How can Ethiopian Adolescents Participate in their own Health?

By Amerti Lemma, Communications and PR Coordinator, PSI/Ethiopia

There is an Amharic joke that goes:

A family meeting was called by a father to decide what the family was going to buy for the New Year’s celebration. The floor was opened by the son who said, “we can’t start the New Year without some Doro wot (Chicken stew) so we must buy a chicken.” The mom continued and said, “No, we need something bigger than a chicken for New Year. We must get a sheep.” The daughter then said, “But goat meat is much softer and delicious than sheep meat!” They just couldn’t seem to reach a decision and so the dad interrupted and said; “Ok, ok I’ve already decided, we’re going to buy kircha (a few parts of the cow).” They all looked at him puzzled and asked, “Why did you ask us what we want then, if you had already decided what we’ll be buying?” To which he replied, “Well now we can say this decision has been participatory!”

The moral of the story directly applies to the way development organizations often operate in developing countries. Organizations already know what they intend to do; they rarely meaningfully engage the end-users in deciding what that is. Too many projects end up hit or miss. Work with adolescents has been particularly “miss.”

Like young people everywhere, adolescents in Ethiopia face many challenges that come with growing up and transitioning to adulthood. Aside from the physical changes they must deal with, adolescents struggle with social challenges as well. Peer pressure and gender inequality, as well as lack of resources, are just a few things that Ethiopian adolescents say makes them feel a lack of control over their lives.

When the Adolescents360 project kicked-off in Bahirdar (in the Amhara region of Ethiopia) participants, used to the old development model, were a little confused. A360 is deciding what activities to implement by engaging adolescents and partnering with them as solution-makers, and not just informants. Potential partner organizations, people from academia and even governments of developing countries are not always involved during the design process of projects before implementation. But Adolescents 360 is different; together with young people, these decision-makers have been part of the process from the beginning.

The first introductory presentation that went over the what, why, when and where of A360 was met with numerous questions from participants such as:

  • Why are we only involving adolescent girls? Are adolescent boys part of the target group?
  • Are you only focusing on family planning or also including HIV and other STI preventions since you’re talking about adolescents’ health in general?
  • Who are your partner organizations that you’ll be working with?


IMG_5009 credit Amerti Lemma

© Population Services International / Photo by: Amerti Lemma

The PSI team tried to answer these questions for people who were wondering why we’re asking for their opinions and organizing brainstorming sessions, rather than beginning with objectives and laying out plans!  At the end of the workshop, it was clear that this was an experience unlike any other that the participants had taken part in. They applauded the project’s way of doing things once they clearly understood what A360 is hoping to get out of sessions like this one.

And what are we learning from young people? The adolescents we worked with confirmed an interesting reality: the existence of early marriage in the regions they come from, which leads to early childbearing within the target age group that we’re trying to reach. During the exercise, they first stated that contraception is not something adolescents require. The ‘aha moment’ for them came after they discussed and identified that girls 15-19 were the prime age group for child bearing in their communities. We also learned from the NGO community, participants from universities, health bureaus and sport organizations. They told us that they have existing frameworks to improve sexual and reproductive health for adolescents in Ethiopia that we can potentially work with.

Through projects like A360, PSI is truly putting “her” — the adolescent girl – first and at the center of all we do. A360 makes certain its project is truly participatory, colorful and unique for adolescents across Ethiopia. So stay tuned! A360 is on the move in Ethiopia—and we’re bringing the community along with us!

Adolescents 360 (A360) is a four-year project aimed to increase access to and uptake of voluntary modern contraception among adolescent girls (15-19 years old) in Tanzania, Ethiopia and Nigeria. The project fuses public health, marketing, human-centered design, developmental neuroscience, and cultural anthropology and will meaningfully engage young people in the design and delivery of solutions that respond to their specific and varied needs. A360 is led by Population Services International, together with, the Center on the Developing Adolescent at the University of California Berkeley, Triggerise, and the Society for Family Health Nigeria. A360 is funded by the Bill & Melinda Gates Foundation and the Children’s Investment Fund Foundation.

Banner photo: © Population Services International / Photo by: Sophia Greenbaum