The Reach and Impact of the PSI Butare Adolescent Reproductive Health Program in Butare Province, Rwanda

Andrea Plautz, Population Services International (PSI)
Dominique Meekers, Tulane University

This paper assesses the reach and impact of an adolescent reproductive health program in Butare, Rwanda, using data from 2000 and 2002 surveys of youth aged 15-24 (n= 2,853 and 2,955). Using logistic regression analyses we assess trends in reproductive health behavior and predictors, and estimate the effect of level of program exposure on these indicators. Program reach was fairly low. Nevertheless, social barriers to buying, negotiating and using condoms reduced significantly, while knowledge and use of VCT increased. Findings suggest that program exposure contributed to some, but not all changes. This paper highlights the difficulties implementing health programs in countries recovering from complex emergencies. To enhance their overall impact future such programs need to improve their reach. This can be accomplished by scaling up peer education and other community outreach communication activities. However, we must have realistic expectations and recognize that programs in disaster areas may be more expensive.