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

青少年占世界人口的18%。他们有独特的健康需求，因为他们从儿童过渡到成人。尽管青少年有着独特的身体、社会、认知和性健康需求，但直到最近，青少年健康在全球或国家一级都很少受到关注。这一趋势正在发生变化，青少年健康在全球卫生议程上占据突出地位。特别是，人们日益认识到，需要对青少年的性健康和生殖健康需求进行投资，因为青少年感染性传播疾病和意外怀孕的风险更高。为了扩大这些服务在青少年中的覆盖面，性健康和生殖健康服务需要适合他们的需要。在塞内加尔，政府致力于通过卫生系统和专门的青年中心向青少年提供性健康和生殖健康服务。尽管有这些服务，但青少年，特别是居住在贫困和农村地区的青少年，在所有年龄组中获得性健康和生殖健康服务，特别是计划生育服务的机会最少。有证据表明，对青少年性活动的态度和信念（规范），以及根据这些规范提供服务的方式，在限制青少年利用现有服务方面发挥了很大作用。通过定性研究和众包，一种创新的干预共同发展的方法，拟议的研究旨在确定限制服务使用的关键规范，以便与15至19岁的青少年共同制定干预措施，以解决这些规范。研究将在塞内加尔的两个地区进行，一个是达喀尔地区的城市周边地区，另一个是该国西南部Kedougou地区的农村地区。由于城市化和金矿开采，这两个地区的人口都在迅速增长。人口的增加意味着生活在这些地区的青少年人数将增加，而且由于移民和采矿工作的增加，性行为可能会发生变化。因此，生活在这些地区的青少年对性服务和生殖服务的需求很大。这两个区域的保健系统还需要为增加的服务需求做好准备，并改进提供服务的方式，以便更好地为这一人口群体服务。具体而言，该研究项目将首先审查这两个地区青少年可利用的性健康和生殖健康政策和方案。随后将与青少年和向他们提供性健康和生殖健康服务的个人进行访谈和重点小组讨论，以调查阻止青少年使用为其提供的服务的障碍。然后，我们将从每个地区选择一组青少年，对我们确定的障碍进行排名，并选择对他们最重要的三个障碍。研究的最后阶段将是举办一场众包竞赛，要求公众就拟议中的问题提出想法或解决方案。在这项研究中，青少年将被邀请设计一个干预措施，以解决被认为对他们最重要的三个障碍。我们将让青少年参与整个项目，并为他们提供成功开展活动所需的技术支持。

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.