YOUTH HARVEST FOUNDATION GHANA
Shifting Gender Norms for Improved Maternal and Adolescent Health in The Gambia and Ghana (SIMAH) Project
In sub-Saharan Africa, access to youth-friendly Sexual and Reproductive Health (SRH) services is expanding although challenges persist. Restrictive laws and policies, capacity of the healthcare system, lack of information, harmful cultural practices, and social norms are restricting young people’s Sexual and Reproductive Health and Rights (SRHR) and the ability to access and utilise SRH services and information. These SRH barriers stem from power hierarchies, long-held patriarchal notions of masculinities and harmful gender beliefs. The barriers are significantly responsible for the high rate of teenage pregnancies, unsafe abortions, Sexually Transmitted Infections (STIs), Sexual and Gender-Based Violence (SGBV) and child marriages in Ghana. There is also a wide agreement that negative attitudes from healthcare providers, also known as the provider bias, form an important barrier to realising youth-friendly services and sexuality education to young people.
Following this, the 3-year project is designed to apply a Gender Transformative Approach (GTA) to SRHR service provision to minimise provider bias rooted in social norms, attitudes, and beliefs. Evidence suggests that attitudes rooted in long-established ideas about gender roles, and age-appropriate behaviour, can be transformed through Gender Transformative Approaches (GTA). It is also established that when healthcare providers participate in GTA training, their service provision can become more equitable which ultimately result in better SRH outcomes for young people.
The project is being implemented by a consortium of three organisations involving the Society for the Study of Women Health (SSWH) and the Agency for the Development of Women and Children (ADWAC) in The Gambia and the Youth Harvest Foundation Ghana [YHFG] in Ghana. The focus of the project in The Gambia will be on positive masculinity and birth preparedness whiles YHFG will focus on Youth-Friendly Health Services (YFHS) in Ghana.
The project in Ghana will be implemented in the Upper East (Talensi and Bawku West districts) and Northeast (West Mamprusi Municipality) regions where five communities in each district will be targeted. The project will partner with Ghana Health Service (GHS) nationally and in the respective districts to train selected healthcare providers (supply side) in selected communities on GTA to provide YFHS to adolescents. Other partners will include the National Youth Authority (NYA), Ministry and Gender and Social Protection, Ghana Federation of Disability Organisations, District Assemblies and other CSOs. Throughout the intervention, the health workers will do self-reflection and share their experiences during reflective sessions.
The research component of the intervention shall have baseline and endline studies and will solicit information from adolescents, healthcare providers and others on health providers’ attitudes, knowledge, and norms and whether GTA can lead to any positive health outcomes. There shall also be regular evaluation meetings with key stakeholders to assess the progress of the project and amend approaches where necessary.
On the demand side, adolescents from each of the communities will be recruited and trained as peer educators on YFHS and GTA. The peer educators will create awareness of YFHS among their peers through community engagements aimed at enhancing demand for YFHS. It is expected that the adoption of GTA will generate increased awareness and critical thinking on gender and power imbalances by addressing their root causes.