Participation Resident Advisor at the Center for Development and Population Activities, La Paz, Bolivia

Sandra Aliaga is a social communicator with 25 years of experience in reproductive health and HIV/AIDS policy analysis, advocacy, formulation, implementation, and evaluation throughout Latin America. She is a gender expert who has researched, taught, and published extensively on mainstreaming gender into HIV/AIDS and reproductive health advocacy strategies and polices. She has more than 20 years of experience working as a reproductive health and gender trainer and women’s rights advocate. She has extensive experience in HIV/AIDS, reproductive health, and gender policy analysis and advocacy. She has worked in Bolivia and throughout the LAC region on strengthening advocacy networks and the political participation of civil society groups. She is a working journalist with experience in all mass media and in governmental communications. She has taught university courses on communication; reproductive health information, education, and communication; and gender mainstreaming.

Youth Policy Toolkit: What interested you in youth RH? Could you please highlight some of the YRH-related projects that you have worked on? What particularly interested you about this/these project(s)?

Ms. Aliaga: The possibility of working with youth is very, very big. They [youth] seem to be more willing to assume changes. And working on health issues with youth gives you the possibility of thinking that you are working with people who are not totally consumed with their prejudices or with an old way of thinking about life.  And for the Bolivian context, I prefer to talk about sexual and reproductive health (SRH) because I think that adding sexual health to our work is absolutely meaningful because we assume that SRH refers to the question of having or not having kids, [rather] it should be a question of having or not having a good life, and the possibility of exercising your rights—to be happy, to have pleasure, to develop as a human being. When you work in the field of SRH, you work with issues such as gender, human relations, and human development. So, youth are at a beautiful age, where they can build on other values that do not come from a patriarchal society.   

As the co-founder of the Center of Investigation, Education, and Services in Sexual and Reproductive Health (CIES), which is a nongovernmental organization (NGO), one of the YSRH projects we developed was the “Youth Corner Program,” which is an  SRH educational program geared toward adolescents that enabled youth to participate, explore, and discuss information related to adolescent sexual and reproductive health (ASRH) at clinic sites. At the sites, the youth could engage in reading educational materials, discussions, informative games, and other activities. Other components of the program involve ARSH personnel providing information and education to youth, teachers, and student teachers using the Para vivir nuestra sexualidad or the “To Live Our Sexuality” module. Volunteer youth replicated the educational activities with peers in and outside of school, while teachers did the same with their students. The teachers also held meetings with parents to sensitize them to the ASRH issues through face-to-face discussions. The project also implemented the module along with sensitization sessions with government institutes such as the Ministry of Health and the Ministry of Education and health workers. The results of the “Youth Corner Program” along with other activities conducted by CIES showed that youth require special attention when it comes to sexual and reproductive health services—and thereby influenced the Ministry of Health to develop the National SRH Plan with a special component for youth.

Youth Policy Toolkit: Next, I wanted to ask you about your work on the USAID?Health Policy Initiative’s Avances de Pazmodel. That was used in a gender-based violence (GBV) project, correct?

Ms Aliaga: Yes, that is correct. The Avances de Paz or the “Advances in Peace” project was conducted from June 2006 to 2008. The project worked in four municipality communities (Quillacas, Machareti, Oruro, and El Alto) to integrate family planning and reproductive health policy with efforts to prevent and reduce incidences of gender-based violence. There were essentially four phases to this project:

(1) Training local people who were considered to be leaders within the four municipalities. We trained the participants continuously for one year on topics such as what is GBV, gender role dynamics, how to participate in the community response to GBV, and how to raise awareness and create a dialogue about GBV with community members. The participants committed to attending 30 or more training sessions in that year.

(2) Community processes analysis and planning, defining the root causes of GBV and opportunities for change, and developing and advocating for GBV action plans at the municipal level. In the community process, the leaders went through auto-diagnostic exercises with community members in order to facilitate a process by which the community members would (a) identify that GBV exists in their communities and (b) identify the root causes related to GBV in their own family and community structures. Along with the community process, we implemented a parallel process, which was going and visiting leaders from the different sectors (education, justice, police, local powers, health sector, youth organizations) that had the power to intervene in any kind of gender-based violence policy. During these visits, the communities were able to advocate for the implementation of their action plans with the authorities. They said that they “empowered themselves” and feel that they “are able to provide their own solutions to their own problems from their own perspective.”

(3) Obtaining political and funding support in order to implement the activities they proposed. All four action plans were funded either by municipal governments or other sources. For example in Machareti, the municipality created a two-year plan for a local network against violence that included the different sectors. In El Altiplano, which is a Quechua and Ayamara indigenous zone, they saw a need for hiring a lawyer to develop a plan to eliminate violence. The lawyer gave continuity to the plan that the community proposed, which was to follow-up on GBV cases that were presented at the health center. They also implemented awareness-raising programs and workshops and created a committee with indigenous authorities from different sectors. In Oruro, they were able to work with a pre-existing network to conduct education and prevention activities with the prefecture, the local government, and thedepartmento, the state government. In El Alto, They advocated for a five-year plan called “Violence and Art,” where they had a GBV-themed theater contest.  Sixteen theater groups participated from El Alto. The entire community of El Alto participated, and there are over a million inhabitants of El Alto, where parents, teachers, and adolescents participated in these plays. The project provided them technical assistance on how to convey theses issues through stories and acting. The play that won the contest was hired around five or six times in other places.

(4) Monitoring and evaluation; and you just heard the results from our discussion. Another result that municipality members continuously reported was that the amount of people that attended sexual and reproductive healthcare centers increased. The project had over 1,000 participants across all four municipalities—of which 40 percent were youth. 

This project was a success because “we really stressed the fact that it had to start from the facilitators and end in the community. It had to be something that you learned with your stomach and your heart and not with your brain.” 

Youth Policy Toolkit: What are the greatest gaps or challenges in youth SRH programming and policy implementation? 

Ms. Aliaga: The challenge is always that you get these beautiful policies sometimes, and do they get implemented? Not always. For example, when we are talking about YSRH policy, you need an office or an institution to articulate with the other national offices, sectors, and stakeholders to guarantee implementation. You need money.  You need commitment. You need trained people. You need possibilities of hiring and paying well. Many times, the NGOs [nongovernmental organizations] have more possibilities of implementing policies than the state. For example, CIES, Save the Children, and PCI [Project Concern International] in Bolivia have a lot of success stories in implementing policies. They have advocated for the implementation of particular policies. From our very small perspective as institutions or NGOs that work in this field, we do implement the policy because we have the money, the commitment, the trained people, possibly the hiring and paying well, and the infrastructure.

Lastly, YSRH planning and policy issues should integrate into the area where youth tend to have issues: work issues, labor issues, educational issues, etc. Health is not an isolated issue, especially when we’re talking about SRH. The main goal is that youth should be able to live better, have better human relationships, and contribute in a better way to their own local development.