Advancing Adolescent and Youth Sexual and Reproductive Health in Bangladesh

Bangladesh’s adolescent and youth population has urgent and varied needs for family planning services and sexual and reproductive health care. Yet a strong tradition of early marriage and childbearing, set against a backdrop of conservative social and gender norms, means adolescent and youth sexual and reproductive health and rights have historically been overlooked in national family planning programs.

The USAID-funded, Pathfinder-led Accelerating Universal Access to Family Planning Project, popularly known as Shukhi Jibon, is working to change this. This publication highlights Shukhi Jibon’s multi-pronged approach to advancing cost-effective solutions that enhance health providers’ skills and responsiveness, facility readiness, community engagement, and young people’s service-seeking behavior and contraceptive uptake—all of which can be scaled up across Bangladesh.

Source: Pathfinder International

Date of Publication: January 18, 2023

Breakthrough ACTION Liberia Rural Sanitation Report 2021

This technical report from a 2021 study on rural sanitation in Lofa and Nimba Counties was conducted by the Johns Hopkins University Center for Communication Programs and Save the Children.

The objectives of the study were to:

  • Determine the current sanitation and open defecation free (ODF) status among previous USAIDsupported communities within Lofa and Nimba counties
  • Deepen understanding of the individual, community and political drivers and barriers to household toilet/latrine adoption and sustained use or “slippage” in both rural Liberia (Lofa & Nimba)
  • Assess the determinants of “drop outs” of sustained toilet use

The main conclusions of the study are as follows:

  • The three groups studied, including two ODF groups, indicate that the ODF groups have more communities with high toilet use compared to the never ODF group.
  • Toilet use attrition, especially 12–18 months after toilet construction, is high. The main reasons of toilet attrition are lack of cleanliness and maintenance of the toilets since a large number are shared toilets.
  • The primary issue of attrition is related to poor toilet use experience.
  • People are already motivated to use toilets in Nimba and Lofa counties. Therefore, implementing programs for toilet motivation is not necessary. Instead, programs that help maintain toilet cleanliness, reduce attrition, and build social norms around consistent toilet use are needed.
  • Handwashing with soap practices are not optimal with only a third of the sample washing their hands daily with soap after defecation.
  • The toilet filling up and the toilet getting “spoiled” are the two major reasons for returning to the bush for defecation.
  • A large number of the bush users are former toilet users, indicating that a high demand for toilets exists in the three communities.
  • However, even the ODF communities have reverted to a large extent to bush use.
  • Therefore, making toilet use a clean and pleasant experience is essential to continued and sustained use.
  • Individuals state that faith leaders, such as pastors (34.9%) and imams (12.8%), influence their decision to participate in community sanitation practices. Overwhelmingly, individuals note that traditional leaders (50.3%) and community role models such as health workers and teachers (48.2%) play the largest roles in affecting individual behavior.

Source: Johns Hopkins University Center for Communication Programs, Save the Children

Date of Publication: November 24, 2021

Breakthrough ACTION Liberia Peri-Urban Water Study Report 2021

This technical report from a 2021 study on peri-urban water access, quality, and use in Montserrado county was conducted by the Johns Hopkins University Center for Communications Programs and Save the Children.

The primary objectives of the study were to:

  • Deepen understanding of the drivers and barriers to household water source selection in peri-urban communities of Montserrado
  • Explore households preferences and practices related to storage, treatment and use in peri-urban communities of Montserrado County

The main findings of this study are the following:

  • A large proportion (63%) of the respondents from the three study sites have challenges securing the minimum quantity of water for daily use as outlined by WHO’s 20 liter/person/day minimum.
  • Household access to improved water sources is relatively high, although water sources vary based on season, convenience, perceived water quality, and distance
  • Despite close proximity to water sources, household water collection burdens are extremely high.
  • Household water storage practices and sanitation practices create significant drinking water quality risks and affect household confidence in water quality
  • Gender disparities in household water responsibilities remain high.
  • Household access to safe and sufficient water resources is hampered by cost, convenience, and reliability of water systems.

For questions or comments, contact
Dr. Nandita Kapadia-Kundu:
Dr. Stephen Sara:

Source: Johns Hopkins University Center for Communication Programs, Save the Children

Date of Publication: November 22, 2021