Girls need a safe place to express fears and emotions. Photo: Mara Martinez.

Preparing young girls in Nicaragua for a healthy future

Editor's note: PATH’s Entre Amigas project helped young girls in Nicaragua grow up safely, empowering them to share experiences, overcome obstacles, and take charge of their reproductive health and relationships. Today, PATH continues to respond to the formidable challenges facing girls in low-resource settings worldwide.

When PATH began work in Nicaragua, it was clear that the country's young girls had a lot to contend with. Growing up in one of the poorest countries in Central America, they faced an obstacle course of serious health risks: AIDS, early pregnancy, unsafe abortion, and violence at home and on the streets. To protect themselves, girls needed access to information and strong support from parents, teachers, and—perhaps most importantly—each other.

PATH’s Entre Amigas (“Between Girlfriends”) project smoothed the way for girls to reach their full potential. A soap opera spoke directly to the problems they faced every day. Monthly gatherings in local community centers or churches gave them a safe place for conversation about intensely private issues. Programs brought mothers and teachers together with each other and with girls to share experiences and ideas.

Focusing on girls aged 10 to 14 years old, the project helped overcome the obstacles that stand between adolescents and adulthood. PATH worked with three local groups to coordinate activities.

The right questions, the right solutions

Jonathan Osejo Morraz and his mother, Ana Maria

Through the Entre Amigos Project, which grew from Entre Amigas, Jonathan Osejo Morraz has transformed his vision of the world. Read his story. Photo: Miguel Alvarez.

In 2002 the Entre Amigas team began by exploring how adolescent girls in Ciudad Sandino—a municipality in Managua where overcrowding, poverty, drug use, and violence were the norm—responded to reproductive health issues. Our survey of 590 girls suggested that mother-daughter relationships and friendships between girls were areas of vulnerability, instead of sources of support.

As a result, project activities centered around creating a safe environment in which girls could express their fears and emotions. The project team incorporated the ideas and feedback of community members, including youth, to design and implement activities, which included:

  • Training peer educators in the use of puppet shows and other interactive activities to promote messages about safe sexual practices and the risks of HIV and AIDS, early pregnancy, and violence.
  • Organizing all-girl soccer teams to help foster trust between the girls and to increase their confidence and self-esteem.
  • Choreographing discussions between mothers and teachers to help them brainstorm ways to talk to their daughters and students about reproductive health issues.
  • Collaborating with the Nicaraguan Ministry of Health to arrange for health care providers to visit schools on a regular basis and talk with students about available health resources.
  • Introducing new characters—a 13-year-old girl and her family and friends—into a popular television soap opera. By highlighting her interactions with parents, peers, and teachers, the program brought forward the decisions that confront girls navigating adolescence and provided a focus for conversation among viewers.

The clearest vision

An project evaluation suggested that girls and mothers had increased their knowledge related to reproductive health, and many reported changes in their attitudes and behaviors. A study found that the package of activities was a feasible and affordable approach for promoting the sexual and reproductive health of girls. To encourage others to replicate these activities, the Entre Amigas team produced and distributed a documentary film about the project.

But the young girls who participated provided the clearest vision. They were leaders in the peer education program; contributors to a nationally televised soap opera; and full participants in the project’s design, implementation, and assessment. Empowering these young women to take charge of their own development was Entre Amigas’ greatest achievement.