“Before, we heard that they treated young people poorly. But now the nurses have all been nice to us. They even go visit the teen club members who have just had their babies.”

In El Salvador the vulnerability of adolescents’ sexual health is illuminated by two statistics. For women aged 15 to 19 the birth rate is 116 per 1,000 women. And adolescent mothers account for a third of all maternal deaths.

Low contraceptive use and lack of prenatal care contribute to these outcomes, yet many young women hesitate to seek family planning services and reproductive health care because they hear reports that adolescents are mistreated in health care facilities.

As part of an effort to develop an adolescent-friendly approach to reproductive health care, the PRIME II Project has helped maternity hospitals in three rural districts of El Salvador to form young mothers’ clubs in which pregnant adolescents learn how to knit. Enabling young women to make clothes for their babies, the clubs also provide a forum where nurses and doctors can discuss reproductive health issues with the adolescents and answer their questions. The goals of the clubs—in addition to healthy deliveries and well-swaddled infants—include the prevention of future unplanned pregnancies and sexually transmitted infections and the promotion of birth spacing. For the majority of participants, the clubs provide the first education in reproductive health they have ever received.

The young mothers’ clubs are just one component of an innovative strategy to improve adolescent reproductive health being implemented by El Salvador’s Ministry of Health through the Healthy Salvadorans Project (SALSA) sponsored by USAID with technical assistance from PRIME II. Motivating providers to be more responsive to adolescent issues and concerns is a primary aim of the project.

Focus group discussions like the one quoted above reveal that the young mothers’ clubs are popular with adolescents and hospital staff alike. As the project expands to other regions of El Salvador, the strengthened relationships between young women and the health care system that serves them will help ensure a healthier future for Salvadoran adolescents.

PRIME Voices #3, El Salvador: Young Mothers’ Clubs Promote Reproductive Health, 7/16/01.