Know Yourself Adolescent Reproductive Health Communication Programme

In response to a baseline study and formative research on what adolescents wanted to know, partners worked together to guide the development of a set of communication materials (a toolkit and various mass media items). While this package was developed for the Bangladesh context, organisers believe that it can be adapted for other cultures. Incorporated into all materials and media is a logo with the slogan Nijeke Jano or "Know Yourself". The logo was developed and pretested with adolescents and adopted by the ARH Working Group as a symbol for all partners to use. In addition to being placed on various information and communication products, this logo has been disseminated in sticker form and placed on walls, vehicles, and other public places. It has also been printed on school books and other materials associated with adolescent health education. The mass media component also involves use of the logo as well as a common theme song.

Specifically, based on formative research and involvement of adolescents, parents, teachers and community members, a "Know Yourself" toolkit was created. Available in both Bangla and English, the toolkit is composed of the following elements:

• Q & A Booklets - The research process mentioned above detailed many of the ARH-related questions adolescents in Bangladesh have; these exchanges were tabulated and answers were developed in the form of Q&A booklets that were pretested with adolescents and revised accordingly. The booklets are:
  
  • It's My Puberty: physical maturity, including body changes, menstruation, sperm production/wet dreams, as well as emotional changes.
  • New Feelings, New Passions: sexuality, sexual attraction and delay of sexual debut (including delay of early marriage, learning about conception and pregnancy, and avoiding premarital sex and unwanted pregnancy), sexual and physical abuse.
  • Preventing Risks to Our Future: HIV/AIDS and other STIs, a balanced approach to prevention: delay of sexual debut/abstinence, faithfulness, condom use; prevention of transmission through Injecting Drug Use (IDU).
  • Preparing for Marriage: delay of marriage and pregnancy, conception, family planning methods, pregnancy, maternal health, childbirth, hygiene, and nutrition.
• ARH Videos - 4 videos were produced through life skills workshops with adolescents involving a series of exercises which were designed to bring out the issues most important to them and to allow them to practice skills in a safe, interactive, and participatory manner. The 26-minute videos address the same topics covered by the Q&A booklets described above, with colour-coding matching the booklets for each topic.
• Facilitators' Guides - Each of the videos has a matching, colour-coded facilitators' guide that contains many life skills exercises on the same 4 subject areas. These exercises were rewritten and adapted to the Bangladesh context through pretesting with adolescents and facilitators. They are designed to involve adolescents in ARH issues in a highly interactive manner, allowing them to think through problems and articulate their own opinions and thoughts.

Materials for parents have been produced and disseminated on a pilot basis. Consideration will also be given to the development and production of other motivational materials for parents and for other audiences, including communication and counseling manuals for RH providers in youth-friendly services. A core group of life skills facilitators from the ARH Working Group members received a training of trainers (TOT). These facilitators will operationalise the ARH life skills toolkit and train facilitators in their own organisations, including peer educators, on its use. Attempts will be made to pilot the package in school settings as well.

Second, as the "Know Yourself" programme developed, a mass media component was articulated and then put in place to motivate adolescents to develop healthy behaviour or to change risky behaviour. This component involves the use of "Entertainment Education" (EE) as a communication strategy. In addition to recognising that access to such mass media by adolescents in Bangladesh had grown rapidly, organisers also realised that parents, community leaders, and service providers could be influenced by these EE strategies, hopefully creating a more enabling environment. This component is also participatory; adolescents were involved in design workshops along with writers, artists, researchers, programmers, and broadcasters. Adolescents, parents, and community stakeholders were also consulted on the draft programmes by pretesting in focus group discussions and interviews. This component of the programme includes:

• Comic Books: Organisers explain, "The advantages of comic books are that they are very popular with adolescents and allow programmers to address sensitive issues more directly than is possible on television or radio." Based on adolescents' input throughout the process, a set of characters was developed and placed in a small Bangladeshi town, where adventures take place on adolescent themes such as emotional change and sexual attraction, peer pressure and dealing with parents, and avoiding early marriage and early pregnancy. Twenty full-colour comic books, each approximately 48 pages, were designed, produced, and distributed through existing networks and sold. Each book includes guidelines and questions for reflection and discussion.
• Television and Radio Magazine Series: Many of these same topics are also being covered in a 52-episode radio series and 26-episode TV series (that may expand to 52 episodes). Both series follow variety-show formats with adolescent anchors and field reporters who conduct interviews with adolescents, parents, teachers, service providers, and community leaders on the issues. There are also celebrity and expert guests, drama (featuring the same characters as the comic books), songs, poems, and quizzes. According to organisers, adolescents are involved in all stages of programme development, from topic choice and story development to production and pretesting.

Youth, Reproductive Health, Population.

BCCP was formed in 1996 as the successor to the Johns Hopkins University/Center for Communication Programs (JHU/CCP) in Bangladesh with the same mandate: to design, manage, and implement large-scale communication programmes for health and other development sectors.

In October 2004, "Know Yourself" was selected as the winner in the Best Combined Media Effort category in the Global Media Awards for Excellence in Population Reporting (sponsored by the Population Institute).

The programme implemented a pilot study of the ARH materials in 3 rural areas of Bangladesh, interviewing 1702 adolescents and 1203 parents in the spring of 2004, and 1827 adolescents and
1276 parents in the summer of 2005. The main findings from this study include:

• Nearly 60% of all adolescents in the implementation areas reported participating in the ARH group sessions.
• Participants in the implementation sites had greater knowledge of puberty and adolescence, pregnancy, maternal health and HIV/AIDS than either non-participants or adolescents living in the comparison sites.
• Participants were more likely to have discussed RH issues with a parent or elder family member than either non-participants or adolescents living in the comparison sites.
• The programme did not have a noticeable effect on adolescents' perceptions of self-esteem or problem-solving ability.
• Compared to parents in the comparison areas, parents in the implementation areas indicated a greater level of participation in household decision-making by adolescents.

A larger study is planned for fall 2006 to assess the joint effects of the mass media and community-level activities.