By engaging adolescent peer educators, volunteer parent counselors, and teachers in a comprehensive program to provide information to adolescents about health and sexuality, Nike is enabling thousands of Nigerian teenagers to make informed decisions that will enhance their reproductive health and their dignity.
The New Idea
Founded by Nike in 1989, Action Health Incorporated is a multi-disciplinary group of parent and teen-age volunteers who believe that, in order to make responsible decisions, adolescents need more information about health and sexuality than schools or parents provide. AHI encourages abstinence as the ideal behavior for adolescents, but also recognizes the need for teens who are already sexually active to be informed about the importance of practicing safe and responsible sex.
AHI increases awareness about adolescent health issues through the use of trained peer educators who provide school mates with information about sexuality, health, and life planning and volunteer parent counselors. AHI also offers non-judgmental counseling and referral services.
Nike's idea crystallized around adolescent health when she realized how many adolescents were at risk and that no program existed to inform adolescents about the their health and sexuality. She began in one local school district to reach as many in-school adolescents as possible, and to give them a forum for discussing their questions and concerns.
Sexual activity among teenagers in Nigeria is high. Studies show that as many as 60% of boys and 48% of girls attending secondary school are sexually experienced by age 19. A study in one city showed that 55% of secondary school girls were sexually active before age 16. This level of sexual activity gives Nigeria one of the highest rates of teen motherhood in the world. As many as 146 out of every 1000 women who give birth in Nigeria are under 19 and 905,000 adolescents give birth annually. Early childbearing, apart from its negative health consequences, is also associated with lower social and economic mobility for teenage mothers who experience a temporary or, more often, a permanent halt to their education. In a study of 127 pregnant school girls in Nigeria, 52% were expelled from school, 20% were too ashamed to return, 15% could not return because their parents refused to pay school fees, and 8% were forced to marry. Career opportunities or any chance of achieving a desirable social standing are severely limited without formal education.
As a result, many teenagers who become pregnant while still attending school resort to terminating their pregnancies, often at great risk since abortion is illegal. By the time they leave school, two out of every five secondary school girls will have had at least one pregnancy. This trend is confirmed by studies in teaching hospitals in the southern part of the country, where doctors routinely describe illegally induced abortion as the "school girls problem."
Over 60 percent of patients at Nigerian hospitals with abortion-related complications are adolescent girls. In addition to serious health risks, many die. Pregnant girls aged 15 and under have a maternal mortality rate that is seven times higher than that of women in their early twenties.
AHI has created a system of school based Health and Life Planning Clubs comprised of teenagers as peer educators, parents as volunteer counselors, and principals and teachers as advisors. The adolescent peer educators begin by participating in an intensive reproductive health training program. They learn to make presentations at school assemblies, organize debates, and establish Health and Life Planning Clubs. When appropriate, they provide referral information to teens who need more information than they are able to provide.
Volunteer parent counselors are drawn from PTA's and undergo an intensive training program. They work through the PTA groups in their communities to mobilize other parents and help them communicate better with -- and address the health needs of -- their adolescent children. Volunteer parents also serve as mentors to the adolescent peer educators.
Principals and teachers participate in focus groups, to enlist support for peer educators, and act as advisors to Health and Life Planning Clubs.
AHI provides information about reproductive anatomy and physiology, sexually transmitted diseases and AIDS, and counseling on the risks of early sexual activity, teenage pregnancy, abortion, STDs, AIDS, and drug abuse. It offers accessible, non-judgmental counseling, referrals for family planning methods, "life planning" programs, that enhance adolescent decision-making. In addition, it encourages communication about reproductive health issues between parents and their adolescent children.
By the end of 1991, AHI had trained 99 peer educators in teams of three and volunteer parent counselors in 33 secondary schools in the Somolu Local Education District of Lagos, reaching over 66,000 students. AHI's peer educators have started Health and Life Planning Clubs in most of the schools in the district. After their initial training, peer educators attend a workshop once a month at the Action Health Center to receive ongoing training and information and to discuss problems or issues that may have arisen in their counseling work with peers.
During the next year, Nike will focus on educational and training activities, the establishment of an Adolescent Resource Center, and strengthening the AHI organization, possibly through income generating activities.
Once she feels that she is on solid ground in the Somolu district, she will expand the program throughout Lagos State and, ultimately, the nation.
A product of the Mayflower School, a progressive secondary school that stresses self-reliance and creativity, Nike went on to study sociology at the University of Nigeria at Nsukka. Her interest in adolescent sexuality developed as she witnessed friends suffering because of teen-age pregnancy, abortions, or sexual relationships that went badly. Though she lost her own mother at an early age, she was influenced by her stepmother, a nurse who was an advocate for young girls "in trouble." She credits her stepmother for her compassion and her father, who encouraged her to "be whatever you can be," as her most significant role model.
Before launching AHI in 1989, Nike was a journalist at Nigeria's prestigious newspaper, The Guardian. There she started a page on women's issues and another on children's issues.