Impact Data - Entre Nous Jeunes
Date
Entre Nous Jeunes is a peer-based adolescent reproductive health programme designed to increase contraceptive use and to reduce the prevalence of unintended pregnancy and sexually transmitted infections (STIs) among sexually active adolescents in Cameroon. The programme addresses urban in- and out-of-school youth aged from 10 to 25. The project involves mobilising peer educators to lead discussions and conduct informal interviews with youth on topics related to family planning (FP) and STIs such as AIDS. It also distributes educational material and sells condoms to youth.
Methodologies
Between November and December 1997, evaluators conducted a baseline survey among youth in the intervention community of Nkongsamba and in the comparison community of Mbalmayo. A follow-up survey was conducted 17 months later (April 1999) among youth in the two communities.
At baseline, evaluators used a multi-stage sampling approach of clusters, blocks, and households to randomly select a household sample of youth ages 10 to 25. Among eligible respondents in each household, one youth was randomly selected. At baseline, 402 youth in the intervention community were surveyed and 400 youth in the comparison community. At follow-up, the survey was restricted to youth ages 12 through 25; 405 youth from the intervention community were surveyed as were 413 from the comparison community. The change between baseline and follow-up in the ages of those surveyed came primarily from parents' resistance to the interviewing of children ages 10 through 14.
At baseline, evaluators used a multi-stage sampling approach of clusters, blocks, and households to randomly select a household sample of youth ages 10 to 25. Among eligible respondents in each household, one youth was randomly selected. At baseline, 402 youth in the intervention community were surveyed and 400 youth in the comparison community. At follow-up, the survey was restricted to youth ages 12 through 25; 405 youth from the intervention community were surveyed as were 413 from the comparison community. The change between baseline and follow-up in the ages of those surveyed came primarily from parents' resistance to the interviewing of children ages 10 through 14.
Knowledge Shifts
At follow-up (17 months after baseline), youth in the intervention community were significantly more likely than youth from the comparison community to know females’ symptoms of STIs (odds ratio=1.16). Controlling for contact with a peer educator indicated that such contact was significantly associated with knowledge of female STI symptoms among youth in the intervention community relative to youth in the comparison community (OR=0.87). The intervention had no significant effect on knowledge of symptoms of STIs in males.
Practices
Sexually experienced youth in the intervention community were significantly more likely to report use of modern contraceptives than were youth in the comparison community (OR=0.53). Contact with peer educators was separately analysed, and sexually experienced youth in the intervention community who had individual contact with a peer educator were significantly more likely to report current use of modern contraceptives than were youth from the comparison community (OR=0.92). Further analysis showed that, in the absence of the peer education programme, current use of modern methods of contraception among youth in the intervention community would have been 21% lower.
To cite an example of findings related to one specific type of modern contraceptive: At follow-up, youth from the intervention community who had an encounter with a peer educator were significantly more likely to be current users of condoms than were youth from the comparison community (OR=2.07). The finding was also significant for in-school youth (OR=1.13) and for in-school youth who had contact with a peer educator (OR=1.09). At the same time, changes in reported condom use at most recent sex, while not statistically significant, were considerable (baseline OR = -0.23; follow-up OR=0.02). By contrast, between baseline and follow-up, youth in the comparison community reported no change in condom use at most recent sex. Further analysis showed that, in the absence of the peer education programme, condom use at most recent sex would have been 53% lower among youth in the intervention community.
The evaluation found that youth in the intervention community were much less likely to have initiated sex at follow-up than were youth in the comparison community; 44% of females and 40% of males in the intervention community had never had sex versus 32% of females and 23% of males in the comparison community. However, because the evaluation did not control for age, these findings must be viewed cautiously: "attributing these differences to the program is difficult, although they are suggestive of positive impacts."
To cite an example of findings related to one specific type of modern contraceptive: At follow-up, youth from the intervention community who had an encounter with a peer educator were significantly more likely to be current users of condoms than were youth from the comparison community (OR=2.07). The finding was also significant for in-school youth (OR=1.13) and for in-school youth who had contact with a peer educator (OR=1.09). At the same time, changes in reported condom use at most recent sex, while not statistically significant, were considerable (baseline OR = -0.23; follow-up OR=0.02). By contrast, between baseline and follow-up, youth in the comparison community reported no change in condom use at most recent sex. Further analysis showed that, in the absence of the peer education programme, condom use at most recent sex would have been 53% lower among youth in the intervention community.
The evaluation found that youth in the intervention community were much less likely to have initiated sex at follow-up than were youth in the comparison community; 44% of females and 40% of males in the intervention community had never had sex versus 32% of females and 23% of males in the comparison community. However, because the evaluation did not control for age, these findings must be viewed cautiously: "attributing these differences to the program is difficult, although they are suggestive of positive impacts."
Access
During the 2-year intervention, peer educators organised 353 discussion group sessions, attended by about 12,000 youth. Peer educators also had personal contact with over 5,000 adolescents in the intervention community.
Source
Sue Alford, MLS, Nicole Cheetham, MHS, and Debra Hauser, MPH, "Science and Success in Developing Countries: Holistic Programs that Work to Prevent Teen Pregnancy, HIV & Sexually Transmitted Infections" [PDF] (Advocates for Youth, 2005); and Entre Nous Jeunes website, February 20 2009.
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