Adolescents are the largest section of the population in Nepal, some 33 per cent, yet their sexual and reproductive health needs had been ignored, with devastating consequences:

• 21 per cent of adolescent women aged 15–19 are already mothers or pregnant with their first child
• 62 per cent of HIV/AIDS cases occur among adolescents
• over 50 per cent of the unsafe abortions carried out occur among women aged under 25

By working with the local community and with young people themselves, the Family Planning Association of Nepal is set to make young people’s lives healthier and safer.

Sexual issues are rarely discussed openly and Government services are tailored to married couples.

The Family Planning Association of Nepal’s three-year youth project Strategies for Sexual and Reproductive Health of Adolescents and Youth is beginning to improve the situation by working closely with parents, teachers and community leaders.

An initial needs assessment among the ten–fourteen year olds showed there was widespread ignorance about sexual health, including puberty and menstruation.

This applied across the board, regardless of gender, social and ethnic group and whether they were in or out of school.

As one of the girls surveyed said: “When I had my first period, I was ashamed and afraid, and didn’t tell anyone. When my mother noticed she kept me in a dark room without explaining why and I was gripped with fear until it was over”.

With the active involvement of adolescents, the project team distributed a wide range of information and educational materials.

These covered growing up and adolescence, sexuality, reproductive rights, family planning, abortion, menstruation, wet dreams and masturbation, pregnancy, marriage, and STIs and HIV/AIDS.

The project also used roadside billboards and wall paintings to get the sexual health messages across.

Street drama was one of the most effective ways for young people to reach out to the community. These dramas highlighted topics such as early marriage, unwanted pregnancy and STIs and HIV/AIDS.

They owe their popularity to the fact that the productions were written and performed by the young people themselves.

In addition, two youth information, education and counselling centres were established in premises donated rent-free by the local community.

Managed by the Member Association’s youth groups, these centres offer both a safe and friendly space for young people to meet as well as counselling and clinical facilities.

From January 2002 to September 2003, the two centres welcomed nearly 5,000 young people.

The support of the local community meant that adolescents feel confident to drop in; a fact reflected in the growing number of young visitors.