Shukhi Jibon Project
"Through Shukhi Jibon, adolescents can create a ripple of positive change through generations, breaking cycles of poverty and inequality by enabling individuals to plan their families and futures."
From 2018 to 2023, the Accelerating Universal Access to Family Planning Project, also known as Shukhi Jibon, was implemented to increase access to family planning services in Bangladesh and to strengthen the capacity of health providers to improve the quality of their services. The project focused on those most in need of family planning services and information - districts and divisions with lower modern contraceptive prevalence and populations facing the greatest barriers. It, therefore, focused on the sexual and reproductive health and rights (SRHR) of underserved adolescents and conducted a number of activities to reach adolescents across 4 geographic divisions in Bangladesh with family planning information and services. Underpinning this work were community-based initiatives implemented by Shukhi Jibon's 6 local partners that sought to: enhance young people's engagement, knowledge, skills, and agency to prevent child, early, and forced marriages; avoid unintended pregnancies; access adolescent-friendly sexual and reproductive health (SRH) services; and create pathways toward healthy adulthood.
Increasing the engagement and agency of young people was one key component of the Shukhi Jibon project in its effort to bring high-quality family planning services and information to people who face the greatest barriers. Other activities (not described below) included: supporting service provision through the training of healthcare providers and the development of manuals; expanding access to quality services, especially for adolescents, through improving facility readiness; pioneering community-based postpartum family planning; and expanding contraceptive method choice.
Shukhi Jibon was funded by the United States Agency for International Development (USAID) and led by Pathfinder International, in partnership with IntraHealth International, the Ministry of Health and Family Welfare, and 6 local implementing organisations (more on these below).
The project sought to achieve the following outcomes:
- Young people have increased knowledge, skills, intention, and agency to make healthy decisions about their SRHR;
- Young people have access to and utilise safe and supportive opportunities that promote critical thinking, healthy decision-making, and the adoption of health-promoting behaviours related to SRHR;
- Young people hold and champion favourable attitudes and perceptions related to sexuality, gender equity, and SRH rights and entitlements; and
- Young people have a better understanding of the attributes of healthy relationships and agency to maintain respectful social and sexual relationships free of violence.
An important strategy of the project was to keep local partners at the centre of activities to ensure that activities were community-driven and built on existing expertise and experience. It, therefore, partnered with 6 local non-governmental organisations (NGOs) with experience, capabilities, and credibility to improve adolescent and youth sexual and reproductive health and rights (AYSRHR) in their communities: Eco-Social Development Organization (ESDO), Family Planning Association of Bangladesh (FPAB), Light House, Partners in Health & Development (PHD), SERAC Bangladesh, and Young Power in Social Action (YPSA). Shukhi Jibon provided focused grants and technical support to these local NGO partners to lead gender-responsive, technology-based AYSRHR activities in Dhaka, Chattogram, Mymensingh, and Sylhet divisions.
Activities that were conducted directly with adolescents and youth to increase their knowledge and agency around SRHR involved the following:
Building young people's skills, knowledge, and social networks
Shukhi Jibon supported NGO partners to leverage new and existing platforms to directly engage young people. Through monthly training sessions, forums, and clubs - conducted in and out of school - young participants gained knowledge and skills to improve their health and wellness, including how to access AYSRHR services. Such platforms include: TararMela, FPAB's signature youth-led programme; the Youth Development Forum organised by ESDO; and clubs for adolescents, including hard-to-reach ethnic minorities, organised by YPSA; among others. Together, young people share their feelings and thoughts with their peers, foster a sense of connectedness that promotes mutual learning, and reflect on gender norms, attitudes, and behaviours that influence their AYSRHR.
Achievement: From 2021 to 2023, 122,271 young people, including 30,000+ very young adolescents aged 10-14, participated in AYSRHR sessions supported by Shukhi Jibon.
Promoting youth leadership
Adolescents and youth are more than stakeholders; they are creative, dynamic partners with the power to shape their own priorities and futures. Shukhi Jibon implemented activities with local partners SERAC, ESDO, FPAB, and Light House to increase the participation and leadership of young people to mobilise their peers and communities to improve AYSRHR. For example, through a partnership with Light House, the project helped establish "Youth Brigades". Comprising young volunteers of diverse genders, including marginalised transgender youth, Youth Brigades receive: skills training; information, education, and communication (IEC) materials; and opportunities to share knowledge related to adolescent-friendly health services, contraceptive choice, decision-making for AYSRHR, and more. During sessions with their peers, visits to their neighbours' homes, and local awareness-raising campaigns, Youth Brigade members spoke out to reduce shame and stigma and increase demand for AYSRHR services.
Achievement: From 2021 to 2023, 6,754 adolescent peer leaders were trained by Shukhi Jibon's local partners to promote healthy AYSRH practices and increase healthcare-seeking behaviours.
Ensuring the inclusion of marginalised young people
Local partners led activities, such as community sessions, to advance the inclusion of marginalised youth populations, including unmarried adolescents, ethnic minorities, transgender youth, young people with disabilities, and young people living in areas that are geographically isolated or prone to extreme natural disasters. For example, in rural tea garden communities of Sylhet, Shukhi Jibon and local partners worked with the Directorate General of Family Planning (DGFP) to reach adolescents and youth - who often face extreme poverty, are socially isolated, and struggle to access distant health services - through tele-counselling sessions that provided knowledge on AYSRHR and referrals for quality AYFHS. The government has committed to continuing tele-counselling for young, hard-to-reach individuals after Shukhi Jibon ends.
Achievement: From 2021 to 2023, 89,063 people participated in project-supported community sessions on AYSRHR, including 1,000+ transgender youth, to increase their knowledge and awareness of AYSRHR. In addition, 3,507 adolescents and young couples received tele-counselling.
Advancing comprehensive sexuality education (CSE)
The project also supported CSE, which is a key component of Bangladesh's National Plan of Action for Adolescent Health Strategy 2017-2030 and a proven strategy that has a positive impact on SRH outcomes, including a reduction in sexually transmitted infections (STIs) and unintended pregnancy. In support of the government's goals, Shukhi Jibon collaborated with local partner FPAB to conduct CSE training sessions with adolescents and youth ages 10-24 to close significant knowledge gaps about sex and sexuality and to empower young people with the information and life skills they need to lead healthy and productive lives. Project-supported CSE sessions focus on a range of topics, such as communication, decision making, negotiation, gender, respect, AYSRHR, relationships, pleasure, diversity, and violence.
Achievement: From 2021 to 2023, more than 44,800 young people, including 7,000 very young adolescents, participated in CSE sessions supported by Shukhi Jibon.
Using digital technologies to promote healthy SRH behaviours
Shukhi Jibon supported local partners to harness the power of popular digital tools, which many adolescents and youth already use, to connect young people to accurate information and skilled providers, and to promote healthy AYSRH behaviours. For example, Shukhi Jibon provided technical assistance to DGFP's Information, Education, and Motivation (IEM) Unit to advance its social and behaviour change communication by launching a new social media plan for IEM that featured live discussions, in-app ad placement, animation, character-based videos, comic strips, quiz competitions, experience sharing, and more. The Shukhi Jibon team collaborated with the IEM Unit to maximise the reach of the IEM Facebook page by improving engagement and increasing adolescent and youth traffic. As a result, young people can directly engage with call centre agents, who are trained to deliver adolescent- and youth friendly information, and service providers ready to answer AYSRHR-related queries and provide referrals for services.
The project also supported key stakeholders, including family planning district managers, to organise virtual seminars with young people and their influencers to discuss a range of AYSRHR topics, including family planning and child marriage. These sessions were recorded and disseminated on YouTube to expand their reach. In addition, through digital tools, voluntarily enrolled adolescent married couples and first-time parents in project areas received voice messages and short message service (SMS) focused on AYSRHR and family planning issues. These messages, which were developed by local partner PHD in line with Ministry of Health and Family Welfare (MOHFW) guidelines, were displayed in Bangla.
Achievement: From 2021 to 2023, 578,800+ people were reached through quizzes posted by DGFP's IEM Unit's social media accounts.
Recognising the complex interplay between individual, interpersonal, household, and community factors on SRHR and family planning outcomes, Shukhi Jibon engaged in a number of other initiatives to support the above activities. These initiatives included:
- Building a supportive social environment: Here, for example, the project sought to raise awareness in communities and transform social norms and behaviours around SRHR and family planning through community discussions. In this regard, Shukhi Jibon worked to revitalise and enhance community dialogues and courtyard meetings. This activity involved, for example, the development of meeting guidelines for officials and providers to facilitate awareness-raising sessions. Drama performances were also staged featuring local volunteers trained through Shukhi Jibon, who delivered SRHR messages scripted through the project.
- Advocacy: From the community to national level, Shukhi Jibon's NGO partners worked to create a policy and resource environment that enabled young people to exercise their right to SRH. This work involved, for example, social media campaigns and adolescents meeting with their local government to advocate and share experiences. In addition, journalists oriented on AYSRHR visited health facilities and met with adolescents to learn about their experiences and challenges in getting the services they need.
Bangladesh's adolescent and youth population - one of the largest and fastest-growing in the world - has urgent and varied needs for family planning services and SRH care. Bangladesh reports one of the highest rates of child marriage in the world. According to Bangladesh's 2022 Demographic and Health Survey, more than 50% of girls marry before age 18, and more than 1 in 4 (27%) marry before age 16. Bangladesh also has the highest adolescent fertility rate in South Asia. Approximately 1 in 4 girls ages 15-19 has begun childbearing. One in 4 female adolescents do not know any modern method of contraception, and nearly all (90%) do not know about emergency contraceptive pills. A strong tradition of early marriage and childbearing, set against a backdrop of conservative social and gender norms, means AYSRHR is often out of reach for Bangladesh's young people, especially the most marginalised.
Overall, as a result of the project, adolescents (ages 10-19) made 1.2 million visits for SRH services at facilities supported by Shukhi Jibon from October 2018 to June 2023. To find out more about the project and its achievements, see "Accelerating Universal Access To Family Planning: Celebrating the Legacy of the Shukhi Jibon Project in Bangladesh" [PDF] (January 2024).
More information about specific aspects of the project can also be found in the following publications:
Pathfinder website; Increasing Agency and Choice of Bangladesh's Adolescents and Youth: Program Brief [PDF] and Accelerating Universal Access To Family Planning Celebrating the Legacy of the Shukhi Jibon Project in Bangladesh [PDF] - all accessed on June 13 2024. Image credit: USAID/Shukhi Jibon Project/ESDO
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