THE ADOLESCENT MULTI-PURPOSE CENTRE

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THE ADOLESCENT MULTI-PURPOSE CENTRE

• A Study of
• Operations Research Brought to Life

PRESENTATION MADE BY MRS. DONA DA COSTA
MARTINEZ EXECUTIVE DIRECTOR, FAMILY PLANNING
ASSOCIATION TRINIDAD TOBAGO
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Sexual and Reproductive Health Issues in Trinidad
and Tobago

• Youth engage in early sexual activity leading to
  high rates of HIV infection, unplanned pregnancy
  and unsafe, illegal abortions
• In Trinidad and Tobago, the number of new cases
  of HIV has doubled every 3 to 4 years
• 50 of the HIV infections occur among teens.
  Peak numbers are in age groups 20-24 for women
• In the 15-19 age group females are 6 times more
  likely to be infected than males

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• Despite the high level of unmet need for
• sexual and reproductive health services
• the numbers of young people UTILISING
• existing sexual and reproductive health
• services did not account for the majority
• of those most at risk.

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IPPF I3 Indicate Project.

• Principal objective
• To increase access by young adults (aged 25 and
  under) to improved service delivery through the
  testing of innovative service models.
•  Hypothesis of Indicate Project
• Utilization of the sexual and reproductive
  services of FPATT by males and females aged 15-24
  varies with the quality of its service delivery
  system.

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Data Collection Methods Utilized During The
Diagnostic Phase

• Service Statistics data
• Questionnaire data
• -         FPATT Service Providers
• -         FPATT Clients
• -         Community Survey
• Focus Groups
• - Youth Advocacy Movement members

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MAJOR FINDINGS OF THE DIAGNOSTIC PHASE OF THE
OPERATIONS RESEARCH STUDY

• (1) Young adults experience considerable
  psychological barriers to the access of SRH
  services.
• (2)  FPATT needs to increase levels of privacy
  and efficiency.
• (3)   FPATTs providers are highly regarded on
  several aspects having to do with their
  competence, patience and friendliness.

• (4)  Young adults are willing to use the services
  of FPATT if they know about them.
• (5)  Underutilization of the media to market SRH
  services to young adults.
•  
• (6)  Gender difference in the effectiveness of
  the media to reach young adults
• (7) FPATT needs to expand its SRH services for
  males

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Findings Disseminated To Facilitate Consultative
Process Of Determining Meaningful Intervention

• FPATT Board
• FPATT Management and Staff
• Youth Youth Advocacy Members, Rap Port
  staff and client

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GOALS AND OBJECTIVES OF THE INTERVENTION

• GOAL
•  
• To improve the sexual and reproductive health of
  young people (14 - 24)
• in Trinidad by reducing unplanned pregnancies and
  STI/HIV/AIDS.
•  
• OBJECTIVES
•  
• 1. Within three years to increase by 10 the
  number of young persons (14 24) in Port of
  Spain and environs who delay the onset of sexual
  activity.
•  
• 2.  Within two years, to increase by 10 the
  number of youth (14 24) in Port of Spain and
  environs who access FPATT services.
•  
• 3. To increase by 10 the number of young
  persons (aged 14 24) in Port of Spain and
  environs who are knowledgeable about sexual and
  reproductive health issues (such as STI/HIV/AIDS,
  contraceptives, Pap smears and breast
  examinations etc.)

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Original foreboding entranceway to what is now
the Youth Centre
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LAUNCH OF DE LIVING ROOM
RIBBON CUTTING (L-R) Jeane Warner (YAM
President), Dr. J. Sharpe (FPATT President)look
on as Ganga Singh, Minister of Youth Culture
Gender Affairs is assisted by Gerry Brooks
(FPATT Chairman) to cut the ribbon and formally
open De Living Room Adolescent Centre. In
background Dr. Claudette Harry of PAHO/WHO and
Abou Bacar Saibou, Area Representative UNICEF
Barbados.
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FPATT SIGNATURE INTERVENTION
DE LIVING ROOM

• Creation of DE LIVING ROOM Trinidad and
  Tobagos first Adolescent Multi-Purpose Centre
  

     Opened to the Public May 7th, 2001
Officially launched August 23rd, 2001 
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 DE LIVING ROOM WHAT DOES THE NAME MEAN? 

• The name makes reference to the living room of
  any home in Trinidad and Tobago which has been
  traditionally the hub of family activity the
  liveliest room where family members relax, bond
  and share stories, where learning is passed from
  generation to generation.

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INNOVATIVE PARTICIPATORY

• De Living Room - first multi-purpose centre in
  Trinidad and Tobago addressing sexual and
  reproductive health issues affecting young
  people.
• Youth-friendly sexual and reproductive health
  services in non-clinical, homey, comfortable
  environment
• High level of youth participation in all stages
  of the project from the development,
  implementation stages, monitoring and evaluation
  stages of the project

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CREATING A WIDER STRONGER NETWORK FOR YOUTH
EMPOWEMENT

• FPATTs De Living Room is the first
  Adolescent/Youth Multipurpose Centre First of
  its kind.

DE LIVING ROOM
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SERVICES PROVIDED AT DE LIVING ROOM
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PEER HELPER TRAINING

• PEER HELPER TRAINING YAM Members pay keen
  attention to the words of Rap Port
  representative, Darryl, during the Peer Helper
  Training Programme.

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PEER HELPER GRADUATES

• GRADUATION Proud graduates (both male and female)
  of the Peer Helper Training Programme pose with
  Nurse/Family Life Educator Ann Ayres (4th right
  to left, standing).

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THE ROLE OF YAM IN FPATT

• They assist with the development of materials,
  which target Youth.
• Provide Assistance to FPATT with educational
  sessions and seminars held at De living Room,
  schools, youth forums and community meetings
• Provide a voice at the National Level for young
  people in the area of sexual and reproductive
  health
• Empower their peers to manage their sexual and
  reproductive health responsibly
• They assist with the monitoring and evaluation of
  the service at the youth centre to ensure that
  the centre is youth friendly
• Participate in the decision making process with
  regards to the planning, designing, and
  implementing programs for themselves within
  FPATT.
• They represent the Association at youth forums
  locally, regionally and internationally.

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MONITORING AND EVALUATION

• Internal evaluation methods
• -    ongoing analysis of service and client
  statistics
• -    frequency of educational sessions held
• -    client satisfaction exit interviews
• -    individual and focus group interview
  sessions with FPATT service providers. 

External evaluation Team contracted by the
IPPF conducted a process assessment of the
overall appropriateness, effectiveness,
efficiency and value of the Indicate project. 
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Client Use of FPATT's Service Before and After
the Intervention
Before Opening
After Opening
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Client Use of FPATT's Service January December
2002
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CLIENT PROFILE

•   In 2002 there were 5693 clients who visited
  centre.
• AGE
• 16 were under 19,
• 37 were 19-21 and
• 47 22-25 years old.
• EMPLOYMENT
• 56 were employed
• 30 were unemployed
• 9 were students.
• EDUCATION
• 88- had had a secondary education or higher
• 7- had had a post-primary/primary education
• GENDER
• - 94 male
• - 5591 female

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Comparison of Client Perceptions of Clinic and
Youth Centre in Trinidad
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SUSTAINABILITY

• Factors which could contribute to the long-term
  sustainability
• of De Living Room

• The National Adolescent Wellness Initiative
  served as a catalyst for the establishment of De
  Living Room.
• Part of the proceeds of FPATTs HealthLink
  programme for corporate clients will be devoted
  to the sustainability of this project.
• Services are available at the same price as
  FPATTs main clinics. The majority of clients are
  in the 22-25 age range (47) of the clients who
  attended the clinic between Jan - Dec 2002 are
  employed and are therefore able to pay for
  service.
• FPATT will continue to seek corporate sponsorship.

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LESSONS LEARNED
Operations Research has demonstrated valuable
lessons pertinent to the design and
implementation of projects.

• Action triggered on the part of policy makers and
  management that led to fundamental changes to the
  design and operations of FPATTs youth program.
• Operations Research is a process that affects
  aspects of the organization other than the areas
  on which the research is focused.
• Change can create differential levels in the
  quality of services provided to different
  segments of an FPAs clientele.
• The more involved participants are in the design
  and implementation of change, the greater the
  sense of ownership participants feel over the
  change.

• The changes made by the FPA have triggered both
  positive and negative reactions from allied
  organizations within the society.
• The underutilization of FPATT services by young
  males persists.
• Maintaining a dynamic focus on the Youth Centre
  to make service providers continuously sensitive
  to the needs of youth will be an ongoing
  challenge of the FPA.

FOOTNOTE Findings of external evaluation of OR
Processes conducted by Kirsten Hawkins
contracted by IPPF July 2002
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PROMOTION OF DE LIVING ROOM

• MARKETING TECHNIQUES UTILIZED
• TO PROMOTE THE CENTRE
• Face-to-face work in the communities done by
  FPATTs youth
• Television appearances- DATELINE - by the program
  staff of FPATT including its youth coordinator
• Flyers describing the youth services of the
  Centre and distributed these widely to parents
  and youth in the six communities.
• Launch of De Living Room
• Full page articles in the Daily Newspaper
  including Youth Feature of Vox Magazine in
  national newspaper
• Half-hour Radio Programme on Radio 102 post
  launch of the Centre

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A PLACE TO CALL OUR OWN

• How to Contact FPATT
• Tel [phone]
• E-mail fpattrep_at_ttfpa.org
• Website www.ttfpa.org