Teen Pregnancy - Honiara

IEC strategies on the prevention of teenage pregnancy
among young people in Honiara.

7
Sarah Ben
Crispin Siama
IEC Strategies on the
Prevention of Teenage Pregnancy
Among Young People in Honiara

6
Solomon lslands
Choiseul
Santa
lsabel
Malaita
ra
Guadalcanal
San Christobal
Rennel
New Geogia
lslands
Honiara

1
IEC strategies on the
prevention of teenage pregnancy
among young people in Honiara
Sarah Ben
Crispin Siama

Supported by:
Ministry of Health,
United Nations Population Fund
Secretariat of the Pacifc Community


2
USP Library Cataloguing-in-Publication Data
Ben, Sarah
IEC strategies on the prevention of teenage pregnancy among young people
in Honiara / Sarah Ben, Crispin Siama. Suva, Fiji : UNFPA ; SPC, 2007.
31 p. : 30 cm.
At head of title: IEC strategies on teenage pregnancy in Honiara
ISBN 978-982-520-026-0
1. Prevention health services for teenages Melanesia Solomon Is
lands
2. TeenagesHealth and hygiene Melanesia Solomon Islands
3. Reproductive health Melanesia Solomon Islands
4. Teenagers Sexual behaviour Melanesia Solomon Islands
I. United Nations Population Fund. Offce for the Pacifc
II. Secretariat of the Pacifc Community.
III. Siama, Crispin
IV. Title
V. IEC strategies on the prevention of teenage pregnancy among
young people in Honiara.
RJ103.S6 B46 2007. 362.10835099593

3
We would like to especially thank the following:
Out of school youths and In-School students who had participated in
the Focus group discussions.
The stakeholders in Government ministries, non-Governmental
Organizations and the Churches who kindly accepted our request to
be interviewed in the In-depth Interview.
We would also like to acknowledge UNFPA/SPC for providing the funds,
the technical assistance, and especially, to Dr Rufna Latu, Dr Annette
Robertson and Agnes Rigamoto for their continuous support and patience
rendered to us during our research.
Acknowledgements
Mr. Crispin Siama
AHD Coordinator
Solomon Islands Planned Parenthood Association
Ministry of Health
Ms. Sarah Ben
AHD Coordinator
Reproductive and Child Health Division
Ministry of Health


5
In an attempt to address service provision gaps for young people and
advocate for more support from all sectors of society, UNFPA under the
joint UNFPA/UNICEF/SPC Adolescent Health and Development (AHD)
project in the Pacifc initiated a series of capacity building processes on
research development and implementation for all the AHD Project
Coordinators from the ten (10) project Pacifc Island Countries (PICs).
The focus was on operations research: the application of systematic
research techniques to improve programme operations that has been used
in many Health programmes for many years to improve the effciency,
quality, effectiveness, and availability of services.
Concomitant to the need for empirical evidence for decision-making is the
need for managerial capacity to understand and use this evidence. It was
imperative that the AHD Coordinators from the 10 PICs were equipped
with the right research knowledge and skills to undertake their studies;
hence a training workshop on Adolescent Sexual and Reproductive Health
Research Methodology was organized and followed up with various
capacity building processes.
The AHD Coordinators ought to be applauded for the immense effort,
time and energy that theyve put into training, planning, data gathering
and analysis and report writing considering that majority of them had very
little or no prior research experience. This is no simple task and it
defnitely should be recorded as one of the many milestones they have
achieved under this project.
More importantly, the wealth of information, particularly the fndings
contained in this report is immeasurable and it is prudent that this
information is taken into account when planning intervention programmes
including ASRH services provision at country level. There are many
lessons learnt from this fndings and it will be good to see that this
methodology is replicated in other countries which will enhance the
networks of information-sharing of that already exists amongst the PICs.
The implementation of this important activity which has resulted in this
report would not have been possible without the support of the respective
governments, AHD Coordinators, researchers, development
practitioners and NZAID in their combined efforts and contribution to
improving the reproductive health of young people in the Pacifc. Credit
should also be accorded to Dr Annette Sachs Robertson, UNFPA Technical
Adviser in Reproductive Health Programme Assessment and Operations
Research and Dr Rufna Latu, Regional AHD Project Adviser, Secretariat
for the Pacifc Community, for their technical assistance and to Mr Allan
Illingworth for his administrative support. We hope that this would be
a stepping stone to further applied research in all felds of Reproductive
Health and not limited only to AHD.
MESSAGE FROM UNFPA REPRESENTATIVE
AND SPC DIRECTOR GENERAL


7
The research reports on IEC Strategies of the prevention of teenage
pregnancy among young people in Honiara, Solomon Islands outlines the
process involved in the conduct of a small-scale operational research from
project proposal phase to discussing the fndings and recommendations.
The exercise was coordinated by the Adolescent Health and Development
(AHD) Coordinator in consultation with a team of committed people.
This report is historic in the sense that is the frst kind to be compiled in
the country. Further, it is a milestone, as it set a benchmark for future
development in IEC and BBC strategies and initiatives targeting our
youth population.
The research project is inline with national priorities and the national
health strategic plan for using evidence as a basis for strengthening and
advancing development and provides direction for the way forward.
The fndings in this study are both informative and interesting. They also
stimulate thinking about the kinds of effective and appropriate strategies
that should be put in place to maximize the role of peer education and
engaging youth participation to support adolescent health programme
and initiatives. Too often we make assumptions, however, the fndings
documented in this report helps to minimize our assumptions and
increase our skills in analysis based on hard facts. These hard facts and
information form the decision making, programme development and
expansion, and resource allocation.
A research project is a complex undertaking requiring time and effort to
carry out the different phases given that there are also given competing
priorities. It is along these lines that I would like to acknowledge and
commend the efforts and commitment by a number of agencies, groups
and individuals whose collective work as resulted in the completion of this
undertaking in the Solomon Islands. In particular, the Ministry of Health
and Medical Services is grateful to both UNFPA for the fnancial and
technical assistance and as well to SPC for the technical support to assist
our local team to complete the study. It is a source of encouragement to
other staff of the Ministry to become involved in research initiatives, as
such would enhance and develop local capacity.
May I take this opportunity to convey my appreciation UNFPA and SPC
for the continuing partnership in supporting our reproductive health in the
region as well as at country level. It is my hope that this type of study is the
beginning of many more research projects to come. Lessons learnt from
this project will contribute to improving future operational studies for our
AHD programme and projects in the country.

FOREWORD

8
Contents
Page No.
Acknowledgements 3
Message from UNFPA and SPC 5
Foreword 7
List of Abbreviations 9
Abstract 10
1. Introduction 11
1.1 Problem Statement 11
1.2 Background 12
1.3 Rationale 15
2. Goal and Objectives 16
2.1 Goal 16
2.2 Objectives 16
3. Methodology 17
3.1 Study Types and Variables 17
3.2 Study Population & Sampling Methods 18
3.3 Data Collection 19
3.4 Data Analysis 20
3.5 Ethical Considerations 20
4. Results 21
5. Discussion 23
6. Conclusion 23
7. Recommendation 24
8. Annexes 25
Annex 1 References 25
Annex 2 Focus Group Discussion Questionnaire 26
Annex 3 In-depth Interview Questionnaire 28

9
ABBREVIATIONS
ASRH Adolescent Sexual and Reproductive Health
ADRA Adventist Development and Relief Agency
BCC Behavioral Change Communication
AIDS Acquired Immune Defciency Syndrome
CBED Community Based Educators and Distributors
COM Church of Melanesia
DRH Director of Reproductive Health
FSC Family Support Center
FP Family Planning
FGD Focus Group Discussion
HPD Health Promotion Division
HCC Honiara City Council
HIV Human Immunodefciency Virus
IDI In-depth Interview
IEC Information Education and Communication
KAP Knowledge Attitude and Practice
MHMS Ministry of Health and Medical Services
NRH National Referral Hospital
NGO Non Governmental Organization
OC Ovulation Clinic
RC Roman Catholic
RH Reproductive Health
RHD Reproductive Health Division
STI Sexually Transmitted Infections
SICAFOW Solomon Islands Christian Association Federation of Women
SIDT Solomon Island Development Trust
SCA Save the Children Australia
SIPPA Solomon Islands Planned Parenthood Association
SDA Seventh Day Adventist
SSEC South Seas Evangelical Church
SRH Sexual and Reproductive Health
SPC Secretariat of the Pacifc Community
TAP Teenage Pregnancy
UNFPA United Nation Population Fund
YFC Youth Friendly Centre
YFS Youth Friendly Services
YFSC Youth Friendly Services Clinic

10
In the Solomon Islands, ffteen
percent of all births are to teenage
mothers. Research suggests that
young people are becoming
sexually active at early ages.
While there appears to be a lot of
information and education activities
on sexual and reproductive health,
it is unclear how accessible and
available are effective strategies for
prevention of teenage pregnancy.
The main objectives of the study
were to assess the types, quality,
content and relevance of the IEC
strategies targeting young people
for the prevention of teenage
pregnancy in Honiara, and make
recommendations as to how
Behaviour Change
Communication (BCC) approaches
may be improved for adolescents so
as to prevent unintended teenage
pregnancies.
An exploratory qualitative study
used focus group discussions and
in-depth interventions to identify
young peoples perceptions and
experiences related to IEC
materials, specifcally in relation to
teenage pregnancy. In-school and
out-of-school youth groups from
Honiara were the sample
population. The fndings were
analysed through compilation
techniques used for qualitative
research. In the groups of 11-20
year old in-school and out of
school males, there appeared to
be little information or knowledge
onteenage pregnancy prevention.
The majority of IEC materials were
on HIV prevention. In the
comparable groups of females,
there was some knowledge about
teenage pregnancy prevention but
no related pamphlets or materials
were available to other groups.
From the interviews with service
providers, they were of the opinion
that more IEC materials were
available. However, both groups of
subjects felt that there was an
urgent need for relevant,
appropriate and focused materials
and media messages on teenage
pregnancy prevention in the
Solomon Islands.
The study should facilitate the
development of more sound
evidence informed behavioural
change communication strategies
in sexual and reproductive health
for young people in the
Solomon Islands.
Abstract

11 8
In the Solomon Islands there is a
clear impression that unintended
teenage pregnancy is high.
Health statistics reveal that
approximately 15% of births are to
teenage mothers.
1
There has been
a lot of awareness, education and
communication (IEC) activities
on sexual and reproductive health
(SRH), but young people dont
seem to be using sexual
reproductive health services,
including contraceptive services,
that are currently provided.
This study was undertaken to
assess the quality and content as
well as the relevance of IEC
resources available for preventing
teenage pregnancy.
1.1 Problem Statement
There is a high level of sexual
activity among adolescents in
Solomon Islands.
2
Some young
people are believed to become
sexually active from as early as
the age of twelve years. Health
workers are very concerned that
due to low contraception and
condom use by young people,
STIs and teenage pregnancies are
becoming increasingly prevalent.
3
The contributing factors to teenage
pregnancy include limited
awareness and knowledge about
safer sex practices and
contraceptive use, limited
education that weakens decision
making, peer pressure, lack of
parental guidance, perceived low
risk of getting pregnant among
sexually active young people,
casual sexual practices and
undisciplined behavior leading to
sexual relationship for social and
economic reasons.
The national recognition of teenage
pregnancy as a reproductive health
(RH) problem among young people
has led to the development of
various programmes targeting
young people. A number of
intervention strategies have been
implemented in the Solomon
Islands to address the problem of
teenage pregnancies.
Programmes implemented focus on
issues such as the delay of sexual
relationships, safer sexual
practices, and behavioral change
IEC resources. Radio programmes
and newspapers transmit
information on the prevention of
STIs, HIV & AIDS, and teenage
pregnacies. The introduction of the
Youth Friendly Services (YFS) clinic
was an initiative that was intended
to better address these issues.
However, evidence suggests that
the number of teenage girls
giving birth is still increasing and
no determination of the quality of
any component of the IEC
programme has been undertaken
in Solomon Islands.
1. INTRODUCTION

12 9
1.2 Background
According to the 2004 National
Census, Solomon Islands is host to
460,000 people, with a population
growth rate of 2.8%. The projected
population for 2006 was 483,083.
Of this number, about 44% are in
the age group 15 years and down.
This high percentage of young
people has implications for
planning and implementation of
SRH services as there is a need
to address the issues affecting
a signifcant proportion of the
population. Literacy rate for adults
(15 years and over) in the Solomon
Islands in 1999 was only 90.4%
and among youth (15-24 years old)
the literacy rate was 80.5%.
4
This
contributes signifcantly to their
decision making in ASRH. Education
is vital to improving the utilization
and understanding of
contraceptives and safer sexual
behaviours.
5
People with better
education have better knowledge
about the implications of
unintended teenage pregnancies,
are less fatalistic, and are better
aware of the behavioral link with
unintended teenage pregnancy than
those with poor education.
6
Solomon Islands accommodates a
multi-cultural people with
Melanesians, Polynesians,
Micronesians, Chinese and
others. Religious infuences unite
the islanders in terms of
acceptance of Christian values.
Honiara has been characterized as
a melting pot of cultures, languages
and traditions. With increasing
urbanization and a rapid pace of
westernization, there is a danger
that Solomon Islands cultural and
traditional values will be eroded,
resulting in worsening of sexual and
reproductive health problems
in teenagers.
A high number of teenage
pregnancies have been recorded
during the past years. Teenage
deliveries account for 9 15%
of all deliveries.
7
In 2005, there
were a total of 818 births to
teenage mothers.
8
Teenage
Pregnancy has been identifed as
a major medical, socio-
economical and psychological
problem for young girls and their
families. It has been found to
impact negatively on the health
of the mother and her new born
baby. Limited educational and
employment opportunities have
often left the teenage mother to
care for her young child with little
assistance from family members.
Young mothers, as well, face bleak
and uncertain futures without
opportunities to maximize their
full potential. In addition, the
families often become socially
stigmatized and angry at their
pregnant daughters.
Abortion is illegal in the Solomon
Islands. However, attempted
abortions by young women are
reportedly common although
there are no statistics to confrm
this. The Central Hospital reports
that admission for attempted
abortions by young women is
common.
9
A reported method for
self-induced abortion is home or
traditional medicines. The fact
that abortions occurs means there
is a signifcant unmet need for
family planning among
adolescents.
Past and recent studies reveal
that there is fairly poor knowledge
of the reproductive health issues,
often inadequate and inaccessible
sexual and reproductive health
services, which include family
planning counselling and
contraceptives. It is reported
that women have limited power
in sexual relationships toinsist
on condom use, leading to girls
getting pregnant against their will
through engaging in unprotected
sexual activity.


13 10
Literacy rate for adults (15 years
and over) in the Solomon Islands in
1999 was only 90.4% and among
youth (15-24 years old) the literacy
rate was 80.5%.4 This contributes
signifcantly to their decision
making in ASRH. Education is vital
to improving the utilization and
understanding of contraceptives
and safer sexual behaviours.
5

People with better education have
better knowledge about the
implications of unintended
teenage pregnancies, are less
fatalistic, and are better aware of
the behavioral link with unintended
teenage pregnancy than those with
poor education.
6
Solomon Islands accommodates a
multi-cultural people with
Melanesians, Polynesians,
Micronesians, Chinese and
others. Religious infuences unite
the islanders in terms of
acceptance of Christian values.
Honiara has been characterized as
a melting pot of cultures, languages
and traditions. With increasing
urbanization and a rapid pace of
westernization, there is a danger
that Solomon Islands cultural and
traditional values will be eroded,
resulting in worsening of sexual and
reproductive health problems in
teenagers.
A high number of teenage
pregnancies have been recorded
during the past years. Teenage
deliveries account for 9 15% of
all deliveries.
7
In 2005, there were
a total of 818 births to teenage
mothers.
8
Teenage Pregnancy has been
identifed as a major medical,
socio-economical and
psychological problem for young
girls and their families. It has been
found to impact negatively on the
health of the mother and her new
born baby. Limited educational
and
employment opportunities have
often left the teenage mother to
care for her young child with little
assistance from family members.
Young mothers, as well, face bleak
and uncertain futures without
opportunities to maximize their full
potential. In addition, the families
often become socially stigmatized
and angry at their pregnant
daughters.
Abortion is illegal in the Solomon
Islands. However, attempted
abortions by young women are
reportedly common although there
are no statistics to confrm this.
The Central Hospital reports that
admission for attempted abortions
by young women is common.
9

A reported method for self-induced
abortion is home or traditional
medicines. The fact that abortions
occurs means there is a signifcant
unmet need for family planning
among adolescents.
Past and recent studies reveal that
there is fairly poor knowledge of
the reproductive health issues,
often inadequate and inaccessible
sexual and reproductive health
services, which include family
planning counselling and contra-
ceptives. It is reported that women
have limited power in sexual
relationships to Peers represent a
signifcantbody of information and
greatly infuence attitudes among
teenagers.

14 11
They serve as common sources
of information about sexual and
nonsexual relationships as well as
advocates for responsible sexual
and reproductive health behavior.
This was highlighted in a study of
the reproductive health risks faced
by teenage girls in Honiara.
10
Further more, teenagers observe
and often copy behaviors and
attitudes of their peers. Generally,
peers communicate better with
other teenagers and may be more
successful at reaching
teenagers who are not to be found
in conventional venues through
non-school-based peer education
programmes.
11
For example, there
are particular groups of teenage
women in Honiara such as house
girls who are hard to access
formally. Studies have found that
community based peer
educators infuence change in
knowledge in adolescents, but
whether sustained SRH change in
behavior occurs remains unclear.
Peer educators are trained and
continuously supported to provide
information and condoms to their
peers. Teenagers have served in
many regions as effective peer
educators.
12
An evaluation of a human rights
training programme for girls
working in the cannery at Noro
found that information was not
shared.
13
Too often the premise is
that information would be shared
among peers. Given the extent to
which teenagers could potentially
share informal knowledge about
sex and relationships, this problem
could be dealt with through
better selection and training of
peer educators. Solomon Islands
have been working on improving
the Peer Education Programme.
Awareness and education do not
automatically guarantee change
in behavior and adoption of safer
practices.
14
As previously
mentioned, studies revealed that
IEC sessions provided by peer
educators in community-based
settings have not always resulted
in sustained behavioral change,
although changes in knowledge
have often been reported. There is
no evidence that sex education in
school leads to earlier or increased
sexual activity in young people.
15

In a review of studies undertaken
to review the impact of HIV
presentation school-based
programmes in 2006, there were
no signifcant changes reported in
behavior as a result of those
interventions in young people.
16
The success of education
interventions, however, can be
improved if the approaches are
age and culture relevant as well
as repeated. In this case, such
interventions target teenagers and
utilize their youth culture as well as
sustained BCC approaches
using multiple methods. The use of
media and public personalities in
education campaigns can capture
the attention of teenagers and
impress them enough to change.

15 12
Communicating with young adults
has special importance. They are
learning about sex and
developing values at a crucial time
of their lives. At the same time they
are being infuenced by their peers,
subject to conficting
infuences and are very selective
about whom they trust.
Through careful choice of
spokespersons and mass media,
programmes can address young
audiences with messages of sexual
responsibility.
17
However, these
need to be carefully implemented
on a sustained and targeted basis.
A Knowledge Attitude and
Practice (KAP) survey
recommended that more intensive
information, education and
communication programmes are
required to target young people
(especially teenagers) focusing
particularly on the female
reproductive cycle, prevention of
unintended teenage pregnancy,
and the effciency and use of
modern family planning methods.
For married teenagers, the use of
contraceptives to delay and space
children should be also stressed.
This study illustrated the need for
more coordinated, targeted and
sustained Behavioural Change
Communication (BCC) approaches
for prevention of teenage
pregnancy in young people in
Solomon Islands.
1.3 Rationale
Despite IEC strategies being
implemented, teenage pregnancy
rates continue to be high in
Honiara, Solomon Islands. Limited
information is available on
effectiveness of IEC materials for
preventing teenage pregnancy
among young people.
Knowing that a problem of teenage
pregnancy exists, IEC strategies
were implemented but there is very
little information about the strategy
and how effective it has been.
Quite a number of IEC
materials on sexual and
reproductive health have been
distributed but most have been
designed outside the country.
Having established services
provided, certain factors could
contribute to young people not
utilizing the services.
This study was designed to
investigate the types, content and
relevance of IEC resources and
strategies targeting young people
for prevention of teenage
pregnancies in Honiara,
Solomon Islands.

16 13
2.1 Goal
The goal of this study was to
determine the relevance of the
IEC strategies targeting young
people for the prevention of
teenage pregnancy in Honiara,
Solomon Islands and make
recommendations as to how BCC
approaches may be improved for
adolescents.
2.2 Objectives
The objectives of this study were:
2.2.1 To review the type, content
and method of delivery of the
current IEC materials available
which target young people for the
2.2.2 To assess the
appropriateness of the content
and delivery methods of IEC
interventions which focus on
2.2.3 To identify defciencies in the
content and delivery method of
current IEC strategies which focus
on prevention of teenage
pregnancy in Solomon Islands.
2.2.4 To determine among youth in
Honiara, Solomon Islands their level
of understanding and their depth of
knowledge of IEC materials which
target prevention of teenage
pregnancy.
2.2.5 To present the fndings and
to make specifc recommendation
to improve the current IEC/BCC
strategies for prevention of teenage
pregnancy in Solomon Islands.
2. GOAL AND OBJECTIVES

17 14
3.1 Study Type and Variables
This study was an exploratory
qualitative study. It used focus
group discussion (FGD) methods
to obtain information from selected
groups of young people and
indepth interviews to collect
information from relevant and
selected service providers.
It focused on the number and type
of IEC materials related to
prevention of teenage pregnancy
and contraception for young
people. Data collected were
qualitative. The reason this design
was chosen was that it was the frst
time that such information was
being collected and it was felt that
an exploratory study would be
most appropriate.
Issues of interest considered in
this research study included:
What was the content and
delivery method of current
IEC/BCC intervention to
young people?
How appropriate was it?
Was the IEC material pre-tested
and adapted to local context and
cultural settings?
Was the delivery method done
acceptable and understood by
young girls?
Did the materials get to the
young girls?
What was the content of IEC
materials that young girls
received?
What issues were being
addressed in the IEC materials
that young people received?
3. METHODOLOGY
What are the defciencies of the
content and delivery method of
current interventions?
Where, how, when and to whom
were IEC materials targeted?
What are the recommendations,
based on the fndings of the
study, for improvement of BCC
intervention strategies aimed at
preventing teenage pregnancy.
Study variables included:
Schedules of RH IEC programmes
for adolescents.
Method of delivering RH informa
tion and services to adolescents.
Awareness of available
information and services.
Access to current interventions.
Usage of available information
and services by adolescents.
Availability of information and
service without discrimination
to adolescents.
Content of RH information
received by adolescents.
Appropriateness of RH
information and service.
Knowledge of RH issues
and services.
Attitude of service providers.
Availability of FP methods.
Barriers to RH information
and services.
Meeting the needs of adoles-
cents.
(What, How, When, Where).

18
3.2 Study Population and
Sampling Methods

The study population for the
in-depth interview were the service
providers in Honiara.
The study populations for the focus
group discussion were the in-school
adolescents and out-of-school
youth within Honiara.
a) In-depth interviews:
17 interviews were done with
service providers from government,
NGOs and churches. People
responsible for information (like
the IEC offcer or a youth leader)
were interviewed. A letter explain-
ing the purpose of the research was
forwarded prior to the interview,
to each organization, so that they
could identify the right person to
be interviewed. The table below
illustrates the organizations that
were targeted.
b) Focus group discussions (FGD):
The total number of focus groups
was 16. There were 8 people per
group. Figure 1 illustrates the
in-school and out-of-school groups
targeted for the FGDS.
There were two sets of focus group
discussions (male and female) for
each of the in-school and out-of-
school youths. Help was sought
from the active young volunteers of
SIPPA (known as the CBED
Community Based Educators and
Distributors), who were actually
living in these communities, to
identify the participants for these
FGD. Letters were sent to schools
identifed to participate in the FGD.
We used convenience sampling to
conduct the FGD.
c) IEC materials
All IEC materials related to
SRH were collected and reviewed.
They were scanned for content and
were reviewed for appropriateness
of information on prevention of
teenage pregnancy.
15
Honiara NR Hospital SIPPA COM
RH Division SCA UC
HP Division ADRA RC O Clinic
HCC Clinics SIDT SSEC
SICA FoW
VBM
Red Cross
PND Private Clinic
SIBC
Table 1: GOVERNMENT, NON-GOVERNMENT and CHURCH
ORGANISATIONS targeted for inclusion in the interview of stakeholders
AREA OF RESEARCH GOVERNMENT NON-GOVERNMENT ORGANIZATIONS CHURCHES

19 16
16 20 yrs
16 20 yrs
11 15 yrs
11 15 yrs
Gilbert Camp
Koa Hill
Burns Creek
In-school Youths
Out-of-school Youths
King George Sixth School
White River School
Panatina Community School
Bishop Epalle Catholic School
Independence Valley
3.3 Data Collection
3.3.1 In-depth Interviews
An in-depth interview schedule was
developed to conduct interviews
on an individual basis for each of
the 17 service providers represent-
ing Government, NonGovernment
Organization and Churches.
Responses were noted against each
of the question. Interviews were
conducted in pidgin and translated
into English languages
immediately after the completion of
the interview. Coding of responses
was undertaken when all scheduled
in-depth interviews had been
completed.
3.3.2 Focus Group Discussions
The Focus Group Discussions were
conducted during convenient times
of the research team and youth.
A FGD guide was used in each
focus group discussion. Each
meeting consisted of 8 adolescents
aged 11-20 years and two
researchers. Responses were
recorded using tape-recorders
and it was noted against each of
the questions in the questionnaire
guide. The discussion was done in
Pidgin and transcribed into English
language immediately after the
completion of each interview.
Coding of responses was
undertaken by the research team
following the completion of the
scheduled Focus Group Discussion.
3.3.3 Pre-Test
Questionnaires were pre-tested
among selected stake holders for
the in-depth interviews, and the
questions for the FGD were
pre-tested with the youths who
attended the AHD Youth Center,
before the research team
commenced with the research.
Figure 1: ln school and Out-of school Youth for Focus Group
Discussion

20 17
3.4 Data Analysis
From the direct interviews,
information was transcribed and
coded into common themes.
The information from the FGD was
also coded into common themes.
The information was then
transferred into matrices for clarity
and comparison.
3.5 Ethical Considerations
The study proposal was
submitted to the Director of
Reproductive Health, and then to
the Ethical Committee in the
Ministry of Health and Medical
Services for approval.
Following approval, a letter of
information and consent was
drafted and sent to the selected
population. Signed consent was
made upon visitation to carry out
the in-depth interviews while verbal
consent was obtained from the
participants of the FGD at the
meeting sites prior to each
interview & FGD. The purpose of
the study was again reiterated and
explained to the participants for
clarity. Participants were reassured
that confdentiality would be
maintained in all interviews
and FGDs.
The venue for all the discussions
were selected on the basis of their
confdentiality, ability to ensure
privacy and non-threatening or
youth friendly environment. It was
intended that such selection will
facilitate open discussions.

21 18
4.1 The fndings of the
FGD on the In-school and
Out-of-school males
and females.
From the 16 FGD, most of them
expressed having some
knowledge on teenage Pregnancy.
Females were more informed than
the males.
Very little information on
teenage pregnancy was available.
The study found that there were
very few existing IEC
interventions that targeted
teenage pregnancy for
delaying sexual intercourse for
the provisio of contraceptives
for young people.
Most of the IEC materials were
on HIV. They were produced by
SCA and SIPPA.
The majority of information was
on pamphlets on SRH. Girls were
aware of more sources of
information than boys. They
discussed radio, newspapers and
home economic teachers.
Information on SRH was provided
through the radio and in news
papers but there was very little
on teenage pregnancy. Young
people were aware that
information was available on
the radio, in the newspapers
and through peer-to-peer
programmes.
No pamphlets were available
in the schools where they were
needed.
The youths interviewed
preferred ASRH information to
be introduced to young people as
well; even as early as 5 years
and upwards.
They recommended IEC
materials to be pocket sized with
pictures, and also be translated
into Pidgin using simple language
and words.
4. RESULTS
Information should be
disseminated to schools,
community, churches and private
clinics through partnerships.
Girls felt there needed to be more
partnerships with church youth
and youth to youth. Girls felt that
information should be more
readily provided at schools,
communities, clinics and
churches.
The services provided to young
people were not reliable and
youth friendly.
Most of the youths were aware
of the services provided but
were not using them because
they thought they were for
married people only.
They suggested that planning
should engage youths more in
providing awareness.
The boys and girls raised the
issues of using drama in
disseminating information as
well as radio. Young people are
talented in music so it was also
raised that it was a good media
for IEC intervention, especially the
production of video cassettes and
DVDs. They suggested that they
be used in schools and
communities at large.
The most unusual
misconception that was stated
was from a female: If you have
multiple partners then no
pregnancy will happen.
4.2 Findings from the
In-depth interviews
From the 17 Stake holders
interviewed, the vast
majority (14) stated that there
were programmes addressing
awareness about RH issues on
Teenage pregnancy.
Concerning youths knowledge
about the services provided, 13
of 16 service providers stated
youth were aware of services
provided while three stated youth
were not aware of any services

22 19
as they were not publicized and
it appeared services were only
curative services for sick people.
They stated that youth did not
use them because there was only
information but no services.
The vast majority felt it was OK
for adolescents to access RH
information services. One of the
service providers stated that it
was not okay for adolescents to
access RH information and
services because it was taboo
according to tradition, custom
and church.
Preferred contraceptive
methods included male condoms,
pills, emergency pills and the
natural method.
While the majority stated that
they had not seen any IEC
materials on SRH, a few of
the service providers said the
available IEC materials are mainly
on HIV. They said these
materials should be simplifed
so that they can be understood.
They also said they should be
updated. They suggested that IEC
materials be pre-tested in youth
groups before they are used and
that very simple language
be used.
On the question of relevance,
12 of 16 service providers stated
that they felt that the available
IEC materials needed to target
young people, specifcally, as
they appeared to be written for
an older female audience and
at times were not relevant.
They felt that young people
had not been consulted from the
planning stages of development
and were, therefore, not the focus
of the materials and messages.
They felt that the IEC materials
were developed by IEC
offcers only.
When asked if FP information
services should be provided to
young people, 9 of them stated
yes. Two respondents stated they
should only be provided
information and two stated that
they should only provide
contraceptives to married people.
They said contraceptives were
not available in some
organizations. Those that stated
that FP should not be made
available to unmarried
teenagers cited that behaviour
should be based on values and
that the church was still not clear
on giving out condoms.


23 20
This study explored available IEC interventions targeting teenage
pregnancy in Honiara, Solomon Islands. The identifcation of current IEC
interventions which address teenage pregnancy in Honiara, Solomon
Islands was very disappointing as there was minimal information or
strategies on teenage pregnancy prevention. It was intended to provide
a general overview of available IEC materials and indicate where further
research was needed prior to the development of strategies as suggested
entry points for further interventions.
Given there is very little targeted and focused information for prevention
of teenage pregnancy for young people, there is an urgent need to
address teenage pregnancy with effective interventions that will improve
young peoples knowledge and practice in sexual and reproductive health
through targeted BCC strategies and specifc IEC materials, music and
drama for young people.
There is a need to address health care providers who do not think it is
appropriate to give FP to unmarried people through training and further
discussions.
The limitations faced in this study related to limited time and resources
for more widespread coverage. Furthermore, because there were no
materials, discussion often focused on which modalities would be
preferred.
This exploratory study has yielded important information on the gaps in
SRH IEC strategies and resources targeting young people for the
prevention of teenage pregnancies. The lack of available IEC resources,
the lack of available services and the non-youth friendly attitude of some
of the service providers means that signifcant change has not yet
occurred in the feld of ASRH in Honiara. There is a clear need for a new
approach for targeted and sustained behavioural change communication
strategies and focused IEC materials and resources for prevention of
teenage pregnancy in Honiara.
6. CONCLUSION
5. DISCUSSION

24 21
The following recommendations should be considered:
The MOHMS and relevant NGOs develop more IEC that are within
the cultural context of the country, in an appropriate language such as
Pidgin that focus on teenage pregnancy as an issue and how
to prevent it.
Focus should be placed on making IEC materials available everywhere
especially schools and places young people gather for young
people to access.
Young people should be involved in designing IEC materials and
pro grammes such as radio and TV.
Given the misconception of surrounding teenage pregnancies in
females and males, there was a need for urgent action by health
authorities to.
Existing intervention programmes should be made more accessible to
all youths and must be youth friendly.
All relevant service providers should be brought together to review
these fndings and discuss appropriate modifcation on IEC material
and programmes on service design & delivery.
There should be a mechanism established more community
collaboration and participation in the programme to allow for greater
ownership and longer term sustainability of the AHD project.
7. RECOMMENDATIONS

25 22
Annex 1 References
1. Davis E. A (1997). Adolescent Health. Unpublished report submitted
to the Solomon Islands government and World Health Organisation
2. Buchanan-Aruwafu, H (2002). Global movements and local desires:
youth sexuality and urban life in Auki, Malaita, Solomon Islands.
U published PhD thesis, Key centre for Womens Studies,
University of Melbourne
3. Davis E. A (1997). Adolescent Health. Unpublished report submitted to
the Solomon Islands government and World Health Organisation

4. Solomon Islands MDG Report (2006).
5. Cubis J. (1992). Contemporary trends in adolescent sexual behaviour.
In R Kosky, H S Eskevari and G Kneebone (eds). Breaking Out: chal
lenges in adolescent mental health. Canberra: National Health and
Medical Research Council
6. Caldwell J C, Caldwell P and Orubuloye I O (1995). Intervention
strategies suggested by the Nigerian segment of SAREC programme
on Sexual Networking, STDs and AIDS. Health Transition Review 5
(supplement):237-244
7. UNFPA (1996), United Nations 1996
8. Ministry of Health (2006) Health Statistics.
9. Dr Jagilly, Head, Accident and Emergency Department, Central
Hospital, 1997: private conversation
10. Burslem F, Laohapensang O, Sauvarin J and Young M. (1997). Naked
Wire and Naked Truth. Executive summary:20

11. McCauley A P and Salter C. (1995). Meeting the needs of young
adults. Population reports Series J 41:1-39
12. Senderowitz J. (1995). Lessons learned: Ten tips for serving young
adults. Population Reports Series J 34-36
13. Underwood P. (1996). The YWCA Human Rights Training Program,
Munda, Solomon Islands: Mid-term evaluation, September 1996.
un published report of the YWCA Section, Honiara. 15pp.
14. Cubis J. (1992). Contemporary trends in adolescent sexual behaviour.
In R Kosky, H S Eskevari and G Kneebone (eds). Breaking Out: chal
lenges in adolescent mental health. Canberra: National Health and
Medical Research Council
15. Baldo M, Aggleton P and Slukin G. (1993). Does Sex Education Lead
to Earlier or Increased Sexual Activity in Youth? Poster presented at
the IXth International Conference on AIDS, June 6-10, Berlin

26
Annex 2. FOCUS GROUP DISCUSSION QUESTIONNAIRE
Focus Group Discussion Questions
1. Content and method of current intervention.
What do service providers talk about with young people?
What materials have they provided?
Do they use any aids (e.g. condom demonstration with model, contracep-
tive pills etc)?
Are you content with the reproductive health information provided?
2. Appropriateness of content and the delivery
method of IEC interventions.
What reproductive health issues/topics are youth being provided
information on?
Can you understand the reproductive health information provided to you
by the services providers?
If not, explain.
How do young people get access to the SRH information?
Where are SRH information readily available to young people?
Is it confdential?
3. Defciencies of the content and the delivery
method of current intervention.
What is the reaction of the service providers when you go for
reproductive health information/services?
Have you received any information on prevention of teenage pregnancy?
What IEC are you exposed to?
Do they discuss delaying onset of sex?
Do they discuss about family planning for young people?
Do they show you the different methods of FP?
Do they discuss menstrual cycle and pregnancy livelihood?
Do they discuss counseling of unintended pregnancy?
Are these also contained in IEC materials?
Are these IEC materials always available? Is it easy for young people to
get these materials?

27
4. Awareness and exposure to current intervention.
Are you aware of the existing family planning services provided?
If yes, how do you come to know about them?
Are you also using the information/services from the existing
services provided?
If you are not using them, explain why
5. Improving IEC intervention strategies targeting
adolescents.
What interventions do you want to see happen to improve the
delivery and accessibility of reproductive health information/services
to adolescents?
When do you think service providers should start delivering reproductive
health information/services to youth?
Where do you think young people would feel comfortable to go to for
reproductive health information /services?

28
Annex 3. IN-DEPTH INTERVIEW QUESTIONNAIRE
In-depth Interview Questions
1. Do you have Reproductive Health programs that address reproductive
health issues such as teenage pregnancy?
Yes
No
If yes, the programs come in what form?
H/Talk IEC Materials Workshops Drama Video
Radio School Visit P/Education Others
2. Explain how your organization delivers reproductive health informa-
tion/services to young people.
.
Can you provide examples of IEC materials (e.g. Brochures, video tapes
etc.)?
3. Do young people know about your organizations reproductive pro-
grams/services?
They know They dont know I dont know
If they know, are they using them?
Yes No I dont know
If they dont know; why and explain
4. How many youth come to your organization for reproductive health

information/services per month?
1 - 5 6 - 10 11 - 15 16 - 20 20 +
None
Provide information/services Provide very little services
5. What do you do with youth when they come to you for reproductive
health information/services?
Question them before providing information/services
No information/services provided.
6. What is your opinion about unmarried youth (adolescent) who come
to you for reproductive health information/services?
OK for them to come They are not old enough
Its taboo according to custom/church I dont know

29 26
25
7. What do you think about the reproductive health information/services
you are providing to youth? Are they relevant to them?
Relevant Not relevant I dont know
If the information/services are relevant, explain why
If the information is NOT relevant, explain why
8. If a young person comes to you for family planning, would you provide
it?
Yes No I dont know
If yes, explain why
If no, explain why
9. Young people come to you for what form of contraceptives?

Condom Pills Depo IUCD
Others
10. What FP methods would you prefer young people using?
..............................................................................................................................................
..............................................................................................................................................
...........................................................................................................................................
11. Are the IEC materials available youth friendly and are easy to
undestand?



UNFPA
Offce for the Pacifc
Phone : 3308022
Fax : 3312785
http : //pacifc.unfpa.org

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IEC strategies on the prevention of teenage pregnancy

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