Action learning has shown promise in understanding young people's SRHR challenges and in developing strategies to advance gender-transformative youth-friendly SRHR services in Nigeria.
Key Findings
Results
Provider-related personal values and beliefs were identified as a key challenge for healthcare workers delivering SRHR services to young people.
Healthcare workers reported personal values and beliefs as barriers specifically regarding providing contraceptives to young unmarried people.
This was categorized as a provider-related issue distinct from community or systemic barriers.
The challenge was identified through three structured action learning sessions conducted in Ebonyi State, Nigeria.
Six action learning groups were formed, each representing one of the six selected local government areas.
Results
Lack of male, parental/guardian, and community support was identified as a major community/client-related barrier to youth-friendly SRHR service delivery.
Community and client-related issues were categorized separately from provider-related and perception-related challenges.
Absent male partner support was specifically highlighted as a dimension of this barrier.
Data were synthesized through consultations with stakeholders using the modified Delphi technique.
Participants included healthcare workers, community members, and researchers.
Results
Negative perceptions regarding health-seeking for SRHR services constituted a third major category of challenges identified.
Negative perceptions were identified as a distinct challenge category alongside provider-related and community/client-related issues.
These perceptions affected young people's willingness to seek SRHR services at primary healthcare settings.
The finding emerged from structured action learning sessions implemented in Ebonyi State, Nigeria.
The modified Delphi technique was used to reach consensus on prioritized challenges.
Results
Reaching young men and boys with SRHR services outside Primary Health Care settings was proposed as a key strategy to address identified barriers.
This strategy was specifically designed to address low male engagement with SRHR services.
It was one of three main proposed strategies developed through the action learning process.
The strategy was developed collaboratively by healthcare workers, community members, and researchers.
The approach acknowledges that primary healthcare facility settings may be barriers to male engagement.
Results
Facilitating dialogue to support female partners and promoting community advocacy were proposed as additional strategies for gender-transformative SRHR service delivery.
Facilitating dialogue to support female partners was identified as a strategy to address lack of male and community support.
Community advocacy was proposed to shift negative community perceptions around youth SRHR service-seeking.
These strategies were developed through the action learning process involving stakeholders across six local government areas.
Strategies were synthesized using the modified Delphi technique to ensure feasibility and consensus.
Results
The action learning approach, implemented through three structured sessions with multiple stakeholder groups, demonstrated feasibility for identifying SRHR challenges and co-developing solutions in a Nigerian context.
The study included three action learning structured sessions with healthcare workers, community members, and researchers.
Participants formed six groups, each representing one of six selected local government areas in Ebonyi State, Nigeria.
The modified Delphi technique was used to synthesize data on challenges and strategies.
The authors concluded that 'AL has shown promise in understanding young people's SRHR challenges and in developing strategies to advance gender-transformative youth-friendly SRHR services in Nigeria.'
What This Means
This research suggests that healthcare workers in Ebonyi State, Nigeria face multiple overlapping barriers when trying to provide sexual and reproductive health services to young people in ways that are inclusive and gender-equitable. These barriers fall into three main categories: healthcare providers' own personal beliefs (such as reluctance to provide contraceptives to unmarried youth), lack of support from male partners, parents, and the broader community, and negative attitudes in the community toward young people seeking these services. The study used a method called 'action learning,' in which healthcare workers, community members, and researchers worked together in structured group sessions to identify these problems and develop practical solutions.
This research suggests that practical strategies to address these barriers include offering sexual and reproductive health services to young men and boys in settings outside of traditional health clinics, creating structured dialogue opportunities to build male partner support for female partners seeking services, and conducting community advocacy to change negative perceptions. These strategies were developed collaboratively using a consensus-building method (the modified Delphi technique) to ensure they were considered feasible by the people who would implement them.
The broader implication of this research is that the action learning approach—bringing together diverse stakeholders to collectively identify problems and co-design solutions—may be a useful tool for improving youth-friendly sexual and reproductive health services in Nigeria and similar settings. Rather than imposing top-down solutions, this method builds local ownership and may make resulting strategies more likely to be adopted in practice.
Agu I, Agu C, Mbachu C, Ekwueme C, Nwankpa O, Ezumah N, et al.. (2025). Applying community-based action learning in the provision of gender transformative sexual and reproductive health services in Ebonyi State, Nigeria.. African journal of reproductive health. https://doi.org/10.29063/ajrh2025/v29i6s.7