Outcomes In Reproductive Health

The effectiveness of reproductive health education at the community level depends on how well integrated programs are. Integration is a proactive way of providing various types of information and services to the community at once. It increases the benefits that an individual or the community at large, gains from a single interaction with a community educator. This is achieved by training professionals and volunteers at community based organizations (CBOs) in the appropriate integration of reproductive health information into their on-going programs.

An on-the-ground collaborative project with three CBOs in Los Angeles illustrates the benefits of integrating reproductive health into programs serving Latina women. We have rooted an understanding about reproductive health and rights in the institutional capacity of partner CBOs, and established a training system that will allow for future staff development, continuing community education, and improvement in women's health.

Between July 2004 and August 2006, the Pacific Institute for Women's Health worked with the East Los Angeles Women's Center, the Los Angeles Indigenous People's Alliance, and the Organization of Lideres Campesinas.

The outcomes of this project include:

• A Guide to Sexual and Reproductive Health that contains accurate, scientific information on sexuality and reproduction, as well as an overview of sexual and reproductive rights, social justice and a focus on gender power dynamics.
• Training Exercises for use in group sessions, including a discussion plan, group dynamic, and suggestions for evaluation.
• A Concise Visual Aid in the form of an easy to carry "flip chart" (or "rotafolio") for group presentations on the main sexuality and reproductive health issues addressed in the comprehensive Guide.

The goal of this project was to strengthen Latino community organizations to become effective providers of information on reproductive health. The capacity building work used a collective, participatory methodology. Our assumption was that CBOs are well positioned, and better equipped than any other social service organization, to bring about social change, to deliver information, and to empower the community to protect their reproductive rights. The project emerged from a careful analysis of results from a study published in the Latino Issues Forum in 2003, and research done by the Los Angeles Reproductive Rights Coalition, which emphasized the role of community leaders in improving the community's health regardless of their primary mission. The project worked from the premise that a reproductive health organization such as the Pacific Institute could work with community partners to build their capacity to integrate sexual and reproductive health and rights into their services and to strengthen their ability to respond to community needs in these areas.

The project employed the following strategies:

• Enabling partners to offer reproductive health education to their community;
• Developing innovative materials for staff and community use;
• Linking reproductive health to other social justice issues;
• Building local leadership in reproductive health and rights;
• Documenting and sharing the lessons learned with other communities.

Prior to launching these strategies, we conducted an in-depth intake assessment of each partner's strengthens and challenges.

The organizational assessment provided a broad understanding about each partner organization's management and program structure, but that information alone would only allow for a one-way contribution to the curriculum development.

This project used a participatory methodology throughout its implementation. To ensure that all involved were equally able to contribute and make decision about the project, we adjusted the project's work plan as we went along, and checked out assumptions at each stage.

Creating a Common Denominator

For example, to improve the ability of our partners to effectively participate in the curriculum development, we offered training in sexuality, gender power dynamics and reproductive health to key staff of each organization.

The training was crucial in raising our partners' understanding of reproductive rights in general, and of sexuality, gender and power dynamics, in particular. It also helped participants gain a new understanding of how complex and interconnected those issues are with other social justice matters of their interest, such as gender-based violence, racism, and poverty.

Checking our Assumptions

As we implemented the three phases of the project, however, other assumptions we had built our work on proved to be wrong. The first assumption referred to the needs of each organization. While we knew that these were very different organizations, we assumed that their needs in reproductive health and rights would be similar. Considering that no one partner had reproductive health as their primary mission, and that their staff did not have specific skills in that area, we anticipated a general lack of knowledge and ability to communicate reproductive health information with their clients. As we mapped the three CBOs, however, we gained a much deeper understanding of the differences and similarities among them.

We came to understand that the nature of each organization, the different types of services they offer, and the differences in the primary community they serve required fairly different approaches to information giving.

We adjusted our schedule to the findings of the project, and worked collaboratively to develop materials that are relevant to their work and needs, as well as those of their communities.

Capacity Building in Reproductive Rights

The strategies and methodology used in this project are in line with the values of the Pacific Institute for Women's Health, and those of our partners.

Capacity building in reproductive health requires close collaboration and the building of trust among partners. To maximize the learning process, we connect reproductive health matters with other issues affecting the community, and establish links with the on-going work of the CBOs.

Work over time is more productive and effective than an isolated intervention. Equally important is to coordinate efforts in collaboration with those directly involved in the community in different capacities.

Making a Difference

We have strengthened three CBOs that were unfamiliar with reproductive health and rights issues prior to this project. The CBOs involved in this project work to prevent violence against women among Latinas, to protect the values and traditions of indigenous peoples, and to support and protect the rights of farm workers. They know first hand that reproductive health is part of people's lives. As we confirmed with this intervention, concerns about sexually transmitted infections, contraception, abortion, and gender-based violence often come up in community discussions and outreach activities that CBOs conduct. CBOs know that reproductive health is an area of interest to women of all ages. Unfortunately, most community outreach workers and educators find themselves with similar doubts and questions as the community they serve.

The strategic intervention s used in this project produced the following results:

They are able to learn the information, and link it to the work they do if the training and materials offered are appropriate; and Reproductive health belongs on the agenda of all community work.

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National Media Campaign: Emergency Contraception. Because $#*! Happens.

Through an innovative media campaign entitled "Emergency Contraception: Because $#*! Happens," the Pacific Institute for Women's Health is helping to transform emergency contraception (EC) from "America's best kept secret" to the widely used contraceptive method it deserves to be.

Widespread use of EC, also known as the morningafter-pill, could prevent 1.7 million unwanted pregnancies a year in the United States, thus greatly reducing the need for abortion. Among teenagers in the U.S., 80% of all pregnancies are unintended, making it especially important to reach young women with information about this option. However, most American women remain unaware of EC.

"It doesn't matter how terrific a contraceptive option EC is, and how many pregnancies it could prevent, if women don't know it's available," says Magaly Marques, Executive Director at the Pacific Institute. "We hope that a combination of bold messages and the use of mainstream media will make women, especially young women, remember that there is something called EC out there next time they need it."

The media campaign promotes EC as a responsible contraceptive back-up plan, to be used in cases of contraceptive failure, sexual assault or unprotected sex. At all stages, the campaign emphasizes that EC does not provide protection against sexually transmitted infections (STIs). All campaign materials refer women to the 888-NOT-2-LATE hotline, through which they can get the address of the nearest EC provider.

The backbone of "Emergency Contraception: Because $#*! Happens" is a series of public service announcements (PSAs), developed by advertising agencies McCann-Erickson and cruz/kravetz: IDEAS, for publications and radio stations. Both agencies have done all their work pro bono. All participating media outlets have been equally generous, printing and broadcasting the PSAs at no charge.

So far, "Emergency Contraception: Because $#*! Happens" PSAs have been posted as bus shelter ads throughout Los Angeles, San Francisco and New York. Tens of thousands of so-called GoCards have been placed in restaurants and gyms, on college campuses and elsewhere. Several magazines have published the PSAs as full-page ads, including Latina and Latin Style, while a number of commercial radio stations continue to play the radio spots frequently.

While public service announcements are the foundation of "Emergency Contraception: Because $#*! Happens," generating editorial and news coverage of EC are additional campaign goals. The Pacific Institute is producing op-eds and pitching news and feature stories about EC to journalists and editors. By training a cadre of EC spokespersons from other non-profit organizations, the Pacific Institute will ensure that the media campaign is further strengthened in the year to come. In addition to colleagues in the non-profit sector, several youth celebrities, including Anel Lopez and Christopher Gorham, are also working actively to raise awareness of EC through the media campaign.