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Adolescent Sexual and Reproductive Health and Rights: Generating Evidence and Strengthening Country Capacity Lab

What are the data problems that this Lab is working to solve?

Global advances have focused on developing high level indicators and generating estimates of adolescent health based on modelling. Yet, countries, and implementation NGOs primarily, need better baseline and monitoring information to guide rapid decision-making for improving the health and wellbeing of adolescent girls.

Evidence and learning are critical elements for promoting adolescent sexual reproductive health and rights (ASRHR). Yet, the generation and use of evidence on ASRHR and related gender issues, such as gender inequalities and female empowerment, are still weak. This lack of data and evidence undermines the ability to advocate for the health and rights of adolescent girls and affects program planning, its targeted implementation and monitoring and accountability.

Key data issues:

  • Missing Data: Data on the youngest adolescent age-cohorts are lacking. The reporting of sensitive events that are critical to measuring ASRHR and gender-related indicators (e.g, sexual behaviour, substance abuse, abortion and violence against women) are  not captured because of low reporting.
  • Service Coverage: Canadian NGOs will contribute to report on 16 key performance indicators (developed by Global Affairs Canada) that capture the implementation of policies and interventions, disaggregated by age and sex and other dimensions of inequality where feasible, but not the coverage and impact of these interventions on ASRHR.
  • Weak Evidence to Action: Knowledge generation and use of evidence on ASRHR and related gender issues are weak and are not being harnessed effectively.
  • Analytical Capacity: Institutional capacity in-country is often inadequate for effective analysis and communication of ASRHR data. Available ASRHR and related gender data through surveys are poorly harnessed by policy makers, program staff and project managers.
  • Reliability in Data: Available ASRHR data are ignored due to low confidence in research quality across data collection methods – varied among self-reports in surveys, health facility data or qualitative studies.

How are partners navigating this innovation?

  • Strong database: In-depth case study for tool development will leverage rich data from existing longitudinal community study (Kisesa Ward, Tanzania), with population data available for 40,000 residents, including data from government-run health facilities and hospitals.
  • Wide Reach: Lab team will work closely with national and regional-level governments to ensure sustainable delivery of high-quality, gender-sensitive health services with an established platform of 10 countries.
  • Context Diversity: Evidence on ASRHR and related gender issues will be generated from two settings in Tanzania, one with a strong Plan International-supported program in disadvantaged districts in Rukwa and one in a periurban community setting in northwest Tanzania with extensive data on adolescents.
  • Data Reliability: The data collection tool, Demographic Surveillance System (DSS) has now been conducted 32 times and is a reliable measure of vital statistics and a basis for linking health facility and population data.
  • Combined research and program relevancy: Given the established research infrastructure in Mwanza and the National Institute for Medical Research (NIMR), much of the formative work is taking place here, embedded within the Kisesa cohort, followed by refinement within the context of Plan Tanzania’s Uzazi Salama project in Rukwa county. This arrangement will provide instruments that are both scientifically sound and programmatically relevant.

What does each partner offer?

Countdown to 2030, University of Manitoba

  • A network of country analysts providing a unique opportunity to work with multiple countries, including public health institutions, civil society organizations and government. The key goals are the generation of socially robust country evidence, strengthening the analytical capacity of country institutions, and the advancement of measurement within host countries.
  • Gender- and ASRHR-related work is a core part of the Countdown, bringing together experts on measurement, monitoring and determinant drivers of change from multiple disciplines. The work includes both quantitative and qualitative work.

Plan International Canada

  • Instrumental in project conception and country selection for all project components and activities to ensure they are applicable to gender transformative programming application and identified NGO priorities.
  • Supporting in-depth field work in Tanzania (Rukwa) by leveraging their local programming community relationships and project infrastructure.

Africa Population & Health Research Centre (APHRC, Kenya)

  • Coordinated analytical workshop of multi-country partners.
  • Prepared and coordinated analytical tools, methods and outputs related to ASRHR in alignment with Countdown’s priorities.

National Institute for Medical Research (NIMR, Tanzania)

  • Contribute to the project’s research analytical capacity with development of research instruments and methodologies, including all fieldwork data collection and administration
  • Leveraging relationships with local leaders (District Medical Officer) to gain community access permission, and supported ethics submission in Tanzania.

Countries of Work:

Workshop:

  • Tanzania  
  • Kenya
  • Uganda
  • Mozambique
  • Malawi
  • Zambia
  • Ethiopia
  • Zimbabwe
  • Ghana
  • Nigeria

In-depth work:

  • Tanzania
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