Reducing unsafe abortion among adolescent girls in Ghana

Project:
StigFAS

Location:
Ghana

Funders:
Planned Parenthood Association of Ghana (PPAG)
International Planned Parenthood Association (IPPF)

Category:
Sexual & Reproductive Health
HIV/AIDS

Challenge

While abortion is permissible under Ghanaian law, 45% of abortions are unsafe, due in large part to pervasive stigma that breeds misinformation and mistrust.

In order to directly address these challenges, YLabs set out to establish peer communication networks that would increase social support among girls and increase access to sexual & reproductive health services.

Innovation

In order to co-design a solution that was both impactful and valuable, our team first set out to:

• Understand the typical abortion journey for adolescent girls and how are they making decisions. Where are they seeking information and how are they verifying the quality of that information?

• Learn about attitudes and stigma: What are community attitudes, including social and cultural norms, that influence adolescent sexual & reproductive health-seeking behavior and service provision?

• Explore adolescent peer relationships: What do peer networks look like and how does information spread among peer groups?

• Explore young people’s aspirations and concerns: What are their hopes, dreams, motivations, and fears?

We were delighted to have the opportunity to increase the youth-driven design capacity of PPAG staff members and their youth champions during this project. We did this through facilitating training workshops at the beginning of each phase of work, integrating PPAG team members into our design and research teams, and providing remote technical support to PPAG as they led the live prototyping phase of the project. StigFAS had been successful in part because the team was able to combine YLabs’ youth-driven design methodology with PPAG’s technical expertise on adolescent health challenges in the Ghanaian context. 

The resulting intervention takes a systems approach to improve the service access and delivery experience for young women in Accra.

Awareness Creation: Girl Boss outreach events are fun, future-focused, and give girls a safe space to get advice on school and employment -- not just sexual health. They leverage slightly older female mentors to educate and inspire younger girls on how to take control of their futures. The event branding, messaging, and activities were co-designed with girls during the prototyping phase of the project.  Leading with career skills helps make the events more socially acceptable to girls and their parents. Girl Boss mentors are able to make educate girls about safe abortion options through private one-on-one mentoring sessions, and make a streamlined referral to youth-friendly care when needed. 

Targeted Support: The Girl Boss events are complemented by a peer-led free phone line and private social media messaging system called Sister Support, where girls in with urgent questions or need for services can get immediate support and linkage to care. We are also partnering with local pharmacists to increase referrals to safe services at the clinic for girls seeking to end an early pregnancy.

Accessible, Streamlined Care:  Affordability and confidentiality are priority concerns for young women when seeking a method to end an early pregnancy. Through the design and research process, we identified various improvements to the clinic service delivery process to ensure that girls feel safe, welcome, and able to access services without stigma regardless of their financial situation.

Next Steps

The StigFAS intervention is being piloted in 2020, with results and reporting expected in early 2021, pending any additional disruptions related to COVID-19 in Ghana. With the design phase completed, YLabs is now leading the monitoring, evaluation, and data analysis for the pilot.