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Preliminary Findings Final Project Evaluation Plan Int.-RHAC January - February 2011

Promoting Healthier Life Choices with Adolescents Project. Preliminary Findings Final Project Evaluation Plan Int.-RHAC January - February 2011. Conducted by. OUTLINES. Project Overview Objectives Methodologies Findings Lessons Learned Key Challenges Conclusions

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Preliminary Findings Final Project Evaluation Plan Int.-RHAC January - February 2011

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  1. Promoting Healthier Life Choices with Adolescents Project Preliminary Findings Final Project Evaluation Plan Int.-RHAC January - February 2011 Conducted by

  2. OUTLINES • Project Overview • Objectives • Methodologies • Findings • Lessons Learned • Key Challenges • Conclusions • Recommendations

  3. 1. Project Overview Promoting Healthier Life Choices with Adolescents Project Obj1: To increase knowledge, promote positive behavior on sexual reproductive health, HIV/AIDS, STD, nutrition, alcohol and tobacco and drug abuse among adolescents aged 10-24 year olds in target areas. Obj2: to increase availability and accessibility of quality sexual and reproductive health services by adolescents and youths at risk in target area. Obj3: to increase political, community and family supports for adolescents and youth SRH interventions to create an enabling environment for youth activities. Obj4: to build the capacity of public health and local authority to manage and implement youth health program. To contribute to sexual and reproductive health rights by improving SRH status of adolescent and young people in Cambodia, especially the poor and deprived and disadvantage young people groups. • Project Period: • 24 Months • July 2009-July 2011 Project Location: Angkor Chum and BanteaySrey District in Siem Reap Province

  4. 2. Objectives of Project Evaluation CLEAR • Effectiveness and Efficiency • Affected Factors • Challenges • Lesson Learned • Recommendations

  5. 2. Objectives of Project Evaluation • Assess and analyze the progress of the project against the project objectives and indicators. • Assess and analyze the relevance, effectiveness and efficiency, sustainability of the project. • Assess and analyze whether the project has created the partnership, social cohesion and interrelationship and participation • Identify lessons learnt and recommendations • Analyze the extent on how this project has contributed to goals and objectives

  6. 3. Methodologies • Survey Tools Development • Project Overview meeting • Researchers Training • Data collection, Process and Analysis • Preliminary Findings Consultations • Feedback on • First draft • Second Draft • Final Draft of findings • Final Report

  7. Evaluation Planning and Approval from Plan International Document review Data collection instruments Development Fieldwork Preparation and review Process Map Field Work FGD KII In-Depth Project Overview meetings Data triangulations and Analysis Preliminary Finings and First Draft Second and Final draft of Project Evaluation Final Report 3. Methodologies

  8. 3. Methodologies Survey Questionnaires 10 components inside: Section 1: Demographic and HH Characteristic Section 2: KAPB on STD Section 3: KAPB on HIV and AIDS Section 4: KAPB on Birth Spacing Section 5: Drug use and it’s consequences Section 6: Nutrition Section 7: Child rights Section 8: Water and sanitation Section 9: Youth’s attitudes toward risk behaviors Section 10: Exposure to ASRH project

  9. 3. Methodologies

  10. 3. Methodologies

  11. 3. Methodologies Study Location Angkor Chum District BanteaySrei District

  12. 4. Findings Routine Program Monitoring and its achievements

  13. 4. Findings-Demographics Demographic Characteristic of the Respondents

  14. 4. Findings-Demographics Demographic Characteristic of the Respondents

  15. 4. Findings-Demographics Demographic Characteristic of the Respondents

  16. 4. Findings-STI Knowledge on STD

  17. 4. Findings-STI Knowledge on STI Prevention

  18. 4. Findings-HIV

  19. 4. Findings-Contraceptive Methods

  20. 4. Findings-Drug Use

  21. 4. Findings-Nutrition Knowledge, Attitude and Practice of Nutrition

  22. 4. Findings-Child Rights

  23. 4. Findings-Water and Sanitation

  24. 4. Findings-Risk Behavior Knowledge, Attitude and Practice toward Risk Behaviors

  25. 4. Findings-Risk Behavior

  26. 4. Findings-Access to information Access to Sexual and Reproductive Information

  27. 4. Findings-Access to information Access to Sexual and Reproductive Information

  28. 4. Findings-Enabling Environment Enabling Environment of HIV and SRH Discussion in Community

  29. Analysis and Discussion Comparison between Kg. Cham and Siem Reap

  30. Analysis and Discussion Comparison between Kg. Cham and Siem Reap

  31. Analysis and Discussion Comparison ASRH and SDHS 2005

  32. Analysis and Discussion Comparison ASRH and SDHS 2005

  33. Analysis and discussions Comparison ASRH and MARA 2010

  34. 5. Lessons Leaned-1 • Management of the Health Centers: Management of the health services is key to the success of the project. With strong support to community related activities, services delivery at Health Centers and the management for Operational District have been improved accordingly through direct communication between health services providers and services users at the HCMC and CCWC meetings. Subsequently, health seeking behaviors are remarkably increasing. As shown in the figure 7 below, the data collected from the Tableau de Bord of Angkor Chum and SnaSanday Health Centers in 2010, striking difference on the achievement in those two Health Centers. The deliveries by the Traditional Birth Attendants (TBA) are almost completely eliminated at Angkor Chum but are still at 10% in SnaSanday commune.

  35. 5. Lessons Leaned-2 • The figure 8 below shows that percentage of family planning (FP) users' coverage in Angkor Chum is almost 2 times higher than SnaSanday (58% and 30% respectively). Besides their trends are on increase with Angkor Chum but on decrease in SnaSanday.

  36. 5. Lesson Learned-3 • Strong support to the local authority and health system and network in place: This project has been designed not work as separate action of civil society but to support local authority and health system and network to be mutually accountable in mobilizing local people to seek SRH and HIV and AIDS services. Through its quarterly meeting (within RHAC Project), Angkor Chum Commune Chief invites RHAC representative, HC Chief, District Governor , Village Heath Support Group, Youth Representatives to provide their respective feedbacks on the progress activities of the project . This working environment creates a strong supportive environment for a good services provision for young people in the commune. The partnership with government and existing structures (local, religious, traditional etc.) increases effectiveness of the project

  37. 5. Lesson Learned-4 Multiple approaches are needed to reach adolescents with HIV information, testing, and services. Innovative IEC approaches should include multimedia (especially videos). The activities should be carried out with the same intensity from the beginning to the end of the project, and should be repeated to reinforce behavior change messages.

  38. 6. Key Challenges • The Risks: • Design for Migrant Population: Through the VCCT services provided by Angkor Chum Commune 16 new HIV infections are found on migrant workers who came back from Thailand. Actually it is not clear to what extent RHAC project manage to reach potential migrant and provide them with a good pre-departure orientation.

  39. 6. Key Challenges • Target Groups: • Age groups of young people • Peer educator per peer beneficiaries • Timeline of peer education

  40. 6. Key Challenges • Limited capacity of local authority and governance • User Fee Policy • Frequency of stock out of the supply of testing reagents and some STI drugs • Harmonization of existing community Structure ( NAA Functional Task Analysis) • Overlapping and double efforts of committee at commune councils (Community Youth Reproductive health Committee) •  The sustainability of youth centre is obscured for the next two or three of continuation of the project. Furthermore, the accessibility of youth centre just came from youth who are living in urban district and communes. • The Education sector is a strategic ally for adolescent's behavior change; however project does not have any collaboration with provincial department of education.

  41. 7. Recommendations • RHAC should build Institutionalized partnership between RHAC and CCWC with clear mechanisms and procedures • Mechanisms • Human Resources • Financial management • Commune Development Plan • RHAC should classify age group of young people with different interest on knowledge, beliefs, attitudes, lifestyle and sexual practices. • Capacity building of peer educators • Training of Trainers and Refresher Training • Community Resources or social capital • Village-based Platform with ingredient of success • Integrated reproductive health into CDP and success indicators into CDB

  42. 7. Recommendations Village-based Platform with ingredient of success • Community Service Directory • Community Communication directory • Viewers and listeners forums on reproductive health • Youth reporting card on 10 positive behaviours • Non Smoking • Avoiding drug use • Non violence • Non gambling • Abstinence • Access reproductive health information • Attend village based platform • Regular school attendance • Meaningful involvement in community activities • Play an specific role to refer youth friend to appropriate services

  43. 7. Recommendations • RHAC should consider integration of the situation of risks and its impact of the Most At Risk Young People Survey of MOEYS( 2010) into the Peer Education , Youth Campaign , Parent education sessions and the CCWC meetings. • Special attention should be made to reach household having Migrant and Mobile Population based on the evidence of risks to this group. • It would be very useful if RHAC can organize meetings and site visits with partners to share the lesson learned on the leadership and management and the implementation of the project. • RHAC should find possible way to improve the community coordination platform between public, private and NGOs working on domestic violence, civil registration, commune/village safety committee and others. • RHAC and other partners in community can coordinate with commune councils and CCWC to award portrayal of good leadership of young people.

  44. 8. Conclusions • The project contributed considerably to making access SRH and HIV/AIDS information available especially to rural youths and increased the knowledge of HIV and STI symptoms and prevention methods, nutrition and created better enabling environment. • The project mostly met or exceeded its key performance indicators, and there are significant increases in knowledge on reproductive health, HIV, STI, and nutrition among the adolescents who attended the program than adolescents who did attend the program. • The project should continue to work with decentralized mechanisms for community participation in social, legal and health sectors or Social Component: CCWC, Education for all, Commune/Village Safety Committee, Health Centre Management Committee etc.

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