Reading IEC material

Building on Experience - A RH Information & Behavior Change Project for Vulnerable Youth in Phnom Penh & Battambang

Project profile: In 2003 Mith Samlanh/Friends implemented the project as the executing agency in partnership with Opération Enfants de Battambang (OEB). Mith Samlanh/Friends had 13 interlinked programs targeting mobile and ever-changing groups comprised of street youth, and migrant youth usually living in pagodas. The project aimed at their social reintegration into their family / community, into their work / schools. It also aimed at providing information and education on topics such as SRH, drugs, hygiene, nutrition, street safety and at designing and developing new IEC materials on SRH/ STIs/ HIV/ AIDS.

Mith Samlanh focused on in-center (youth centers, clinics), street (outreach services) and community based education. The youth friendly center “Condom Café” served as an additional venue for providing condoms, offering SRH information, medical and referral services to a wider group of low income youth. Both male and female doctors were available. Moreover, young people were directly involved by becoming peer educators. The main aim was to seek alternatives to street life and SRH risks associated with it.

In addition, OEB worked on vulnerable ASRH awareness education in the Battambang province using both training and peer activities. Secondary target groups were factory workers, sex workers and MSM. Also, OEB supported young HIV/AIDS patients in 2 hospitals and provided their family with information on HIV, birth spacing and STIs. Mith Samlanh and OEB actively worked with local government staff within its programme to promote political support at grass roots level, and trained other partners’ staff to develop their capacity building education. OEB heavily focused on recruiting and training peer educators to continue education sessions in their villages.

Strategy: Mith Samlanh targeted a very mobile and ever changing group comprised of street living youth, street working youth, youth living in the streets with their families and migrant youth often living in pagodas. Indeed, this situation implied the need for on-going information and education since new youth appear in the streets/pagodas. Mith Samlanh also noticed that the background of this youth is also changing: there is an increasing number of middle class youth who are drawn into the street because of their drug habits. All these youth are therefore very vulnerable to risky SRH behavior. Moreover, Mith Samlanh identified that young people are increasingly precocious in their life style/ sexual activity, and so forth, susceptible to behave in a risky way. In addition, the baseline survey (BLS) indicated high knowledge on HIV/AIDS transmission but a limited condoms use (60%). The low knowledge of STIs mirrors in fact a low educational level: 80% of the target group has no primary education. STI/SRH education and services are very critical. Mith Samlanh realized the need to prevent HIV, reduce STIs and unwanted pregnancies through influencing their sexual behavior.

Based on the above assessments and lessons learned from the previous project, Mith Samlanh addressed the need for on-going information and education skills through focusing on the regular updating of information, training curricula and IEC material for youth and the regular training provided to staff members and peer educators. The IEC material was also adapted to different age/gender groups (such as material with no text for illiterate) and young people were involved in the development of this material to make it more “suitable”. The locations in which Mith Samlanh and OEB worked also had to be flexible to reach the target group. They did so through street outreach activities, youth center, and drops in centers, and created an enabling environment for RH information and services (especially for women) through various events. Moreover, Mith Samlanh and OEB developed appropriate strategies for medical services such as facilitating access to friendly clinical services, distributing free condoms in appropriate locations and reinforcing a referral system with NGO partners, local leaders, heath centers at the communal level and the government for vulnerable youth to access SDPs, antenatal care, HIV blood testing…

Outputs: 1) Increased political community and familly support for ASRH intervention creates enabling environment: Political support gradually increased because all partners such as relevant Ministries, Phnom Penh municipality authorities participated in all events related to ASRH. Some of those events were even featured on national TV, radio and in newspapers. (41 media printed stories and 24 TV programs). A total of 65 events were hosted at the “Condom Café” and in Mith Samlanh center to provide knowledge on ASRH, HIV/AIDS, drugs… A total of 1457 community gatekeepers including commune council members, monks and parents were provided with knowledge on ASRH, drug prevention, safe migration education etc…through various training sessions, special events such as “candle light day” or ‘Youth Camp”, workshops and exchange visits, to help them understand and support ASRH issues and interventions.

2) Increased knowledge of SRH issues and awareness of risk among target group: Mith Samlanh developed an appropriate curriculum and IEC materials for outreach and social workers to use with vulnerable/street youth, including modules on how to conduct educational sessions on topics such as ASRH, HIV, condom use, STI, birth spacing and unwanted pregnancies. A total of 21,360 pieces of IEC material were provided by RHIYA including leaflets on STI, HIV and Drug booklets, distributed on a daily basis. Owing to this, OEB and Mith Samlanh increased the spread of ASRH related information and services such as where to access free consultations, counseling, medicine, safe abortion, identification / treatment of STIs… to vulnerable youth Phnom Penh and in remote areas in Battambang province.

3) Increased avalability of an access to quality SRH to youth at risk in targeted areas: The number of youth receiving YFS increased; services were situated in vulnerable community settings such as the Condom café and then moved to a squatter settlement. They included counseling, consultation / treatment, STI identification referral to partners for safe abortion and pregnancy check ups.(RHAC, Marie Stopes...) All services were free of charge and opening hours were adapted to the target group needs. A total of 121,000 youth aged 10-24 accessed medical services. Most of these youth increased their knowledge on ASRH through education sessions when visiting centers and through marketing the services of the youth center to community by staff members and peer educators. Regular special events, training to gatekeepers in the community also helped to promote these services.

4) Enhanced technical, planning and managerial capacity for local provision of youth friendly SRH services: Training was carried out with the support of Friends International Technical Assistant. Individual Training Plans were established for: Mith Samlanh staff: 487 peer educators were trained and provided educational sessions with the support of staff members. 465 of them were then provided with refresher trainings on ASRH, menstruation, hygiene, pregnancy, safe delivery…etc; 572 Government staff were trained on drug prevention, HIV/AIDS, RH, using IEC materials, reintegration process, social work and communication with street children…etc; 172 NGOs partners’ staff received internship/ hands on training on the effectiveness of outreach work, working with street children, social rehabilitation, creating IEC material with peer educators, methodology of teaching …etc. In addition, Mith Samlanh provided certificates of acknoledgement to 580 youth when passed final exams on SRH/HIV/drug prevention. 446 graduated were also supported to start their own buisness.

Lessons learned: Good collaboration and involvement from all levels of authorities with NGO partners is a key to develop and improve implementation of any project: MS increased its political, community and family support of the project. Outreached educators and social workers in the streets/communities established a strong trusting relationship with A/Y and gatekeepers. Collaboration enabled the development of activities, advocacy strategies and IEC materials to be shared and used both by NGOs and goverment ministries. Linkage with the Municipality Department of Health reinforced links with government hospitals, health centers and NGOs partner services. Exchange visits also helped to further collaborate.

IEC production and events/activities were most important for delivering and conveying messages to young people. Material with no text designed for youth with low level of education was a success. Events/activities organized allowed A/Y to express ideas, ask questions, share experience on ASRH and acted as reminders on information and services. 275, 861 youth were reached in targeted areas. Increased participation and involvement from peer educators indicates increased understanding/ awreness on ASRH/HIV/AIDS and drug use prevention. The project featured prominently in local and international media.

Peer educators have more confidence on facilitating and organizing education activities when are closely supported by project staff: It was important to improve their capacity and building their confidence in facilitating and organizing special events and other peer activities with support from government services. Mith Samlanh staff resignation led to difficulties in the provision of training to new peers who were difficult to retain since they are vey mobile.

ASRH: Strong collaboration between outreach project staff and health center staff motivated more young people to use SRH services at government health centers. Community people’s involvement and training such as parents is important for the understanding of ASRH issues and the support of the project and the continuation of activities/facilities to meet needs of target group. Experience showed that it is important to have both female and male staff to address A/Y needs.

The main lesson is the importance to be flexible in every aspect of the project design and implementation: Mobile outreach activities and services were indispensible for reaching some A/Y and meeting their specific needs in various situations. E.g.: Condom café had to be opened 24 hours in response to the eviction of families from their homes which affected number of contacts. Collaboration with Municipality and Minister of socail affairs helped to find an appropriate approach.

Partner Profile: Mith Samlanh/Friends is a Cambodian Non-Governmental, non-political and non-denominational organization. Friends ran twelve interlinked programs for street children with centers in Phnom Penh, Kampong Speu and Kampong Cham provinces and outreach activities in all provinces in Cambodia. Friends supports various NGOs and GOs throughout Cambodia and around the world (Pakistan and Thailand) to start effective street children projects. Friends have recently started a project in Vientiane, Laos. There are currently 155 Cambodian staff at Friends, and six expatriate staffs with the capacity as technical advisors.

Contact: Mith Samlanh/Friends House #215, Street #13 Phnom Penh Cambodia Tel/Fax: +855 23 426 748.