Sustaining Youth-Friendly Services (YFS): Oromia Regional Health Bureau s Ownership and Scale-up of YFS. Worknesh Kereta, Senior Youth Advisor

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1 Sustaining Youth-Friendly Services (YFS): Oromia Regional Health Bureau s Ownership and Scale-up of YFS Worknesh Kereta, Senior Youth Advisor

2 OUTLINE Background What is YFS Process of scale-up and adoption of YFS Key results of scale-up Lessons and implications

3 BACKGROUND 34.7% of Ethiopia s total population are adolescents and youth. The period of adolescence and young adulthood is a pivotal development period. This age is also accompanied by early marriage, and disproportionate risk of STI, HIV, and unintended pregnancy. Access to sexual and reproductive health (SRH) information and services is very limited. Stigma, service costs, and provider bias pose barriers to young people s ability to access services.

4 YOUTH-FRIENDLY SERVICES YFS is an evidence-based approach to reducing barriers to service uptake among young people. In 2006 Pathfinder International/IFHP and the Ethiopian Federal Ministry of Health (FMOH) partnered to introduce and scale up YFS in public health facilities in 6 regions of the county. Integrating YFS into Ethiopia s health system enabled the country to meet the SRH needs and rights of the largely underserved adolescent and youth population.

5 Process of scale-up and ownership in Oromia

6 INITIATION OF SCALE-UP : Pathfinder established 67 YFS in Oromia Region in partnership with the Oromia Regional Health Bureau (ORHB) : ORHB made a commitment to integrate YFS into all health facilities in the region and to include YFS in: Woreda-based planning and budgeting Integrated supportive supervision checklist Pathfinder agreed to provide technical assistance

7 PROCESS OF TECHNICAL ASSISTANCE AND SCALE-UP Technical capacity building: Provide technical orientation and skills-building on AYSRH and YFS to RHB (particularly AYSRH focal point) Support to understand and operationalize national YFS standards Refine the existing YFS model to make it more scalable and less resource-intensive Organize regional AYSRH Technical Working Group to bring actors together and generate synergies (rather than duplication)

8 PROCESS OF TECHNICAL ASSISTANCE AND SCALE-UP To operationalize scale-up, Pathfinder support ORHB to: Map existing YFS within the woredas Identify facilities to be in first and second phase of the scale-up Orient and facilitate zonal and woreda managers to visit existing YFS to learn Map NGO/partners working in the area to help them leverage resources Conduct a regular meeting to standardize the YFS in the region

9 PROCESS OF TECHNICAL ASSISTANCE AND SCALE-UP In the first phase of scale-up, major towns with high population of young people were selected (YFS in 138 facilities) TOT for 30 participants from all zones of Oromia to roll out YFS training to 275 providers from 138 facilities YFS standards and reporting format was developed and disseminated to all YFS facilities ORHB conducted a 3-day orientation on how to further scale up YFS using the existing learning sites as a model

10 PROCESS OF TECHNICAL SUPPORT AND SCALE-UP All zonal managers drafted action plans to scale up YFS in their respective woredas by leveraging resources Zonal health managers organized a 2-day orientation for all woredas in their respective zones ORHB worked with the media to continuously discuss SRH needs of young people and YFS in order to: Improve SRH knowledge among youth Generate demand for YFS

11 Results of scale-up efforts

12 RESULTS/KEY FINDINGS YFS were scaled up from 65 facilities to 232 in the region. These facilities can ensure access to contraceptives and other SRH services for young people in the region.

13 Recommendations

14 RECOMMENDATIONS The Pathfinder-pioneered YFS became an excellent learning site to further scale up YFS and shift ownership of the program in one of the country s biggest regions. The shift from NGO ownership to government ownership ensures program sustainability. Securing high-level officials commitment is critical to program implementation, but it is time consuming.

15 For more information contact Worknesh Kereta twitter.com/pathfinderint facebook.com/pathfinderinternational Youtube/user/PathfinderInt