Supporting Access for Adolescents to Integrated Sexual and Reproductive Health Services (Safire)

23 million girls aged 15 to 19 years in low and middle-income countries have an unmet need for modern contraception. As a result, half of pregnancies among this group are estimated to be unintended.

Where girls do seek an abortion they face social, legal or economic barriers. Girls are forced to resort to unsafe methods of abortion and can’t access post-abortion contraception. This year, 3.9 million girls in low an middle income countries will have an unsafe abortion – more than 10,600 every day.

Complications in pregnancy and childbirth are the leading cause of death for this age group globally. The WHO estimates that 10,000 teenage girls will die each year, and for every death, 15 will suffer life-changing injuries. In addition, we know that many girls face misinformation, fear and stigma and services and information are often not tailored to girls’ specific needs.

‘Supporting Access for Adolescents to Integrated Sexual and Reproductive Health Services’ (Safire) was an innovative programme seeking to dramatically reduce deaths and injury from unsafe abortions among girls in some of the countries with the highest burden in Sub-Saharan Africa.

We worked with local implementing partners and community based Oorganisations, leading technical experts, and social marketing organisations to destigmatise and support girls’ choices to reduce unsafe abortion.

Taking a Human Centred Design approach, we used in-depth research and analysis to develop solutions to enable girls’ access to quality and confidential reproductive health services.

By the end of the five-year programme (2018-2023), we had:

• Reached 263,148 girls with sexual and reproductive health information. A group of ‘Big Sisters’ were trained to provide information through group and one-to-one sessions with girls. They also supported girls to access to safe abortion services with accredited service providers (vendors). The Safire network of vendors served a total of 36,548 girls with quality medical abortion services, with 75% of these girls also receiving post-abortion contraceptives.
• Civil society organisation partners and champions led community dialogues which helped raise the profile and normalised conversations on adolescent sexual and reproductive health. This included talking about preventing unintended pregnancies and access to safe abortion services.
• Through tailored training, coaching and mentorship, the programme strengthened the capacity of local implementing partners. The support helped position them for future engagement and participation in adolescent sexual and reproductive health service delivery opportunities.