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Health services, HIV, Sexual & reproductive health

Participatory Action Research of SKILLZ to improve sexual and reproductive health and gender-based violence services in Malawi

2022

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Brief Summary

Background

Adolescent girls in rural Malawi continue to face significant barriers to accessing gender-based violence support and sexual and reproductive health services, despite sustained attention to women's and adolescent health in the region.

What Grassroot Soccer did

Grassroot Soccer used Participatory Action Research and theater-based workshops in Neno District, Malawi, bringing together adolescents participating in SKILLZ Bwalo La Achinyamata and local healthcare workers to explore shared experiences and build mutual understanding.

What the study found

Youth described forms of violence often invisible to adults, while healthcare workers were found to restrict adolescents' access to services based on conservative gender beliefs. Despite this, both groups shared a vision for more respectful, youth-friendly care.

Why this matters

This research highlights how healthcare systems can inadvertently exclude the young people they are meant to serve. Participatory methods like theater-based workshops offer a promising way to surface hidden realities and build the provider-youth trust necessary for equitable health services.

DETAILED SUMMARY

Importance
Rural regions of Malawi have had difficulties in actualizing health and gender rights for women, in spite of significant attention being devoted to adolescent and women’s health. This persistent gap highlights the need for a stronger, more equitable model of healthcare delivery.

Objective

Three-fold goal to: (1) assess the challenges faced by adolescent SKILLZ participants in seeking gender-based violence (GBV) and sexual reproductive health (SRH); (2) assess the challenges faced by healthcare workers in providing GBV and SRH care; and (3) build a shared understanding between SKILLZ participants and healthcare workers about what composes gender-sensitive, youth-friendly SRH and GBV care.

Study details

  • Study design: Other (Participatory Action Research (PAR) and Participatory Theater Workshops)
  • Data collection tools: Participatory Theatre Modules and SKILLZ Bwalo Lo Achinyamata Practice
  • Participants: Adolescents aged 10-14 participating in SKILLZ BLA
  • Implementation setting: Neno District, Malawi
  • Study period: 5 years

Intervention

  • SKILLZ Bwalo La Achinyamata: a community-driven adolescent program that equips youth (ages 10-14) with essential life skills.

Results

  • Process Findings: Participatory Theater allowed youth to discuss difficult realities through theatre exercises, but exhibited some shyness and tendency to follow others. Healthcare workers were able to build knowledge and demonstrate empathy towards sexual and reproductive health rights challenges.
  • Participatory Theatre Findings: Youth are subject to forms of violence and oppression that may be hidden to adults. Health workers control adolescents’ access to essential services based on conservative, gendered beliefs about appropriate behavior. Despite these barriers, both youth and providers share a vision for adolescent‑friendly services grounded in more supportive, respectful interpersonal interactions.

Conclusions and implications
 PAR allowed for deeper insight into the challenges and difficulties experienced by youth and healthcare workers in GBV care and SRH contexts.

Citation

Year: 2022

Authors: Grassroot Soccer, Abwenzi Pa Za Uyomo/Partners In Health

Grassroot Soccer, Abwenzi Pa Za Uyomo/Partners In Health. No Woman or Girl Left Behind (NWOGLB) Participatory Action Research (PAR) Summary [presentation]. Neno District, Malawi; 2022 Aug 5.

Partners

Neno District Ministry of Health

Abwenzi Pa Za Uyomo/Partners In Health

Grassroot Soccer

Funder

Global Affairs Canada

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