Motherhood in Childhood

and Nicaragua to strengthen the capacity of
pharmacies to provide youth-friendly reproductive
health services with a focus on emergency
contraception. The initiative trained pharmacy
staff and peer educators to provide accurate, upto-date
information on emergency contraception
and other reproductive health services.
An assessment of the initiative found that
the project increased the capacity of pharmacy
personnel to provide high-quality reproductive
health services to youth. Data suggest that
pharmacy staff gained knowledge of emergency
contraceptive pills, sexually transmitted infections
and modern methods of contraception.
RESPONDING TO THE NEEDS OF ADOLESCENTS AND YOUTH IN COLOMBIA
On the second floor of a modern building, the youth-friendly
health centre in Duitama, Colombia, has a few white walls, but
most have been painted by local adolescent graffiti artists. Of
Duitama’s 111,000 inhabitants, about one quarter are between
the ages of 10 and 24.
Every month, more than 600 young people take advantage
of the centre’s services, which include everything from dentistry
to sexual and reproductive health and psychotherapy.
“It’s not only about health, it’s also about communication,”
says Nubia Stella Robayo, a nurse specializing in maternal and
perinatal health services for adolescents.
“Most of the girls have financial problems,” Robayo says.
“Eighty per cent of their pregnancies were unplanned.” And
most of the girls and boys who come to the centre for the first
time are not using contraceptives.
Robayo says many of the girls she sees think that their bodies
are too immature to become pregnant, so they think they do
not need to worry about using a condom. This is especially the
case among girls from surrounding rural areas. The confusion
about sexuality and pregnancy, she says, points to a need for
better sexuality education and information.
“When I first heard about youth-friendly services, I thought
it was a fabulous idea and I said ‘we have to do it’,” says Lucila
Esperanza Perez, the centre’s manager, who says preventing
adolescent pregnancy is the main goal. Perez herself had had
two children by the time she was 20 and knows first-hand
the challenges adolescent pregnancy can pose. “We wanted a
centre where young people could receive the information they
need to manage their sexual and reproductive lives," Perez
says. “And young people were consulted from the beginning of
the project; they have been the true managers.”
A service is considered youth-friendly when it meets the
needs of adolescents and youth, recognizes their rights, and
becomes a place where they can be informed, guided and
taken care of, she explains. Health, she adds, is a state of physical,
mental, spiritual and social well-being.
Catherine, 19, is 32 weeks pregnant and gets her antenatal
check-ups at the centre. “Pregnancy is hard if it is not
planned,” she says, “as there are too many goals and dreams
to be deferred.”
Catherine says the nurses and doctors at the centre make
her feel appreciated. “The nurses and doctors speak to you
with affection, and they are always receptive to any question or
situation you may have,” she says.
Juan, 20, has joined one of the centre’s peer groups, where
young people have an opportunity to share their experiences
and knowledge with other young people in schools and
throughout the community. His peer group also leads workshops,
forums and other activities that bring young people
together to discuss issues ranging from responsible sexuality
to gender-based violence. Sometimes as many as 1,000 young
people turn up for events.
While more and more young people are using the centre’s
services, and adolescent pregnancies are starting to decrease,
Perez says “there is a lot to do” to help even more people
prevent pregnancies and address other problems that affect
Duitama’s youth, such as preventing sexual violence and
stopping substance abuse.
THE STATE OF WORLD POPULATION 2013
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