No quick fix: how MSI has transformed its global reach to adolescents

By Diana Amanyire, Global Marketing Advisor

When we shifted our focus and invested in delivering adolescent-focused services in 2017, we saw our reach significantly increase across our country programs. By putting young people at the heart of our programs our proportion of adolescent clients grew from 6% in 2016 to 15% by 2019.

Young MSI clients visit a “Diva Center” in Zambia, receiving services tailored to adolescents.

Despite continuous recognition of the importance of providing choice for adolescents and young people, MSI’s adolescent reach remained stubbornly low for years – with adolescents averaging just 6.3% of all client visits between 2012 and 2016.

So, in 2017 we shifted our focus and invested in delivering adolescent-focused services, in the knowledge that adolescent access to sexual and reproductive healthcare is key to MSI’s mission. As shared previously on our website, the new adolescent strategy required resources, new operational guidelines and an effective way of measuring impact and it worked. By putting young people at the heart of our programs we witnessed our proportion of adolescent clients grow from 6% in 2016 to 15% across our country programs by 2019.

This means that since launching the strategy, we have served an estimated 3.5 million adolescents with high quality sexual and reproductive health (SRH) services, equating to more than 100,000 adolescents per month in recent months. This impact has resulted in approximately 4.9 million unintended pregnancies being averted and 1.3 million unsafe abortions averted across MSI’s country programs.

However, as a global community, we have a long way to go before all young people can access their sexual and reproductive health care and rights. Evidence indicates that an estimated 20 million adolescents aged 15-19 still have unmet need for contraception and 3.2 million adolescents resort to unsafe abortion annually. At MSI, we are committed to playing our part in ensuring young people have the information and access they need to make informed decisions. And although we have learned that there is no quick fix to reaching young people with sexual and reproductive health services, along the way we have identified three key steps that are essential to successfully improving access.

An MSI provider counsels a young client in Ghana.

1. Make it normal

In most of the countries where we operate, young people’s autonomy is influenced by others – including their peers, parents, community leaders, health workers, and policy makers. Social norms around fertility expectations and taboos on discussion of sex and unplanned pregnancy limit adolescents’ ability to make healthy decisions. Often, community gatekeepers play a critical role in reinforcing or challenging these social norms. As a result, ensuring that community leaders are aware of the benefits of access to sexual and reproductive healthcare services for the young people in their community is key. Having their support for programs can reduce any stigma and backlash and create an enabling environment for adolescents to access or ask for the SRH information and services they deserve. To create this community buy-in, we learned that:

2. Make it desirable

Adolescents face several barriers in accessing accurate and complete information during their SRH journey. Adolescents often cite fear of side effects, not being married, having infrequent sex, having no children, partner/spouse opposition, breastfeeding, and postpartum amenorrhoea as common reasons for not using contraception. To address these barriers, we use behavioral insights to design communication strategies that support adolescents to build the urgency for contraception and frame family planning as a lifestyle choice. In doing this we have learned that:

3. Make it easy

We know that adolescents face a multitude of barriers in accessing SRH services such as pricing, provider bias, location, and discretion of services. To address these barriers, we adapted our service delivery channels to be welcoming, accessible, and responsive to the needs of adolescent clients. During this process we learned that:

We know that we are making in-roads with our adolescent SRH services, serving around 4,000 adolescents every single day. We are also still learning. Adolescents are the future and yet one of the most difficult segments to reach with sexual and reproductive health services. However, guided by evidence and pragmatic insights from our on-going programs and the wider adolescent and youth SRH sector, MSI is proud to continue to support adolescents to step forward and make choices to define their own future: for themselves, their families and their communities.

Diana Amanyire is MSI’s Global Marketing Advisor, focusing on adolescents and vulnerable populations


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