Faith-Based Organizations as Sites for Adolescent Health Interventions: A Feasibility Study in the Bañado Sur Neighborhood of Asunción, Paraguay Open Access

Couper, Catherine Elizabeth (2014)

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Background: Nearly half of Paraguay's population is under age 25. Many youth are in their prime reproductive years, and gaps in education and parent-child communication on sexual-reproductive health (SRH) put youth at risk for experiencing negative SRH outcomes such as unplanned pregnancies and sexually transmitted infections. Faith-based organizations (FBOs) are a potential site for intervention programs, particularly in marginalized communities where churches are among the strongest local organizations.This project explores the potential for FBOs to help promote healthy SRH among low-income youth in Asunción.

Methods: In-depth interviews and focus group discussions were conducted with adolescent females ages 15-18 in the Bañado Sur neighborhood of Asunción. Key informant interviews were conducted with clergy and non-clergy. Data were analyzed to identify patterns and variation in participant responses and compare how groups of participants felt on various topics.

Results: Adolescent females do not feel comfortable discussing SRH with clergy and prefer to learn about SRH from their parents or trained providers. Adolescents also note that parents and adolescents struggle to engage in comfortable, effective conversations on SRH. Clergy believe that SRH education is the responsibility of parents, not that of the church, except in the case of discussions around marriage and marriage preparation classes.

Discussion: Churches may be an appropriate location for an SRH intervention for adolescents, however adolescents and clergy both felt the intervention would be more appropriately implemented by outside experts. Given that adolescents and clergy both emphasized that parents should give SRH education to their adolescent children, churches could foster interventions with parents to better prepare them for successful conversations with their adolescents. Materials from recommended interventions should be adapted to better serve the linguistic, cultural and literacy-appropriate needs of Bañado Sur parents.

Table of Contents

Chapter 1: Introduction and Rationale. 1
Why Paraguay?. 1
Study Site: Bañado Sur. 3
Religiosity in Paraguay: 5
Problem Statement: 6
Purpose Statement: 7
Statement of Significance: 7
Chapter 2: Review of the Literature. 8
Country-level Data on Adolescent Reproductive Health. 8
Other Risk Behaviors Among Adolescents. 11
Faith-Based Organizations: Sites for Health Interventions. 13
Faith-Based Organizations and Sexual-Reproductive Health Interventions. 14
Conclusion. 15
Chapter 3: Methods. 17
Study methods. 17
Key-Informant Interviews. 17
In-Depth Interviews. 18
Focus Group Discussions. 19
Data Preparation and Analysis. 20
Ethical Considerations. 21
Limitations of the Data. 21
Chapter 4: Results. 23
PART ONE | The Bañado Sur: "Poverty beats the Bañado down, but does not destroy it.". 23
Neighborhood Insecurity and Violence. 27
Drugs and Alcohol 30
PART TWO | Sexual-Reproductive Health. 31
Family. 34
The Church and Religion. 37
Chapter 5: Discussion. 49
Summary of Findings. 49
Characteristics of Effective Interventions. 51
Kirby's 17 Characteristics of Effective Programs. 52
Recommendations for Interventions Involving Parent-Adolescent Communication: 53
My Changing Body. 53
Fertility Awareness Methods. 56
Families Talking Together. 57
Bibliography. 59
Appendix 1: Adolescent Interview Guide. 63
Appendix 2: Non-Clergy Interview Guide. 67
Appendix 3: Clergy Interview Guide. 70
Appendix 4: Codebook 73

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