Plan at Hand: A Success Story Against Challenges

These seed grants were funded by Johnson & Johnson and WomanCare Global via the Women Deliver C Exchange Youth Initiative

By: Maureen Anyango Oduor, Plan At Hand Girl Empowerment Project (Tanzania)

To most effectively engage adolescent girls in their own healthcare decision-making, they must be approached on their own turf. The use of technology and social media is widespread among adolescents, and these tools have the potential to improve healthcare delivery and health outcomes.

Pregnancy among adolescent girls is prevalent in Tanzania, potentially leading to health and other complications. Babies born to teenage mothers are more likely to be born preterm, to be of low birth weight, and to have higher rates of morbidity and mortality than those born to older women. In Muheza District, adolescent mothers often miss out on educational opportunities, and the burden of young motherhood has immense psychosocial implications. Major causes of morbidity and mortality in adolescence have changed from being largely biological in origin to being the result of environmental and psychosocial circumstances. This is why the Plan at Hand Girls Empowerment Project works to engage adolescent girls in preventative services, particularly access to family planning information and services, which remains notoriously challenging for a number of reasons.

While many adolescent girls, especially married ones, report experiencing “wanted” pregnancies, this can often be due to high social pressures. Socio-cultural beliefs place value on girls’ roles as wives and mothers at the expense of other potential roles, limiting the opportunities that are available and seen as appropriate for them. Thus, many girls have a desire to prove their fertility and fulfill their roles as mothers. Additionally, girls, both within and outside of marriage, view pregnancy as a path to adulthood, or as a way to gain power and respect.

In addition, girls are subject to norms governing gender-appropriate expressions of sexual needs and desires. Furthermore, they experience fear, shame and embarrassment because of the stigma they encounter in seeking family planning information, services and use. Often, cultural taboos bar parents and teachers from talking about sexuality and reproduction. Teachers also may shy away from providing sexual and reproductive health content because they themselves do not feel comfortable talking about and teaching the material. Also, many adolescent girls have an incorrect understanding of how contraceptive methods work and their level of effectiveness. Fear of side effects, real or exaggerated, and lack of understanding of the full range of contraceptive methods, can inhibit girls from accessing contraception.

Even when adolescents want to contraceptive information and services, many do not know where to obtain them or experience obstacles. Long distances to clinics, inconvenient hours,  and long wait times discourage use. Additionally, the cost of traveling to the family planning service provider, as well as the costs of the methods themselves, hinder adolescents’ use.

Plan at Hand Girl Empowerment Project use mobile phone technology to overcome the above challenges. Mobile phone technology, due to its relative accessibility and portability, is a fresh and innovative method to increase access to family planning information and services for adolescent girls in diverse settings. Text messages, or SMS, can help promote family planning awareness, uptake and continuation by helping adolescents girls use and maintain the family planning methods most suitable for their needs. Moreover, mobile phones are private and confidential. Through SMS, adolescent girls are able to access correct and comprehensive information about family planning methods, ask questions, get answers for clarification, and get information regarding youth-friendly family planning facilities that have been established within the community.

The project’s community steering committee has been instrumental in addressing cultural beliefs, taboos and myths associated with culture and religion. Community campaigns and peer to peer education have been instrumental in making family planning discussions more easy and open. This is how Plan at Hand is working to make a difference for girls in Tanzania and beyond.

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