Adolescent Reproductive Health (ARH) Program
Adolescent Health in Bangladesh
There are more than 36 million adolescents within Bangladesh's population of over 130 million. Research shows that adolescents do not have correct information about their own reproductive and sexual health. This result is accompanied by the following facts:
 Average age of marriage among girls is 15 years
- Only 34% of girls know about menstruation before they experience it and only 42% of rural boys and 20% of urban boys are aware of the wet dreams before they have one
- 35% of all adolescent women under 20 are either pregnant or have a child
- Only about 5% of adolescents know about STIs and only half of these are aware of signs/ symptoms and modes of transmission.
- Boys are at risk with increasing drug use and smoking rates
- Anecdotal evidence suggests that many boys visit sex workers without using condoms
Project Background:
The Adolescent Reproductive Health (ARH) Communication Program addresses the gap between knowledge and practice through its multi-pronged communication strategy focusing on priority adolescent issues revealed by adolescents themselves. The comprehensive program is based on extensive research revealing the need to create an enabling environment that supports adolescents knowledge and service seeking behaviors. The program was developed by the Bangladesh Center for Communication Programs (BCCP), with support from an in-country ARH Working Group, and technical assistance from the Health Communication Partnership, based at the Johns Hopkins Bloomberg School of Public Health. The program is funded by USAID and UNICEF.
 The "Know Yourself" Life Skills Package:
The package aims at four critical components of behavior change: provision of information, motivation for behavior change, building life skills, and creating an enabling environment to support and sustain behavior change over time.
All ARH materials and media, including the theme song use the logo, slogan-"NijekeJano" or "Know Yourself". This provides 'branding' to identify the ARH program materials and a rallying point for the partners involved.
Adolescents are involved in all stages of program developments: Formative research, character development and story writing for scripts and comic books, retesting, acting, and evaluation.
Providing Information
Four Q&A booklets were developed based on questions from adolescents. The health topics covered are:
 It's My Puberty: Physical maturity, menstruation, sperm production/wet dreams, and emotional changes.
- New Feelings, New Passions: Sexual attraction, delay of marriage, avoiding unwanted pregnancy, sexual and physical abuse.
- Preventing Risks to Our Future: HIV/AIDS and other STIs: delay of sexual debut, faithfulness, condom use, and prevention of Injecting Drug Use.
- Preparing for Marriage: Delay of marriage, family planning, maternal and child health, hygiene and nutrition.
Encouraging Motivation:
Adolescents could be motivated to develop healthy behavior or to change risky behavior through Entertainment Education strategy. Comic books are very popular with adolescents and allow programmers to address sensitive issues more directly than is possible on television or radio. Comic books feature the adventures of adolescents Sajjad and his sister Shanu in a semi-urban town that touch on the reproductive health issues. Each comic book includes guidelines and questions for discussion on these issues.
Building Life Skills:
 Four Life Skills Facilitators' Guides with Videos have been development to encourage adolescents to think through goals and problems and articulate their opinions. The guides contain many life skills exercises on the same four subject areas as the booklets. The life skills workshop is a forum where adolescents practice decision making, problem solving, critical and creative thinking and interpersonal skills. The videos feature adolescents speaking openly, role-playing, comic animation and parent and service provider statements.
A core group of life skills facilitators has received a training of trainers (TOT). These facilitators will operationalize the ARH life skills toolkit and train facilitators in their own organizations on its use. The workshops are implemented throughout Bangladesh with a series of partner NGOs, youth groups, schools, clinics, and community based organizations.
Video clip of puberty: Quicktime | Windows Media Player
Creating An Enabling Environment:
 A 39-episode TV series and 52-episode radio series follow a variety-show format with adolescent anchors and field reporters who conduct interviews with adolescents, parents, teachers, service providers and community leaders on issues. The program also presents songs, poems, quizzes, dramas using the same characters as the comic book. The national TV and radio broadcast will extend ARH messages to adolescents, parents, community leaders and service providers. The TV and radio series are linked to the toolkit and comic books through the logo and theme songs.
Evaluation
A monitoring and evaluation system is in place, however, results are not yet available.
Anecdotes on the impact of ARH program:
Dr. Mostafizur Rahman, Upazila Health and Family Planning Officer of Sakhipur Upzilla of Tangail District: "Adolescent girls are gathering at their own initiative to the health complex for the TT. We have received letters from students of different schools requesting to organize Health Camp every month so it becomes easy for adolescent girls to get health and other services from the camp. I am impressed at the eagerness of the girls here and BCCP has made it through their ARH program.
Tanzila Khatun, adolescent girl: "I was depressed and afraid of a deadly disease when I saw first blood dropping out of my body without any reason. All happened around me so dramatically that me me completely frustrated and I was feeling distressed. At that time I heard about BCCP's video show at Chowdhury Bari which I attended. Through watching the video show and reading the booklet (My puberty), I knew about the changes that occur in the human body during adolescence and also I knew what should I do to take care of myself."
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