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Promoting sexual and reproductive health and rights for youth and drug-affected youth in Afghanistan through art, education and services

NAC aims to improve knowledge of and access to SRH services through creative workshops, school engagement and consultation services.

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What specific problem(s) are you trying to address?

Youth in Ghazni live in one of the most insecure provinces in Afghanistan. In addition to displacement the province is also faced with high numbers of returnees and deportees from Iran and Pakistan. Drug-abuse is often prevalent among returning youth and increasing among youth in Afghanistan. UNODC recently reported that 46% of rural children and youth tested positive for opiates (9% active users, the remaining 91% is exposed through drug use of family members). Prevalence of HIV and HBV/HCV is high (concentrated epidemic) and increasing. This has further implications for youth and SRH issues, in a context with serious challenges for youth and SRH, especially for women and girls with traditionally limited influence and knowledge on SRH.

What are some of your unanswered questions about the problem(s) you are working to address?

How can youth access SRH rights and services when their choice of partners often are determined by others? How can youth be empowered to access sensitive information and make informed choices in an enabling environment? How can we increase awareness on SRH issues linked to drug abuse? How can we address other protection issues linked to SRH and drug-abuse? How can we in a meaningful and constructive manner facilitate access to SRH information and services in a context like Afghanistan?

Explain Your Idea

1 COMMUNITY AWARENESS EVENTS (ART & THEATER): It is difficult in a conservative cultural context like Afghanistan, to talk about drugs and sexuality. Awareness-raising through creative work-shops and events targeting youth, community/religious leaders, health personnel, families and community members can be a door opener for initiating dialogue in a safe environment with peers. In Jaghori and Malistan NAC has established Activity & Leaning Centers (A&LCs), where young people receive citizenship education, life-skills, training on health, nutrition, academics etc. These A&LCs will be used to conduct a series of art and theater workshops promoting SRH issues for youth in an interactive and culturally appropriate manner.
2 SCHOOL ENGAGEMENT ACTIVITIES: In collaboration with School Shuras, district education authorities, Mosques and the local Teacher Training College (TTC), NAC will conduct a activities in minimum 10 schools to raise awareness on SRH and on SRH issues linked to drug-abuse (medical and psycho-social). The school activities will be a pilot on developing messages on SRH and drug-abuse in cooperation with youth and teachers and by using Project-Based Learning methodologies.
3 PSYCHO-SOCIAL CONSULTATION (PSC): To facilitate access to information and relevant services NAC will establish PSC services through Comprehensive Health Center and District Hospitals for specialized delivery of information, services and consultation for youth and family members for SRH issues

Name the three most important ways that your idea will address your identified problem(s).

1 Through creative events communities will receive information on and explore SRH issues in a less sensitive approach than typical information sessions. Even if many of the SRH challenges affects women and girls it is crucial to mobilize men to facilitate an enabling environment for improved access to information on SRH for all.
2 Through engagement of youth and teachers on material on SRH and drug-abuse the target groups will increase their own awareness at the same time as they are actively engaged in exploring and developing appropriate and relevant material, as well as inform NAC on future SRH activities.
3 Through the PSC service youth and family get access to vital information, services and follow up by qualified personnel.

How is your idea unique?

This idea is unique in Afghanistan in the community wide approach for the targeted end users as well as for the creative aspect of the approach. The additional aspect of linking SRH issues to drug-abuse is effectively also addressing another serious and increasing challenge for youth in Afghanistan. Awareness on both of these problems also facilitates the room for addressing specific health related SRH issues in a wider context: protection issues, psycho-social and economic issues.

Creative exploring of SRH issues linked to drug-abuse enables communities to also discuss wider challenges linked to these issues. This may lead to issues that initially might be too sensitive to address are brought up and discussed in a wider context. This process itself may lead to the need of addressing other issues not explored through a realization and recognition of the importance of them due to the societal impact of the issues.

What are some outstanding concerns or questions that you have regarding your idea?

The main challenge will be involving religious leaders in a constructive and meaningful way, as well as making sure that we reach the most relevant community members (from youth to community leaders) in a way that is acceptable and paves the way for change.

The establishment of the PSC service linked to established health facilities is a way of exploring how NAC can provide services. How this is received and how the councellors spend their time/types of services provided remains to be seen.

Who are your end users?

The beneficiaries are primarily youth and drug-affected youth, but also parents, teachers, community/religious leaders, School Shura members, and district officials.
All end users will gain knowledge, learn practical tools to inform youth and family members, and to discuss sensitive issues like drug-abuse and SRH issues.
The target areas are Jaghori and Malistan districts, Ghazni Province. These two districts have an estimated population of 600,000.

POTENTIAL END USERS OF THIS IDEA (1st step)
NAC aims to reach 800 youth (minimum), 1,200 community members (including parents, community and religious leaders), 80 teachers, 10 schools and 14 Community Development Councils (CDCs) within the first 12 months of the project.

Where will your idea be implemented?

  • Afghanistan

What is the primary type of emergency setting where your innovation would operate?

  • Armed conflict
  • Prolonged displacement
  • Other

Tell us more about the emergency setting that you intend to implement in

Due to the ongoing conflict between government and opposition forces, access to Jaghori and Malistan (Ghazni) is challenging and displacements occur. The increased number of deportees and returnees put additional stress on existing resources. Prevalence of STIs in Iran and Pakistan is higher than in Afghanistan, and along with increased use of drugs the vulnerability of youth is increasing. The target areas are culturally conservative so all SRH aspects must be addressed in a sensitive manner.

What is your organization's name?

Norwegian Afghanistan Committee (NAC)

Tell us more about you.

NAC is a member-based solidarity organization with the goal of reduced poverty in rural Afghanistan. The organization has been working in support of the Afghan people since 1979. From a grassroots movement in Norway, the organization has developed into a professional humanitarian development organization working in some of the most challenging and insecure provinces of Afghanistan. We work in 11 Afghan provinces and have 315 national (40% female!) and 3 international staff in Afghanistan (1%). NAC has the opportunity to draw on a range of professionals: medical doctors, midwives, nurses, lecturers, teachers, artists, community mobilizers and youth activists.

Organizational Characteristics

  • International/global organization

What is the current scale of your proposed innovation?

  • Still in planning phase and does not exist yet

Experience in Implementation Country(ies)

  • Yes, for more than one year.

Expertise in Sector

  • Yes, for more than a year.

Organization Location

NAC is registered in Norway and Afghanistan with Head Office in Oslo, Country Office in Kabul, and Regional Office in Jaghori (Ghazni) and Fayzabad (Badakhshan).

What is your organizational status?

  • Registered non-profit, charity, NGO, or community-based organization.

What is the maturity of your innovation?

  • Early Stage Innovation: exploring my innovation, refining, researching, and gathering inspiration.

Website

www.afghanistan.no
https://www.facebook.com/afghanistankomiteen/

How has your idea changed based on feedback?

When the idea was published we were already aware of the many sensitivities linked to SRH issues, in particular issues linking SRH and drug-abuse and we were not sure how the idea would be received in communities or how the particular focus on SRH and drug-abuse would be received.

The most important feedback we got in the refinement process was from the communities: while recognizing the sensitivities linked to the topics the need for addressing these issues was recognized and encouraged. The increasing problem of drug injections among youth seemed to a good "door-opener" for addressing the topic.

Through OpenIDEO we received support for the approach and good ideas for next steps for the proposed idea like: the use of “ambassadors” and systematic training of community leaders.

The need to add services was also a refinement of the initial idea, we had already started discussions on this in the team, but it was useful that this perspective also was emphasized in the feedback.

Who will implement this idea?

In addition to existing NAC team members in Ghazni that would follow the project for this particular idea would also require recruitment of additional health staff with qualifications suitable for SRH and drug related issues and with the ability of providing psycho-social support. Additionally there would be a Project Coordinator dedicated to the management role of the project to ensure quality implementation and project coordination.
In addition to the key project staff (working full time on the project) additional support would be provided by the NAC team (national level: Health Coordinator, Country Director, International Program Specialist, Knowledge Management Specialist, Finance staff, M&E Coordinator etc. Local level: Regional Manager, M&E Officer, finance staff, HR officer etc.)

Using a human-centered design approach, you may uncover insights that lead to small or foundational changes to your organization’s existing strategy or processes in order to unlock the potential of your idea. How would your organization go about making such changes?

The OpenIDEO model has inspired the NAC team to invest more time in human-centered design and refinement of project ideas. The process has encouraged and forced us to spend more time than we often "allow" ourselves in design phases and been a good reminder on the importance of keeping end-users at the forefront throughout the process through consultations and refinement of ideas.

In NAC I think the approach to developing new projects/activities and refinement of existing ones will improve through for instance of stronger integration of human-centered design approaches through all phases in Project cycle Management.

This integration encourages a stronger communication from field officers to senior management, as well as a greater understanding of needs and solutions at all levels.

What challenges do your end-users face? (1) What is the biggest challenge that your end-users face on a day-to-day, individual level? (2) What is the biggest systems-level challenge that affects your end-users?

The biggest challenge our targeted end users face on a daily basis is a lack of access to SRH information and services, this prevents youth to make informed decisions and choices on their own health and future in a context where social structures often in practice make the decisions for them.

The biggest systems-level challenge affecting the targeted end users is the lack of access to services and information. In addition the sensitivities and stigma already linked to this; these problems are further exacerbated by lacking access to information and services available. The lack of knowledge and prioritization of SRH issues, combined with increased drug-abuse, contributes to an even more challenging foundation for the future of a rapidly growing generation of youth in Afghanistan.

Tell us about your vision for this project: (1) share one sentence about the impact you would like to see from this project in five years and (2) what is the biggest question you need to answer to get there?

IMPACT: In 5 years we wish to see an increased awareness and knowledge among youth and in the communities about the importance of SRH issues and links to drug-abuse and improved access for youth to SRH services.

HOW DO WE GET THERE? What approaches are the most effective and culturally appropriate to ensure that access to SRH rights and services are more acceptable, available, and recognized in 5 years in Afghanistan and Ghazni compared to the current situation?

What is it that most attracted you to Amplify instead of a more traditional funding model?

The Amplify Model is attractive to us for several reasons:
-It encourages and facilitates more consultation with staff, beneficiaries and a wider community than in "normal" design processes
-Refining ideas over time improves projects (and relevance)
-The tools provided (and interactive sessions) throughout the challenge are useful tools for capacity building and project design
-The opportunity of feedback (and inspiration) from a global community concerned with the same issues is inspiring!

Do you intend to implement your Amplify idea in refugee camps / temporary settlements?

  • We aim to implement our Amplify idea in support of displaced populations, but not in a refugee camp / temporary settlement.

How long have you and your colleagues been working on this idea together?

  • Less than 6 months

How many of your organizations’s paid, full-time staff are currently based in the location where the beneficiaries of your proposed idea live?

  • Between 20-50 paid, full-time staff

Is your organization registered in the country you intend to implement your idea in?

  • We are registered in all countries where we plan to implement.

My organization's operational budget for 2016 was:

  • Above $1,000,000 USD

What do you need the most support with for your innovation?

  • Program/Service Design

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Team

Dear Eunice,
Family Planning services are indeed highly relevant for SRH responses. In activities we are however sensitive about framing projects as FP and try to link it more to issues such as for instance responsible parenting that further facilitates exploring specific issues in terms of how it resonnates with the audience. For drug-affected youth this idea is about SRH so we will not focus on rehabilitation or treatment services. We're aiming to increase awareness about SRH issues that are linked to drug-abuse such as infections that are transmitted through blood and sexually transmitted, but also to other infections that may have SRH implications and that are relevant for drug-affected. Additionally we will also focus on wider SRH issues such as protection risks experienced by user and family of users as a consequence of drug-abuse (such as SGBV, HH economy etc.)

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