1. Empowering Young Adolescents through Body Literacy and Fertility Awareness The societal messages that children acquire about their bodies and body functions influence them throughout their lifetime. Between the ages of 10 and 14, boys and girls are beginning to solidify their sexual and gender identities and develop attitudes and skills that lay the foundation for future sexual and reproductive health and well being. Many programs focus on the vulnerability of young girls and miss opportunities to provide boys with critical information and support during puberty. Fertility awareness is important for both boys and girls as it is core to understanding our gendered, sexual selves. Body literacy enables young people to recognize how their sexual and reproductive selves are influenced by gender and social norms. The resulting knowledge, social awareness, and skills facilitate the passage through puberty and prepare youth to care for their health and that of their partners. Georgetown University’s Institute for Reproductive Health (IRH) has worked for several years developing materials and approaches for increasing fertility awareness, mainly for adults. Results from studies conducted by IRH in numerous countries have shown that few women and men really understand their fertility and that this lack of knowledge constrains their ability to protect their reproductive health. Adolescents need this information as much or more than adults. To meet this need, IRH has initiated a number of programs on fertility awareness and body literacy How important is your rt SEXUAL HEALTH? to help young people understand their maturing bodies and how to protect their own sexual and a Go to the clinicst Many days for EC reproductive health. Fertility awareness and body literacy empower young people in navigating in a row If your guy never If your guy uses a talks about your When can a girl condom and it relationship, breaks, you: you: get pregnant? Wait for Bring his next it up move Pray puberty. Only 1 or 2 days a month If your guy says, If your friend is worried “You probably can’t get she might have a pregnant today,” disease you can get you: Take a Several of IRH’s programs to empower youth are described below: from having sex, Use you say: chance Take a Go to protection shower the clinic 1. To contribute to the evidence-base regarding strategies to address the sexual and Drop him quick If your friends tease Safe If a date you because your Birth control physically hurt you, guy is “not cute,” you: methods are: you would: Find a cute guy Still reproductive health needs of very young adolescents, with USAID support, IRH has Try not to upset him like him Harmful t Super Importan t More Importan conducted formative research to identify the appropriate channels, messages, and strategies t Becoming Importan about care You’re de nitely thinking You’re on your way to taking your sexual health and ways to There is a lot to learn about of your sexual health. But, there happy. keep yourself healthy and sexual health. Keep asking are still more things to know and You what Keep looking out for you. questions. Learn about do to keep healthy. Do what’s to deserve the very best! is right for you. Make sure right for you. You deserve the You take good care of yourself. for working with 10-14 year olds in Guatemala and Madagascar. IRH held in-depth best! deserve the best! TIps for Sexual Hea lth interviews with youth service organization leaders as well as focus groups with pre-teens and adolescents, parents, and teachers to explore issues related to puberty, including fertility, the Learn about your body and how to stay healthy. body, self-image, gender norms and roles, communication, protective and risk behaviors, Be wi and relationships in and outside the home. Key findings from across countries revealed: you th a pe Talk feel go rson wh abou od ab o he t wh ou lp at‛s t your s best self for . you. Protect yourselves from • Low knowledge regarding fertility and reproductive processes among both boys and girls. you pregnancy and from diseases Tell can get if you have sex. some one yo pres u trus sure t if yo d You de in a relat u feel serve ion the be ship. If you have any que stions, or for mor st! • e informa The influence of traditional gender roles on perceptions regarding puberty, and how tion call Teen Cit : 39500 Libe y Clinic Fremont, rty St. CA 94538 510-77 0-8131 gender and sexuality norms are reinforced by poor body literacy and fertility awareness. www.tric ityh ealth.or g • Discomfort with puberty-related changes among boys and girls.

2. • Unease among parents with discussing puberty-related changes with their children. • The need to sensitize parents and the community about how puberty and gender roles intersect, and help them build skills so they can create more supportive environments. 2. To contribute to development of better program practices, particularly appropriate methodologies and information content to include in programs for very young adolescents, IRH is currently testing and evaluating a series of six participatory education sessions designed for 10-14 year olds and their parents. Partnering with youth-serving organizations in both Guatemala and Madagascar, IRH is implementing interactive sessions designed to teach girls and boys ages 10 to 14 about their fertility and other physical and social changes they experience as they move through puberty. The material is drawn from My Changing Body, a training manual for youth originally developed by the IRH in collaboration with Family Health International (FHI), which IRH recently revised (2007/2008). A corollary set of participatory exercises for parents improves their understanding of puberty-related issues and builds their skills to support their IRH’s Research children. Take home exercises also help facilitate communication between young Partners adolescents and their parents.• Instituto Promundo, Brazil• Instituto Peruano de The evaluation will use a modified nonequivalent control group design to Paternidad Responsible measure changes in knowledge, attitudes and behaviors related to puberty and (INPPARES), Peru fertility awareness, gender roles, intergenerational relationships, and interpersonal• Institut Nationale de Santé communication, in both parents and youth. Preliminary evaluation results indicate Public et Communautaire that introducing topics of fertility and body awareness, while weaving in (INSPC), Madagascar gender and sexuality, is an effective way to improve knowledge, increase social• APROFAM, Guatemala awareness, and leads to more healthy behaviors of boys and girls and their• Tri-City Health Center, parents/adult guardians. What youth learn from an intervention that includes My California, USA Changing Body can help them to become more self-confident, practice good health habits, and gain a positive self-image — all of which contribute to their future sexual and reproductive health. Findings from this evaluation could have important implications for the development of effective, feasible and replicable strategies focused on this age group—10-14 year olds— that has traditionally been neglected by sexual and reproductive health programming. 3. IRH collaborated with a not-for-profit health center in California to evaluate new approaches to teen counseling in the USA, under a project funded by the U.S. Department of Health and Human Services, Office of Population Affairs. IRH developed and evaluated new, interactive, educational materials to help teens engage in conversation about healthy sexual behaviors with their respective partners. The project incorporated the use of CycleBeads® as a visual aid for understanding the menstrual cycle and improving teen knowledge of fertility, health and body changes that occur during a women’s cycle. Results suggest that teen girls use the materials to engage their partners in conversation about sexual health. Providers found the educational materials and CycleBeads useful for teaching clients about sexual health and fertility awareness. [2007-2008] The Institute for Reproductive Health conducts research and provides technical assistance on expanding access to family planning and HIV/AIDS services and improving options for women and couples worldwide. This publication and the project featured were supported by the U.S. Agency for International Development under Cooperative Agreement 596-A-00-06-00060-20. For more information, visit: www.irh.org or email: irhinfo@georgetown.edu