By Dr. Shamsher Ali Khan & Dr. Munir Ahmed

At the age of 11, Razia was nervous on her first day of school. Almost three years later, she sits comfortably with her friends in the after-school library. One of the top students in her class, Razia will enter the formal schooling system as a 5^th grader in a few months. "I plan to go to college and be a teacher!" Razia vows. Her mother, married at 13, agrees. "Even though she’s already had suitors, I won’t let Razia to marry until she’s at least 18. I don’t want her life to be a repeat of my own."

Razia is one adolescent whose life has been changed by BRAC (the Bangladesh Rural Advancement Committee). In Sherpur, the village she is from in Bangladesh, most adolescents have never attended school. Girls may marry as early as 12, and many start childbearing before they are 18. A BRAC survey found low levels of understanding about anatomy and reproduction, personal hygiene, fertility and pregnancy, and sexually transmitted infections (STIs) among youth age 10-15.

In response, in 1995 BRAC developed a reproductive health Rural Service Delivery Program (RSDP) with a special focus on poor youth, ages 10-15, 70% of whom are girls. The RSDP establishes informal schools that provide 3 years of primary schooling to adolescents who have never attended school. After graduation, students can join Grade 5 in the formal schooling system. Monthly reproductive health sessions are integrated into the regular school curriculum and include topics such as adolescence, reproduction and menstruation, marriage and pregnancy, STIs, family planning and contraception, smoking and substance abuse, and gender issues.

The adolescent program builds on BRAC’s social development approach designed to address the needs of poor rural communities. BRAC’s strategy mobilizes communities to support social change by taking the following steps:

1. Identifying social groups and mapping existing formal structures or networks. In many rural areas, networks include adult males, religious leaders, teachers, and the parents and extended family of children. BRAC also recruits and trains female volunteers who become the nucleus of a social network of women.
2. Building trust with the community by providing something to meet their perceived needs. In most communities, BRAC starts a credit program that involves the poorest of the poor in economic activities to alleviate poverty.
3. Developing fora around social networks to engage in dialogue with the community. Key elements of developing effective community fora include 1) identifying appropriate actors; 2) recognizing and responding to communication patterns and behavioral cues that exist in the community; 3) building cultural beliefs about the authority and reliability of the information provided in the forum; and 4) using fora to strengthen existing positive relationships within the family and community.
4. Within community fora, exposing members to new ideas, involving them in problem solving, and encouraging "risky innovations." As forum members are taken through this process, they become advocates for the program approach by integrating program objectives into their own lives and value systems.

It was through the process of community mobilization that BRAC was able to establish the RSDP program for adolescents. We engaged communities in an evolutionary process that introduced new ideas, such as schooling for adolescent girls. Through dialogue, community members could then address more sensitive issues such as adolescent reproductive health. As a result, BRAC has established 175 informal schools in 4 districts. Each school provides free schooling for 30 students, at least 70% of whom are girls; the teacher is recruited and trained from the village where the school is established. Major strengths of the RSDP program include:

• Emphasis on parental and extended family involvement. Through monthly parent meetings, BRAC has fostered parental support for the program, and in some areas spurred the start of informal adult education for adult family members of adolescents.
• Influencing community norms. BRAC supports norms that encourage girls’ delayed marriage and continued education through community fora and outreach.
• Communication between boys and girls. Since reproductive health is built into the regular curriculum, the program allows boys and girls to discuss reproductive health together, and builds communication skills for opposite-sex relationships.
• Continued programming. The school is used for a library for youth who have graduated, providing a space for young people to gather in an environment with supportive resources.

BRAC program planners have identified several elements as key to the success of the RSDP program; namely, BRAC has:

• established "exchange relations" with the community so that people recognize the benefits and opportunities for engaging in programs such as the RSDP; staff are then able to add on program innovations incrementally.
• introduced a feedback loop so that as the program gains experience, it has the capability to use that experience to reflect on what it has learned and implement innovations in the program. Program staff have been involved in data collection, and are encouraged to reflect on evaluation results.
• worked in the domestic and the public domain simultaneously. For example, while female staff can effectively engage women in dialogue at the household level, involving male community leaders who interact in the public domain has been crucial for program sustainability.
• developed simple, correct messages on the new ideas BRAC introduces so that communities are able to understand and integrate them into their own lives.

Finally, program planners have identified the following future needs for the RSDP program:

1. An assessment of the reproductive health curriculum found that youth thought the curricula should be focused more on reproductive health and sex education than "family life;" that environment and drug abuse issues should be discussed; and that contraceptive methods should be demonstrated. The evaluation also found that peer networks should be strengthened through the program, that teachers need more support to teach the curricula and that youth wanted interactive teaching methods such as role plays and drama.
2. Understanding and documenting the dynamics of community involvement, and the shifts from community resistance to social action, is needed. Documentation of how BRAC is able to communicate about sensitive issues would allow replication of the program and further diffusion of social action.
3. BRAC has anecdotal evidence that people exposed to one aspect of the program become agents of change, and involvement or exposure to several interventions may expedite the changing of social norms. Developing indicators to capture this "snowball" effect would help track the program’s evolution as new innovations are added.

Contact person:

Dr. Munir Ahmed, Program Coordinator

Health and Population Division

BRAC

75 Mohakhali

Dhaka 1212

Bangladesh

Tel: 880-2-9881265

Fax: 880-2-883542

Email: hpd@bdmail.net