A. INTRODUCTION
Originated from these 2 projects VAM established a Center for Counseling and Reproductive Health (RH) Service provision for adolescents and youth which is called “ YOUR HOUSE” . This model is also originated from a Project funded by the Japanese Embassy which helped VAM establish an Ob/Gyn Clinic in 1998 .
Since the beginning, all the project activities have been implemented not only during project period but also after the project although the projects ended in 2006 . The Center for Counseling and Reproductive Health (RH) Service provision for adolescents and youth which is called “ YOUR HOUSE” is really a friendly, confidential, non-judmental clinic for adolescents and youth which have been attracting more and more clients .
To evaluate the effectiveness and sustainability and the lessons learnt from this model, we would like to present some outlines of the projects and the activities of “ YOUR HOUSE” since its establishment.
I. “Reproductive Health Care for Adolescents in TT Hue Province” Project ( RAS 98/P52)
1. Objectives of the Project
• Improving the status of adolescent/young people’s reproductive health through a quality, friendly and affordable reproductive healthcare service delivery center meeting the needs of adolescent/young people in Thua Thien Hue.
• Increasing the accessibility to sustainable reproductive healthcare services meeting the needs of adolescent - young people.
• Providing information, education and communication (IEC) activities on reproductive health for adolescents.
• Improving awareness on the importance and availability of reproductive healthcare and family planning services.
2. Achievements:
VAM set up successfully an Adolescent Reproductive Health (ARH) Center in TT Hue to provide RH services for adolescents in the project areas .
With the model integrated between IEC and services provision, focusing on raising awareness among adolescents on RH, the project has been creating a friendly and trust-worthy address for adolescents/young people who ever come to the project centre which widely known as the “YOUR HOUSE”.
The centre consists of two main teams:
- Centre based team.
- Out-reach team.
Personnel at the RH Center:
• 01 Manager
• 03 Doctors
• 02 Midwives
• 01 Technician
• 01 Cleaner
• 02 Guards and also drivers
• Beside the knowledge and experience gained from the previous Obs-Gyn Clinic of the Midwives Association, team members received refresh and further trainings on the counseling skills, RH knowledge, quality services for Adolescent Reproductive Health(ARH), especially approaching methods and friendly services for adolescents and youth .
• “Client-oriented” as the bottom line, “Your House” receive positive supports from provincial authorities, community and active participation of adolescents youth in particular. “Your House” has built privilege and trust from clients, especially adolescent and youth on a friendly, open, confidential and quality service delivery environment.
• “Your House” has provided RH services free of charge for adolescents as to help them overcome economic barrier in accessing the services.
• Extra working time has been extended for adolescent – youth so that they can find it more flexible in accessing and receiving services (from 07 AM to 08 PM )
• Established a hot line – 1088 – to provide indirect counseling to the adolescents and youth . The staff working for this line are experienced in providing RH counseling for adolescents and youth
A Successful Model of Friendly RH Center for adolescents & youth:
Activities At The ARH Center
• Counseling on Reproductive Health ( RH ) : New clients coming to the centre increasingly, they are not only in the project area but also from other areas who know the centre via telephone and direct counseling. The centre consists of a group of skilled counselors addressing high demands of clients on RH especially adolescent and young people.
Counseling at the centre
Forms of counseling at the centre
Adolescents/youth under 24 years old use services at the centre.
Family Planning and ante permanence used by adolescents/youth
Services provided in the centre 2000 – 2008
| No. |
Services |
2000-2001 |
2002-2004 |
2005-2008 |
| 1 |
Menstrual Regulation Procedures |
1,845 |
3,625 |
5,420 |
| 2 |
IUD Removal |
147 |
296 |
448 |
| 3 |
IUD Insertion |
87 |
176 |
265 |
| 4 |
Gyn. Exam |
2,225 |
4,447 |
6,665 |
| 5 |
Gyn. Treatment |
787 |
1,576 |
2,365 |
| 6 |
Pregnancy Check-ups |
535 |
1,067 |
1,675 |
| 7 |
Ultrasound Check-up |
20,064 |
39,420 |
61,015 |
| 8 |
Electrocardiogram -check-up |
47 |
95 |
146 |
| 9 |
Breast Exams. |
47 |
91 |
135 |
| 10 |
Papsmear |
2,475 |
4,958 |
7,429 |
| 11 |
Polyp removal |
23 |
49 |
78 |
| 12 |
Wetmount |
4,449 |
8,997 |
14,345 |
| 13 |
HBsAg |
38 |
67 |
125 |
| 14 |
Direct Counseling |
1,867 |
3,695 |
5,476 |
| 15 |
Ict Counseling (1088) |
2,894 |
5,757 |
8,690 |
| TOTAL |
37530 |
74316 |
114277 |
Out-reach activities
The out-reach team was trained to access the target groups, provided IEC and counseling and through those activities they refer clients to the centre.
Personnel of the Outreach Team :
• 01 out-reach team leader/doctor
• 01 educator - doctor
• 02 health workers.
• The out-reach activities conducted mainly in the field. The project creates a helpful and healthy “play ground” for adolescents where they can share, discuss social issues, life skills, and adolescent psychology. Adolescent’s concerns and questions are all answered by the team with great attention.
• IEC materials on RH were designed suitably to adolescents and young people and disseminated widely by the out-reach team.
• The outreach team activities have been contributing actively to raise awareness on RH among adolescents in Thua Thien - Hue. Through different kinds of activities, including direct talks to adolescents and youth in school and out school, the youth working at restaurants, bars, hotels, hairdressers, cafes, and jobless adolescents, disseminating IEC materials and contraceptive methods especially condoms in various friendly ways to young people The out-reach team also participates in meetings, workshops for adolescents and youth...
II. RAS 03/P2 :“Promotion of health services and health-seeking behaviour output project”:
The success of the project RAS98/P21 brought VAM to the RAS 03/P52 also funded by EC/UNFPA which aims at :
• Established an enabling policy environment for adolescents and youth- oriented RH information and services at the national and local level.
• Sustained behavior change through increased awareness of RH issues among youth.
• Increased utilization of quality RH service provision to adolescents and youth at risk target area.
• Strengthened technical, planning and management for NGOs/partners in provision of adolescents and youth-oriented RH services.
With this project VAM set up 7 Friendly RH Corners in the Communal Health posts of the Government which provided RH friendly services for adolescents and youth.
• The prject also mobilized the participation and the active support from related agencies, community leaders and gained a commitment between local authorities and the Board Members of VAM.
Friendly corner model of the project:
III. National goal on reproductive heath care
From the success achieved in the projects funded by EC/UNFPA,VAM is funded by the Ministry of Health to continue its activities focusing on RH for adolescents. The project activities have been implemented in 3 provinces ( TT-Hue, Quang Tri and Quang Binh ) with the collaboration of the RH Centers of the three provinces aiming at improving the RH knowledge and behaviour of the adolescents & youth in project areas.
IV. Lesson learnt
The RH Project for adolescents/youth funded by EC/UNFPA is the first quality, confidential and friendly service provision project model for adolescent and young people in Thua Thien Hue, in particular and in the whole country in general .
• A team of doctors, midwives, educators who are skilled and experienced in providing friendly, un-judgemental services for adolescents is the critical factor to ensure the success of the project.
• Great support from relevant authorities, especially the active participation of adolescent – young people and their parents and teachers contribute to the success of the project.
• Easy to find clinic location helps the centre attract a lot of adolescents and young people.
• Suitable working hours is important factor attracting clients to the centre.
V. Strategy for sustainability
Since VAM has created a very successful model to serve for the RH for adolescents & youth VAM focus on the following issues to sustain the model .
• Continue to improve the management skill, professional skill for the service providers who are working at the ARH Center of VAM .
• Continue to improve the status of adolescent/young people’s reproductive health through a quality, friendly and affordable RH services.
• Set up the same RH Centers for adolescents in other potential provinces where the Provincial associations of Midwives are strong
• Searching more fund , national and international, to continue the RH activities for adolescents and youth .
VI. Conclusion
• The success of the projects has proved that VAM could contribute actively to the National RH program, especially the RH care for youth and adolescents.
• The RH program for adolescents /youth should be socialized so that not only the adolescents and youth participate in the program, but parents, teachers, social organizations such as Youth Union, Women’s Union... also participate in . Without this participation , the RH program for adolescent can hardly be successful . The RH project for adolescents/youth funded by the Ministry of Health is very meaningful in terms of assisting VAM in maintaining the sustainability of our RH Model for adolescents and youth .
Dr. Nguyen Van Tri
Director of center for counseling and RH services
