(January 2002) They have grown up poor, surrounded by violence, disease, and stifling social customs. They have never gone to school, or have dropped out, or have finished without learning much of practical use. They are members of the largest-ever generation of youth — 1 billion plus — living mainly in less developed countries. And too many of them lack the education, skills, and opportunities necessary to become economically productive and to avoid unwanted child- bearing that will restart a cycle of deprivation.

To help them make their way, community leaders around the world have established “linked” programs that impart reproductive health information and services along with job skills and training. Because of the reproductive health focus and because girls tend to have less school-based education and training than boys, most of these programs target young women. Thousands of youth now have schooling, job training, and control over their reproductive health thanks to these programs.

Good intentions and common sense guide these grassroots initiatives, but that goes only so far. Recent research by the International Center for Research on Women (ICRW), complete with case studies and data from three countries, shows that many such programs need better strategies, better management, and more resources to continue and especially to meet rising demand.


In the department (state) of Antioquia in Colombia (home to Medellin), violence has disrupted agriculture, discouraged outside investment, and accelerated migration toward urban areas with no surplus of jobs. Squeezed financially, the government in 1993 slashed funding for social programs, including health. In response, a group of nurses founded Empresa Cooperativa de Servicios en Salud y Educación (ECOSESA), which offers job training in health care to some 400 young people (16 to 25 years old) each year. Ninety-five percent of trainees are women, mostly poor. Graduates of the training, which is funded through user fees, complete unpaid internships in local hospitals, after which 50 percent are hired permanently. The training covers the study of reproductive health topics, which in addition to preparing the trainees to render services to others, advances the young people’s own understanding and influences their sexual behavior.


In Kenya, economic contraction and AIDS have flooded the labor market with laid-off civil servants and with teenagers serving as heads of household due to the absence or illness of parents. West of Nairobi, a community-based group, the Teenage Mothers and Girls Association of Kenya (TEMAK), assists unwed mothers and female dropouts — many of whom have HIV. Forty trainees at a time learn tailoring, hairdressing, typing, or computer literacy. At the same time, they receive reproductive health information and education, counseling, testing for HIV, treatment for skin infections, free condoms, and access to clinical services through referrals. TEMAK provides on-site day care and early education for trainees’ children. Volunteers from domestic and international organizations help TEMAK run activities, and funds from international donors supplement the income TEMAK makes from the sales of participants’ crafts and from course fees.


In many parts of India, girls are thought of as belonging to another family because they marry — usually very early — and go to live with their husbands’ families. Because of this pattern, families tend not to invest much in girls and often send them to work full time after primary school. (Other factors enter in, too: Schools are often far from home and of poor quality, and parents are reluctant to send their daughters to school once they start menstruating and are at risk for getting pregnant.)

Bhartiya Grameen Mahila Sangh (BGMS), a nongovernmental organization in the north- central Indian state of Madhya Pradesh, runs programs related to literacy, health, entrepreneurship, and community development. The organization’s original goal — to raise awareness and build leadership among poor rural women-has broadened to include adolescents. Key features of programming include girls’ forums (discussion groups), peer educators, vocational and residential training, and the training of other nongovernmental organizations. Some 5,000 youth ages 12 to 25 have benefited from the training over the last nine years (see “Success Story”). BGMS receives funding from several international and national organizations, and through public contributions.

Program Objectives

ICRW’s research, which provides insights into model characteristics and recommendations for channeling internal and donor resources, stresses the need for programs to:

  • Tailor programming to local conditions (cuts in social spending and violence), needs (high prevalence of AIDS), and customs (early marriage and low status of women).
  • Deliver both livelihood and health services well. The hook or promise of acquiring marketable skills should not be used only as a means to reproductive health education; both aspects need to be done right and done well to ensure program sustainability and good relations with the community.
  • Go beyond just providing skills and instruction by helping trainees apply their newfound knowledge. Do market research to ensure that there is adequate demand for the skills taught (markets for hairdressers, for instance, may quickly become saturated); help with job searching and job placement; and provide access to reproductive health supplies and services.
  • Allow participants to earn income during training, and — if trainees are parents — provide child care.
  • Monitor and assess achievements and progress.

Communities understand the importance of young people having the means to make a living. Indeed, this is the preoccupying concern for most. But as promising as community programs are, they cannot stay in business or reach enough youth without growing and acquiring more resources. Operating on a greater scale with government and donor support, these demand-driven programs could, experts believe, be extraordinarily successful.

For More Information:

The recently published ICRW report, Making It Work: Linking Youth Reproductive Health and Livelihoods, by Simel Esim, Anju Malhotra, Sanyukta Mathur, Guadalupe Duron, and Charlotte Johnson-Welch, will soon be available on the ICRW website: www.icrw.org.

Success Story

Nineteen-year-old Sapna dreamed of becoming a teacher but was forced to drop out of school after eighth class (age 14) to work in the fields and to care for her younger siblings.

Then in 1996 a village center for girls sponsored by the nongovernmental organization BGMS opened in her village. With support from center staff, she persuaded her reluctant parents to let her enroll. She learned basic vocational skills, and she attended family life education classes. Her confidence grew, and after passing board examinations, she was able to resume her education and complete 12th class (high school).

She took advanced training at the BGMS campus and then opened a center of her own in a village near her home. Now Sapna also teaches at the school in her village. She has become a teacher and a community worker and is a role model for young women.