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AIDS 2012 - Turning the Tide Together Promoting sexual and reproductive health (SRH) in adolescent girls through traditional initiation in the Coast region.

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Presentation on theme: "AIDS 2012 - Turning the Tide Together Promoting sexual and reproductive health (SRH) in adolescent girls through traditional initiation in the Coast region."— Presentation transcript:

1 AIDS 2012 - Turning the Tide Together Promoting sexual and reproductive health (SRH) in adolescent girls through traditional initiation in the Coast region of Tanzania Aziz Itaka, Program Officer Maende Makokha, Senior Technical Advisor FHI 360/Tanzania – UJANA Project XIX International AIDS Conference, 22-27 July 2012 Washington DC, USA

2 Introduction

3 UJANA UJANA is Swahili for “Youthfulness” Six year project (July 2006 – September 2012) facilitated by FHI 360 Funded by U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) via USAID Aims to reduce HIV infection among youth ages 10-24 years Traditional initiation is 1 of 4 UJANA adult-led programs

4 ‘Unyago’ is a three-stage rite of passage for girls (10-18 years) triggered by onset of menstruation Done at parents’ request by respected mature women (‘manyakanga’) Uses local values, rituals, art forms and idiom to prepare girls for womanhood Critics think ‘unyago’ is outdated, and encourages: ₋early sexual debut ₋forced/arranged teenage marriage ₋teenage pregnancy and early child-bearing ₋multiple sexual and concurrent partners Traditional Initiation (‘Unyago’)

5 Girls entering puberty are at greater risk of unfavorable SRH outcomes than their male peers Negative social norms encouraged by the initiation may have lifelong impact on girls’ SRH and well-being Intervening with girls at the point they make the social transition to womanhood is critical ‘Unyago’ provides a locally-appropriate vehicle to promote SRH information and rights As custodians of tradition, initiators are more powerful than parents and can be change agents for girls Rationale for Interventions Targeting ‘Unyago’

6 Methods

7 With Partnership for Youth Development (PAYODE), a community-based organization, we explored: traditional initiators’ SRH knowledge potential to serve as SRH promoters and use ‘unyago’ as an avenue for promoting SRH parents’ and male community leaders’ attitudes towards incorporating ‘new themes’ into ‘unyago’ how to introduce ‘new themes’ into ‘unyago’ mindful of the important social role of the practice Participatory Learning and Action (PLA): 2008-2009

8 28 traditional initiators (50%) in project sites, received a 5-day training led by PAYODE and FHI 360 Key training topics included: ₋traditional initiation and girls’ risk behavior ₋pubertal changes and reproductive biology ₋personal hygiene ₋early sexual debut and pregnancy ₋STIs including HIV ₋gender-related vulnerability and protective norms ₋healthy child-bearing Conducted assessment pre- and post-training Capacity building: 2010-2011

9 Trained initiators conducted ‘unyago’ with 450 girls; ~35% of all ‘unyago’ ceremonies in project areas Incorporated ‘new themes’ in each of three stages of ‘unyago’ PAYODE conducted 42 observations of public activities and eight monthly forums with initiator FHI 360 provided 28 person-days of on-site technical assistance to PAYODE Implementation and Technical Assistance: 2010-2011

10 Objective is to recognize and congratulate girl on becoming a woman Focuses on girl’s roles as a woman and what it means to be “a good woman” Trained initiators intervene by: ₋introducing themes around value of delaying sex and staying in school to improve one’s prospects of good family life ₋conducting small groups discussion/one-to-one talks with other participants ₋using testimonies or local stories of girls who exemplify themes ₋distributing IEC/BCC materials Stage 1: ‘Mkole’ – Theory

11 Objective is to teach girl “secrets of womanhood”, and being “a good wife” Focuses on values, norms and skills required to start and maintain a family, including how to sexually one’s husband Trained initiators intervene by introducing themes around: ₋sexual abstinence until marriage and fidelity ₋effective communication between couples and mutual sexual pleasure to avoid infidelity ₋risks of having multiple sexual and concurrent partners, especially older partners Stage 2: ‘Fundo’ – Practical

12 Objective is to introduce initiated girls to the public as women, signaling availability for marriage (nubility) Initiated girl accompanied by peers participates in a nightlong dance in her honor Trained initiators and dance artists intervene by: ₋introducing themes around discouraging alcohol/drug use/abuse and risky sexual behavior ₋educating girls on risks of unchaperoned nightlong dances and reaching out to parents Stage 3: ‘Kunema’ - Graduation

13 Results

14 Initiators’ Pre- and Post-Training Assessment

15 “Now I am aware of the risk of having many partners especially ‘fataki’ (older men who use their resources to lure young girls into sex).” – 19 year-old girl whose parents and initiators say was transformed after her initiation in 2009 “She changed after initiation. Up to this day! We had given up on her.” – mother and sister of above girl during interview in 2012 for a success story on her; The two considered burning girl to death because of her behavior Improved Individual Risk Perception

16 No girl initiated by trained initiators has dropped out of or been withdrawn from school Not a single case of forced marriage and unintended pregnancy has been reported amongst them “Some of our peers who were initiated by other ‘manyakanga’ dropped out of school after initiation saying they had ‘graduated’ into women, some have become pregnant because they say initiation gave them a ‘license’ to engage in sex” – In conversation with girls who have benefited from program (n=5) Decrease in School Drop-Out and Unintended Pregnancy

17 “The parents come to us and say: girls initiated by you are well-behaved as compared to those initiated by other ‘manyakanga’, please come and officiate my girl’s ceremony.” – In conversation with trained initiators (n=8) “Trained ‘manyakanga’ are so popular. Before there was suspicion that they wanted to spoil our culture. Now we receive requests to expand activities to other areas.” – In conversation with local government officials in one project area (n=4) Increased Demand for Trained Initiators

18 Parents are heeding initiators’ advice not to hold nightlong dances “I understood them. When my daughter was presented, we stopped her dance at dusk and allowed it to continue the next day.” – Father of initiated girl In some project areas, local government authorities have stopped issuing permits for night-long dances Some dance artists modified songs used in dances from encouraging sexual experimentation to HIV prevention ₋Before: “I am going to bare it all, nobody knows me here.” ₋After: “If I bare it all now, HIV will finish me and my family.” Increased Parental and Other Influential Adults’ Involvement

19 Harmful aspects of a traditional practice can be modified to promote positive behavior Training and advocacy that involves community leaders and influential adults (such as traditional initiators) can produce a sustainable system of effective change agents To be effective in modifying a traditional practice, the intervention should: ₋be locally appropriate ₋be led by custodians of that practice ₋incorporate the purpose and beneficial aspects of a practice ₋demonstrate added value Conclusion

20 Mama Blandina Mbaji, Chairperson of group of trained ‘manyakanga’ and her team Salum Mbaruku, PAYODE Executive Director, and his team operating in Coast region of Tanzania Mo Schroeder-Sanai – UJANA Project Director, FHI 360/Tanzania Dr Doris Macharia – Senior Regional Technical Advisor, FHI 360 Regional Office, Kenya U.S. Agency for International Development (USAID) Acknowledgments

21 Welcome to Tanzania, home to Kilimanjaro Ahsante kwa kunisikiliza (Thank you for your attention) Contact: aitaka@fhi360.org


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