Crowdsourcing with adolescents in Senegal to address social norms limiting their access to sexual and reproductive health services

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Adolescents make up 18% of the world population. They have unique health needs as they transition from children into adults. Despite their unique physical, social, cognitive and sexual health needs, until recently adolescent health has received little attention globally or nationally. This trend is changing, with adolescent health featuring prominently on the global health agenda. In particular, there is growing recognition of the need to invest in the sexual and reproductive health needs of adolescents, who are at higher risk of acquiring sexually transmitted infections and of having unwanted pregnancies. To increase coverage of these services among adolescents, sexual and reproductive health services need to be tailored to the their needs. In Senegal, the government is committed to providing sexual and reproductive health services to adolescents through the health system and through dedicated youth centres. Despite the availability of these services, adolescents, particularly those residing in poorer and more rural areas, have the lowest access to sexual and reproductive health of any age group, particularly family planning services. There is evidence that attitudes and beliefs (norms) towards adolescents' sexual activity, and the way in which services are provided in response to these norms, play a large role in limiting adolescents use of available services. Through qualitative research and crowdsourcing, an innovative approach to intervention co-development, the proposed research aims to identify the key norms that limit service use in order to co-develop an intervention with adolescents aged 15 to 19 to address these norms. The research will take place in two regions of Senegal, one peri-urban area in the Dakar region and one rural area in Kedougou region in the South West of the country. Both regions are experiencing rapid increases in population due to urbanisation and gold mining, respectively. This increase in population means the number of adolescents living in these regions will increase, and that sexual practices may change as a result of increased migration and mining work. Adolescents who live in these regions therefore have a high need for sexual and reproductive services. The health systems of the two regions will also need to prepare for the increased need for services, and improve the manner in which services are delivered in order to better serve this population group. Specifically, this research project will first of all examine the policies and programmes on sexual and reproductive health available to adolescents living in the two regions. This will be followed by interviews and focus group discussions with adolescents and the individuals providing sexual and reproductive health services to them to investigate barriers that stop adolescents from using the services intended for them. We will then select a panel of adolescents from each region to rank the barriers we identify and select the three barriers most important to them. The final stage of the research will be to run a crowdsourcing competition, where members of the public are asked to submit ideas or solutions to a proposed problem. In this study, adolescents will be invited to design an intervention to tackle the three barriers identified as most important to them. We will involve adolescents throughout the project and provide them with technical support they need to conduct the activities successfully.