Co-creating sexual and reproductive health interventions with adolescents: the experience from Rajasthan

Abstract

Despite a clear policy recognition of the need for special programmatic attention for adolescents to ensure access to sexual and reproductive health information and services, almost all existing programs in India face critical challenges in effectively delivering sexual and reproductive health information and services, which leads to early marriages and teenage pregnancies. Teenage pregnancies directly threaten women's sexual and reproductive health and well-being. States like Rajasthan with high adolescent pregnancy rates demand better solutions. IPE Global implemented project Udaan to reduce teenage pregnancies in the state, adopting a 360 degree approach. Improving Sexual and Reproductive Health was one of the critical components of the project, and a human-centred design method was adopted to co-create an effective sexual and reproductive health intervention relevant to the community. The human-centred design approach incorporated multiple steps, including formative research, iterations, prototyping and piloting. Five potential interventions emerged after a series of iterative explorations. The in-school SRH intervention has emerged as an excellent model of reaching adolescents effectively in culturally sensitive rural geographies in the evaluation of the pilot, which successfully covered over 10,800 adolescent boys and girls across 66 government high schools in the Bari block of Dholpur. An independent evaluation suggested a significant increase in the awareness of contraceptive methods in the intervention area from 24 per cent to 50 per cent. Contraceptive self-efficacy, a measure of girls' agency, increased by 18 per cent in the intervention area. Further, qualitative findings showed a significant improvement in SRH awareness and service utilization.