| Issue/Objective |
Adolescent pregnancy is a major public health issue in Mozambique, fueled by limited contraception access, gender inequality, and socio-cultural barriers. The IMPACTO Project (2018-2024), funded by Global Affairs Canada and implemented by Pathfinder International, aimed to improve gender equity and empower adolescent girls and young women (AGYW) aged 15-24 in Manica and Tete provinces. It addressed challenges like low contraceptive use, gender-based violence (GBV), and patriarchal norms. The project used education, advocacy, gender-transformative communication, and community mobilization, aligning with national health policies to support SRH rights. This study assessed knowledge, attitudes, and practices regarding gender, family planning, GBV, and abortion services. |
| Methodology/Approach |
A non-experimental quantitative evaluation used household surveys at baseline (2019) and endline (2023). Samples included 4,861 participants at baseline and 5,028 at endline across nine districts in Tete and Manica. The survey assessed gender and contraception indicators (95% confidence interval, p=0.05). Sixty-eight trained surveyors used tablets with the adjusted GEM Scale questionnaire via CommCare. Analyses were done in SPSS and Excel. This assessed changes in family planning knowledge, gender norms, decision-making, and awareness of GBV and abortion laws. |
| Results |
Modern contraceptive use among AGYW increased from 40% to 56%, with implant use rising from 3% to 15.4%. Agreement on contraception use among those with no sexual experience rose from 54.1% to 63.4%. GEM Scale scores improved significantly among AGYW (13.4% to 41.8%) and adolescent boys and young men (ABYM) (33.1% to 49.3%). Community leaders with low/medium equity reduced from 32% to 8%. Fewer ABYM (38.8% to 17%) and leaders (44% to 1%) believed women should endure violence. Joint household expense decisions increased from 16% to 65%. Male-dominated norms diminished, and AGYW gained autonomy. Awareness of GBV laws improved (43% to 73%), and knowledge of abortion decriminalization rose (11% to 41%). |
| Discussion/Conclusion |
IMPACTO demonstrated that integrated, community-centered approaches can change attitudes/behaviors on contraception and gender equity, even in rural areas. Local collaboration was crucial. Success validates the GEM Scale and behavior change strategies. Engaging ABYM and AGYW promoted joint decision-making and legal awareness. Adaptable strategies are needed to address persistent myths and disparities. |
| Presenters and affiliations |
Baltazar Chilundo |
