In most of the countries where PRIME II worked, the need for improved adolescent reproductive health care is acute. In the developing world, complications of pregnancy, childbirth and unsafe abortion are major causes of death for women aged 15 to 19. Contraceptive use remains low for single, sexually active teenagers. And adolescents aged 15 to 24 have the highest rates of infection for HIV and other sexually transmitted infections. Consequently, PRIME incorporated adolescent reproductive health initiatives into its programs whenever appropriate.
Creating adolescent-friendly services within reproductive health clinical
settings was a strength of PRIME II. A pilot program in
Jinja district, Uganda succeeded in changing provider attitudes about
adolescents, attracting youth to primary-level health care facilities
through structured activities, and improving the reproductive health knowledge
and care-seeking behavior of adolescent clients. In El
Salvador, as a component of the PRIME-assisted SALSA project,
“young mothers' clubs” were established in maternity hospitals to serve as a forum for educating pregnant adolescents about reproductive health. The clubs, which feature discussions on such topics as birth spacing and prevention of unwanted pregnancies, proved popular with providers and young mothers alike. PRIME also worked to expand access to family planning and reproductive health services for young females at high risk as part of the AIDS Surveillance and Education Program in the Philippines.