Empowerment and independence: In pursuit of adolescent-friendly mental health
A wide-reaching programme in Bangladesh tackles mental health and social taboos around adolescent development.
By age 17, Alia* had already experienced significant loss and instability in her life.
When she was 9, her mother died, and her father remarried. When she was 16, her father died, leaving Alia to care for her younger sister.
Determined to continue her studies, Alia worked as a household helper. And she found guidance and information at a local Adolescent Friendly Health Services (AFHS) centre in the Mirpur neighbourhood of Dhaka.
Her dream – and the dream of her dying mother – was that she would be able to live an independent life.
“The AFHS programme taught me how to speak, to address my struggles, reach out,” Alia said. “No matter how grave the crisis seems, by sharing, anything can be resolved given the proper attention.’’
The AFHS programme was founded by the Directorate General of Family Planning and UNICEF with the support of Bangladesh Association for Prevention of Septic Abortion (BAPSA). Throughout Bangladesh, AFHS functions at scale with support from the country’s Ministry of Health & Family Welfare, with about 1,240 programmes run through health facilities. In Dhaka, UNICEF and BAPSA provide support for six AFHS programmes, though others are supported by non-governmental organizations in Dhaka and throughout Bangladesh.
AFHS is a wide-reaching programme with multiple focuses. For adolescents aged 10 –19, the programme provides information on menstrual and reproductive health and puberty. In addition, it offers psychosocial support and individual and group counselling. The programme also includes recreational and cultural activities and vocational training in fields such as computers and photography.
In districts throughout Bangladesh, the AFHS programmes usually reach between 2,000 and 3,000 adolescents a month.
“We assure adolescents, this is a safe space to speak easy,” said Mahamudul Hassan, a counsellor at an AFHS centre in Dhaka. “All your queries will be resolved, maintaining utmost confidentiality.”
During the COVID-19 pandemic, the AFHS programme was able to adapt to social distancing guidelines by offering sessions on rooftops, in fields, in outdoor courtyards and over phone and video.
“From prolonged isolation, disruption of social practices with friends and community, adolescents suffered from depression and fatigue,” said Mou Juliet, an AFHS counsellor. “Providing counselling helped them to cope, interact better with their families and motivate them through such grave times.”
AFHS also reaches out to parents and communities to raise awareness about adolescent sexual and reproductive health and mental health – breaking down silence and misinformation.
“Receiving counselling from the programme, my daughter achieved skills needed to tackle issues which hinder her psychological well-being,” said Minu Alam, whose daughter, Sharmin Akhter Eti, 19, is a peer educator at the AFHS centre in the Azimpur part of Dhaka.
“She even can consult and clear up many confusions and misinformation of mine or many others like me.”
Indeed, peer educators – male and female – play a vital role in the AFHS programmes as they reach out to other adolescents at the centres and interact with members of their families and communities. For 18-year-old Mohammad Shohan, becoming a peer educator has helped him gain the trust of his family members, whom he can help with information, guidance and support.
“The AFHS programme has helped to break through the social taboos that … we carry around about adolescent development,” Mohammad said. “This generated confidence within me …, made me confident to talk about these issues.”
Now that Alia has completed her Secondary School Certificate examination, she is also volunteering as a peer educator.
And she has already accomplished a significant goal: She and her 15-year-old sister, Shima, live independently – on their own, together.
* Alia’s family name is being withheld to protect her identity. She was interviewed in Dhaka in April, 2021. This and other stories like hers feature in the State of the World’s Children report 2021 - On My Mind: Promoting, protecting and caring for children’s mental health.