Project Accomplishment Report - HYDA :: Horn Youth ... Accomplishment... · Project Narrative...

Project Narrative Report [Year]

Increasing Accessibility to Reproductive Health Services and Information

Project Accomplishment Report

Sep – Dec, 2010

“Increasing Accessibility to Reproductive Health Services and

Information”

Implemented by: Funded by:

HYDA UNFPA

Hargeisa, Somaliland Somaliland Program


Contents

1. Introduction ....................................................................................................................... 3

2. Background and Rationale .............................................................................................. 4

3. Executive Summary .......................................................................................................... 6

4. Project Information ........................................................................................................... 7

� Planned Activities .................................................................................................................................... 8

5. Accomplished Activities .................................................................................................. 8

I. Producing and Disseminating Film Documentary ......................................................................... 8

- Presentation and Dissemination of the Film Documentary......................................................... 9

II. Commemoration of International Year of Youth ........................................................................... 10

III. National workshop on Discussing Adolescent Reproductive Health Strategy .................. 122

IV. Monitoring the Existing Youth Friendly Health Facilities (YFHF) ............................................ 15

V. Advocacy Campaign for University Students .............................................................................. 166

6. Lessons Learnt ............................................................................................................. 177

7. Challenges .................................................................................................................... 188

8. Recommendations .......................................................................................................... 19


1. Introduction

Horn Youth Development Association (HYDA) is a local, non-profit, non-government

humanitarian youth organization dedicated in addressing and responding the priorities

of young people and overall community problems contributing the situation of children

and youth in Somaliland.

HYDA has being working with UNFPA as a local partner organization in Somaliland in

the implementation of various project complementing in achieving both organizations

objectives. The project of which this report showing its accomplishment is mainly

addressing the commitment of responding to the recommendations and gaps identified

during an assessment which was conducted in September 2009.

This project aimed to have an impact in increasing the number of young people

attending and aware of existing health facilities as well as to enable a discussion of

Adolescent Reproductive Health strategy for national stakeholders.

Both UNFPA and HYDA committed in HIV/AIDS, SRH and Youth Empowerment has

continues collaboration in addressing these issues through innovative and participatory

approaches for involving young people in the decisions affecting their lives.


2. Background and Rationale

In September, 2009, HYDA with the technical support of Ministry of Health and Labour and with the financial assistant of conducted assessment on Youth Friendly Accessibility on the health professional in the main cities of Somaliland regions. The assessment was targeted six cities through interviewing 150 youth individuals and health professionals of 43 health centres. The overall objective of this assessment was to identify; “How Health facilities are friendly accessible for young people considering both perspectives of young people and health-care providers”.

As regards of the assessment findings, it was shown that; there is low attendance of youth in the health facilities. Most of the youth attend health facilities after serious illness. The major health facilities which 71% of youth attend are the private health facilities (mainly pharmacies) which are very expensive comparing to the public health facilities. Youth also expressed that; they do not like attending health facilities and very less proactive about their health which caused most of the youth clients received by the health professional to be at very late stage illness.

Concerning the reasons why young people are not making use of the available health services; youth interviewed in the assessment specified that; 56% they do not recognize illnesses; 42% they want to spend money on other things; 40% they are not interested; 12% they do not know where to go. – Another major factor which hindering from youth to attend health facilities is the lack of information of youth with regards to the availability of health services in their respective towns/villages as well as inadequate knowledge for youth about the importance of attending health facilities.

Health professionals reported that; most of them don’t have a concept about the youth friendly health services – Most of the health centres do not have specific services for youth and adolescent – 75% of youth mentioned that; there are not specific health services they receive from health centres. For the skills of health care providers on dealing with youth clients, 68% of health care providers indicated that they as well as the other health professionals of their respective health centres received NO trainings on dealing with youth clients. Also this assessment shown that; health care providers treat with youth as same as they treat with adult.

Considering the above-mentioned factors; there is high demand to address youth friendly accessibility in the context of Somaliland. Addressing and improving youth


friendly accessibility in the health facilities needs two different simultaneous interventions from two different perspectives. Firstly, there is a need to increase youth awareness towards the importance of health services as well as its availability in the context. Secondly, health care providers need also capacity building training on dealing with youth clients friendly with special treatment and consideration about the vulnerability of youth to STIs and their stigma stage and shyness.

Apart from the findings of the study, another important intervention which needs to be considered is the integration of the response towards HIV and SRH. Due to the co-relation between HIV and SRH it’s important to tackle HIV while working on SRH.

Respecting and giving consideration to the above-mentioned gaps on youth friendly accessibility to health facilities, HYDA proposed to UNFPA and Ministry of Health of Somaliland immediate and prioritized interventions to be implemented as a reference of implementing recommendations made during the assessment which based on the local context and the most appropriate mechanism possible as well as the socio-cultural and economic situation of young people in Somaliland.


3. Executive Summary

This report covers activities implemented in the framework of the project named

“Increasing Accessibility to Reproductive Health Services Available and Information”

during the period of four months (Sep – Dec, 2010). This report shown accomplishment

of complementing activities responding to recommendations outlined by an

assessment that has been made in September 2009

In implementing this project, all planned activities including: Producing and

disseminating film documentary; commemoration of International Year of Youth;

National workshop on Discussing Adolescent Reproductive Health Strategy; Monitoring

the Existing Youth Friendly Health Facilities (YFHF) were implemented successful.

A Film Documentary about adolescent reproductive health awareness with various

messages and images motivating young people in attending health facilities was

developed. Advocacy campaign for University Student in HIV and RH has launched

through involving students unions and around 400 students in the Universities.

International Year of Youth was conducted in Somaliland in holding one day session

whereby youth delegates discussed youth problems and made call for action to

leadership of the government. 40 youth and youth stakeholders attended national

workshop and discuss youth & adolescent reproductive health strategy. Monitoring

sessions of YFHF has conducted through visiting and observing the youth friendly

services in Hargeisa and Gabiley health facilities.

The film documentary, an innovative approach in awareness, was disseminated in

various mechanisms which enabled to reach thousands of the general population with

special emphasis on adolescent and youth.

In very short period of four months, 100% of the project activities has fully achieved.

The implementations of this project discovered how adolescent reproductive and youth

friendly accessibility in health facilities are new in the context. The immaturity of these

issues has less hindering as perceived and commitment as well as willing of youth and

adolescent is an indicator of continuing more strategy interventions.


4. Project Information

• Project Objectives

Overall objective

The overall objective or goal of these proposed interventions is; to increase

accessibility to and utilization of comprehensive quality reproductive health

services and information, including context-accepted family planning with

special focus on disadvantaged areas

Specific Objectives:

1. To develop film documentary motivating young people to attend

health facilities and make use of the available health services 2. To develop messages on different perspectives including, medical

perspectives, traditional perspective and religious perspective. 3. To develop scrip for interviewing doctors, traditional elders and other

most influential and key person that can motivate young person for attending health facilities.

4. To conduct public awareness rising through film presentation targeting for both out of school youth and youth in schools.

5. To available video resources through producing DVDs that can be used for any relevant places and events.

6. To develop a nationwide distribution of DVDs in order to reach large number of young people including distribution through schools.

7. To build the capacity and skills of health care providers on dealing with youth clients.

8. To improve the knowledge of health care providers towards the youth vulnerability to STIs and HIV/AIDS.

9. To establish mutual understanding between youth clients and health care providers in regards to services delivery with confidentiality.


• Planned Activities

The following five activities were planned to be implemented in the framework of this project

I. Producing and Disseminating Film Documentary II. Commemoration of International Year of Youth III. National workshop on Discussing Adolescent

Reproductive Health Strategy IV. Advocacy Campaign for University Students V. Monitoring the Existing Youth Friendly Health

Facilities (YFHF)

5. Accomplished Activities

I. Producing and Disseminating Film Documentary

• Production and Overview of the Film Documentary

Responding to the need of young people to be aware of the existing health facilities,

HYDA developed a film documentary. The film documentary which was delivering

comprehensive message towards maximizing utilization of young people in the

available health facilities covered all perspectives including, religious, medical and

traditional methods that can motivate young people in attending health facilities as well

as the availability of services in the health facilities.

Through professional institution on film production, the script and the design of the film

documentary was developed which enabled appropriate and well-coordinated

processes of interviews, graphics and background information. The design and script

of the film were developed with the comments and direction of UNFPA and its partner

organization HYDA and this enabled the production of film documentary corresponding

the predetermined intentions and objectives beyond developing film documentary.


The film documentary composed on messages captured from well-known traditional

leader; one of the most popular religious leader; a doctor with deep understanding on

reproductive health situation in the context; the leader of Somaliland Youth Peer

Education Network (SYPEN); Minister of Youth, Sports and Culture; Executive Director

of HYDA. The film also covered all perspective of persuading young people in

attending health including; traditional point of few, Islam and its motive in attending

health facilities; medical perspective on prevention and cure; role and the word of

SYPEN; leaders point of few and HYDA message on motivating utilization of available

services.

Apart from messages captured from above-mentioned stakeholders, the film also

shows clips on available services including, physical appearance of health facilities,

work going on the health facilities which indicating the practical existence of health

facilities for young people.

Documentary film for night Presentation including universities students, line ministries and Youth Organizations

• Presentation and Dissemination of the Film Documentary

1.

Airing in the local TV station

• The film documentary was released

in Somaliland National Television

• More than thousands watched the

film documentary

• The audience were both young

people and adults specially parents


2.

3.

II. Commemoration of International Year of Youth

Taking part the global commemoration and celebration of International Year of Youth

which was adopted by the United Nations General Assembly in its resolution number

64/134, signifying the importance of international community places on integrating

youth-related issues into global, regional and national development agendas.

Somaliland committed integrating youth-related issues into its national development

agenda. HYDA partnering with UNFPA conducted one day session in 9th December

2010 for 250 numbers of young people, mainly come from Student Unions of

Somaliland Universities.

Night Presentations

• The film documentary was

presented three nights (one night in

Hargeisa, one night in Gabiley and

one night in Arabsiyo)

• More than 2000 audiences watched

the documentary presentation

• The film was presented through

projector and loud speakers

Presentation in schools

• The film documentary was presented

through projector in five Hargeisa

based Schools.

• This presentation had impact on the

minds of young people in Schools.

• Such presentations will be continued


The aims and objectives of this session regarding the commemoration of International Year of Youth were; to instill in the youth, at large, unswerving commitment to Patriotism, national Security, national Integration, Non-violence and Social Justice; develop qualities of citizenship among youth; provide the youth educational and training opportunities; facilitate the youth for access to ”affordable” Health, information, employment opportunities; promote among the youth for strong commitment to contribute social development. The young people attended in the session also discussed and discovered challenges and problems young people in this nation faced and needs to be integrated in the national development agenda. Some of the issues young people agreed as common problem and needs immediate response as follows:

1. Lack of National youth policy 2. Unemployment 3. Chewing Kat 4. Educational opportunities 5. Migration 6. Harmful traditional practices 7. lack of information and communication

Young people not only indicated problems but also came up solutions in overcoming

the challenges mentioned above. Due to the multi-dimensionality of these challenges,

in order to flourish solutions to be achieved, it requires compilation of stakeholders’

Group Photo of International Year of Youth Participants


effort and thus, Government, CSO and other concerned actors including INGO and UN

agencies intervention is indispensable and urgent. Following are some of the

recommended solution:

• Formulating effective National youth policy and strong commitment to it.

• Generating employment opportunities.

• Awareness of harmful drug/Kat use.

• Creating educational opportunities, equal opportunities for schooling, availability and affordability of educational access.

• Change of attitude towards the Harmful traditional practices by alerting them.

• Building and improving health service centers and health delivery systems.

• Sufficient funds for youth development and empowerment.

Finally, HYDA promised that they will forward concern and youth-related issues

(problems and proposed solutions) to all stakeholders including government agencies

with the mandate of integrating these issues into the Five Years Somaliland National

Development Plan which government is currently in the process of compiling.

III. National workshop on Discussing Adolescent Reproductive Health

Strategy

In December 2010, National Workshop on Discussing Adolescent Reproductive Health

was conducted in Hargeisa. 35 participants (25 male & 15 female) attended this

workshop. Various stakeholders including: line ministers, professional health workers,

youth organization, CSOs, INGOs and UN agencies who are serving for young people

attended this workshop.

Participants from the six regions of Somaliland including ministries, UN , INGO’s , Universities Students and Youth NGOs


This workshop commenced six days and the first two days, different stakeholders

made presentations enabled participants to get an overview about Youth, Adolescent

and RH. This presentation including; SRH Global and National Overview presented by

Dr. Deq (WHO); UNFPA mandate and its International Strategy by Mawliid (UNFPA);

Somaliland National Youth Policy by Sayd Omar (MOYS&C); Findings of Youth

Friendly Accessibility in Health Facilities Assessment – Sep 2009 by Regina (HYDA).

During these presentations, participants have shown willing and raise lot inquiries to

the presenter of each presentation.

Following the design and program of the workshop, four days of participatory sessions

took place through brainstorming, group discussion, home assignment and experience

sharing. Most of the discussions were basically addressing the issues of youth and

adolescent with regards to RH through discussing, problems and situational analysis,

priorities and strategic activities; stakeholder and their roles.

From left; Representative of UNFPA, Mr. Mowlid and right the DG of MOYS&C, Mr. Mustafa in the opening remarks


The outcome of this workshop was the approaches and strategies that youth and

adolescent reproductive health strategies can be integrated into the draft national youth

policy and national RH strategy. Other outcomes come out from the various

discussions including, problem identifications, strategic call for actions and key players

will also catalyze the smooth development and finalization of adolescent reproductive

health strategies.

Participants of the Workshop in Groups discussions about the challenges of Adolescent with regards to SRH

Workshop participants in group photo after closure of the last day


IV. Monitoring the Existing Youth Friendly Health Facilities (YFHF)

Following an Assessment done by HYDA with the funding of UNFPA in September

2009, an intervention as part of this project, was to monitor the somewhat existing

youth friendly health service. Monitoring visits done by the project Officer and a

member of the outreach team observed that no changes have taken place in the health

facilities for all the regions in Somaliland.

Systems, environment and health professionals were indicators of continue and similar

services discovered in the assessment findings last year. End of January till mid

December, formal and informal observations and monitoring made by the project team

concluded no change and improvement comparing to the assessment findings.

The team undertaking these monitoring visits attended sessions on assessment

findings presentations to have base-line information to compare with current situation

of 9 health facilities. The team visited different time in each health facility as different

form of visitors. Some of the team members were visiting the health facilities

pretending as “Youth Clients”.

The monitoring with ethics and confidentiality with regards this nature of work and

respecting the principles of HYDA and its human resource sum up their discussions

after the monitoring that the current situation of Health facilities with regards to Youth

Friendly Services is typically a proof of the assessment findings and the similarities of

the monitoring findings and the assessment findings.


V. Advocacy Campaign for University Students

Reflecting to be a part in the process of changing youth behavior, attitude and

knowledge about SRH, HIV & AIDS, this project engaged young people in University to

have further information and discussions. HYDA conducted advocacy campaign

through providing a presentation aimed to warm up and enabling a sessions for

discussions with students from different Universities including; University of Hargeisa,

International Horn University, Admas University College and the student unions of each

university.

Four University including ADMAS, Hargeisa University, Golis and IHU Students

Around 400 hundred young people attended four sessions conducted in Hargeisa in

four consecutive days as well as follow up sessions with committed members of

student unions and Individuals with the commitment to achieve behavioral and attitude

change amongst young people in the universities.

During these sessions, a young female doctor recruited as the project officer of this

project, made presentation regarding the global, regional and national overview of SRH

and HIV & AIDS. This presentation enabled participants to critically discuss the issue

and made personal feedback on the importance of such campaigns and how young

people are committed to pass information and Ideology among their peers.

Though, SRH discussions created some controversial ideology, an important outcome

of the sessions were to develop a national advocacy program based on the perspective


of religion. Another important observation came out from these sessions were that,

SRH is new to the context when it comes to public dialogue on issues related SRH.

Linkage of SRH and HIV were the major methodology used during these sessions

which enabled to have some discussions with regards to SRH open dialogue.

6. Lessons Learnt

• During the implementation of this project, the project team observed that

negative attitude towards RH exist among various levels of Somaliland people

particularly the adult.

• A less knowledge with regards RH is a common problem and there is a few

people who have concept about RH.

• Gaps exist among the stakeholders of RH interventions in Somaliland. Totally,

local authorities and government agencies has no plan and priorities in

responding to RH.

• An expected pregnancy exists among the clients of health facilities. Some of

these clients are not even aware that they are pregnant and attend health

facilities with general complaints. A case study indicated by a Doctor indicated

that one of his clients has six months pregnancy but not aware of it.

• Due to the lack of harmonized plan with regards to RH and Youth Friendly, those

ad hoc interventions will not enable to overcome gaps and weakness existing in

those areas.

• That it’s important to adopt guidelines on RH which is applicable and culturally

insensitive in this early stage of introducing RH in Somaliland context.


7. Challenges

• Inadequacy of professional local trainers available in delivering RH trainings and

workshops.

• Inadequacy of time in properly designing the strategic implementation of the

project.

• Capacity of line authority in contributing the implementation of the project were

very low

• Night presentations of the film documentary were bit difficult due to weather

which was very cold. For this reason, the film presentations were not able to hold

as public event that can reach. The only way this was managed was to hold in

conference rooms.

• Lack of adequate training in RH for some of the staff involved in the project.


8. Recommendations

• To develop long term plan and harmonize efforts of Youth/adolescent RH which

will enable to come up with annual implementation plan.

• To continue finalizing the Adolescent Reproductive Strategy and integrate with

national policies and plans.

• Providing training and capacity building to health facilities to establish and

improve the existing youth friendly health services.

• Maximizing the utilization of ARH film documentary in launching national

awareness program to increase the number young people seeking health

services and attending health facilities.

• Developing M&E tool to measure the impact of this program and collect success

stories that can be used as awareness tool in motivating others to attend

• Exploring the possibility of long term partnership between HYDA and UNFPA in

responding to challenges and implemented rationally the recommendations of

Youth Friendly Accessibility in Health Facilities as well as promoting youth and

adolescent reproductive health concept and application in Somaliland.

• Creating youth multi-purpose center that can be used for developing a group of

young people capable in delivering public awareness and trainings to young

people.

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