In December 2004, YouthNet conducted an assessment of youth reproductive health programs in Paraguay. USAID/Paraguay requested YouthNet to carry out the assessment as part of the development of its new strategic plan and to recommend adjustments to USAID's current activities. These include working to increase contraceptive prevalence and reduce maternal mortality, especially among poor women and rural populations, by expanding access and the use of family planning services.
YouthNet's Assessment
A YouthNet team conducted the assessment over two weeks in Paraguay, following a desk review of key survey and programmatic data, including the 2004 National Demographic and Sexual and Reproductive Health Survey. The team gathered information in-country through key informant interviews and site visits to identify how youth reproductive health (YRH) programs address the needs of youth at different life stages and in varying settings (e.g. rural/urban, in-school/out-of-school). The team also looked at the social and cultural context including family and community norms, the technical and program gaps and challenges, and stakeholder views on possible solutions to existing YRH problems. The assessment report noted several trends in YRH behaviors, documented in surveys conducted in 2004 and 1998.
Assessment Findings
Among the positive trends were:
- Falling fertility rates among adolescents and young women
- Rising contraceptive prevalence among adolescents and young women
- Increasing use of contraception at first sex
Other behavioral indicators were stagnant or showed a negative trend, including the following:
- Low age at first sex
- High rates of adolescent maternal mortality
YouthNet submitted the assessment report in January 2005 and included recommendations to address priority YRH needs and build upon the strengths of existing programs. Recommendations address:
- Access to services
- Access to contraceptives
- Sexual and reproductive health education
- Communications and mass-media
- The policy environment and interagency coordination
- Community/parental support
- Program design/evaluation research
