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Table 2 Intervention and monitoring framework on the prevention of early and unintended pregnancy and sexually transmitted infections including HIV in Liberia

From: A never-before opportunity to strengthen investment and action on adolescent contraception, and what we must do to make full use of it

Interventions to address the determinants Factors that contribute to the adolescent behaviours Adolescent behaviours most directly related to these health outcomes Health outcomes
Population-wide actions: Individual Unprotected sexual activity
Early initiation of sexual activity
Early marriage
Early pregnancy
Sexually transmitted infections, including HIV
 1. Improve community awareness about adolescent sexuality andsupport for protecting adolescents with sexuality education and sexual and reproductive health services, notably contraception and HIV testing and counselling.
 2. Improve access the contraceptive information and services and HIV testing and counselling services to all segments of the population.
 Adolescents have many knowledge gaps about sexuality and reproduction and how to avoid problems. They have many misconceptions about contraceptives.
Immediate environment
 Adolescents are not able to get sexuality education at home, school or elsewhere in the community. Adolescents are not able to obtain contraceptives from government facilities and cannot afford them from private providers. They are under pressure to have sex early from peers and from adults
Adolescent-specific actions:
 1.Educate boys and girls about sexuality and reproduction.
 2.Build individual and social assets of adolescent girls to avoid from choosing child marriage/to being forced into child marriage.
 3.Improve access and uptake of contraception through government clinics and through complementary approaches community outreach, social marketing and commercialsales.
 4.Improve access to HIV testing and counselling and links to HIV-related care.
Wider environment
 Social norms do not acknowledge adolescent sexuality and are not supportive of providing adolescents with sexuality education and contraception. There are few educational and employment opportunities especially for girls. Traditions and economic constraints pressure families to have their daughters married early.
Indicators and means of verification
Quality and coverage of school and community based education and health service provision (Source: Implementation reports and assessments) Proportion of adolescent boys and girls who are knowledgeable about contraception and know where they can get them (Source: Surveys) Proportions of adolescent girls who report using modern contraception and boys who report using condoms (Source: Surveys) Data on adolescent fertility, and prevalence of STI/HIV disaggregated by age and sex (Source: Surveys)
  1. Source: Liberia 2016–2020 Investment Case for Reproductive, Maternal, Newborn, Child, and Adolescent Health (RMNCAH) [68]