Despite a clear policy recognizing the need for special programmatic attention for adolescents, almost all existing programs in India face critical challenges in effectively delivering Sexual and Reproductive Health information and services, leading 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.
To reduce teenage pregnancies in the state, IPE Global1 implemented project Udaan2, adopting a multisectoral approach. Improving Sexual and Reproductive Health was one of the critical components of the project. A Human-Centered Design (HCD) approach was adopted to co-create an effective sexual and reproductive health intervention relevant to adolescents. The HCD implementation took around two years with activities spread over 4 key phases – inception and inspiration, ideation, prototyping3 and piloting. Five potential solutions emerged after a series of iterative explorations.
Of the five potential ideas, the in-school SRH education pilot emerged as a cost-effective, sustainable, and most effective mode of reaching adolescents in culturally sensitive rural geographies, as evidenced by the independent evaluation of the pilot. The pilot intervention successfully covered over 21,000 adolescent boys and girls across 66 government high schools in the Bari block of District Dholpur in Rajasthan. An independent evaluation of the pilot 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. The pilot was successfully scaled up from 66 schools to 287 schools across the district and from an external facilitator-driven model to a sustainable teacher-driven.