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This study aims to evaluate the impact of a national family programme on sexual practices, including abstinence and the use of contraceptives, and other sexual and reproductive health services among young people in Uganda. This youth-friendly intervention focusses on young people between the ages of 15 and 24 years.
Uganda’s population is growing at approximately three per cent per annum - one of the highest in the world. It also has one of the biggest youth populations in the world. Young adults become sexually active at an early age and a poor contraceptive prevalence rate of only 11 per cent contributes to unplanned or unwanted pregnancies, unsafe abortions and related complications.
The Ugandan government has been active in designing and delivering family planning, and sexual and reproductive health services that has included targeting young people.
This impact evaluation will generate evidence on the impact of the national family planning programme on youth.
- What is the impact of youth-friendly family planning services on contraceptive use, abstinence, unwanted pregnancy and other fertility outcomes among young people aged 15-24 in Uganda?
- Is there any evidence of heterogeneous effects, in which the benefits are particularly large for young people already engaged in risky behaviours ex-ante?
- Are the effects of youth-friendly family planning services different for young men and women, and in urban and rural areas?
- What is the cost-effectiveness of the youth friendly services provided?
The family planning programme aims to provide age-appropriate information and access to family planning products and services to young people, aged 15–24 years. The intervention includes activities such as establishment of youth friendly corners where youth or adolescent-friendly health services and information are provided, training of health workers in provision of youth friendly services and increasing service delivery hours to include outside school hours.
Theory of change
The theory of change proposes that if youth corners are established within existing health facilities, and are well equipped with material and trained health workers, then family planning services and counselling would become more accessible to the youth, and it would better serve their sexual and reproductive health needs. Young people would use the services provided – such as condoms and other contraceptive methods - which would then reduce risky sexual behaviour.
This evaluation uses a randomised encouragement design. The evaluation team randomly selected 118 villages from 12 programme districts to provide youth with informational flyers (encouragement to use the services) describing the services available at the clinic and its working hours. The evaluation team is working with local actors to distribute fliers to young people at their homes and through other pre-existing structures such as youth groups and youth peer educators. They are also sent SMS reminders once every month for six months. The remaining 118 control communities would continue to receive the services that were provided by the government and partners through the existing channels.
Qualitative data will also be collected through focus group discussions and in-depth interviews. The qualitative research aims to gather general views and experiences on the roll out of youth friendly family planning, and sexual and reproductive health services. In-depth interviews will be conducted with key informants to assess the knowledge of family planning interventions in Uganda, their uptake and the factors affecting them.