In September 2016, the Minister of Health of the Dominican Republic (DR) presented the Protocolo de Atención para Manejo de Consejería y Asesoría en Anticoncepción para Adolescentes (Contraceptive Counseling Care Protocol for Youth) to the National Health Service, the media, and civil society. The protocol will ensure health care providers in all public and private health facilities in the country deliver quality and confidential sexual and reproductive health care for young people. It will also ensure that there is an adequate budget for training of staff in the new protocol, and will measure the quality of services provided. The implementation of the protocol will likely begin in early 2017; currently, the protocol is awaiting official signoff from the Minister.
Ampliando el Acceso partner PROFAMILIA-DR and other civil society organizations collaborated with the Ministry of Health since February to create the protocol.
The Dominican Republic has one of the highest rates of teenage pregnancy in Latin American and the Caribbean. To ensure that youth have the skills and services they need to make informed decisions about pregnancy and contraception, PROFAMILIA-DR developed a youth-led social monitoring mechanism that trains youth volunteers to measure how accessible public healthcare services are to young people. The monitoring is done through interviews with staff and clients, and the youth deliver recommendations to the government based on the observations gathered in the audit. The protocol will incorporate the use of this youth-led social monitoring mechanism.
Through this social accountability mechanism, PROFAMILIA-DR identified barriers many youths face when trying to access contraceptives. Barriers include a lack of trained personal on youth services and supplies and stigma from providers who believe parents should be involved when requesting contraceptives.
Through Ampliando el Acceso, or "Expanding Access," a joint project between Advance Family Planning (AFP) and the International Planned Parenthood Federation/Western Hemisphere Region, local partner PROFAMILIA-DR shared with the Ministry their methods and experience in working with young people to implement youth- friendly protocols in clinics.
Once signed the protocol will cover, among other topics, non-judgmental and confidential counseling on:
- Sexual and reproductive rights
- Myths, prejudices, and stereotypes related to sexuality
- Gender roles and sexuality
- Creating safe, consensual sexual relationships
- Proper and consistent use of contraception and comprehensive information about all family planning methods
- HIV/STI prevention
PROFAMILIA-DR will continue providing technical assistance to the government through a working group. Once the protocol is in place, the organization will ensure that there is an adequate budget for training of staff and service delivery, and it will measure quality of services for youth. PROFAMILIA-DR will also conduct follow-up social audits to ensure that the protocol is being fully implemented.