Reproductive health outreach programs for young adults

The models described include: (1) youth centers, both those that assist pregnant and parenting teens to pursue educational and vocational objectives and those that try to prevent premature pregnancy and other risky behaviors while helping to enhance life skills; (2) peer promotion programs, which have been successful in identifying and contacting difficult-to-reach populations such as out-of-school youth, street children, and commercial sex workers; (3) outreach programs delivered by adult professionals, e.g., the workplace model, where information and services are provided by the employer or at the place of employment; and (4) RH projects developed by youth-oriented organizations for their constituents. While very few evaluations have been done on these models, there are promising indications. There is limited evidence that centers for pregnant and parenting teens can delay a second pregnancy, but these facilities are very costly. Such programs have definitely succeeded, however, in improving educational policies so that young mothers can return to school. Multiservice youth centers designed to prevent premature pregnancy are also costly; furthermore, no clear conclusions can be drawn about if and how they improve adolescent RH or which of the many components play what kind of role in doing so. There is evidence that outreach programs using peer promoters are less costly per contraceptive user than fixed centers. They appear to be effective in reaching their target audiences, in HIV prevention programs in particular, and in distributing or referring for contraceptives. Also, young people seem to prefer their peers to adults in this area. NGO activities have not been extensively evaluated, but several implementation issues are becoming clear. The strong positive track records and reputations of many NGOs, especially the well-established groups, is especially important in the area of RH. At the same time, the difficulty of incorporating a challenging issue tends to be underestimated. Finally, while practically no evidence exists for individual project components or characteristics, there is considerable agreement among professionals in the field concerning what elements are necessary and likely to result in improved operations and better outcomes. A summary of key elements, values, and benefits from their inclusion in young adult programs and examples of their implementation is included in tabular form.