Community-embedded Reproductive Health Care for Adolescents in Latin America.
Community-embedded Reproductive Health Care for Adolescents in Latin America.
Adolescents in Latin America are at major risk for unwanted pregnancies leading to unsafe
 abortions and maternal health risks. Mostly, adolescent health programmes tend to focus on
 unidirectional interventions aiming at a single determinant of adolescents´ sexual and
 reproductive health. However, evidence exists that a complex health problem should be
 addressed by an equally nuanced and multipronged response. Knowledge is lacking on how to
 develop a comprehensive approach to promote adolescents' sexual health.

 The CERCA study will conduct an implementation based on the hypothesis that a comprehensive
 strategy of community-embedded interventions helps to improve the sexual health of
 adolescents. We will test this hypothesis and describe the development, implementation and
 testing of interventions in three Latin American cities: Cochabamba (Bolivia), Cuenca
 (Ecuador) and Managua (Nicaragua).

 The research methodology has been designed based on the methodological frameworks of action
 research, community based participatory research and intervention mapping.

 The interventions are complex addressing different target groups (adolescents, parents,
 authorities and health providers) and focussing on various behaviours that are related to
 communication about sexuality, information seeking, access to health care and safe sexual
 intercourse.

 For the evaluation of effectiveness a randomised and non-randomised controlled study was
 developed for respectively Managua and the two other cities. Furthermore a process evaluation
 is conducted.

 This research will result in a framework that will contribute to the planning of
 interventions that are effective and responsive to adolescents' sexual health needs.
Inclusion Criteria:

 Nicaragua - adolescents aged 13-18 living in the 33 town districts of Managua with a
 population number that varies between 1400 and 4500 inhabitants and with more than 50 %
 poor people.

 Bolivia and Ecuador: Students from conveniently selected secondary schools in Cochabamba
 (Bolivia) and Cuenca (Ecuador).