported and challenged each other. It was difficult for implementing agencies as well as communities to completely reject the Rights discourse, which, however much it may be violated in practice, functions as if it is a fait accompli in modern societies, if only because the countries in question have ratified the international agreements which supports this discourse, even if it is not perceived as part of the traditional cultures. As organisations with stated missions to support young people, and speaking the language of rights, the approach to actually include young people’s participation appeared logical, even if it had less of a strength in the past, in spite of IPPF initiatives in this matter18. However, both for any real acknowledgement of rights, or demonstration of young people’s participation, acceptance of young people’s sexuality was critical. Within the keystone of RAP, acceptance really represented the proof of the pudding, which determined whether rights were respected, and participation not only permitted, but actively encouraged and celebrated. In this sense, making the RAP approach the base of the design of the programme was perhaps one of the most important factors that affected the quality and relevance of the programme. In addition, in the 2009-2010 period, adjustments were also made in the design of the programme following the mid-term evaluation, to address specific concerns, which especially related to quality and relevance. Issues addressed included:

Laying greater emphasis on advocacy about the programme within the local community, especially parents, which has made a tremendous difference to final outcomes of the project in the 2009-2010 phase.

Changing target groups where this was found to be necessary – in Bangladesh, the programme changed from being targeted at specific vulnerable target groups like sex workers and rickshaw pullers to a more mainstream programme, because the peer educators had been drawn from the mainstream. Consequently, the numbers reached improved tremendously in the second phase.

Specific concerns raised in the report, related to the quality and relevance of the design led to other adjustments, including:

IPPF (2004). Setting Standards for Youth Participation: Self Assessment Guide for Governance & Programmes. United Kingdom: London.

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the creation of trainings and relevant IEC materials which addressed identified needs in MAs19

increased sensitisation and capacity building training for service providers, which led to the provision of more youth-friendly services20

strengthening of youth organisations21

increasing involvement of young people in more and different ways, which increased ownership and commitment to the project22

improved monitoring and evaluation

improved reporting, which in turn led to smoother fund disbursement.

Other elements in the design, which looked at the details of how the programme would reach young people, also affected quality and relevance. For example, paying real attention to the degree to which young people who were the targets of the programme lacked access to resources. Thus, when young people designed the Mali project and included a telephone hotline, it was designed in such a way that young people without resources could send a free SMS and receive a call back, so that they did not have to pay for the call. This also represented a creative use of the new digital media to address the not inconsiderable problem of the relative locations (often distant) between service provider and young person. Taking on tricky issues like abortion, sexual diversity and gender and sexual-based violence and putting it on the agenda in a way that it could not be ignored, even if not quite addressed (e.g. in the form of project activities), also contributed to the quality and relevance of the design in this phase. While all these helped to advance the quality and relevance of the design, the overall approach still has a strong bias towards a focus on the individual young person. It takes some significant account of the importance of working on the surrounding environment as laid out in objectives 3 and 4 (namely, improving conditions for young people to exercise rights and reduce resistance to sensitive issues), but does not fully appreciate the constraints of the individual in the context of the different kinds of pressure that can be exerted by the role of the family and the community. A young person in a traditional setting may have complete knowledge of rights, access to services, a support network of peers, etc., and still be subjected to tremendous pressures when traditional cultural practices like arranged marriages are concerned, which pose a challenge to the design of the project. For example, peer educators at Khulna said that after one of their community sensitisation meetings, they were approached by a young man who said that his wifeâ&#x20AC;&#x2122;s family was planning to marry off her twelve year old sister that week, and sought their help to stop the marriage. The peer educators suggested that he meet the district officer to strategise. By the time the peer educators followed up a week later. The wedding had already taken place. The person who sought help was male, and the elder son in law of the family, and so had status, and yet felt unable to oppose what was both an illegal action and a rights violation. The peer educators too felt unable to support him, referring him to an older adult. At that stage, so close to the wedding, any intervention that could 19

Youth Incentives. (2009). Workplan 2010: MFS YI Programme. 2009-2010. The Netherlands: Utrecht. 20 ibid. 21 ibid. 22 ibid.

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have worked would have had to come from some significant position of authority, e.g., the police, or a religious leader refusing to conduct the wedding because it was illegal. The young man clearly felt unable to jeopardise his own position within the family by subjecting the family to an intervention by police, and hence sought help. The peer educators also felt uncomfortable about taking such a big step. If they had immediately taken the initiative to contact the district officer themselves, and together, they had got other NGOs in the area (e.g., women’s rights and child rights organisations, and legal rights organisations, etc.), action could potentially have been taken, while ‘spreading the blame around’ so that the personal consequences for the young man trying to stop the wedding would have been reduced. Without that support, he felt unable to make an effective personal intervention, and the marriage went ahead. Likewise, in Malawi, the YAM president reported that in certain poor communities, families which felt that a sonin-law was doing a lot for them economically, would offer him another daughter, often a young child only 11 or 12 years old, as a second ‘wife’ or sexual partner, saying “We bring you a gift.”. The family often saw this as a perfectly legitimate way of expressing their gratitude, and the girl child in question usually got no support if she protested. Even the mother might say “I did that myself. Who are you to protest?” If the husband is reasonable, the child may get to go to school, but as a married woman. Otherwise, the child’s schooling would stop. The half-yearly programmatic report of FPAM states "More girls still enter into early marriages and there is not much respect to the choice of the partner in most arranged marriages. Most young...girls still think it is the responsibility of the boy in a relationship to decide when to have sex.23 The report went on to say that "the girls feel more valued in a relationship" when the initiative for sex comes from the boys. The project did understand the importance of the role of the community, and did make a strong effort to involve them, particularly with the adjustments that were made after the TMF phase. For example, in Abraham Village in TA Kachindamoto, after youth club members had performed a play on the evils of forced marriage, a father trying to arrange a marriage for his young daughter studying in primary school with a well-to-do person, found unexpected opposition from his wife. She requested him to continue letting the child go to school, as if she got married, she might get pregnant, and face complications in labour. She also pointed out that the proposed groom was much older and who knew how many relationships he had had, whether he was HIV positive or not, and so on. The village headman, who was called to negotiate, was a supporter of the FPAB project. He said that he did not want any avoidable maternal deaths in his village, and convinced the father to continue sending his child to school. Hence, the relevance and quality of the design were apparent throughout the evaluation process. However, as S.M. Sohail, one of the youth counsellors pointed out, sometimes, they continue to have to resort to a little subterfuge, even after they have obtained permission to conduct the classes. “Sometimes the teachers come to monitor our classes. Then we talk about topics like ‘eve-teasing’ and women’s rights. When the teacher leaves, we give more explicit information. When the teacher comes back, we go back to discussing women’s rights. We also tell them to come to the Tarar Mela, so that we can give them the information they need without the knowledge of the teachers.” Also FPAM reported that in meetings held with the chiefs, older members of the community feel that "young people do not need to enjoy sex" and "allowing young boys and girls the freedom to do what they want is something they would make sure to stop 23 FPAM (2010) Youth Incentives Fund Project: Programmatic 1st Half Year Report 2010. Malawi: Lilongwe.

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because they that that it is giving young people too much freedom which will cause more problems."24 In trying to propagate the rights discourse and practices inspired by that discourse, the project is also trying to counter the weight of cultural traditions that are sometimes hundreds of years old. Progress is, almost inevitably, slow. As late as January 2011, the village arbitration council of Shariatpur village in Dhaka division sat in judgement over a 14-year old girl who had been raped by a 40 year old relative the previous day. They decreed that the young girl be punished with a 100 lashes. After 80 lashes, the girl collapsed, and was taken to hospital where she died25. In the context of many cultures, patent injustice perpetrated with community consent against groups with less power, or marginalised in some way, is not only possible, but real. In such circumstances, the limitations of young people’s individual agency must be compensated for with adequate attention to systemic and structural changes and the building of a strong adult ally group. The importance of continuous and strong local advocacy is further emphasised here. "It took me and the project volunteers some time to convince the imam, but we visited him over and over again, and finally he understood that it is an important project. In Islam, it is the parents' responsibility to educate their children. The imam agreed that education about relationships and reproduction is part of this education, and that parents should talk to their children more about these issues, it is their responsibility. That is why he now supports the Youth to Youth project and he has allowed to have a community meeting on their mosques’ square, which is normally never allowed." Focal point, Koulikoro, Mali26 4.2 Effectivenes Progress towards objectives and results Overall, the progress towards the objectives and results envisaged during the design of the project has been excellent. The first four objectives of the YIF programme were a.

To increase the number of young people who recognise and realise their sexual and reproductive rights

To improve the conditions for young people to exercise their sexual and reproductive rights

To reduce resistance to addressing sensitive youth sexuality issues

To increase youth participation in partner organisations and RNG.

The evaluation found that the programme was very effective in advancing towards the objectives and results envisaged, as determined by several indicators. 4.2.1 Gains in Knowledge There have been significant increases in the numbers reached across the four partner projects, ranging from several thousands in Bangladesh to several hundreds in Malawi. a.

Bangladesh used creative strategies to upscale the project from the 4 districts envisaged in the original proposal to 21 districts in the country27, with a

ibid. “Teen raped, whipped to death.” Deccan Herald, February 4, p. 14, columns 7-8. 26 Youth Incentives (2010). Youth Incentives Fund Project: Partner Description and Qualitative Results 2009. The Netherlands: Utrecht. 27 FPAB (2008). 2nd Phase YIF Project: FPAB Proposal. Bangladesh: Dhaka. 25

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corresponding increase in the number of young people reached. Further, because of the relative population density of Bangladesh, a project initiative in even a small area is able to reach hundreds, and sometimes, thousands of direct beneficiaries (e.g., through awareness programmes held in local schools.) Field observations showed that the Tarar Mela initiative28, to open up youth friendly spaces within the FPAB clinics, which was implemented in 13 districts, was very successful. These spaces had various resources for young people like books, computers with an internet connection, board games, etc. There were separate toilets for boys and girls, and male and female youth counselors, both of whom had private spaces apart from the common area. The Tarar Melas also offered courses of various kinds, in spoken English, computers, singing, dancing, etc., to try and break the link of FPAB solely with family planning in the public perception, and create an impression of a youth resource centre. Such spaces are few and far between, so young people did see this as a resource. The safety they felt there also enabled them to approach the counselors with sexual and reproductive health concerns, if any. If they were still too shy to approach the counselor, they could drop their questions in a question box. At periodic intervals, the counselors put up the answers to the questions on the notice board for everyone to read. This way, the questioner could get information without having to be singled out, and simultaneously, the information reached other young people who might have the same question. Through innovative techniques like this, the Tarar Melas have played a significant role in opening up the FPAB clinic spaces as a place that was youth-friendly and accessible, and consequently the number of young people dropping in had gone up in some areas to almost a hundred a day. b.

The project reached several hundreds of young people in Dedza district in the Malawi project. While in comparison to Bangladesh, these numbers may seem small, given the geographical spread and relative inaccessibility of the tiny hamlets in which most of these young people live, this is a creditable achievement.

In addition to this, significant gains in knowledge, which lead directly to the recognition and realisation of young peopleâ&#x20AC;&#x2122;s SRHR, have happened with peer educators, Youth Action Movement (YAM) members, and project staff and management in the Member Associations.

The use of new media like community radio has also assisted with increasing reach. The use of a telephone hotline helped young people in remote areas to seek information with confidentiality in Mali.

Quantitative information provided by the Monitoring and Evaluation Officer at YI, who collated the information related to numbers reached by the project in 2009 and the first semester of 2010, showed that the project had made very respectable gains with respect to the first objective of the project, as represented below:

Table 1: Numbers reached by the YI projects. In general the data for 2009 have been aggregated for the four countries the data for January to June 2010 are separate by country. Bangladesh Malawi Mali Rwanda Trainer of trainer 19 (now called training (directed master trainers) at peer 28

ibid.

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education) Training of youth organizers (by the PE’s who had TOT training earlier) Empowerment training (2009) Training on communication about sexuality (2009) Number of young people trained on aspects of project cycle management (2009) Training of community counsellors Training of field level managers Training of PMC members

116 people 5 sessions

In Malawi and Bangladesh RAP trainings were organised for MA staff and young people, where gender and empowerment were central aspects. Over 100 girls and 50 boys were trained in empowerment relating to SRHR. In Mali, Bangladesh and Rwanda, a training on communication and sexuality was executed; over 50 young people were trained. People who participated in activities on sensitive themes: Over 60 staff 30 young people 23 young people involved in the project trained on Monitoring, Evaluation & Research • 30 young people trained in project cycle management • 30 young people trained in communication skills and youth-friendly service provision • 30 young people trained in advocacy 19 people • • •

22 people Total number of PMC members: 126 Trained with funds from P-safe (RFSU/SIDA funded) and SALIN plus projects: 78 PMC members Trained with YIF funds: 48 The unspent fund in this head will be used to organize TOT for youth master trainers later this year. Duration: 3 days Facilitators: 1 master trainer

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and 2 co facilitators. Number of people who had a RAP training (in 2009)

Number of service providers trained on youth friendliness (2009)

Peer education sessions (2010)

Community meetings (2010)

• • • • • • • • • • • • • • • •

Over 3,700 young people (peer educators, YAM members and youth club members) over 1,000 teachers more than 300 staff from CSO’s over 500 journalists 20 parents nine MA staff members two service providers and two district officers 68 service providers 200 youth peer educators 30 community distributors 94 teachers 35 community counsellors 2 traditional healers 120 village head men/chiefs 12 religious leaders Sikasso 120 talks 180 youths (120 46 Peer girls, 60 boys) in 9 educators (34 on sexual youth clubs reached 9,094 violence, 17 on trained on SRHR young people (M: youth sexual (2 day training) 6,056, F: 3,038) rights and the with messages on others about STI's SRHR; GND, abortion, counselled 254 menstrual cycle youth on safer etc. sex, condoms, 3,666 youths took contraception part (M: 1,861 and rights; and F: 1,805 aged distributed 2,000 between 10 and male and 120 25; female condoms Koulikoro: 60 talks and 5 conferences reached 3,200 youths (of whom 400 at the school conferences) 110 people Koulikoro: 2 attended meetings, 650 people (150 men, Biannual 190 women, 170 meetings were boys and 140 conducted in girls).

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Communication workshop between youths and parents (2010) Number of community stakeholders trained (2009) Money paid for health insurance to cover medical costs Reagents purchased (to be used during VCT) (2010) Production of materials (2009)

Production of materials (2010)

Kamgunda involving 275 community members – 53 were youth from 5 youth clubs and 5 peer educators. The meetings revealed that 11 new youth clubs with membership of 213 (M: 145, F: 68) have been established following the sexual violence campaigns conducted in the two areas. 1; 10 youths and 20 parents (M: 13 and F: 17)

• • • • •

Sikasso: 2 meetings, 324 people (88 men, 127 women, 46 boys and 63 girls).

869 religious leaders 20 local project committee members 2,223 community stakeholders 26 teachers people informed through sensitisation: over 30,000 In 2009 4,000 CHH In 2010 3,615 1,000 aiguille, 1,000 tube, 900 determine and 20 uni gold

1,500 T-shirts and caps 500 training modules three bill boards were designed The Rwanda MA was supported in the adaptation of a sexuality and lifeskills toolkit 5 brochures translated into Bengali 1 film (A Jihad for Love) dubbed in • • • •

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Bengali Home visits to HIV+ youths (2010) Youth visiting health clinics (2009)

In Malawi and Bangladesh service statistics show an increase in the number of young people attending the clinics. In Bangladesh, the YIF programme has been mainstreamed in all clinics where an increase of 75% was noted in 2009; service provision to youth increased from 25,000 in 2008 to over 95,000 in 2009. In Rwanda and Mali young people themselves stated that more young make use of SRHR services and in Rwanda access to ARV and treatment for opportunistic diseases has increased. In Mali, there has been a large increase in condom distribution (in one district 18 times more than before the start of the programme). Examples from 2009 are: Over 300,000 condoms distributed or sold. Over 1,000 young people received VCT. Over 8,500 young people received counselling from youth- friendly services • 185 bicycles distributed that help to access clinics and provide HBC (home-based care). 2010: 25,729 2,726 young 2010: In Rwanda youth visited the people had clinics have youth friendly accessed Mjini become mobile: corners in clinics clinic’s Youth 20 VCT’s; (tarar mela) Corner since 669 youths were January, 2009 tested; 13 of them had to be sent to hospital for further testing; one of them proved H+. 73 YPLWHA attended • • •

Youth visiting health clinics And Mobile VCT

Follow-up meeting with YPLWHA (2010) Media (2009)

Media (2010)

Concerts

In Mali the project was covered four times by National Television, three times by national newspapers, and eight times on regional radio. In Bangladesh the project was widely covered by media and in Rwanda local media covered poetry competitions regarding the role of youth in HIV prevention. 76 journalists 5 radio emissions informed about (each with SRHR around 4,000 3 TV programmes listeners) mentioned SRHR 1 with youth 3 theatres (3,000 activists from 9 people attended)

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Campaigns 2010

Campaigns 2009 Telephone hotline (only for Mali)

districts 89 talent competitions held

6 mobilization campaigns conducted in the 2 areas

213 parents (M: 83,F: 130) 51 chiefs (M: 33, F: 18), 32 (M:17, F:15) traditional _counsellors, 11 (M: 7, F: 4) YAC Members and 25 (M:15, F:7) other opinion leaders attended the meetings. Over 14,500 young people received information on RAP through community events. 325 calls in 2009

248 calls from January to June 2010 Number of youths Over 130,000 young people were reached through training, peer education or reached school activities and have increased their capacity to understand and exercise their right to information, services, participation and enjoyment of sexuality. Number of youths Over 100,000 young people are part of youth groups. who are member of a youth group

4.2.2 Internalisation and Application of Information As revealed by focus group discussions with young people who were beneficiaries of the programme in the different countries, the programme was able to realise a distinct shift in the way in which young people learned about sexuality related issues, and then applied these learnings. There was a progression from receiving increased information about sexuality through the project, to internalisation of that information, to reflection on current practices as related to SRHR, to applying it to their own lives, to converting that knowledge into health-seeking behaviour,

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or action to improve expression of sexual and reproductive rights. There were any number of examples of these that emerged during the evaluation. For example: a.

In Rwanda, young people shared that they used to think people who used condoms were prostitutes, that condoms were for adult married people, got stuck in the vagina and caused cancer. After the program they gained a more accurate understanding of condom usage and learned that sexually active young people can use condoms to protect themselves from HIV/AIDS, STIs and unwanted pregnancies.

Young people have been able to actively resist debilitating myths and misconceptions regarding body changes during adolescence. For example in Bangladesh, young girls were prevented from eating several nutritious foods during their menstrual period. The project has been very effective in countering such myths and improving their nutritional status. Young girls have also been educated about how to hygienically maintain cloth sanitary pads, if these are used, to prevent the likelihood of infections.

Young men in Bangladesh believed that losing semen during wet dreams led to debilitation and wasting of the body, resulting in considerable emotional distress as well. To relieve these fears, they would visit quacks or street vendors of ‘medicines’, who played on these fears to sell their products.

In Mali, the coordinator of the AMPPF centre in Sikasso, "keeps meticulous track of the number of contraceptives sold in and around Sikasso. Since the arrival of the youth project, the sales have steadily been going up."29

“The availability of condoms is definitely a factor in the continuation of girls’ schooling. Previously, it was pregnancy after pregnancy.”- Mrs. Pulikeria, Village Head, Kakhobwe, Malawi.

“Our area is periodically visited by entertainment groups which play music the whole night or over a weekend. Young people used to flock to these, and the atmosphere tends to promote more and promiscuous sexual behaviour. Now I notice that even when these groups come, the attendance by young people has really gone down. They are much more responsible about their sexual behaviour. And if you come to our areas now, you will see many more girls in uniforms, going to school, compared to five years ago.” – Mrs. Feresta, Village Head, Andrew, Malawi.

“I want to thank the project. Previously, it was very difficult for young people and parents to discuss sex and related issues. Now, thanks to the training given by FPAM, we are able to interact with young people freely on these matters. The examples of improvement I am able to see in my area are provision of condoms, reduced incidence of STIs like syphilis and gonorrhea, and reduced incidence of early pregnancy. I am actually able to see the decrease of infections in my community. Mrs. Zeneida, Group Village Head, Kabulika, Malawi.

"I think people should not be shy when having sex. Before, I could not indicate I was not happy with having sex. Before we could only discuss if my

29 Youth Incentives (2010). Travel Report: M& E Mission to Mali by Gudule Boland, M& E Officer, Youth Incentives, RNG.

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partner was not happy. But I have learned now that sex is not only for men, it is for both partners. I learned from the project that pleasure belongs to both." Young person (female), Koulikoro, Mali30 i.

“Some time ago, I went to a young women’s hostel to give a session on SRHR. After the session, I gave the participants my mobile number so that they could contact me if they had any doubts or questions. Then I got a call on my mobile from one of the girls. She asked, “If we have sex without a condom, what will happen? I had sex without a condom.” I asked her how long ago that was, and she said two hours earlier. I suggested that she use the emergency contraceptive pill. Later I contacted her and asked her if she had any problem. She said that she was not pregnant. Then I explained to her that the e-pill would protect her from pregnancy but not from HIV or other STIs. When I checked back with her later, she said she and her partner were now using condoms.” – Rabiya Parveen, Peer Educator, Bangladesh.

“I gave a session on SRHR at the Bahadurpur School. A week later, I was woken up very early in the morning by my mother, who said someone had come to see me. It was a 14 year old boy, who as soon as he saw me, hugged me and began sobbing. He said that he had been at my session in the school. I was surprised because I had not given my address – he had tracked me down. He said that he masturbated regularly, and also had wet dreams and that he was afraid that his penis was shrinking. I assured him that wet dreams were normal and that masturbation would not cause him any problems, but to reassure him further, I took him to meet the Youth Counselor. The Counselor also reassured him, but after talking to him, suspected that he might have an STI. We persuaded him to undergo testing, and it turned out that he did have an STI. He was treated and got better. Now he keeps referring more young people to the Tarar Mela.” – Topu Raihan, Peer Educator, Bangladesh.

“Yes, there is an improvement. Earlier, if someone got an STI, we went looking for roots, and often we were missing the right diagnosis, and the herbs were not necessarily effective. Now, when they have problems, more young people are confident about going to the clinics for services.” – Mrs. Angela James, Village Head, Nkoholokhombwa, Malawi.

4.2.3 Contact with the project has given young people an alternative source of trusted health information That this is a real need is evident from the agonizing that young people do in relation to sexuality related matters at a time when they are developing their sense of self. As one young man in Rwanda shared: I have always been very curious about sex but every time I asked I was told that I was too young to talk about it. When I was twelve I fell deeply in love with a girl my age. We 30

Youth Incentives (2010). Youth Incentives Fund Project: Partner Description and Qualitative Results 2009. The Netherlands: Utrecht.

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decided to have sex. I asked but no one wanted to discuss sex with a very little boy. I promised myself that I would ask my parents again when I got older but they both died in the genocide. I remember they told me once when I asked them where babies came from that “the little creature came from the navel”. As babies come also from having sex, I concluded that sexual intercourse happens in the navel. So of course I tried this with my girl friend. It felt weird. Why do people make so much fuss about sex when it is not even fun? And the girl laughed so much at me. I promised that I would never have sex again. Equally, when they receive accurate information, their sense of confidence increases, and the need to experiment with risky sexual behaviour out of curiosity decreases. As one young woman said: I would love to have breasts so that I can be beautiful and walk with my chest wide open. I would love to have hips so I can walk and move them. But I am so small that it is desperate. They told me “If you want breasts, get those little insects that you find in water, let them bite you at the end of your breasts and they will grow for sure, for sure, yes for sure”. What about hips? man.”

“Oh, that is more difficult to grow.

You have to have sex with a

I also have this stomach ache that comes and goes. “That definitely will be cured by having sex,” I was told. And in my mind I was already scheming a way to have sex when I was only twelve. I met with the Youth Incentives team by chance. They were operating in our area and thanks to them I learned that what I had been hearing was false. There are other ways of healing stomachaches and hips and breasts grow eventually. The intervention of the project had given the young people a sense of empowerment from having such a resource at hand. "Because of the project, we know about the clinic from the radio shows and group talks, and we now have a phone number we can call for advice and information. We can get the information when we want it." Young person (male), Koulikoro31. Older people also have become aware of the value of this resource: "Because of the project, we elderly [people] now know that there are many modern methods, which actually work better against pregnancies than the traditional methods we used in our time. And which protect against diseased that didn't even exist in our time. It is our responsibility to guide the younger people, so it is important for us to learn these things, so we can educate our children. If we elder[s] are more aware and supportive of the new methods, this will reassure the young people. If this means we have to go to the clinic with them, then that is what we should do." Village elder (male), Koulikoro, Mali32

31 32

ibid. ibid.

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4.2.4 Gains in Knowledge of Rights From not being aware of the concept of rights to dimly being aware of it as an abstract concept, to a more concrete and personal knowledge of sexual and reproductive rights, the programme has managed to achieve a noteworthy transformation among the participants in the projects managed by the member associations, as field observations, interviews and focus group discussions revealed during the evaluation. This has happened at multiple levels: a. Young people’s understanding of themselves as rights-holders, and being willing to express this in various contexts, including in the family, among peers, the community, and at local and national advocacy levels. As Mr. Sohail, Youth Counselor in Bangladesh said, “Young people now say, we want to take care of ourselves, so we want information.” The Chief of TA Kachindamoto, at an event to plan for World Health Day programmes in early November 2010, asked a young person to chair the meeting, at which other Chiefs, Group Village Headmen, and NGO representatives were present. When, as part of the evaluation, the Chief was asked about her action, she said, “These are their issues. They are our future leaders. They must chair the meeting.” b. Acceptance by the community of these rights to a certain extent (as revealed in focus group discussions with parents and community members in the project areas in Bangladesh), and to a greater extent in Malawi, and Rwanda as revealed in focus group discussions with parents, community leaders, traditional counselors, representatives of churches, etc. As Mr. Shahjahan, community advocate in Bangladesh said, “There are barriers within the family to discuss these issues,” to which Mr. Mohammad Abdul Kalam, Union Parishad Member, added, “There are words which we cannot use within the family.” In this context, they felt, FPAB and the Tarar Melas were doing very good work. Mr. Saiful Zaman, a parent, said, “Instead of wandering around, they come here. We know they are in a safe place and doing something useful. This is a service to the community. This is important for children. Issues that we cannot discuss in the family are dealt with here. FPAB should promote sexual and reproductive health even more widely.” In Malawi, local leaders lauded the approach of using young people to reach young people to promote rights related to their sexual and reproductive health, while at the same time, to secure “the involvement of local leaders and community members was a fine decision,” said one of the village elders. Mr. Patson, Village Headman of Abraham, explained how this approach helped to promote young people’s rights in Malawi. “We identified cultural practices that were not fine for young people. For instance, during the initiation ceremonies some songs were sung which were very sexually explicitly, we felt that it tended to promote early initiation into sexual activity. Initially traditional counselors were not in favour, but those who were able to understand stopped it. To deal with the resistance, I have a court, and I put it to the council. Involvement of other parties in the discussion, helped to break down resistance. Also we are the leaders of the community. We have power. If someone was particularly defiant, I said, “I think you are giving me trouble. I think I may have to give you some punishment.” After that decision (to alter some of the initiation ceremonies) we observed that young people are not sexually active at the age of 10 and 11. Then, the community members thanked me for bringing down the early initiation into sexual activity for young people.”

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In Mali, AMPPF is now able to make presentations on the issue of young people’s sexual health issues in mosques. Equally, there was an increase to a certain extent in the knowledge of limitations to one's rights, and the need to respect the rights of others: "Before, we would not listen: we men thought we were like kings, we had the right to take [sex] when we [felt] horny. We now know we have to ask, it is not our right. Even if we want to kiss our girlfriends, we ask for their permission now."33 c. Acceptance by the member associations, as evident in the willingness to open up their spaces in welcoming ways to young people and taking active steps to improve access to health facilities in the context of young people’s exercise of SRHRs. This opening up has been in many ways: i.

Through the creation of more youth-friendly spaces in clinics, and training service providers to be more youth friendly. This has happened in all project locations, with some variation, sometimes, in the degree of youth friendliness, of individual staff.

ii.

Through identifying leaders from among the young people, providing them with training and capacity building opportunities and employing them in project implementation (This has happened in all the project locations).

iii. Through creating spaces for young people in institutional structures (this has happened to different degrees in different countries.) As the AMMPF branch coordinator in Koulikoro, Mali, noted: "The young people in the YAM structure, the focal point and I, together, we are the core of the organisation of the Youth to Youth activities in our branch. I am very committed to work with young people on this project, I see we are reaching many more youths this way."34 All these have helped young people to exercise their SRHRs. In areas where the project is working, there has been a shift in the matter of addressing sensitive youth issues. For example, the perception of sexual activity prior to marriage as being “immoral” has weakened a little to help to increase the focus on improving young people’s health and saving their lives by permitting them access to relevant information and services related to SRH. There is a strong effort being made to get the legal environment to change to prevent forced marriages in Malawi in TA Kachindamoto (which could then be used for broader advocacy.) In Rwanda, a YAM representative, Ms. Chantal Muhoza, has just been appointed to an assessment team to help frame a government policy on adolescent sexual and reproductive health. In Bangladesh, young people are using existing legal frameworks, and the support of peer groups and alliances with adults formed through the project, to help some young people resist marriages at a very young age. However, the struggle against the weight of tradition is not easy, and while some successes can be claimed in the project areas, at this stage, a lot of support from institutional stakeholders is necessary.

Youth Incentives (2010). Youth Incentives Fund Project: Partner Description and Qualitative Results 2009. The Netherlands: Utrecht. 34 ibid.

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4.2.5 Gains in Skills In addition to the skills built in MA staff, and across the board, skills of young people have been developed in many ways through the projects. These include: a. Communication skills: In addition to specific trainings on communication given to peer educators, a larger section of young people in the project areas in all four countries have, through the project, learned to communicate openly and directly about sexuality related issues, as well as other issues of concern to them. Young people reported during focus group discussions that they were better able to articulate their needs within their peer groups, families, communities, etc. Sometimes these gains in skills had very important and immediate pragmatic uses. As one child in the Rwanda project poignantly said: "I raise other children. If a child comes back with new trousers that it didn't buy, at first I felt it was not so important to ask about it, or talk about it. Now I feel I need to have the courage to ask and discuss sexuality with them, and to teach them how we can protect ourselves. Also not to give ourselves for materials. And if you fail to abstain, then to use condoms."35 b. Doing Needs Assessments: In doing the needs assessments which preceded the development of the project, young people were actively involved. They were also involved in specific research on topics related to SRHR, commissioned either by Youth Incentives or the IPPF, gaining valuable skills which has even helped a few members get employment. c. As a result of this project, young people have begun to critically analyse social systems and structures prevailing in their communities, which are inimical to the full realisation of their rights. Thus, for example in both Bangladesh and Malawi, young people are beginning to resist child marriages. d. In all the countries, young people were actively involved in implementation of the project, providing SRHR related information and facilitating access to services. In some countries like Rwanda, ARBEF staff regularly reviewed the knowledge of these young people by asking them questions and providing them with new information. In addition to the adult counselors in their clinics, FPAB also appointed male and female Youth Counselors in the Tarar Melas, who are directly involved in providing services to young people. e. Specialised training on communication on SRHR issues, monitoring and evaluation and research and advocacy were also provided as part of the project to the MA staff, which helped to increase capacity. Said the Advocacy Officer in FPAB, â&#x20AC;&#x153;The Advocacy department in FPAB changed after the training. What we had being doing was not really advocacy. We were primarily sharing information with people doing similar work. We realised the importance of disseminating to different stakeholders like other NGOs, media and the government.â&#x20AC;? The YIF Focal Point in Sikasso, Mali, said, "I now feel very comfortable to talk about relationships and sexuality...I can also more easily discuss Malian practices, such as the gender role in relationships. The young people I talk to are often very surprised to find out I know so much about sexuality now. They even ask me sometimes: "How come you know so much, are you a sexologist of something?" I always smile and explain to them that it is Youth Incentives that has taught me

35 Youth Incentives. (2009). Report on Focus Group Discusion with Child Headed Households on Effects of YIF Project. The Netherlands: Utrecht.

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these things, and that they can come to me or the clinic staff any time [with] any questions."36 These gains in skills have been the result of, and in turn helped to increase, youth participation. In Malawi, Mr. George Malema, District Environmental Health Officer of Dedza district said that the project staff of the YI project and the staff at the district hospital have been working hand in hand, and the project had built skills to provide services in a youth-friendly manner to government health staff as well. To a lesser extent, skills have also been built in communities, to discuss young people’s SRHR issues, and to critically analyse cultural practices and norms that act as barriers for the realization of young people’s SRHR. 4.2.6 Gains in Space Voice and Acknowledgement of Young People as a Group with Needs, Skills and Agency: Prevailing traditional cultural, patriarchal and familial norms often limit the spaces in which marginalised groups can operate, and the extent to which their voices can be heard in public and private spaces, including the family. One such marginalised group in many cultures is that of young people, with the marginalisation increasing if factors of poverty, lack of educational opportunity and gender come into play. Hence, for all marginalised groups, carving spaces where they are viewed as agents with legitimate claims (often even within the family), and creating voices for themselves which are heard and acknowledged is a part of the process of restructuring social life, and prevailing norms and ideals, in ways that obtain attention and action for their interests and rights. The project helped bring about gains in space and voice for young people in all four countries. Literally, the opening of the Tarar Melas, and the Youth Club spaces attached to some of the FPAM clinics represent designated spaces that young people claim as theirs in which to participate in cultural activities, gain information, plan events, etc. The MAs have also become used to having young people’s opinions sought and listened to in the planning and implementation of activities. Both in Malawi and in Bangladesh, young people were comfortable entering the offices of the project officers of the YIF projects and claiming their status in that space on the basis of their acknowledged contributions to the project. Their status within the community has seen a significant improvement, as revealed in the description of this interaction of an older male religious leader with a young female youth advisor in the project from Bangladesh: Not long ago, the imam in our area approached me. He said that his wife and he wanted to use some contraception, but his wife was really reluctant to go to the doctor. He asked if I would give her the necessary information. I gave him the information I knew but also told him I would ask the doctor and get back to them. I met them and explained all the possible methods. The imam’s wife said she was uncomfortable with some of the side effects of the pill, and the imam said he would use condoms. In Malawi, Mr. Chris Salaniponi, Health Services Administrator of the Dedza District Hospital, felt that the young people were contributing to the good strategy of having other young people talk to someone of their own age on SRHR issues. “If adults talk to them, they may feel that they are being shouted at or imposed upon. When it is someone of their own age or close to it, they take the messages seriously.” Also, generally speaking the negative impression of youth clubs has undergone a significant change, compared to the previous TMF phase. Traditional healers, parents, local political 36

Youth Incentives (2010). Youth Incentives Fund Project: Partner Description and Qualitative Results 2009. The Netherlands: Utrecht.

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leaders, etc., recognised the ability and willingness of young people to work for the community, particularly in health. Focus group discussions with local leaders made it clear that whereas earlier young people were not perceived as sensible or capable of contributing to the community, they were now seen as resources and a group that was working for positive change within the community. Hence, these gains also helped to increase youth participation, institutionalise learnings from the project, and improve the general conditions for young people to exercise their sexual and reproductive rights. Young people who participated in the focus group discussions in Mukingo sector in Rwanda summed up the impact the project had had on them in this manner:

They have become members of clubs and thus no longer feel lonely.

They have opened up to talk about issues relating to sexuality.

They are now able to make their own decisions regarding sexuality issues, such as choosing when and who to marry.

HIV positive individuals have learnt to live positively.

They have benefited from medical insurance.

They are able to prevent unwanted pregnancies.

They freely go to VCT’s for HIV testing.

They have learnt peer education skills.

4.2.7 Gains in Exposure Through the project, the young people also received a lot of exposure at different levels. Many of them participated in local trainings on SRHR, gender, communication, advocacy, monitoring and evaluation, etc. A smaller number also participated in national level events, some of them organised because of the renewal of the YAMs and Youth Clubs which came about as a result of the added impetus provided by the project, and a few also in international events, for example, the regional events on sensitive themes held in Nairobi, Bamako and Dhaka (Summer 2010), the Study Tour organised in the Netherlands (December 2009), the International Conference ‘Sexuality Under 18’ (October 2010) and the Annual Meetings of the YI Trust Fund (Bamako 2009 and Utrecht 2010). Though the project began with the comparatively limited objective of empowering young people in the matter of their sexual and reproductive health, as it turned out, it helped to provide important opportunities for skill building and exposure for a number of young people from comparatively non-privileged backgrounds. If this can be built upon further, the multiplier effects of the project could create a substantial group of young people with the leadership skills to effect change in their communities. Apart from helping to institutionalise learnings from the project, which these young people are likely to carry with them wherever they go, this represents a group that can work towards the vision and goals of the YIF programme in a broader context. The appointment of the YAM member, Ms. Chantal Muhoza to the committee that will work on a national policy on sexual and reproductive health for young people in Rwanda is an example of how this kind of investment is already beginning to pay off.

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4.2.8 Gains in Opportunities Young people also received opportunities to take on roles as peer educators within their communities, building the skills to work with different sets of stakeholders, e.g., inschool youth, out-of-school youth, traditional counselors, etc. They also became advocates with local political and religious leaders. In the case of Bangladesh, where there is both a young person and a Member of Parliament on the Board of FPAB, there is the opportunity to obtain the attention of national leaders. Also the Project Monitoring Committees (PMCs) set up in Bangladesh were an important effort in getting young people involved in the nitty-gritties of project planning and implementation. In Rwanda too, a very vocal and empowered member of the YAM is on the board of ARBEF. Bangladesh’s Youth Parliament is another step in this direction. Young people have received intensive training in research from international researchers, and are invited to events as experts on young people’s SRH issues. The helpline run by young people in Mali is an example of significant opportunities created by the project for young people to design, implement and provide services in a project that is meant to serve themselves and their peers. At the regional events on sensitive themes and the conference on youth and sexuality held in the Netherlands in 2010 (called Sexuality Under 18), young people played a major role, helping to organise it, facilitating workshops, etc. Such opportunities contribute to the possibility of the vision of the project having a broader influence.

The contributions of the YAM members to the YIF project in Rwanda were summarized thus:

Planning: YAM members have been involved in the planning of the project’s activities. An example is the advocacy program for out of school youth with the National Youth Council, where two YAM members assisted with designing the program. One YAM member was also admitted to the Youth Advisory Group (YAG) of Youth Incentives, the Netherlands, where she has been giving her input regarding YI youth programs and projects.

Monitoring: Many of the YAM members who have participated in different project activities like Mobile VCT services, anti-stigma campaigns of HIV positive young people, girls’ empowerment trainings, etc. have taken the responsibility of monitoring other projects’ activities, through discussions with beneficiaries.

Evaluation: YAM members have been involved in activity evaluation and internal evaluation, where their role has been data collection through focus group discussions with project beneficiaries, data analysis with the M&E officer and reporting.

Execution: YAM members have participated in the implementation of project activities. Some of these activities include trainings where they are being trained and where they train other YAM members (these trainings teach communication skills with young people, peer education, monitoring and evaluation, advocacy skills etc). Other activities include anti stigma campaigns where they serve as facilitators, girls’ empowerment trainings, and Mobile VCT’s projects where they have served as young counselors. They have also helped with the establishment of youth clubs.

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4.2.9: Gains in uptake of services All countries reported an increase in the number of young people accessing SRH services. This increase in numbers represents a logical improvement. Young people are provided with information, usually by peers in contexts where they are free to ask questions and clarify their own health concerns, and also receive information about where clinical services are available. The process of sensitization of health workers to make them more youth friendly was a big part of the project37. This has definitely had an impact. In TA Kachindamoto, the young people confirmed that there was only one clinic where they felt that services were not really youth-friendly, primarily in terms of their concern that the health worker in that particular clinic might provide them with services, but not be so concerned about confidentiality. In Bangladesh, it was possible to observe the ease with which young people walked into the Tarar Melas, knowing that they would receive caring counseling support in the rooms separately earmarked for males and females. In Malawi, the evaluator observed young people coming to the health centre in the evening (after the clinic hours when they might reasonably expect a larger crowd, and possibly, curiosity from members of the community whom they knew) to collect condoms, and clinic staff obligingly opening up the store and providing them with these. These were members of the health clinic who were not aware of the evaluation and paid no attention to it, and equally the young people who walked in off the street had no knowledge of the evaluation, so it was clear that there had been an authentic improvement of the ability of young people to access services. In Rwanda, YPLHA who had benefited from the programme brought in their siblings to be tested. In Mali, there was a major difference in uptake of services by young people in the districts where the youth-led programmes under the YIF programme is in place, compared to other districts, as a consequence of which young people in the other districts had begun asking for similar programmes. 4.2.10 Gains in support for vulnerable groups: Given that young people in general represent a vulnerable group, the whole project represented gains in support for a vulnerable group in terms of information, opportunities, services, etc. as described above. However, within this broad category, other more vulnerable groups received support. e.g., young unmarried girls who normally would not receive information or services were now able to obtain services more easily and with less stigma. In Rwanda, the project operated in 37 sectors of the southern province of Butare because of the severe consequences of the war and the 1994 genocide, which left many widows and child-headed households, which in turn made sexual violence and chronic famine important issues. Provision of support for child-headed households affected by AIDS or the genocide was a key element of the project in Rwanda, which also provided insurance support, coverage of medical costs for opportunistic infections, etc. for young people living with HIV and AIDS. As one young participant from a child headed household in a focus group discussion in Butare, Rwanda, said, ""It's obligatory to have health insurance. Officials can ask you to show your pass, they are checking. Now that we receive insurance from YIF, we no longer have to be afraid [of] checks [by] officials."38 Said another, "Before when a child fell sick, we did not have enough money to bring it to the hospital. This was a big issue for us. 37

FPAB (2009). 2nd Phase YIF Project 2009-2020: FPAB Proposal. Annual Plan for 2010. Bangladesh: Dhaka.

38 Youth Incentives (2009). Report of FGD with CHH on Effects of YIF Project. The Netherlands: Utrecht.

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Sometimes we had to steal money. But now it's much easier for us because we have insurance and bicycles [at the youth club]."39 Apart from such practical support, support in terms of provision of relevant SRH information was also much more critical for this group, because of the lack of adults who could provide such support in the immediate context. "[We learned] how we should behave and protect ourselves from HIV/AIDS. They gave us the knowledge that we should have got from our parents."40 One young woman from Butare, who was 19 and headed a household that included her 15 year old brother explained how he had told her "that sometimes in the morning he sees a wet patch on the bed and on his penis and wonders if there is someone who comes in the night and pours water on his bed. Thanks to the information she had received from the project, she was able to reassure him that this was a normal consequence of his body developing as he grew older" "it shows you are grown up and your reproductive organs are working well." "So the SRH information obtained from the [ARBEF] meetings and trainings helps us teach our young brothers and sisters."41 Just having a supportive community that was created through the intervention of the project, was a huge impact in the life of these individuals who felt very alone and vulnerable prior to the project: "I used to feel alone as an orphan. Once the club came, I met others and became friends. It always makes me happy to meet them."42 4.2.11 Reduction in stigma As a result of the project, significant reductions in stigma were noticed. For instance, young people living with HIV being stigmatised by their own families in Rwanda began to receive support. Families realised, through information and actions modeled through the project by peer educators, that their own fears of infection were baseless as long as basic precautions were taken. "Now we know we can continue living with them and relate with them and how to support them. We learned not to leave our HIV+ children and siblings. We bring them to the hospital when they get sick with opportunistic infections," said a participant in a focus group discussion in Butare, Rwanda.43 Even more important, the status of the YPLHA increased within the community through participation in the project and its participants. Young people also took the lead in providing home-based care and support for YPLHA. The project provided a good example for the community at large, and stigma came down significantly. After this, broader community support was mobilised through directly addressing stigma issues for child-headed households affected by AIDS. Young people with HIV have been included in young peopleâ&#x20AC;&#x2122;s groups as a result of the project, due to efforts made in building empathy and understanding. YPLHA are able to obtain community support to secure food, companionship for hospital visits, etc. In Malawi, the project also challenged the notion of male primacy in sexuality and was able to begin asserting the relevance of concepts like womenâ&#x20AC;&#x2122;s right to pleasure in sex without being stigmatised, the right of young people to obtain information and services related to sexual and reproductive health before being married, etc. The stigma associated with condom use also has come down.

ibid. ibid. 41 ARBEF (2010) Youth Incentives Fund Project. Annual Programmatic Report 2009. Rwanda:Kigali. 42 Youth Incentives (2009). Report of FGD with CHH on Effects of YIF Project. The Netherlands: Utrecht. 43 ibid. 40

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“Earlier we used to say: ‘Can you taste a sweet in its wrapper?’ wrapper can save our lives.”

Now we know the

4.2.12 Positive changes in MAs in terms of providing non-stigmatising services for young people The notion of young people as sexual beings with rights, whose sexuality needed to be accepted as a reality is a change in the perspective of the MAs which has been a direct outcome of the project. Although the IPPF had a stated commitment to supporting young people even prior to the project, in practice, office bearers of the MAs candidly admitted that while services were provided, service providers almost inevitably employed the traditional lenses which viewed young people who were sexually active before marriage as “immoral”. This affected both youth friendliness of services as well as willingness of young people to take them up. As a consequence of the YIF project, compared to a few years ago, there has been a marked change in the MAs in terms of helping to provide non-stigmatising services for young people. “We have decided that it is not our business whether a girl is married or unmarried, our business is to provide services. So now we don’t ask that question,” said the doctor heading the FPAB clinic at Khulna. A colleague countered wryly, “Not that it made that much of a difference, in the past, if they were unmarried, they just said that they were married.” “No, it is not true that there is no change. Earlier they came with fear that they may be found out. Now because they go to the Tarar Mela, they experience that there is no judgment for young people who are not married getting information. They also speak to the youth counselor when they need a service, and the youth counselor accompanies them to the clinic if necessary so that they feel comfortable.” The FPAB said that it was true that some of these changes were in direct contradiction with traditional values in Bangladeshi society. But as a result of the project, they had had a series of capacity building trainings for service providers where the management sent a strong message that while they could hold their traditional values, in the clinic, the provision of youth-friendly and non-judgmental services had to happen. That this was happening was confirmed in separate interviews and focus group discussions by management, service providers and young people. In Malawi, this kind of stigma-reduction training for providing youth friendly services had also happened for the service providers in the district hospital in Dedza, and for service providers at the health centres in TA Tambala and TA Kachindamoto with slightly more mixed results. However, here too, a significant change had come about, and only a few service providers represented problem areas, in that they do provide the service, but are less concerned about confidentiality. The district health officials also pointed out that the increased uptake of services also represented a challenge for them, since the supply of contraceptives can be erratic and insufficient at times. They candidly admitted that there have been instances of health providers complaining to young people that “You are finishing up are supplies”, because of the increased run on a limited resource. Here again, the stigma was more against unmarried girls. In refusing contraceptives to unmarried girls in favour of their married women clients, some health providers used the argument that “You can say no, but she can’t say no [i.e., can’t refuse sex within the marriage.”]

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In addition, earlier the focus in the MAs were on the list of client’s rights promoted by the IPPF. In more recent times, IPPF has also begun stressing sexual and reproductive rights. Thus there is increasing congruence between the vision and goals of the YIF programme and IPPF’s promotion of SRHR more generally. Generally speaking, MAs have also begun the shift from an approach focusing on HIV and “the dangers of sex”, to a more positive approach towards sexuality, in which good information and protection and prevention of disease is part of a larger, more positive picture of SRHR. As Dr. Chikumbutso Mpanga, District Health Officer of Dedza district, and head of one of the key agencies which collaborates with FPAM in the execution of the YI project, felt that this was a contribution that the project was making. “SRHR is an area in which there are a lot of problems. For instance, women have difficulty in even recognizing that they have the rights to access contraceptive methods. That is an area that touches their lives directly. If we only talk about HIV, a lot of people don’t relate it to their lives. Stigma and discrimination is actually the result of the negative approach that we followed for many years. The positive approach is also acceptable to the community. Earlier, the community associated HIV with death, and the attitude was, if you know your positive status, don’t talk about it. The community does not want to take risks with issues that are taboo. But when someone starts, like this project did, it serves as an ice-breaker, and the community follows. This is the start to taking a more integrated approach, offering family planning, antenatal care, PMTCT services, and youth-friendly services and so on in an integrated fashion.” In FPAB too, issues such as women’s right to pleasure had never been considered prior to the project. 4.2.13 Foregrounding gender The programme made it a point to foreground gender. Hence, when peer educators were chosen, most MAs chose equal numbers of girls and boys. For all capacity building trainings too, equal opportunities were provided for both boys and girls. During all the focus group discussions, young people asserted that information was being provided equally for both boys and girls. Young girls were found to be accessing resources like the Tarar Mela, in numbers which were quite comparable to those of boys. In Malawi and in Rwanda, the YAM president was a young woman. The first speaker of the youth parliament in Bangladesh was a young woman. Girls and young women were as articulate as the boys and young men during focus group discussions during the evaluation in all the countries. The project had helped to foreground gender and sexuality related issues that were not normally part of the sexual social ethic of the culture, e.g., women’s right to refuse sex to their partners when they did not wish it, women’s right to pleasure in sex, etc. The project also helped to counter many of the prevailing myths about women’s sexual and reproductive health. Nevertheless, both in Malawi and in Bangladesh, heads of clinics reported that while in general, the uptake of clinical services had increased both by young men and women, sometimes by as much as 50 per cent (as reported by the District Health Officer, Dedza District Hospital), service providers reported that was uptake was less by young women than by boys and young men. In both countries, young girls reported that even though a good deal of change had happened with respect to access to services, there was still some amount of stigma about approaching the clinic if a girl was unmarried, and concern about confidentiality issues, which affected the extent of uptake of clinical services by girls.

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4.2.14 Changes in MAsâ&#x20AC;&#x2122; perceptions towards sensitive issues Through the YIF project, there has also been an opportunity for the MAs to engage with sensitive issues like abortion, sexual diversity, and sexual violence to varying degrees. Interestingly, it was found that the issues were of varying sensitivities in the different cultures. For instance, while abortion was viewed fairly pragmatically in Bangladesh, it was viewed as a difficult topic in Malawi, and in Rwanda could even invite imprisonment. Likewise, the issue of sexual diversity could invite severe punishments to the extent of even sentences of capital punishment. Hence, the willingness of MAs to engage with these issues were closely related to information gathered and generated about these sensitive issues in their larger societies. For example, after the sensitisation process, YAM Malawi organised debates for young people in Mayani and Dedza Boma on whether abortion should be legalised in Malawi, and whether it was acceptable to have sex with or marry a partner of the same sex, in which, in spite of the hesitations because of the cultural and legal norms, young people participated enthusiastically44. In Mali, while there was general disapproval of both sexual diversity and abortion, some sections involved in the discussions felt that it could perhaps be viewed as not the business of larger sections of society but of the individuals involved. An example of the change at the MA level came from the Project Coordinator in Mali, who said, "I now believe abortion should be accessible for all. I have seen in the Netherlands that there are ways to have safe abortions and that could save so many lives here in Mali: girls are having abortion anyway, one way or the other, even now [when] it is illegal. In the Netherlands some people still oppose as well, but a woman should be able to make her own choice. I have also seen that the abortion rates have not increased after it was legalised in the Netherlands. I guess it is just like with condoms: people before [were] opposed: saying young people would have sex ALL the time once condoms [were] available, and did that happen? No. The same is [likely to be] the case with abortions, as long as family planning is available, and the abortions are accompanied by good counseling." However, in the communities, no similar accommodation was made in matters related to gender and sexual violence. Any view that challenged male privileges and primacy, including in matters related to sexuality, were firmly and vociferously resisted, even by young people. MAs are, therefore, necessarily constrained by these difficulties, but the project has definitely helped to create a little more space for these issues. Consequently, there have been small, but significant steps, related to these issues. FPAB has begun receiving input sessions from Bondhu, an organisation working with homosexuals in Bangladesh, and has committed to providing health services to all clients regardless of sexual orientation. The Jessore clinic has equipment to carry out proctoscopic examination and provides treatment for anal STIs. The Khulna clinic collaborates with a specialised clinic that has been set up for men who have sex with men and provides referrals in cases of anal STIs that require specialised medical support. The Director of ARBEF shows great personal courage in using public fora to point out the health risks to citizens within a legal framework that criminalises abortion, and young people have taken the initiative to carry out research with young women who have been jailed for seeking or undergoing abortions. In Malawi and Rwanda, the absence of supportive legal frameworks prevent broader advocacy on issues of sexual diversity but awareness and discussion within the organisations have begun.

FPAM (2010). Youth Incentives Fund Project. Annual Programmatic Report 2009. Malawi: Lilongwe.

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4.2.15 Favourable comparisons with other SRHR interventions for young people In Rwanda, a representative of the Committee de District de Lutte Contre le SIDA (CDLS) programme felt that the YIF project had been the only successful SRHR project in Nyanza district. According to Lule et al (2005) examined reviews that summarized research into interventions to promote adolescent SRHR. They found that there are seven characteristics that mark successful adolescent sexual health interventions. They are:

Peer education

Clinical health services

Social Marketing

School-based sexual health interventions

Mass media and community mobilization

Youth development programmes

Workplace programmes45

The YIF programme had each of these elements to some degree, with the first three elements being present in all projects, and the rest being present in some projects, with the maximum number of elements being present in the Bangladesh project. All the YIF projects use peer education as a strategy. Likewise, all the YIF projects actively worked to build access to youth-friendly clinical services. All the YIF projects also tried to bring products like condoms and clinical SRHR services into the young people's community, and increase demand for these, and hence were involved in social marketing. The FPAB project provides SRHR information in schools. The AMPPF project used mass media (community radio and mobile telephony) and all the projects worked on community mobilization. The FPAB project linked young people's SRHR with a broader conception of youth development as conceptualised through the Tarar Melas. In Rwanda too, the empowerment created by the project helped young people form collectives which then worked on income generation activities. Many SRHR programmes which provide explicit information and referrals for services, e.g., the APSA-SHIP project in India, tends to focus on particularly vulnerable groups, e.g., street and slum children, while other programmes for children and young people perceived as coming from a more â&#x20AC;&#x2DC;normalâ&#x20AC;&#x2122; upbringing, e.g., the ENFOLD health programme, tend to be slightly sanitised, aimed to getting some good information to this group, without rocking the boat of prevailing societal norms pertaining to gender and sexuality too much. In this sense, the YIF programme is unusual in that it recognises the need for all children to get complete, clear and accurate information, improve access to youth-friendly clinical services and products, and makes a bold attempt to actively engage with the sensitive issues of sexual violence, sexual diversity and abortion, even at relatively younger ages. Looking at disease control priorities in developing countries 45

Lule, Elizabeth, James E. Rosen, Susheela Singh, James C. Knowles, and Jere R. Behrman. Adolescent Health Programs. In Dean T. Jamison, David B. Evans, George Alleyne, Prabhat, Joel G. Bremen, Anthony R. Measham, Mariam Claeson, Anne Mills, and Philip R. Musgrove, (eds.) Disease Control Priorities in Developing Countries. Bethesda, MD: Disease Control Priorities Project.

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for adolescent health, Lule et al found that “poor adolescents bear a disproportionate burden of the health problems in their age group” and that there is “a strong association between poverty and the health status of adolescents and poverty and adolescents’ use of health services.”46 Within the generally positive picture of progress towards objectives and results, there are nevertheless concerns, which will be addressed in the section on constraints and problems. 4.3 Contributions of Stakeholders The progress observed in the project has been the result of varied contributions by multiple stakeholders.

Young people responded with enthusiasm to a project that placed them at the centre, and in particular, addressed an issue about which, historically, they have not received adequate or accurate information within their families and communities. The opportunities to participate in project design, implementation and monitoring, as well as research and advocacy, while also getting adequate capacity building and training, were appreciated and contributed enormously to the success of the project. YAM members, members of Project Monitoring Committees, Steering Committees, and Youth Parliaments were all willing to take up leadership roles. Young people also proved to be much more flexible and willing to engage with sensitive issues, even under conditions which were less than optimal. Capacity was built to a level where young people served as facilitators and co-facilitators of workshops at international conferences.

Representatives of the local community responded to overtures for building support for the project. Such representatives included head teachers, teachers, religious leaders, traditional healers, church leaders, social workers and influential persons in the community. Several participated in the sensitisation and capacity building provided in the community and served as advocates for the programme, to help reduce resistance, etc.

Local governments: In Malawi, cooperation with the local government played a significant role. The YIF project was seen as extending and adding value to the services provided by the government, and the government also responded by providing institutional support, including permission for government staff to attend capacity building trainings, being open to advocacy to bring about changes in the legal framework to protect children from forced child marriages in Malawi, etc. The rehabilitation of the Mjini health centre made a big difference, as the clinic previously had been completely run down, with no water supply or electricity. The decision to reassign project funds for this purpose, while not part of the original plan, reaped rich dividends in terms of the project’s credibility in the district and enhancement of a positive perception by the district health administration and the traditional authorities. For instance, the local health administration agreed that the health service providers posted there would not immediately be transferred47. This support is critical, especially given that three health centres in the district are run by the Christian Health Association of Malawi,

Ibid. FPAB (2008). 2nd Phase YIF Project: FPAB Proposal. Bangladesh: Dhaka.

47 47

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which being a Roman Catholic agency, does not discuss family planning, provide menstrual regulation services, etc.

The presence of supportive project staff made a big difference to the project, especially, the belief and commitment of the project coordinator to youth participation. For instance, in Malawi, the first half of the project was carried out under the leadership of a coordinator, who, while supposedly stationed in the field, was actually trying to run the project by remote control. The transfer of an experienced development professional who believed in the needs, rights and capacities of young people has created a significant change in the impact of the project, to the extent of actually being able to change the legal framework within the project areas to act against violations of young peopleâ&#x20AC;&#x2122;s rights and support their SRH generally. However, this staff member too, was very stretched. Her very capacity and the range of skills that she possesses means that she is often used for a range of other tasks by FPAM, so this continues to be a challenge for the project. Among field staff, where the field staff are able to create space for young people to help them problem-solve around local issues, the projects work efficiently.

The MAs made an effort to internalise the RAP approach and practise it. Further, in Bangladesh, Malawi and Rwanda, MAs were open to the adjustments in the programme necessary following the mid-term evaluation. Not only staff from the YIF project, but staff from other projects and some of the senior management participated in the trainings, and hence the chances of the institutionalisation of the learnings from the project were also higher. Where staffing changes were necessary in order to improve the effectiveness of the project, MAs were willing to make it. For the most part, the MAs also provided significant support to young people implementing the project.

The attitudes and actions of the senior leadership of the MAs can make a significant contribution to the relative success of the project. Where the senior leadership is willing to support the philosophy and methodology of the project, it makes a difference. Thus Bangladesh was able to upscale the project to 21 districts from the original four envisaged in the project, with creative problem solving by the leadership on how to resolve funding issues. There are other instances where senior leadership pays lip service to certain aspects of the project, like dealing with sensitive issues, but their personal values and religious beliefs run counter to the project philosophy. In such situations, no significant improvement may be expected. Hence it is important for the consultants to probe for the real opinions of such leaders, collaborate with the IPPF regional office, and see how dialogue can lead to a more constructive engagement with the sensitive issues.

Youth Incentives Fund Programme consultants and staff contributed by providing technical support, together with standard project management support - ongoing monitoring, including through periodic field visits and suggestions for adjustments in project management, analysis of accounts and recommendations for periodic disbursement of funds. YI consultants were also responsible for planning and executing evidence-based interventions, and as part of this effort the designing and coordination of specialised trainings, creation of IEC materials including brochures, leaflets, training manuals, toolkits, etc. was a major task. MAs reported that the training provided was very useful â&#x20AC;&#x201C; e.g., the monitoring and evaluation training helped the MAs strengthen narrative reporting, and also brought in monitoring by multiple stakeholders, including young people. The training on research has meant that the organisations have been approached to

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undertake more research with participation of young people. Across the board, MAs reported that the training on communicating about sexual and reproductive health issues helped the project staff. Since staff from other projects in the MAs also participated in several trainings, the associations were able to build more broad based capacity. The support provided with respect to sensitive issues has also helped to begin to create space for these issues within the MAs to varying degrees, because the widely differing cultural contexts means that the three issues, abortion, gender-based violence and sexual diversity, are differentially sensitive and difficult to address in the MAs. The consultants also problem solved with the leadership and the MAs to take crucial decisions related to important changes in the programme, like the dropping of Tanzania for the second phase, changing the target group in Bangladesh, bringing the Mali project on board, deciding to reallocate certain funds in order to rehabilitate a health clinic in a very dilapidated condition in Malawi, etc. The high turnover of staff within the YIF project in the TMF phase also meant that this was a concern for MAs, and maintaining continuity in the MFS phase of the programme was critical.

External resource persons: The programme also made use of the support of external experts and consultants, e.g., advocates working with sensitive issues, local research experts, and programme officers from the regional offices of IPPF.

IPPF ROs and CO: The YIF programme also built useful alliances with the IPPF’s Central Office and the Regional Offices in Africa and South Asia. Representatives from both the Central Office and the African Regional Office felt that the results of the YIF programme had strengthened attention in the MAs to the rights and participation of young people. The reaction of Ms. Doortje Braeken from the Country Office of IPPF to a question on whether the YI intervention had helped to change MA attitudes and practices in young people’s SRHR programmes was “100 per cent yes. Absolutely. Bangladesh is the most excellent example. In Malawi too there has been a great change. Homosexuality was previously a “no-go” area, and some thought is beginning in this area now.” The positive results of including young people in needs assessment and implementation sparked interest, and the IPPF commissioned research by young people in Bangladesh and Malawi, and felt that the results showed actual evidence of how to do research with young people, and how this could inform programme development, and served as an example of both youth participation and the rights-based approach. The South Asia Regional Office was very progressive, and the organisation’s Programme Officer in charge of Youth Programmes assisted with some of the trainings in Bangladesh. The South Asia and Africa Regional Offices collaborated with YI in organising the regional events on the sensitive themes of abortion, gender-based violence and sexual diversity, and in a sense, YI helped to put these tricky issues on the agenda of IPPF more strongly. The fact that four MAs from different cultural contexts found the YI interventions valuable could give the IPPF food for thought about considering the worth and value of extending these to other MAs. Already some of the materials from YI are being sent to other regions. For YI, potentially, IPPF can help to carry forward the learnings from the YIF projects in a much more broad-based fashion.

4.4 Constraints and Problems Encountered Limited Youth Participation in YI From the interviews, it appeared that incorporating young people’s participation in design, implementation and monitoring of the programme at the YI level in the

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Netherlands was considerably less than at the MA level, where there had been some substantial gains. While a YAG was constituted, it was done so in a fairly ad hoc manner, pulling together some young people from different countries who happened to be in the Netherlands for an event. There were very few young people helping to implement the programme at the YI levels. Though the YI programme employed three young people during this phase, for reasons of needing to comply with labour laws and protect the positions of those employees who had been in the organisation longest, any budget cuts tended to affect the younger employees first. Many of the senior staff are also extremely skilled, and under constraints of limited time and deadlines, it may be difficult to consciously build in time for consultations with younger people. However, this may put YI-RNG on the shaky ethical ground of advising MAs to â&#x20AC;&#x153;Do as I say, not as I doâ&#x20AC;?, and also undermine the credibility of a programme that stresses youth participation. Constraints related to local conditions Several constraints related to local conditions affected the projects. The local cultural contexts in which the projects functioned did not have a culture of sharing clear, accurate and adequate information on sexual and reproductive health with young people, and creating another culture in which young people could receive this information without being labeled immoral was a challenge. In all the countries, there were difficulties with adults accepting young people as sexual beings. Constraints imposed by religion compounded this issue. The Tarar Melas in Bangladesh were located on the premises of the FPAB clinics, and the association of family planning with marriage meant that the MA had to work very hard to overcome the stigma inherent in young people accessing such a space. The TMF review identified the need to build support for the project among parents and the local community, and this was an ongoing challenge, with some gains, but equally, the need for ongoing work. For example, a focus group discussion with teachers in a higher secondary school in Khulna in Bangladesh revealed that although an FPAB outreach effort was providing information on sexual and reproductive health in the school, most of the teachers did not feel that this was a worthwhile activity. While they agreed that young people needed information related to SRHR, they felt that this information should be provided by teachers or parents. Although they further admitted that they themselves could not imagine seeking information from parents or teachers, and also that neither their own children, nor their students would consider seeking information from them or other authority figures, and that their students were more likely to open up and get their doubts clarified from other young people, they still felt it was not an activity that strangers should undertake, and especially not young people. So, in designing and implementing SRHR projects for young people, expecting the choices of the community to be rational is not always an option, because deeply held beliefs may continue to hold sway even in the light of reasons that the community acknowledges are valid. In Malawi, hamlets are widely scattered, and young peer educators may have to walk 10 to 12 miles in order to reach a hamlet and provide the sensitisation training to young people in the area. In Rwanda, the project reached out to child headed households and YPLHA where young people less than 25 years old were heading households of their siblings. However, once they reached the age of 25, they could no longer be part of the project, while often, the need for support did not automatically stop at that age.

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As one young woman in Huye district in Rwanda said, “As an HIV positive person and an orphan, my life has changed from the time I joined the project, I am even earning some money from the skills I have learnt. The project gives me ARVs (Anti Retroviral drugs) and pays for my medical insurance. But I don’t know what will happen when the project ends.” Difficulties with Sensitive Issues While small but significant changes have occurred in the MAs perceptions with regard to sensitive issues, and some effort has occurred to engage with them, there is still a long way to go. The lack of a supportive legal framework, personal values and religious objections that view issues like homosexuality and abortion as sinful, all make working with these sensitive issues a significant challenge. And yet, the commitment to the rights-based approach demands that these issues be taken into consideration. Work-related tension between older staff and young people In carrying out certain activities, for example, facilitating focus group discussions, providing information to young people, etc., young people have proved that they are very good at the work that they are assigned. This causes tension with some of the older staff, who find it difficult to give up control. While some senior staff are receptive to young people in the MA offices, others are more conservative, and see young people as beneficiaries rather than partners. Operation of traditional hierarchies, and economic hardships In most project countries, social hierarchies were well established and norms of respectful communication made it difficult for young people, especially unmarried young people to seek information related to sexuality issues. The project had to actively counter such norms. This required specialised attention: for example, the development of the communication trainings. Equally, economic hardships could make it difficult for important adults in young people’s lives to give them the guidance they needed. As one parent in Mali said: “We are losing our daughters to the sand workers and we also have an international school where the fellowships of the students are higher than parents’ salaries. How can we talk to our children?” Location of the clinics and limitations in availability of health services and products The sheer numbers involved meant that Bangladesh did not have to serve a catchment area of over five square kilometers around the FPAB clinics to far exceed their targets. However, lack of space forced these clinics to create the Tarar Melas (youth-friendly spaces) in the same building as the clinics where services were simultaneously provided for adults. FPAB clinics had gone to a lot of trouble to provide various youth- friendly services, including computer classes, spoken English classes, singing and dancing classes, a library and indoor games, to break the association which they had with solely providing SRH services, and they have been successful to a great extent. Nevertheless, a lingering stigma remains that the clinic is not a legitimate place for young unmarried people to be seen at, and remains a challenge. In comparison, services for the Dedza project district were largely provided by the public health system. There were only a limited number of clinics serving a very large project area, and many of these were located along the main arterial roads, which meant that

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areas remote from the main roads were very much underserved. Raising awareness about sexual and reproductive health, without an adequate system of health services to back up any demand generated by this process, raises difficult ethical issues. “Frequently, the clinics run out of condoms,” complained local leaders during the focus group discussions in TA Tambala. Retention and turnover of staff, and loss of trained young people after the age of 24 Keeping trained staff in the programme, was a constraint both at YI and, to a lesser extent, at the MAs. Consequently, the need to have good project documentation became necessary to ensure continuity. However, capacity building of new staff becomes an ongoing challenge. Young people who have received a lot of capacity building automatically have to leave the programme once they no longer officially qualify as young people. Around this time, young people also have to seriously think of career options and earning a serious income, which makes it difficult for them to provide time for the project voluntarily or for a small honorarium. This represents a loss of built capacity for the project. Other competing issues of importance for young people: In some of the project countries, children are initiated into sex at a very young age, sometimes as early as 11 and 12. However, significant amount of advocacy with the local community is necessary for building support for providing information and services to ‘older’ young people. Under such circumstances, it would be even more challenging to provide such information to young children. In Rwanda, young people very keenly felt the lack of opportunities to alleviate poverty and earn a decent income. Opportunities were also very scarce for young people in Malawi. Participation in the project empowered young people significantly, and this was especially true of the young people who acted as peer educators. This, in turn, made them begin to aspire for opportunities for advancement which their immediate environments could not provide. The project too was not equipped to address these aspirations. In a sense, this represents an ethical dilemma for some staff in the MAs. “We are all for using young people because they are efficient at getting work done, and also cost efficient, but do not want to commit to giving them a better honorarium, or anything beyond the project,” said the project coordinator in one MA. “We have taken these young people from backgrounds where they had nothing, given them some opportunities, so that they want more for their lives now, but will drop them back into their settings once our work is done. If this happens, young people may feel frustrated, as if they have been used and discarded,” said the project coordinator at another MA. Staying within MAs’ and YI’s sphere of competence: Because of the clear need for poverty alleviation measures which were much more immediate for young people in Rwanda, YI budgeted some funds for an income generation project in Rwanda. However, both YI and the MA quickly realised that implementing such a project successfully required very different skill-sets and brought it to a quick close. The experience seemed to teach YI and the MAs to focus on work that related to their sphere of competence.

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And yet, it is necessary to address issues of economic hardship to help young people make empowered choices in favour of sexual health and rights. Parents expressed their concerns in Koulikoro, Mali, in this manner: “When you have struggles paying for a pair of house shoes for your daughter and they go and see a man who can give them twenty times the price, what can you tell her that she would listen?” Local advocacy vs. broader advocacy: One of the lacunae identified during the mid-term evaluation had related to advocacy. One of the shortcomings, namely, local advocacy had been addressed by MAs to a significant extent. The mid-term evaluation had specifically mentioned that parents needed to be taken into confidence, and it was clear during the focus group discussions that quite a lot of effort had gone into securing the support of this set of stakeholders. Parents at Khulna, TA Tambala and TA Kachindamoto clearly said that the programme was useful for their children and they were glad that their children were getting information and skills designed to protect their lives and help them make choices that would help to keep them happy. Said one parent from TA Kachindamoto: “Initially I used to curse the peer educators when they came to our village, calling them sex teachers and prostitutes. But now I know that they care for our young people and are trying to help to protect them. I am happy to support their work. I even approach them for condoms to distribute in our village.” “We find it difficult to talk to our children about such matters. They would also naturally find it more comfortable to seek information from someone around their own age than an elder, so this is a good methodology. It works.” Parent from Bangladesh. FPAM has also succeeded in working with the traditional authorities in TA Kachindamoto to change laws to end early forced marriage of children. In Rwanda, the PSI coordinator has been working with YIF in different activities including conducting trainings for young people and advocating for youth sexual rights to be integrated in the National Youth council’s plan of action. However, the MAs had been less successful in collaborating with other civil society organisations. In Khulna, the FPAB clinic had signed an MoU with more than a dozen organisations working with the community to refer people who had concerns related to SRH to the clinic. However, such alliance-building appeared to be more the exception than the rule. In many countries, IPPF partners have played pioneering roles in helping to establish SRH services and hence enjoy a high status with the government. This helps them advocate with the government. Thus, FPAM played significant roles in developing policy documents related to SRH and HIV/AIDS in their country. However, this same high status could be one factor that appears to preclude them from thinking creatively about broader alliances. Sharing the learning’s from the YIF projects with UNICEF and other organisations working with children and young people especially, and with other community-based organisations, for example, those working with the urban poor, it might help to convince such organisations about the importance of working on SRH issues of young people, and in time, realize the objectives of the project for a wider audience. Likewise, it appears imperative that in countries like Malawi and Rwanda, the MAs need to collaborate with organisations working on poverty alleviation, income generation, and skill training for young people, so that young beneficiaries from their own programmes, and in particular, peer educators, can be linked to these programmes so that they have

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some skills and options for income generation post the completion of their assignments with the YIF project. The training on Advocacy provided by the YIF programme was well-appreciated by the MAs, who have been enthused by it, and feel their capacity for and understanding of advocacy has increased. However, with reference to this particular project, it may be an issue of “too little, too late” within this project period, even though the learning will be valuable in the medium and longer-term. The IPPF country office, too, felt that the MAs were much weaker with broader national and regional advocacy, whereas they were much better with local advocacy at the level of individual communities. Advocacy at the YI level too is not as strong as the other elements of the programme. For example, a year-long campaign planned to get the Dutch government to champion the cause of comprehensive sexuality education with its development partners, with a significant budget, grew smaller and smaller in scope and changed its focus to eventually become a single half day pre-conference event of much more ambiguous impact, if any. Gender inequalities: continue to be a constraint which the programme has to engage with. MAs have achieved quite a lot in terms of first-level results – for example, ensuring participation of both boys and girls as peer educators in comparable numbers, providing information to both sexes, trying to gender-sensitise health services, etc. However, they need support to deepen the levels of gender analysis and address issues of masculinity. 4.5 Efficiency of Planning and Implementation The mid-term evaluation had raised several concerns related to the efficiency of planning and implementation, cited earlier in this report. The 2009-2010 phase consciously addressed these concerns, and tried to ensure that the programme and individual projects within it were in alignment with the stated objectives. Several of the steps taken for this purpose have been referred to earlier in the report, e.g., winning the confidence of parents, changing the target group in Bangladesh, increasing sensitisation trainings for service providers to encourage them to provide youth friendly services, etc. Steps like these also helped reach the project to larger numbers of young, which in turn increased the efficiency of the project in terms of expenditure incurred. According to the Annual Report for 2009, “By the end of 2009, Over 130,000 young people were reached through training, peer education or school activities and have increased their capacity to understand and exercise their right to information, services, participation and enjoyment of sexuality.” However, the wide variations in local conditions (e.g., relative densities of population in Bangladesh and Malawi) make a comparison of relative cost-efficiencies of the project in terms of just numbers reached is unrealistic. Efficiency in the planning of the second phase was also seen in the efforts to address specific gaps or drawbacks of the project. For example, it was felt that reporting by the MAs focused largely on numbers and not on impacts or outcomes (e.g., number of trainings conducted). Hence a training on monitoring and evaluation was designed and conducted to build MAs capacity. Consequently, implementation improved as the perception of the activity changed from one that was a responsibility solely of the M & E officer, but rather one to which all staff could contribute, and an ongoing activity that

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could play a formative role in the development of the project, rather than a summative role at the end of each quarter solely for reporting to the donor. Although reducing resistance to sensitive issues was one of the stated objectives of the project, this aspect was really taken up only in this phase and in the face of resistance from the member organisations. YIF not only showed courage in this, but also employed an efficient and innovative approach (which will be discussed in a later section.) In Rwanda, YIF decided to use the limited resources to target a very vulnerable section of the population, namely households that had become child-headed in the aftermath of the genocide and YPLHA. Young people need information and empowerment about sexual and reproductive health and rights, as sexuality is still a very taboo subject all over the world. But young people in Rwanda in the aftermath of the genocide have an even greater need. In Rwanda the ratio of adult to young people is low, as is the break down between generations. It has been sixteen years since the genocide; those who were born during that time are now teenagers and those who were children are now young adults. Many parents are very young and do not have information on safe behaviours or sexual and reproductive health and rights themselves to pass down to their children. In Malawi, the decision to link up with government clinics and build their capacity to extend the reach of the project contributed to the efficiency of the project. The creation of toolkits and IEC materials related to the communication training, the workshop on sensitive themes, etc. also created the potential for a multiplier effect, and hence also contributed to the efficiency of the project. Apart from being effective radio broadcasts on regional youth stations have proved their efficiency in reaching young people. This is because, unlike presentations by individuals, they can be repeated at different times of the day more easily. Many young people reported having had their curiosity aroused by the radio talks, which then led them to go to the group talks.48 Prior to the M & E training which led to improvement in reporting by MAs, the issues with inadequate reporting led to delays in disbursement of funds, which in turn led to underspending of allocated resources. However, this situation improved greatly over the course of this phase. In Rwanda there were also issues related to temporary transfer of YIF funds to other projects run by the MAs. The lack of buffers for the implementation of projects in many MAs led to such shifting of funds, which in turn would also have affected cash-flows related to the YIF project, and efficiency of implementation at certain times during the project. While the value of the technical support from YI experts is unquestionable, the costeffectiveness of the measure of holding one communication training, one training on advocacy, one on M&E, etc., with consultants from the Netherlands needs to be seriously evaluated. YI may want to consider creating regional pools of expert trainers who can provide quicker and cheaper services of comparable quality, repeatedly by the MAs, once their capacity has been built.

Youth Incentives (2010). Youth Incentives Fund Project: Partner Description and Qualitative Results 2009. The Netherlands: Utrecht.

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In broad terms, the decision to collaborate with MAs of the IPPF meant that the information and technical support provided by YI would be backed up by rights-based clinical health services, and hence this was both an efficient and ethical strategy. 4.6 Impact: Progress towards Vision and Goals “Youth Incentives vision of an ideal world is one where all young people can enjoy safety, confidence and pleasure in relationships and all aspects of sexuality.” This vision clearly drove the project, and some substantial gains were made. Nevertheless, countering cultural and religious views, developed over centuries in order to promote sexual and reproductive health is very difficult and will require a long time, and sustained effort. However, all stakeholders testified to the effectiveness of the RAP approach, as well as the strategy of using young people to reach out to young people. Hence, there is a real value in the approach that YI is demonstrating in its effort to realise its vision. For example, the evaluator found that the young people who participated in the focus group discussion in Kigembe district in Rwanda showed a high level of knowledge and understanding about their sexuality, which they associated with participating in the YIF project. The project brought them very important information, as well as empowerment and the capacity to feel comfortable with themselves and with their rights. This was as a result of regular training and contact with YIF staff and peer educators. Apart from this, even with the substantial increase in numbers of young people reached at the end of the project period compared to the beginning, in absolute terms, they represent a fairly small percentage for the country. For example, the Malawi project only covered two TAs (Traditional Authority areas – the next sub-unit within the district) within a single district, Dedza. And even within these TAs, hamlets are so scattered that only about 40% of the hamlets in these TAs could be reached, and this with some extraordinary efforts on the part of the peer educators. Malawi has a total of 28 districts. Hence, over the project period, only a miniscule part of the area and population of Malawi has been covered. Efforts have also been made to include YAM members in the projects, but limitations also apply. In a focus group discussion held with YAM members in the Karama sector in Rwanda, they said that not many members have participated in the YIF project because the project only operates in three districts of the southern province. As a result, only some members from the southern province, especially those in the National University have been involved. Additionally, as the YIF project has a limited budget and has to facilitate their transportation, YAM member participation in YIF project was restricted. The staff of the YI project have disseminated the learnings and results from the project through papers, and articles in magazines, guest lectures at universities and presentations at international conferences. More efforts need to be put into publicising the results and impacts and learnings from the YIF projects to a broader group of civil society organisations, and in the Netherlands, even within the broader RNG, and now Rutgers WPF, much less other donor agencies working with children’s and young people’s issues, especially as the latter could think of using these strategies and approaches in working with their own primary stakeholders. Where sharing has occurred in the project countries, it has been restricted to organisations working on SRHR issues. Other potential interested consumers for these learnings would be for organisations working for children and young people and their rights, organisations doing community outreach with the urban and urban and rural poor, etc. While in countries like Rwanda and Malawi, the project managed to reach some of the most vulnerable young people, in Bangladesh, it

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reached young people who belonged to the lower middle class, or faced some economic hardship, but were not of the ultra-poor category. Nevertheless, there are many promising reasons for hope that the programme is well on track too.

In all the MAs, the effectiveness of using young people to reach out to other young people on matters of SRH has been clearly demonstrated in the four projects.

Young people have become more open to discussing issues related to sexuality with their peers and with adults.

Such results have been extensively shared within the MAs through the periodic project reviews that happen at the organisational level49, and, for instance, there is a demand in Mali from districts where the YIF project is not located to extend the project to those areas as well. The extension of learnings from the YIF project into the SALIN+ project are also a result of sharing within the organization, as well as building alliances with IPPF.

Also, managers of other projects in the MAs have received opportunities to be part of trainings carried out in the YIF project, and hence efforts have been made to build capacity across the board in the MAs.

Space has been created for young people within the governance structures of MAs, and it is to be hoped that this will help to continue to provide support for progress towards the YI vision and goals.

Also, increasingly, within the MAs, the YIF project, undergirded by the RAP approach, is being perceived less as a project, and more as a resource, a strategy, a way of working that is effective in addressing SRHR issues of young people.

IPPF’s increasing interest in partnering with YI, for example, in organising the regional events on sensitive themes, funding more research on young people’s SRHR issues and using young researchers trained under the auspices of YI projects, are all positive signs.

The scale of YI, as an organisation, means that it can only point in the direction of the ideal world envisaged by YI. In that sense, the YI projects can only serve as models or pilots, for larger organisations and governments to learn from and upscale. 4.7 Sustainability and Replicability of the project/programme impacts Some of the issues related to sustainability and replicability of the project/programme have been discussed in the previous section. Other issues that need to be highlighted are as follows.

The 2009-2010 phase of the YIF project has clearly showed that the organisation is committed to and capable of learning from mistakes and making course corrections and adjustments in strategy, planning and implementation to reach its goals. This willingness to learn and adapt bodes well for the sustainability of the learnings, practices and strategies of the YIF project.

The project also amply demonstrated that it was willing to listen to young people and tailor the programme around felt needs with respect to SRHR issues – this too is likely to contribute to the sustained relevance of the programme.

FPAB (2010). Report on the Annual Project Review Workshop 2009. Bangladesh: Dhaka.

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Young people trained by the project are joining the member associations in various capacities like project staff, or being given more and varied opportunities to collaborate with the MAs.

Learnings from the YIF project helped to feed into the design of the SALIN+ project in Bangladesh. In Malawi, the youth-focused aspects project is seeking to be upscaled to more districts over the next few years. In Rwanda, the learnings from the project will feed into a project to reach children in school, with funding from the Danish embassy, over the next few years.

In Bangladesh, the consultant is working closely not only with the SARO office, but also with her counterparts in the Swedish donor agency RFSU and the Dutch embassy. The purpose is to arrive at a shared vision for the nature of SRHR programmes to be developed for young people and the technical capacity to be built for this. With the viewpoint that fragmented efforts bring fragmented results, and that bringing about more equitable norms around gender and sexuality required a combined effort, an effort is being made to work together more.

Potentially, strategies like these, together with the demonstrated effectiveness of the RAP approach, are likely to help to sustain learnings from the project in the MAs, even if the project is discontinued or takes a different form. Using young people to spread messages of SRHR and encourage uptake of SRHR related health services is both an efficient and cost-effective methodology, and this bodes well for it as a strategy that lends itself to replicability. However, it is equally true that the young people who serve as peer educators will need good and sustained training and handholding support, as well as support from influential adults in the community to provide the necessary political advocacy to ensure their programmes are well-received in the community. The need for the project will never diminish, as the natural process of the passage of time brings new young people into the ambit of the programme’s services. However, this equally indicates that, given the size of the YIF project and staff, it is unrealistic to expect the YIF programmes to make a significant difference with respect to both longterm and broad-based sustainability. For this, building in enough effort to get the government and other donors working with children’s and young people’s rights to be interested in the approach, as has happened with Malawi, or really spending time building alliances with the Regional and Central Offices of IPPF so that they can upscale the approach with all their member associations, appears to be the way to go. The constraints of the new coalition and application for funding, which requires that at least two members of the new Unite for Body Rights coalition must have partners in a given country and at least € 500,000 must be spent per country has made it inevitable that YIF will not be supporting the Mali project from 2011. This is unfortunate as the project itself was started only a year and a half ago, and has had much less time to establish itself within the organisation, while simultaneously being both unique as a youth-designed and led project, and very successful. For the same reason, the Rwanda project will also be discontinued, but ARBEF has secured funding from the Danish Embassy to carry forward the work with young people, albeit with school children, rather than child-headed households and YPLHA, with whom too, the project will stop.

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As an immediate concern, the restructuring within the RNG-WPF combine will necessarily involve a transition phase in which the two organisations try to reconcile their own strategies, approaches and learnings within the process of working towards a broader common vision. The YIF programme is a small part of this larger whole, and securing enough airtime within the organisation and building enough of a voice to propagate the learnings from the YIF programme will be critical to ensure their sustainability and replicability. 4.8 Capacity Built There has been significant capacity built across different stakeholder groups in the project, and that has been referred to multiple times at various points in this report. Consequently, in this section, only a few examples are reiterated:

While MAs have traditionally been experts on sexual and reproductive health, capacity has been built to a significant degree on how to reach such information to young people in larger numbers, using young people. Initiatives have also been taken to make service providers more youth-friendly. Often, this has involved getting service providers to think out of the box of the traditional values within which they have been reared, for example, that sexual behaviour is acceptable only after marriage. â&#x20AC;&#x153;We donâ&#x20AC;&#x2122;t ask whether a young girl is married or unmarried when she comes to us for a service. We provide her with the service, even if it is menstrual regulation. If she needs additional emotional support, then she receives that from the counselor, who keeps any information she receives confidential.â&#x20AC;? - Doctor at FPAB Clinic, Khulna.

Trainings in participatory research, advocacy and communication: MA project staff as well as young people have built skills in various areas as a result of the project. Examples of such capacity built include carrying out assessments of the needs of young people, at local level, using participatory methodologies, increasing the degree of narrative detail in monitoring reports, exploring areas with advocacy potential and developing advocacy plans, etc. The value of this has been established, with IPPF commissioning multiple research projects using the young people trained in the project.

Critical analysis of social systems, structures and norms: The project has also created a greater capacity among MA staff as well as young people to undertake a more critical analysis of existing social systems and norms, particularly gender and sexuality related norms, triangulating it with actual SRH concerns and needs of young people in the project countries. Whether it involved questioning the rationale behind denying nutritious food to a menstruating girl in Bangladesh, or the right of a girl to say no to her partner when she does not want sex, the project brought up social systems, structures and norms for critical analysis and discussion, about the extent to which these then impacted individual rights and health seeking behaviours.

The project built capacity in the MAs for an increased focus on gender balance.

A beginning has been made for engaging with sensitive issues in the project MAs and at the regional level.

4.9 Institutional and Stakeholder Issues Many institutional and stakeholder issues were articulated during the evaluation.

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YIâ&#x20AC;&#x2122;s decision to implement the project in partnership with IPPF MAs is an excellent strategic and ethical choice. As pioneers for providing SRH services in many countries, IPPF MAs have a history of progressive work, and hence are more likely to be open to new ideas and technical support from an organisation like YI. Equally, IPPF MAs ability to provide health services to back up the sensitisation and capacity building approach of the YIF programme makes the approach more complete and definitely more ethical. To raise awareness without adequate support would have undermined the ethical basis of the programme.

Nevertheless, some sections of the staff of the MAs were found to be more conservative than others, and less receptive to the RAP approach.

Another concern was that core-funding tended to be limited, and hence, in some cases, staff paid from the core funds tended to be less well paid than some project staff. Likewise, there was a difference in salaries for men and women doing similar jobs in some cases. Hence, some organisational development support may be necessary for the MAs, and this is something to be discussed collaboratively with the MAs and the IPPF. The difficulty in bringing these issues up for discussion is compounded by the fact that in many of the MAs, the YIF project is one of many projects, and a comparatively smaller project at that.

Another institutional concern was that the Boards of the MAs were often drawn from influential elders and leaders in the country, who are not always as aware as they could be about issues and realities related to young peopleâ&#x20AC;&#x2122;s SRH needs in the country. They are also volunteers, and speaking from more traditional viewpoints in consequence, some of these Board members may not provide adequate support or may even actually oppose elements of the programme. This may make it difficult for professional staff to push more progressive agendas. It therefore becomes important to be aware of some of the political ramifications and the constraints under which they may be working.

In some MAs, the clinics are already working to full capacity. While some senior managements are open to expanding the capacity of the clinics, other service providers have concerns that expanding the programme or making it work efficiently to increase demand for services from young people may increase the burden on them if there isnâ&#x20AC;&#x2122;t a corresponding increase in infrastructure and human resources.

While the governance structures in the MAs have been adapted to allow for greater participation of young people, it is important that such participation is real and not tokenistic. For example, there have been instances where a young person has been invited to board meetings but did not have a voice or enough respect at these meetings, but was only tolerated and patronised.

Several staff members expressed concerns that over the past year, sharing within the YIF programme in the Netherlands had focused almost entirely on strategic and implementation issues and much less on content. While this may have been because of the additional pressures involved in preparing for a merger, building an alliance across many organisations, and applying for a new cycle of funding, there were strong concerns that there is inadequate sharing of lessons and experiences across the national and international programmes of RNG. Now, the challenge will be to ensure linking and learning with the WPF as well at the intraorganisational level, and the other partners in the alliance in the new Unite for Body Rights programme at the intra-alliance level.

As the example of the discussion with the teachers in Khulna reveals, even when the programme has proved its relevance and pragmatic efficiency, deep seated internal barriers related to norms about young people and sexuality may continue

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to operate even when the holders of such reactionary views admit that these may have no rational basis. Such views can be fanned by vested interests and quickly take on a more ugly character, which can jeopardise the status of the project politically. Until the views that the programme advocates for, which run counter to prevailing religious and societal views on young people and sexuality, become more general, this factor can always affect the sustainability and replicability of such projects in many countries.

The issues with MAs finding it difficult to collaborate with other NGOs highlighted in the mid-term evaluation continues to be a challenge two years on. There may be several reasons for this. As pioneers in SRH services in most of the project countries, these organisations enjoy a fairly high status, are more settled and looked up to by other organisations. Under such circumstances, reaching out to other organisations may not seem an immediate necessity. The multiplicity of projects that come to established organisations, and the consequent pressure of work, coupled with the amount of time and sustained efforts required for good inter-organisation collaboration may also be a deterrent.

Although the decision to hold the YIF Board meetings in the partner countries in rotation was really appreciated, the hope that these would become genuine opportunities for linking and learning appeared to be realised to a lesser extent. There was a reluctance to share mistakes and failures and learn from them, and partners were unfailingly polite to one another, which limited the potential learning impact of these meetings.

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Programme 2009-2010

Chapter 5 Conclusions and Recommendations 5.1 Insights into the findings Many of the insights into the findings have been woven into the main body of the report. However, a few key ones are highlighted.

The MFS phase of the programme was able to address most of the important concerns raised in the mid-term evaluation, and undertake a course correction to make significant gains towards the achievements of the first (increased number of young people reached), second (improve conditions for exercising SRHR) and fourth (youth participation) objectives of the project.

A good and courageous beginning has been made in working towards the third objective (reducing resistance to addressing sensitive issues.)

Institutionalisation of learnings from the project (the fifth objective) has happened most spectacularly in the FPAB project, which has upscaled it to 21 districts. By working with the local government and providing capacity building to service providers in government clinics, FPAM has also succeeded in some degree of institutionalisation of learnings – this is however limited by the very small geographical area on which the project currently has an impact. The short duration of the Mali project, the ‘falling away’ of the current target group in Rwanda and the fact that YI will not continue working in Rwanda and Mali raises some real concerns about institutionalisation of learnings in these two settings.

Young people are happy to respond to any work that addresses a felt need in their lives – of receiving clear, accurate and complete information on SRHR and nonstigmatising and easily accessible SRH services.

If services for young people are combined with services for older people, the level of uptake by young people is likely to be lower.

Young people are also willing and able to acquire the competence to be full participants in the design, implementation and monitoring of such projects which are relevant to their lives, especially since the social and religious environment in most of the project countries precludes many possibilities of receiving these resources from other sources.

Since most of the young people came from areas and backgrounds which did not afford them many other resources either, the ramifications of the support they received from the YIF project far exceeded the bounds of SRHR. They became much more empowered and articulate, and willing to take on responsibility and be change agents in their communities.

Consequently, their status in the communities went up as well, with more traditional leaders seeking their support as allies.

Young people were more flexible and courageous compared to the member associations when it came to engaging with sensitive issues.

There was significant capacity building and empowerment of MA project staff and young people, both in their work, and even at the personal level.

That said, it is important to remember that, in addressing young people’s sexual health concerns, especially sensitive themes like sexual diversity and abortion, the member associations work within the constraints of unsupportive, and sometimes hostile, frameworks of organised religion, the law and the political environment. It is important for YIF project leaders not to judge for others, even as they push for change.

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Religion continues to be a key environmental factor which influences the work towards YI’s broader vision.

Many of the young people have critical immediate concerns beyond their sexual and reproductive health, like finding opportunities that will help them learn a skill, get a job, earn an income, contribute to the family, etc., and they need support for this as well.

While the MAs are carrying out their responsibilities to the project effectively, the sense of responsibility towards young people may be less than optimal. While the success of this project depended critically on the participation of young people, MAs may have not explored enough efforts to pay them a reasonable honorarium, or look for alliances with other NGOs which would support them with skill development or income generation.

While the first steps towards bringing in young people into the governance structure of the MAs have been taken, more work will be needed before they are acknowledged as valuable advocates for their peers within these structures.

YI needs to advocate within its own governance structure for meaningful participation of young people, an area in which it has not achieved any significant success. Likewise, the proportion of older, sometimes very senior staff, to younger staff is extremely skewed in favour of older staff. If not addressed, contradictions between what the organisation preaches and what it practises may raise issues of philosophical and operational consistency, and eventually, to concerns related to credibility and ethics.

In spite of the high turnover of project staff within YI, the second phase of the project was able to provide the continuity of support necessary to achieve the objectives of the project. This points to good internal systems within YI of leadership and adequate project documentation necessary to provide this continuity.

In addition, it is also important for YI as well as the member association to maintain both self-reflexivity and community dialogue. This is because there is such a divergence between the traditional values of the communities and those of the project. Even though many of the important values of the project come from events like ICPD, ICPD+5 and Beijing+5, in which there was tremendous participation and representation from women from the south, many communities still perceive these as “western values” or “white people telling us how to lead our lives.” It is very important to ensure that local data is generated or gathered at regular intervals, and genuine dialogue promoted for local contextualization at the level of project communities, and self-reflexivity at YI level to ensure that issues related to cultural hegemony are constantly articulated and consciously explored. Often, it is perceptions and not facts that drive the choices made by communities, and the long term sustainability of the project will be strengthened by these elements of reflexivity and dialogue.

5.2 Reasons for Successes and Less than Optimal Performances Successes a. The project was responding to a felt need, and the project provided resources to meet the need for good information and non-stigmatising services. b. The project consciously and meaningfully addressed gaps identified in the midterm evaluation.

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c. The project created spaces and opportunities for young people to contribute to their communities in meaningful ways. d. Many of the young people involved in the project also lacked much access to other resources, including educational and livelihood opportunities to any significant degree, hence apart from providing information about health and rights, often the YIF Project took on a role of mentorship, of bringing some hope of possibilities into their young lives. e. The project was successful in establishing the importance of acceptance of young people’s sexuality, and to help transform rights from an abstract concept to concrete stigma-free services. f. The programme paid attention to the fact that young people in general, and young people in the project countries, were likely to have few resources, identified critical needs, and almost all services were provided free of charge. In Mali, young people do not even have to pay for the phone call to reach the hotline that provides them with information. Young people can send a free SMS and receive a call back. In Rwanda, the project paid for health insurance and ARVs for young people living with HIV/AIDS. g. There was significant capacity building and empowerment of MA project staff and young people, both in their work, and even at the personal level. “I can now speak to my husband about sexuality-related matters.” – MA Staff member, Rwanda. “I broke off my friendship with a friend of mine who was gay when people teased me about being gay too. I feel bad, I will go back and apologise and resume our friendship.” Young participant in sensitive theme workshop. h. The project consciously worked to increase support from influential members of the community and engage in processes of sensitization and increased dialogue to counter opposition to the project. i. Wherever possible, most notably in Rwanda and Malawi, the project actively collaborated with local government. j. Most member associations reported that the YI consultants in charge of the projects really made an effort to understand their constraints, and collectively problem solve with them to address difficulties. k. However, where the consultants found issues they were seriously concerned about, for example, timely and targeted use of project funds, inadequately detailed reporting, etc., they took the time for very close monitoring and follow up until the issues were worked out. l. The use of personal stories, (e.g., of a girl drinking crushed glass to try and end an unwanted pregnancy) either in testimonies in direct interactions with members of marginalized groups or in films like “Jihad for Love” on the struggles of homosexuality with Islam has definitely contributed to shifts in perception about sensitive issues, especially the notions that some of the issues like sexual diversity are Western imports, or “urban problems”, and to accept the relevance of these issues in the societies of the MAs. Less than Optimal Performances a.

Across the board, peer educators felt that they needed more training than they were getting at present. Whereas in places like Bangladesh, there were back ups in the form of Youth Counselors, Nurse Practitioners and doctors available close by

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for back up in case a peer educator did not know the answer to a particular question, in remote places where peer educators provided services, e.g., in Malawi, if they did not know the correct answer to a question, there might be a temptation to make up an answer to prevent loss of face. b.

Even when the trainings provided by YI are excellent, e.g., on communication on sexuality or M & E, there is need for follow-up trainings. At the same time, it can be considerably more expensive to organise trainings by consultants from the Netherlands.

Most of the training materials are in English and not the local language and this is a serious limitation in some countries. The concerned MAs had not taken enough of an initiative with this aspect, even though adequate budget was available.

Confessing weaknesses in the programme is perceived as threatening by MAs.

The Bangladesh programme is urban-based, and reaches people in some economic hardship and the lower middle class, but does not reach the ultra-poor or rural communities.

Linking with other organisations to realise the full advocacy potential of this programme continues to be a challenge both at YI and the MAs.

The legal, religious and political environments are less conducive to reduce resistance to sensitive issues of youth sexuality in most countries.

The advocacy potential of the RAP song event has been allowed to diminish in most MAs. While older participants in the programme knew it, younger ones did not. The song can be used for multiple purposes: to build solidarity among young people with the objectives of the programme, to reiterate the message of sexual rights, to reduce resistance to acceptance of young peopleâ&#x20AC;&#x2122;s sexuality, etc.

The rapid changes in the policy environment and constraints imposed by new alliances and back donors has also affected the sustainability of parts of the programme. For example, the requirement that at least two donors must work in a country meant that the Rwanda and Mali projects cannot be continued into the next phase. If YI had had some inkling of the coming changes in the policy environment, choosing a partner organisation with which it could have a longer cooperation agreement may have been possible.

Some of the senior leadership and key staff hold traditional views of morality which run counter to taking a rights-based approach to issues like sexual diversity and abortion. While it may be strategically important for the leadership to assent to the relevance of these issues, their own personal barriers, added to the legal and social barriers that exist in their societies, may further inhibit significant action on these sensitive themes.

5.3 Innovations The programme had some important innovations to its credit.

All the MAs felt that the RAP approach had brought in a new way of looking at young peopleâ&#x20AC;&#x2122;s sexuality, which was tremendously helpful.

The most important innovation was the use of young people as resource persons for sexuality and sexual health and rights-related services and events. This includes the appointment of youth counselors in FPAB clinics, and empowering young people to teach sexual health related material and facilitate international workshops and conferences.

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FPAB had upscaled the project by creatively linking it with another project, the SALIN+ project, according to which that project would pay for the honorariums of the peer educators hired in the new districts. However, that project had fewer capacity building funds, so the new peer educators would be included in the trainings for those in the YIF project, which was also more operationally and cost efficient.

The programme harnessed the openness and innate appeal to justice that young people possess, together with project resources and support, to fight stigma against YPLHA and serve as a model to families and communities that were rejecting them in Rwanda. As an unexpected outcome of the project, the solidarity built also resulted in the creation of collectives of YPLHA who worked on income-generation projects and were able to better their economic prospects.

The project in Mali was entirely youth-designed, youth-driven and youthimplemented, and had a tremendous impact in increasing the uptake of services by young people.

Working closely with the traditional authorities, traditional healers and church authorities of Kachindamoto and Tambala to bring about changes in the manual for the initiation ceremonies for young people was the most significant innovation. The manuals have been altered to make them include accurate sexual healthrelated information and counter myths and traditional practices that violated the rights of young people, and these, while awaiting finalisation, are already being implemented. Likewise a law has been passed within the TA to prevent forced child marriages.

YI has increased its collaboration with the regional and central offices of IPPF and succeeded in securing more attention to the issues of the sensitive themes.

5.4 Recommendations (based on evidence and insights)

Empowerment training and life skills: As the project is currently implemented, the bulk of the information shared by the peer educators with young people through the project focuses on reproductive biology and the physical details related to sexuality, apart from rights information. The project also focuses to a great extent on the individual young person learning about his or her sexual and reproductive rights and health. However, what one expert called “the plumbing of sex” is only the most basic aspect of sexuality-related training. To be able to negotiate within environments that traditionally do not give space to their opinions or needs, young people also need empowerment training, and a number of relevant skills, including good decision-making; assertiveness skills; learning to say no, negotiate safe sex, and respect boundaries; stress reduction, building support groups, etc. Without such skills, young people cannot negotiate the strong prevailing social norms and structural barriers and benefit completely from the information they have received in this phase of the project. All these aspects need greater attention within the project.

More attention to gender and masculinities: While the basic level of attention has been paid to gender, ensuring equal access of boys and girls in the programme, both at implementation and participation levels, a number of stakeholders felt that the programme has not paid sufficient attention to analyzing how the project could be gendered at a deeper level. As Ms. Braeken of the IPPF Country Office remarked, “We all use the word a lot, but do not do enough.” Not enough attention has been paid to the separate difficulties faced by girls and boys and how the project can help them address these. For example, levels of sexual

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activity at a young age tend to be lower for boys in Bangladesh, compared to the African countries, and hence they may need less access to condoms and VCT services. However, they tend to have a whole range of other concerns, and issues that need to be addressed: for example, worries related to genital sizes, power within the family and relationships, self-esteem, relying on pornography for information related to sexuality, reliance on street hawkers and quacks for medicines and oils aimed at increasing ‘sexual power’, fears that masturbation made them weak and compromised their health, anxieties related to virginity, etc. In Mali, the issue of gender-based violence was far more contentious than issues related to abortion and sexual diversity as it challenged gender norms. As one older male community volunteer said during one of the trainings carried out by YI, “Our society values men more than women, and I don’t have a problem with that because it is to my advantage.” When this is the point of view of a person who has supposedly been empowered by the project, bringing about change in the field would require much more attention and effort. Hence, there is need for a much deeper analysis of how gender norms should be addressed through the project, and how gender-based violence is perpetuated in sexual norms. Further, gender, rather than being interpreted as more attention to women’s issues must take into account and address masculinities in a way that men can be part of the solutions generated.

Monitoring the levels of knowledge of peer educators: Currently, peer educators receive approximately one training a year. Training manuals in some countries have also not been translated into local languages. Some project coordinators, consultants, as well as peer educators themselves said that they needed more training. Quick methods of reviewing key points (e.g., collaborative group quizzes and group discussions, input sessions and interactions with doctors from the MA’s clinics, etc) should occur periodically (at least once in two months) not only to ensure that the information passed on by peer educators is accurate, but that it is communicated in appropriate ways. Training MA staff and peer educators to a greater extent in using participatory methodologies will also be valuable in more effective outreach.

Developing a pool of trained local consultants who can build capacity: Inevitably, as they seek out new opportunities in education, skill training or careers, or simply as they outgrow the programme, peer educators are going to self-select their exit from the projects, even as new beneficiaries who need the support of the programme come in. It would be impractical, and inefficient costwise, to think of each new group of peer educators being trained by consultants from the Netherlands. Locating local consultants who can be trained and then form a resource pool that can be accessed by MAs periodically would be created. This would mean that the YI communications expert would not need to give repeated trainings in the partner countries. Rather, he would build skills in local consultants who would then replicate the trainings locally, which would also be more efficient operationally and time-wise, as translations will not be necessary, and cultural contexts immediately understood.

As the project stands, each of the YI consultants is in charge of a single project in a single country. By the standards of most donor organisations, this represents an unimaginable luxury. To some extent, this is also because the YI consultants provide technical support, in addition to programme management support. Finding more technical resources locally would free up consultant time which can then be freed up for addressing other technical gaps and new challenges.

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Sharing results of programme with broader networks of organisations that work with young people: The YIF programme has demonstrated several successes which need to be shared beyond the community of organisations working on SRH. Many organisations working with children and young people are reluctant to take up work on sexual and reproductive health issues, even though they know that this is necessary, because of diffidence and a reluctance to handle sensitive issues. Sharing the learnings from this project will encourage some of them to consider taking up this work, and contribute to YI’s vision of a world in which all young people are able to realize sexual and reproductive health and rights.

Establishing linkages with organisations that work on poverty alleviation programmes: Establishing linkages with organisations that work on poverty alleviation programmes, and provide vocational training and income-generation programmes for young people will help to increase the value of the YIF projects to young people. While young people find sexual and reproductive health and rights information necessary and relevant, beyond a point, the pressing business of earning an income becomes of critical concern. Providing such linkages will also contribute to the sustainability of the programme.

Transition planning for peer educators: In countries like Malawi, most of the peer educators attach a lot of value to their association with the YIF programme. This was because many of them had extremely limited access to any kinds of educational or job-related opportunities in the rural communities where they lived. At the same time, the success of the Malawi programme is heavily dependent on the contributions of the peer educators, who often have to walk very long distances to reach the remote rural communities that they serve. The sum paid as honorarium is also very limited, about MK 500, which is about the price of a single meal for one person in an extremely ordinary restaurant in many rural communities. To ensure that these young people do not end up feeling used by the programme, it is important that the MAs work on some transition planning with the young people to help them find some viable options for the next stage of their lives.

Consistent and sustained advocacy at the local level in Bangladesh: There are stark differences between YI’s perception of young people’s sexual rights (“to enjoy safety, confidence and pleasure in relationships and all aspects of sexuality” and “to support and empower” them to “make informed choices regarding their sexual rights”) and the community’s perception (namely, almost none, unless they are married, and then rather limited for young women). The MA is caught in the middle. The organisation has achieved a great deal by winning the support of local leaders; however, this advocacy has to be carried out in a consistent and sustained fashion. This is because the project’s assumptions run counter to the expressed dominant cultural views, and public opinion can easily turn against the project. For example, young people come to the Tarar Melas for, among other resources, singing and dancing lessons. Dancing lessons appear to focus on a form of dance called “cinematic dance”, dances based on popular Bangla and Hindi cinema. These dances include a number of moves which can be perceived as very sensual and suggestive. Most young people who participate in these dancing lessons, and especially the girls, do not have permission from their parents to participate in these dances, especially those in which boys and girls dance together. During the evaluation, it was seen that young girls participated in these dances, and then dressed in demure burqas to return home. It is easy to imagine a situation in which a parent or community member may drop in to check on the activities of the Tarar Mela, form a negative opinion of the project’s activities, and

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garner public opinion against the project. In such a situation, the hard won gains of the project can be quickly negated. It is important, therefore, that the importance of local advocacy not be underestimated at any time. In spite of all the work done by the project, some educated community members expressed their apprehensions that the project “promoted free sex”. It is important to counter such perceptions with factual information based on research on the realities of young people’s sexuality in Bangladesh, and what international research says on the benefits of providing young people with timely, sensitive and accurate information on SRH. Consistently monitoring the project for potentially negative political fallout, while working towards the goals of the project may be critical.

Work more explicitly on religion and sexuality: In all the project countries, religion was a very important factor affecting attitudes to and practices related with sexuality. The YIF project appears to have acknowledged this, viewed it largely as a reactionary factor, and relied on member associations to address the issue. For many people, however, religion is key to the way they choose to live their lives, and the dilemmas related to the choices they make in addressing their sexual and reproductive issues are very real. There is also expertise and resources available on this issue in the Netherlands which can be sourced by YI and provided to MAs so that they can be assisted to address the issue in a sensitive way, as they adapt these resources to local contexts. Helping MAs establish linkages with local chapters of the International Network of Religious Leaders Living with or Personally Affected by HIV and AIDS (INERELA+) in Rwanda and Malawi and the Asia Interfaith Network on AIDS (AINA) which brings together Buddhist, Christian, Hindu and Muslim religious leaders on issues related to sexual health, as well as providing information about interventions in Muslim countries like Senegal, Uganda and Indonesia, as well as initiatives like the Naz Project in the UK will help MAs address the stigma associated with working with young people and issues of sexual health, while engaging with religion in empowered ways. Apparently, a beginning has been made with this with the proposed next phase of the programme, and this will be an important step in a critical direction.

Build on momentum generated by the study tour and regional events on sensitive themes: The challenges posed by the sensitive themes are undoubtedly difficult for the MAs to address. The initiative taken by YI and IPPF to collaborate on holding the regional workshops on sensitive themes is also praiseworthy. It is important to build upon the momentum generated by this event through collaborative strategizing and support from YI.

Developing child protection policies and HIV workplace policies and making them living documents: As an organisation that works with young people, it is imperative that YI develops a Child Protection Policy. This is true for member associations as well. Where HIV/AIDS workplace policies do not exist, these need to be developed. Where they do exist but are not generally known among staff or operate as living documents, a process may be necessary to transform them to help HIV positive people to feel comfortable about being staff or potential staff in the organization. This may involve taking steps by which the organisation becomes more ‘porous’ in actively seeking the collaboration of positive people’s networks on certain events, e.g., an input session, or a strategic planning session, prior to a discussion on whether there is need to review the HIV workplace policy. This needs to happen for philosophical congruence as well as concern for the staff and the young people that the YI and MAs work with, on terms similar as those used with the community.

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Increase the extent of youth participation in RNG: While the MAs have taken important steps to increase the extent of youth participation in the design, implementation and monitoring of their programmes, this has been less of a strength in YI. Admittedly, there are logistical difficulties for YI in undertaking this. Building a Netherlands-based advisory group would mean that these young people might not have enough information about the different cultural contexts of the MAs to play a suitably supportive role. Building a global-based group would increase costs. YI may have to explore a variety of creative options to ensure youth participation in spite of the prevailing institutional constraints. Some possible ways might be: o

Young people from the project countries who come to the Netherlands to attend courses (e.g., study tours, courses at ISS) may be engaged in facilitated focus group discussions (about 2-3 a year) to understand issues of importance that need to feed into programme or project design. Likewise, every half year, MAs may also be requested to send in recommendations from the YAMs. A 1-page document may be prepared at the end of the following six-month period to indicate congruence between recommendations from young people and project design/implementation.

To establish internships for young people in RNG: Young people from the Netherlands may do part-time/full-time paid/voluntary internships for between 6 months to a year and assist the consultants with their work. While gaining valuable work experience, they can also assist the consultants with some aspects of programme implementation.

Consultants may be accompanied on monitoring visits by one young person, preferably from another MA in the region. In addition with strengthening youth participation in programme monitoring while keeping costs low, these can also serve as ambassadors and advocates for transfer of innovations from one country to another in the region.

5.5 Lessons learned with wider relevance that can be generalised beyond the project Some of the important lessons that can be generalised beyond the project include:

Given the taboos associated with sexuality in societies around the world, and the sexuality of young people in particular, any programme targeted at young people sexual and reproductive health issues must address the difficult issue of acceptance of youth sexuality. Without this, any reference to rights will remain rhetorical, and services will not be youth friendly. The project understood this important aspect, and actively engaged to address it.

Building support networks of influential adult allies is essential for the success of any programme on young peopleâ&#x20AC;&#x2122;s SRH. The visibly increased success of the project in the MFS is a testimony to this element.

The view that programmes addressing young peopleâ&#x20AC;&#x2122;s SRH will promote early initiation into sexual activity and promiscuity, as the teachers in the secondary school at Khulna feared, persists across the world. This must be, equally persistently, countered with factual information about the SRH realities and risks faced by young people around the world, and the results of the number of research studies showing that clear, accurate and complete information on SRHR delays the age of first sexual intercourse and teenage pregnancies.

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The project demonstrated that young people are very receptive to receiving information on SRHR from their peers and most comfortable with this methodology.

Empowering extremely vulnerable young people in poverty with information, strategies and services related to SRHR appears to empower them more generally to take responsibility for their lives and act as change agents in their communities, and increases their aspiration levels. The increased responsibilities given to young people, and their improved status, in communities, MAs, and the increased initiative shown by the YAMs is evidence of this.

Many faith-based institutions and leaders continue to view SRHR issues through the lenses of morality and sinful behaviour versus behaviour acceptable according to religious views, as evidence from the field showed during this evaluation. This is true of all religious groups to some extent, and more true of some groups than others. Instead of dismissing such views as reactionary, organisations working with issues of young people’s sexuality need to engage with the enduring power of this perspective, as well as the very real role played by religion in the lives of many of the target groups they work with. Accordingly, they need to consciously seek out resources and allies who can help them engage in constructive dialogue and collaboration with these groups. The strategies and achievements made by projects such as the YI project in Malawi and FPAB's Madrassa project in Bangladesh need to be studied and used for advocacy purposes.

Working on programmes on young people’s sexuality that focus on the individual’s knowledge of SRHR issues has only a limited value. The project has demonstrated that, to be truly effective, the structural barriers and societal and systemic constraints need to be addressed, and simultaneously, young people provided with empowerment training to undertake their own negotiations with these barriers.

Addressing issues of SRHR, while ignoring the systemic relationship of poverty and violation of sexual and reproductive rights and access to sexual and reproductive health services, can have only a limited value as people struggle to earn their daily bread. Communities and local leaders in Rwanda and Malawi repeatedly asked for such support, and where some additional resources were provided (e.g., computers, spoken English lessons which increase employability, sports materials and so on, in Bangladesh), these immediately increased numbers accessing services and their receptivity to SRHR messages as well. Linkages of SRHR programmes with (other organisations’) programmes on poverty alleviation, education and income generation will help in their sustainability and continued relevance.

The project shows that the systemic relationship between gender and sexuality needs to be constantly analysed more deeply and creatively and consistently addressed. First level gains made in this phase of the project, e.g., increased space and voice for young girls and women, must be built upon further. The persistent association of ‘gender’ with ‘women’ needs to continue to receive adequate attention, but not at the cost of ignoring issues related to masculinities - as the evidence from countries like Bangladesh and Malawi reveals, in spite of their comparatively higher status, young men struggle with gendered norms as well. Solutions for the continuing systemic and personal imbalances of power between men and women must necessary include continued and creative engagements with men, otherwise, as the comment from the male community volunteer showed, men may not feel that there is sufficient incentive for them to change the status quo.

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Issues of sensitive themes in sexuality are difficult to work with, as the project's initial exploratory steps working with abortion, gender-based violence and sexual diversity show, and easy to ignore when there is still a lot of work left to do with the mainstream issues like reducing teenage pregnancy and maternal mortality and prevention of HIV. Repeated efforts are necessary for mainstream organisations working on SRHR to engage with these issues, and take up issues related to sexuality minorities, people with disabilities, and conflicts between dominant cultures and sub-cultures related to sexuality, in order to achieve social justice.

Addressing young peopleâ&#x20AC;&#x2122;s sexual health issues from the lens of positive sexuality, rather than that of disease and death, is of great value, as the District Health Officer of Dedza pointed out, and needs to be propagated far more widely than it is at present.

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Programme 2009-2010

Annexure 1

Before Youth Incentives: “Menstruation is a disease. During this time, one should eat very little. One should not eat meat or fish. One should not eat turmeric or oil one’s hair. One should not go out of the house. The cloth one uses as pads should not be taken out of the house and should be kept hidden. It is not right to discuss this with anyone.”

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After Youth Incentives: “Now I know that menstruation is not a disease, it’s a normal happening. One can eat all kinds of food during one’s period. One should eat nutritious food and drink lots of water. The cloth that is used as pads should be dried in fresh air and strong sunshine. One should use clean water to maintain good menstrual hygiene. I have learnt all this. Now I am completely free from anxiety.”

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Programme 2009-2010

Annexure 2 Terms of Reference for the External End Evaluation of the Youth Incentives Programme 2009-2010

1 Youth Incentives-project background and context Youth Incentive’s vision of an ideal world is one where all young people can enjoy safety, confidence and pleasure in relationships and all aspects of sexuality. Its mission is to support and empower young people, male and female, to make informed choices regarding their reproductive and sexual lives. In order to achieve this mission, YI promotes a ‘RAP’ based environment: Rights-Based, Acceptance of Young People’s Sexuality and Participation of Young People in Programme Development, Execution and Evaluation. Acceptance encompasses youth friendly services at health clinics; acceptance of youth sexuality by parents and teachers; and a better mutual understanding of young(er) and old(er) people. This environment is at local, national and international levels, including governments, organisations, service providers, communities and individuals. A RAP-based environment refers to a gender-equal environment where young people can recognize and realize their sexual and reproductive rights, where their sexuality is accepted and where they can participate in sexual and reproductive health matters that affect them, in particular with regard to sexual and reproductive health and rights (SRHR) interventions. Through the promotion of a RAP-based environment and through the specific activities of the partner organisations, YI intends to: 1. 2. 3. 4. 5.

Increase the number of young people who recognize and realize their sexual and reproductive rights (SRHR); Improve conditions for young people to exercise their SRHR; Reduce resistance to addressing sensitive youth sexuality issues50; Increase youth participation in partner organisations and RNG; Institutionalize learning from the project.

These sensitive issues are (gender based) sexual violence, sexual diversity and abortion.

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Programme 2009-2010

Country and project specific information on Mali, Rwanda, Bangladesh, and Malawi can be found below. Count

Project Name

Project Location(s)

Project Budget

Project Duration

Partner Organisation

Target Group(s)

Malawi

FPAM -

Promoting the rights and acceptance of young people’s sexuality and effective use of SRH services by young people in the Dedza District, Malawi

Kachindamoto and Tambala Traditional Authorities (TAs) in Dedza District

2009:

2006: needs assessment; 2007-2010

Peer educators

Family Planning Association of Malawi)

Available € 58,000 Extra budget for YAM € 2,000

Youth Counselors

2010:

Parents

Available budget € 58,000

Service providers of the youth corners

Extra budget € 10,000 for advocacy and € 2,000 for YAM Mali

AMPPF Association Malienne pour la Protection et la

Youth to Youth

Koulikoro and Sikasso

ARBEF Association Rwandaise

pour le bien être Familial

€ 145,000 2009 - 2010

for

2009 -2010

Youth aged 12 to 24

2004 - 2008 and 2009 - 2010

Child Headed Households and Young People Living with HIV/Aids

AMPPF contributes

Promotion de la Famille Rwand a

Young People

€ 49,200 Promotion of Sexual and Reproductive Health and Rights (SRHR) of Child Heads of Households (CHH) and improvement of the care of HIV positive youth (YPLWHA) in

Huye, Nyanza and Gisagara district;

€ 81,867 for 2009 (includes extra funding for RAP song activities and expenses for training provided by YI).

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the Southern Butare

Province

of € 81,500 for 2010 (total, consisting of € 62,658 YIF project + € 10,000 advocacy plan + € 6,000 YAM project sensitive themes + € 2,840 repair)

Bangla desh

FPAB - Family Planning Association Bangladesh

Promoting SRHR of Young People through Youth Participation

Chittagong city, Bangladesh city, Faridpur Municipality and Jessore Town

car

2009: € 70,000 2010: € 67,000

2004-2008 2009-2010

and

Total: € 137,000

Note: The Malawi project is co-funded by Simavi and the Mali project has secured additional funding through a cooperation with the Royal Dutch Embassy in Mali (2008 - 2012). YI is the donor to these partner organisations, provides technical assistance and advice and is responsible for maintaining relations with back donors. In addition YI disseminates information on RAP, conducts research on youth sexuality and maintains a close working relation with IPPF and its regional offices.

Sex workers Riskha drivers

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Programme 2009-2010

2 Objectives of the evaluation For the past six years YI has worked on youth and sexuality. After the external evaluation of the 2005-2008 period many adjustments have been made. The current evaluation will focus on the adjusted programme as it has been executed for the last two years: 2009 and 2010. The most important element of the YI-programme, and therefore the evaluation, is the RAP-approach (as a principle). As the RAP-approach has slightly differed per country the evaluation will be country specific. Nevertheless there is enough common ground to make comparisons and to aggregate findings. The five aforementioned objectives51 of the YI-programme have been put into a monitoring and evaluation framework that has been used during the mid-term evaluation (2005-2008) and will again be used for the end-term evaluation of the programme (see Annex 1 for the framework). The objectives from this framework will be further operationalised in the paragraph on evaluation issues and key questions. This external evaluation is the final evaluation of the Youth Incentives Programme. The first phase of the programme (2005-2008) has already been evaluated. The current evaluation covers the second and final phase (2009-2010). It serves the following objectives: a)

The external evaluation should provide an analysis of accountability with respect to the use of project funds for the backdonor(s), principally the Ministry of Development Cooperation/MFS1. The evaluation should provide recommendations that serve as input for the new programmes in the field of SRHR for the new Rutgers WPF organisation52, the SRHR Alliance53 and IPPF. The evaluation should provide recommended strategies to integrate the RAPapproach and activities from Youth Incentives into other programmes of the Member Associations, Rutgers WPF and the SRHR Alliance. The evaluation should provide input (experiences, strategies and methodologies) for organisational learning of both Member Associations and YI itself. This aspect is especially important in view of the upcoming merger between Rutgers Nisso Group and WPF.

Repeating them: Increase the number of young people who recognize and realize their sexual and reproductive rights (SRHR); Improve conditions for young people to exercise their SRHR; Reduce resistance to addressing sensitive youth sexuality issues; Increase youth participation in partner organisations and RNG; Institutionalize learning from the project. 52 On January 1 2011 Rutgers Nisso Groep and the World Population Foundation will merge into a new organisation called Rutgers WPF. 53 The SRHR Alliance Unite for Body Rights consists of Rutgers Nisso Groep, World Population Foundation, Simavi, Dance4Life, Choice and AMREF Flying Doctors. This Alliance has made a joint MFS II proposal.

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3 Evaluation issues and key questions The evaluation will be conducted at four levels: Youth Incentives, the four Member Associations, the Youth Action Movement in the four countries, and finally youth in the four countries. Of course not all research questions apply to all four levels. The evaluator will have to decide what questions are appropriate and when. Please assess the findings against the conclusions and recommendations of the mid-term evaluation. Special attention should be given to the (changes in) project strategy and design. Key Questions

Specific Research Questions. Note that these are not always directly linked to the Key Questions

Design of the YI-programme To what extent are the objectives of the project still valid? Is the RAP strategy?

approach

appropriate

Are there any major risks that are currently not being taken into account? Do stakeholders care about the project (i.e. working with young people and sexuality/RAP) and believe it makes sense? Distinguish between MA’s and YAM; include IPPF CO, ARO and SARO here.

Are member associations54 better equipped to execute youth sexuality programmes? How do MA’s deal with youth and sexuality and is the RAP-approach recognizable? Is the MA (providing) a environment for young people?

supportive

Changes in gender roles (another outcome) will be a focus in the end evaluation. The position of women and men in society strongly affects their sexual lives and it is therefore important to see what changes at individual and community level YI has achieved. Has the RAP-approach been sufficiently gender specific? Is upscaling of RAP or elements from the RAP approach already taking place at MA and Regional Office levels? If yes, where and how. Can it be attributed to the project?

Effectiveness at MA and YI-the Netherlands level Assess the major achievements of the project to date in relation to its stated objectives and intended results. As far as possible this should be a systematic assessment of progress based on monitoring data for the planned objectives and activities. (Data already collected by 54

The YI projects wanted to create a conducive environment for young people and wanted to achieve changes in young people’s sexual and reproductive lives, both at individual and at community level. Have the projects in the four countries succeeded in doing this? Include changing perceptions,

When talking about MA’s we refer to the paid staff at HQ and at district level. Also included is the paid staff from MA clinics.

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the project’s monitoring and reporting systems should provide much of the basic information). Describe any unforeseen effects/outcomes (whether positive or negative). What has been the quality and effectiveness of technical assistance to MA’s by YI consultants (bilateral TA, training on M&E, research, communication and advocacy)? What has been the outcome of the TA?

Youth Incentives, 2010

changing values on sexuality, increased decision making power on matters regarding sexuality, positively changing gender roles, etc. Identify any exceptional experiences that should be highlighted e.g. case-studies, stories, best (or promising) practices. Peer education is one of the main methods used. Most projects use peer educators to disseminate information. Does it have the desired quality and effect? The project desires a ‘gender balanced environment’. What progress is made to reach such an environment? What (kind of) attention do the MA’s pay to gender issues, does YI do that? Etc What are the personal and organisational viewpoints of MA’s, CO, SARO, ARO and YAM regarding the sensitive themes? Have they succeeded in addressing sensitive themes? How (freely) do staff of MA’s, CO, SARO and ARO speak of youth sexuality and the so-called sensitive matters?55 Is intensification of the programme through advocacy taking place? What are the results at local, national and global level? Has advocacy been brought to the attention of SARO, ARO, CO (as being part of RAP)? Has advocacy on the RAP approach taken place? [This question will probably be taken out because it is too early to assess the effects of advocacy.]

Efficiency Assess programme management factors important for delivery, such as: Capacity gaps (these could be in the project team, other internal functions such as HR or Finance, or external organisations as appropriate).

How does the project succeeded in involving young people in planning, monitoring and evaluation, but also in execution? Do young people feel they ‘own’ the project? This question must be considered under effectiveness and impact as well.56

Working relationships within the team Working

55 56

relationships

with

partners,

Specifically for Malawi: An assessment of the infrastructure, resources or leadership

This question refers to the A in RAP. This question refers to the P in RAP.

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stakeholders and donors. Learning processes such as selfevaluation, coordination and exchange with related projects.

of the Youth Clubs (this was identified as a weakness during the baseline).

Internal and external communication. Capacity on advocacy’ (relating to the rights based approach of RAP); what is the potential to work with a rights based approach. Impact What are the indications that the RAPapproach has had or will have a long-term positive effect on young people’s lives, health and sexuality? How is YI making a difference? (See also effectiveness). Has the project succeeded in changing gender relations and cultural values regarding sexuality and gender roles?

The project has strived for individual empowerment and the establishment of a conducive environment – have both goals been reached, to what extent, has this combination worked and how has it changed young people’s sexual lives? What cultural and religious factors influence the conducive environment (the baseline study has shown that these factors are barriers for RAP. How has the project dealt with religious/cultural barriers and how religious leaders have dealt with RAP. Do young people feel their social environment has become more conducive? Do the partners objectives?

the

engendered

How are gender issues addressed? What capacity and commitment is there at MA (staff) level to work on changing gender relations? What changes in gender relations can be seen within the target group? (We realize that this is an extremely difficult thing to measure. What role do HIV problems play in the project? YI has tried a positive approach to sexuality: what effect did this have on attention for HIV?57

This is an important question for Malawi and Rwanda.

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Sustainability Assess the key factors affecting sustainability of the project, such as: What is the social and political environment/ acceptance of the project? Both within the MA’s and outside.

How have the member associations incorporated the RAP-approach? Is RAP included in the Annual Budget Plan and IEC materials? (See also design and effectiveness). Is it used in other programmes as well?

Will the project contribute to lasting benefits (i.e. capacity building of MA’s and results of project activities)?

Has RAP become methodology?

Which organisations could/ will ensure continuity of project activities in the project area? (This question is especially important in Mali and Rwanda as YI will end there in December 2010).

Is there sufficient commitment from IPPF CO, SARO and ARO for the RAP approach (or more generally a youth approach)? How does RAP coincide with the 5 ‘A’s59 from IPPF?

Is there evidence of organisations /partners/communities that have copied, upscaled or replicated project activities beyond the immediate project area. Is such replication or magnification likely?

Specific question for Malawi: how does the strategy complement (or not) the strategy and policy of the Ministry of Health (MoH)/local government?

part

the

MA’s

Assess whether the programme can be considered as delivering value for money for its present scope/ scale of impact (it is recognised this will be a somewhat subjective view)? Assess and make recommendations on the key strategic options for the future of the project at country level i.e. exit strategy, scale down, replication, scale-up, continuation, major modifications to strategy.58 Comment on any existing plans. Other key issues How have the M&E cycle and various researches contributed to institutional learning, both in project countries and in the Netherlands?

The existing projects in Bangladesh and Malawi will continue under the new MFS II plans; the projects in Rwanda and Mali will unfortunately be discontinued. 59 Abortion, Access, Adolescents, Advocacy, Aids

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4 Methodology

Focus on the higher level results. Assess what has been achieved, the likelihood of future achievements, and the significance/ strategic importance of the achievements Use the quantitative and qualitative assessments from reports of partners Include qualitative evidence e.g. opinions on the project’s effectiveness based on impressions and interviews with target groups, partners, government, etc.

The (team of) evaluators will be asked to include their ideas on the methodology in their pitch. It is important to note that although there is one ToR for four countries, it is nevertheless possible to differentiate between countries in the importance given to certain specific research questions. The YI consultants can assist the external evaluator in adding country specific issues and questions. Below we make some general suggestions on methodology. It might be interesting to consider including (elements) of the Most Significant Change methodology in the evaluation. The methodologies used could include field observations, observation of training sessions and lessons at school, focus group discussions, quantitative and qualitative data from the M&E system in place and from IPPF research taking place in Malawi and Bangladesh, interviews with key informants: staff at MA’s, teachers, community leaders, parents, but most important: young people (either involved in the training sessions, peer education, health programmes and/or in the MA’s), participatory methodologies, analysis of IEC materials and the way they are used etc. Methodologies used can differ from country to country but the choice of methodologies should nevertheless make comparisons between the different projects and countries possible.

5 Profile of the evaluation team At this moment YI would prefer one evaluator from South Asia and one African evaluator to make up the evaluation team. At a later stage we will decide who will be the head of the team as this depends on the profile of the evaluators. In addition we would appreciate the inclusion of two young researchers/consultants; one from South Asia and one from one of the African countries (or perhaps one from every project country, so three African young people). These youths needn’t be fully qualified consultants; they must not be affiliated to the YAM. Their participation in this evaluation should be considered as a learning experience for them. We would appreciate it if the senior evaluators would include some ideas on capacity building for junior consultants in their pitch and how they would accompany these juniors. The team is composed of women and men evaluators. The evaluators should not have an affiliation to the MA or to IPPF. The senior evaluator(s) should have the following skills and characteristics:

knowledge of youth sexuality;

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commitment to sexual rights; acknowledge that young people are sexually active, acceptance of that fact and understanding of the fact that participation of young people is important; be able to administer a complex evaluation (four countries, several languages; sensitive themes); proven gender expertise is a must the evaluators have the capacity to identify and collect gender disaggregated information using a mix of different methods, including the capacity to develop gender sensitive indicators be familiar with Mali, Malawi, Rwanda and Bangladesh, or at least a number of these countries, and the context and culture of the aforementioned countries; be proficient in English and French and preferably one or more local languages; experience in executing evaluations; interviewing skills, especially with young people; intention to use local expertise (women and men) and involve young people the evaluators have the capacity to analyse data collected in relation to the activities in a systematic way.

6 Output and deliverables A list of key deliverables and deadlines (e.g. work plan, briefings, draft report, final report) can be found under 8. The required format for the evaluation report is attached as Annex 4. The way the methodology and used tools have been engendered is explicitly described in the final report.

Sound quantitative and qualitative data about progress made for women and men over the period evaluated (no general remarks unsupported by evidence) is included. Analysis of these data is consistent. Recommendations and other comments regarding actions needing to be taken to ensure that gender issues are properly addressed are included.

7 Evaluation time table The external evaluation will take place between September and December 2010. Preparation August â&#x20AC;&#x201C; September 15

Development and discussion on the ToR with YI consultants, directors and other representatives of MAâ&#x20AC;&#x2122;s, representatives of IPPF and Simavi. Simultaneously: search for external evaluators. Start with logistical planning

First phase September 15-30

Logistical planning of the evaluation with MAâ&#x20AC;&#x2122;s and other organisations involved once the evaluation team has been established; including decisions on the

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locations to be visited in each project country. Rwanda: Huye, Nyanza and Gisagara district; Malawi: Kachindamoto and Tambala Traditional Authorities (TAs) in Dedza District; Bangladesh: the project has been mainstreamed and is executed in all FPAB clinics. Mali: Koulikoro and Sikasso. Interviews with (senior) consultants of Youth Incentives. Reading various relevant documents.

Field visits Between September 15 and October 30: field visits to Bangladesh, Malawi, Rwanda and Mali

The four member associations of the IPPF and the other partner organisations at national level will be visited; a detailed programme will be drawn up by the evaluation team. Participation of the evaluator(s) in the Annual Meeting YI Trust Fund, October 14 and 15 in the Netherlands and perhaps a first presentation of ideas and results.

Reporting phase Until 30 November

Presentation and discussion of the preliminary results to the MA will be organised at the end of each country visit. The preliminary results, conclusions and recommendations will be brought together in a power point presentation and will be presented to the M&E Officer of YI. The first draft of the report will be submitted to Youth Incentives before November 15; YI will send it on to the four MAâ&#x20AC;&#x2122;s and the IPPF coordination of the Trust Fund. The evaluators will be asked to get the wanted feedback in a creative way, ensuring maximum participation of those involved (e.g. a conference call while people look simultaneously at a PowerPoint presentation at their computers). The report will be discussed and finalised by the end of November.

If the need arises additional time is available until December 10.

8 Cost The evaluation team will make a detailed budget in their pitch.

9 Logistical support YI and the MAâ&#x20AC;&#x2122;s will provide logistical support for the evaluation team.

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Programme 2009-2010

List of Individuals Interviewed and Stakeholder Groups and Communities Consulted Youth Incentives, the Netherlands Marijke Priester

Head of YI (until March 2010)

Ruth van Zorge

Head of YI (from March 2010)

Teun Visser

Senior consultant, responsible for Malawi

Miranda van Reeuwijk

Senior consultant, responsible for Rwanda (from July 2010); M&E&R training

Maeva Bonjour

Junior consultant, coordinator YAG

Anny Peters

Senior consultant, Bangladesh

Gudule Boland

M&E Officer (from May 2010)

Barbara Oosters

Advocacy Officer

Yuri Ohlrichs

Trainer/media consultant

Bianca Simons

Junior researcher/consultant

Henri van den Idsert

Junior researcher/consultant

responsible

for

Mali;

responsible

for

International Planned Parenthood Federation Ms. Doortje Braeken

IPPF CO, London

Mr. Leonard Zondetsa

IPPF ARO

Family Planning Association of Bangladesh â&#x20AC;&#x201C; FPAB KM Tarek

Interim Director

Moazzem Hossain, Youth Team

Focal Point Youth, responsible for YI project

Shahana Rahman

Director M&E

Magfera Begum

Focal Point Access

Gias Uddin

Head of Advocacy

Abid ur Rahman

District Officer, FPAB, Jessore

Mahfuza Rahman

Youth Project Member

Monitoring

Committee

Munmun Parvin

Youth Project Member

Monitoring

Committee

Sinthi Sultana

Youth Project Member

Monitoring

Committee

Md. Golam Kibria

Youth Project Member

Monitoring

Committee

Md. Khairul Alam

Youth Project Member

Monitoring

Committee

Md. Nasim Reza

Youth Project Member

Monitoring

Committee

Md. Shahidul Islam

Teacher and Community Member

Md. Islam

Imam and Community Member

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Ashhaful Gazi

Head Teacher

Razaul Islam Kamal

Community Leader

Atiqur Zaman

NGO representative

Saiful Zaman

Parent

Shahjahan

Community Advocate

Atiya Siddiqui

Elected Representative, Union Parishad

Md. Abdul Kalam

Member, Union Parishad

Md. Zahiruddin

Businessman and Parent

Fatima Begum

Parent

Salma Khatun

Government Health Worker

Sharmeen Ara Urmi

Peer Educator

Rabiya Parvin

Peer Educator

Fatima Khatun

Peer Educator

Laboni Sultana

Peer Educator

Topu Raihan

Peer Educator

Sajjadul Karim

Peer Educator

Mahruf Husain

Peer Educator

Qutubuddin

Peer Educator

Shoaib Husain

Peer Educator

Monjula Khatun

Peer Educator

Neelima Biswas

Exective, Jessore

Mazedunnisa

Counsellor, FPAB Clinic, Jessore

Nomita Rani

Coordinator, Finance, FPAB Clinic, Jessore

Razaul Haz

Execurive, Clinical Services, FPAB Clinic, Jessore

Dr. Farhan Tamanna

Medical Officer, FPAB Clinic, Jessore

Mushataquddin Ahmad

Coordinator, Urban Clinic, Jessore

Md. Hafizul Islam

Transportation Jessore

Ibad Husain

Youth Counsellor, FPAB Clinic, Jessore

Zakia Sultana

Youth Counsellor, FPAB Clinic, Jessore

Parul Das

Janitorial Assistant, FPAB Clinic, Jessore

Sheikh Akram Husssain

District Officer, FPAB, Khulna

Meenara

Youth Project Member

Monitoring

Committee

Afroza Khanum

Youth Project Member

Monitoring

Committee

Probhati Biswas

Youth Project Member

Monitoring

Committee

Tayabur Rahman

Youth

Monitoring

Committee

100

Administration,

Project

FPAB

Clinic,

Programmes,

Assistant,

FPAB

FPAB Clinic,

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Member Karum Biswas

Youth Project Member

Monitoring

Committee

Tauhidur Rahman

Youth Project Member

Monitoring

Committee

S K Alauddin

Parent

Aneesur Rahman

Parent

Anwar

Parent

Mohamed Chand Miya

Imam

Md. Nurul Islam

Local Community Leader

Romit Chowdhury

Parent

Babur

Parent

Mannan

Parent

Nitun Khan

Parent

Zakir Husain

Parent

Sheikh Gamaluddin Ahmed

Local Community Leader

Md. Salama

Local Community Leader

Pustun Malik

Parent

Khaleelur Rahman

Parent

Nadira Parveen

Teacher

Sheuli

Teacher

Mallika Pal

Asst. Head Teacher

Md. Islam

Teacher

K M Farooq

Teacher

Santar Kumar Sheel

Teacher

Md. Sameeruddin Sheikh

Teacher

Mashooq Shadul

Teacher

Shamim Sohail

Md.

Youth Counsellor

Md. Mushfique Mahruf

Youth Organiser

Nazneen Sultana

Youth Organiser

Sharmin Akhtar

Peer Educator

Ehsanullah Sujan

Peer Educator

Sourabh Kundu

Peer Educator

Irfan Khan Babu

Peer Educator

Aisha Khatun

Peer Educator

Chameli Akhtar

Peer Educator

Fatima Khatun

Peer Educator

Manwara Akhtar Rumi

Peer Educator

Kabul Fattah

Peer Educator

Sheuli Akhtar

Youth Counsellor

101

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Dr. Halim

Medical Officer, FPAB Clinic, Khulna

Deepankar

Medical Assistant

Zabirunnisa

Executive, Clinical Services

Athleema Khatun

Coordinator

Seema Akhtar

Field Coordinator

Lila Afroze

Counsellor

Fatima Begum

Executive, Clinical Services

Afzal Hasan

Coordinator, Finance

Shami Mohamed

Youth Counsellor

Abdul Rauf Sheikh

Project Coordinator

Family Planning Association Malawi – FPAM Effie Pelekamoyo

Executive Director

Ruth Kundecha

Programme YIF project

Matthias Chatuluka

Director of Programme

Ignasio Wachepa

M&E Officer

Graham Luka

Director of Finance

Robert Dzonzi

Assistant, Department of Finance

Henri Mfune

District Youth Officer

Chris Salaniponi

Health Services Coordinator, Dedza District

Dr. Chikumbutso Mpanga

District Health Officer, Dedza

George Malema

District Environment Health Officer, Dedza

Centa Kavalo

District Nursing Officer

Senior Chief

Kachindamoto,

Lizzie Waya

YAM president

Chikondi Liwonde

YAM member

Innocent Folopensi

Youth Advocacy Committee Mayani; VCT Counsellor Health Centre Mayani

Mr. Mmadi

Medical Centres

John Bonga

FPAM, YIF-CRHP (accompaniment of PE’s)

Freston Dambuleni

FPAM, YIF-Community Reproductive Health Workers (CRHP) (accompaniment of PE’s)

Mr. Ndindi

Village Headman, Wanya

Mr. Patson

Village Headman, Abraham

Mr. Cmakunganya

Group Village Headman, Ngwimbi

Mr. Michael

Village Headman, Yosefe

Mrs. Ethel

Village Head, Biswick

Mrs. Angela James

Village Head, Nkholokombwa

Mrs. Stelia

Village Head, Mjasi

Mrs. Feresta

Village Head, Andrew

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coordinator/district

Assistants

Dispensary,

manager

Health

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Mrs. Pulikeria

Village Head,, Kakhobwe

Mrs. Zeneida

Village Head, Kabulika

Veronica Justin

Traditional Counsellor, Mganga

Adam Idana

Member, Ngwimbi

Alikanjo Jalasi

Member, Mganga

Nurse Kabichi

Zanga

Cecilia Keeala

Parent

Honesta Singano

Youth Advocacy Committee

Monica Chingema

Member, Task Force for Enforcement of Bye-Laws Against Early Child Marriage

Agreeda Khamalatha

Traditonal Counsellor, Kamkhwani

Christina Dixon

Traditonal Counsellor, Ngwimbi

Ellen Tungande

Traditonal Counsellor, Kabulika

Lexito Mpeketula

Chairperson, Youth Advisory Committee

Blessings Kathumba

Community Development Assistant, Dedza

Letia

Peer Educator, Mzanga

Mike Chipembere

Peer Educator, Abraham

Charles Chingwalu

Peer Educator, Abraham

Trasca Lenard

Peer Educator, Mkhumbi

Chisemo John

Peer Educator, Ndindi

Lustica Ausesio

Peer Educator, Mkhumbi

Steven Mbongule

Peer Educator, Phikani

Stephen van Beswick

Peer Educator, Kaphuka

Madanitso Beswick

Peer Educator, Kabulika

Youth

Advocacy

Village

Health

Josephy Samson

Youth Club Member, Bizek

Cidrick Duwe

Youth Club Member, Bizek

Chance Ndalale

Youth Club Member, Abraham

Abas Mndala

Youth Club Member, Ngwimbi

Eplimark Moses

Youth Club Member, Michembo

Innocent Yoma

Youth Club Member, Mzanga

Davson Lawe

Youth Club Member, Yoseph

Godfley Arick

Youth Club Member, Mzanga

Levson Lenard

Youth Club Member, Mkhumbi

Diverson Thomson

Youth Club Member, Kadewere

Blessings Imadi

Youth Club Member, Kachemba

Alikanjero Gerard

Youth Club Member, Mkhumbi

Thomas Chingwalu

Youth Club Member, Mkhumbi

Benson Andreas

Youth Club Member, Mkhumbi

Maupo Gabliyele

Youth Club Member, Kachemba

Committee, Committee,

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Youth Club Member, Mzanga Jamielly Chikaoneka Daston Shadleck

Youth Club Member, Abraham

Elifa

Youth Club Member, Yosephy

Delifo

Youth Club Member, Yosephy

Emele

Youth Club Member, Yosephy

Funny

Youth Club Member, John

Tamara

Youth Club Member, Ngwimbi

Mayeso

Youth Club Member, Mzanga

Charity

Youth Club Member, , Nkholokombwa

Rebecca

Youth Club Member, Mkhumbi

Judith

Youth Club Member, Mganja

Catherine

Youth Club Member, Mzanga

Rose

Youth Club Member, Mkhumbi

Josephine

Youth Club Member, Mkhumbi

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Programme 2009-2010

List of Supporting Documentation Reviewed Youth Incentives (2009). Annual Report 2008. Youth Incentives. The Netherlands: Utrecht. Youth Incentives (2009). Workplan 2009. MFS-YI Programme 2009-2010. The Netherlands: Utrecht. Youth Incentives (2010). Annual Report 2009. Youth Incentives. The Netherlands: Utrecht. Youth Incentives (2009). Workplan 2010. MFS-YI Programme 2009-2010. The Netherlands: Utrecht. Youth Incentives (2009). Youth Incentives Fund Plan of Operation and User Guide 20092010. Second Phase. The Netherlands: Utrecht. Youth Incentives. Meet Youth Incentives. The Netherlands: Utrecht. Youth Incentives. Abortion and Young People. The Netherlands: Utrecht. Youth Incentives. Juvenile Sex Offenders Need Guidance! The Netherlands: Utrecht. Youth Incentives. Let R.A.P Rule Our Approach in Sexual and Reproductive Health. The Netherlands: Utrecht. Youth Incentives. Sexual Orientation and Young People. The Netherlands: Utrecht. Youth Incentives. The Grey Areas of Sexual Violence. The Netherlands: Utrecht. Youth Incentives. Facts and Fiction About the Hymen. The Netherlands: Utrecht. Youth Incentives. When You Choose the Pill: The Guide to Getting Started. The Netherlands: Utrecht. Youth Incentives. Young and Sexual. The Netherlands: Utrecht. Youth Incentives. Toolkit for Young People in the Youth Incentives Programme: How to Start a Discussion on Sexual Diversity, Sexual and Gender Based Violence and Safe Abortion? The Netherlands: Utrecht. Youth Incentives. Trainers Manual: Communication with Young People on Sexual Health Issues. The Netherlands: Utrecht. Youth Incentives. Workbook: Communication with Young People on Sexual Health Issues. The Netherlands: Utrecht. Youth Incentives. Training Manual: Monitoring, Evaluation and Research. The Netherlands: Utrecht. Youth Incentives. Handbook: Monitoring, Evaluation and Research. The Netherlands: Utrecht. Youth Incentives. Workbook: Monitoring, Evaluation and Research. The Netherlands: Utrecht. Youth Incentives. Designing an Advocacy Plan on Youth and Sexuality: Trainers Manual. The Netherlands: Utrecht. Youth Incentives. Designing an Advocacy Plan on Youth and Sexuality: Handbook. The Netherlands: Utrecht. Youth Incentives. Designing an Advocacy Plan on Youth and Sexuality: Workbook. The Netherlands: Utrecht. Youth Incentives. â&#x20AC;&#x153;First the Window was Open, Now the Door is Openâ&#x20AC;?: The Grey Areas of SRHR Study Tour 2009. The Netherlands: Utrecht. Youth Incentives. The Grey Areas of Sexual and Reproductive Health and Rights in Francophone Africa: Report of a Regional Event in Bamako, Mali. The Netherlands: Utrecht. Zuidberg, L. (2008). External Evaluation. Youth Incentives Trust Fund Rutgers Nisso Groep TMF Funded Programme 2005-2008. The Netherlands: Utrecht, EOS Consult.

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Programme 2009-2010

Short biographies of the evaluators Meera Pillai MA MPhil MEd EdD Meera Pillai is an independent consultant based in Bangalore, India, with an international practice in research, training, organisational development, and monitoring and evaluation. She applies these skills primarily in the areas of gender and masculinities, sexual and reproductive health, and the issues of vulnerable children. She has undertaken a variety of national and international assignments, including pioneering work in India on devising methods for working on SRH issues with street and slum children, and in mainstreaming HIV in organisations working with microfinance. After 14 years of academic experience with Mount Carmel College, Bangalore and the University of Vermont, Burlington, and 24 years of voluntary experience with the non-profit sector, Meera has been consulting full-time with the non-profit sector for the past ten years. She can be contacted at mpillai65@yahoo.com Chikondi Liwonde Mr. Chikondi Liwonde is a peer educator in YIF-FPAM project in TA Tambala in Dedza District in Malawi. An active member in the project, Mr. Liwonde received opportunities to participate in a number of trainings through the project, including the regional event at Nairobi and the study tour in the Netherlands. His experiences with the YI project inspired him to take up his education again, and he is now a college student. Mahfouza Rahman Ms. Mahfouza Rahman is a college student from Jessore in Bangladesh. Actively involved in YIF-FPAB project, Ms. Rahman is a master trainer within the peer education programme. Having received a three-month training in research methods conducted by Youth Incentives for young people, she also serves as a Youth Researcher in the project.

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