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Grant Reference:    UKAD-INN-081    

Full Title:  Improving access to effective sexual and reproductive health services and strengthening the ability to exercise sexual and reproductive health rights for adolescents aged 11-19 in Badarganj sub-district, in rural north-west Bangladesh.

Brief Title:  Improving access to effective sexual and reproductive health services for adolescents aged 11-19 in Badarganj sub-district, Bangladesh.

Acronym:  ASHIRBAD (Bengali: blessing) – to be used in correspondence with LAMB.

Project Outline: The aim is to reach 16,000 adolescent girls and 8,000 boys, which represent about 50% of the adolescent population, the rest being reached indirectly. Across ten unions in Badarganj LAMB will:
•    do an extensive survey of 5 unions looking at the family demographics. LAMB has already performed base line surveys in the other 5 unions 5 years ago, and these will be resurveyed (in another LAMB  project).
•    provide life skill training for 5000 adolescents, hoping that they will become peer mentors for local groups.
•    run 1200 groups of adolescents,  using trained peer volunteers – organised by 24 adolescent facilitators.
•    improve the functioning of health service providers. There are 44 mainly government health posts including 10 Safe Delivery units. The staff will be trained (or have training refreshed) to do family planning, antenatal care, postnatal care, post abortion care, treat sexually transmitted diseases, and primary health care, with an emphasis on treating adolescents with respect and knowing when onward referral is needed. The 10 SDUs will have greater expertise and include counselling for those experiencing gender based violence.
•    build networks with schools and education authorities.
•    motivate the community through training for parents, teachers and community leaders
train CBOs and community leaders to create advocacy.
•    run campaigns against gender violence, and use TV and video for dissemination.

Expected outcomes:
Two types of change in relation to child marriage within the project timeframe:
 a)  change in relation to the views/attitudes developed amongst the adolescents, family and community members on child marriage
b)  delay in child marriage (reduction in marriage rates amongst girls under 18 years of age).
We hope that the above will mean that girls remain longer in education, and that maternal mortality and neonatal mortality (stillbirths and deaths within a week of birth), will decrease. We will be looking to see if gender based violence decreases, both because the new brides will be older and also because of new respect within the relationship following group membership where such things will be discussed.
Measurable outcomes are:
1  Number and percentage of target married adolescent girls (ages 11-19) who report using a family planning method.
2  Number and percentage of target adolescent girls (ages 11-19) who have attended at least four times for antenatal care during pregnancy.
3  Number and percentage of births given by target adolescent girls attended by a skilled birth attendant.
4  Number and percentage of target adolescent boys and girls (aged 11-19) attending Adolescent Sexual and Reproductive Health Service, who report that their health care provider showed them respect and explained things carefully.
5  Number and percentage of a) target adolescent boys and girls (aged 11-19), b) female and male parents/guardians and c) male and female community leaders who express a positive attitude to decreasing child marriage and delaying first pregnancy.

Grant award:      DfID award is £249,365 over 3 years to July 2018, payable in arrears.

LAMB will provide £19,262, LHCF £2,040 and local communities will pay community worker salaries of £22,885.  
The total project cost is £293,552.

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