Applying community-based action learning in the provision of gender-transformative sexual and reproductive health services in Ebonyi State, Nigeria

This study describes the adoption of an action learning (AL) approach to (i) identify challenges that primary healthcare workers face in delivering gender-transformative sexual and reproductive health and rights (SRHR) services to young people, and (ii) recommend feasible solutions to resolve these challenges. This study implemented in Ebonyi State, Nigeria, included three AL structured sessions with healthcare workers, community members, and researchers. AL participants formed six groups, each representing one of the six selected local government areas. Data on potential challenges in providing youth-friendly gender-equitable and inclusive SRHR services and strategies for addressing them were synthesized through consultations with the stakeholders using the modified Delphi technique. The key challenges that health workers faced were: (i) provider-related issues such as personal values and beliefs regarding providing contraceptives to young unmarried people; (ii) community/client-related issues such as lack of male, parents/guardians, and community support; and (iii) negative perceptions regarding health seeking for SRHR services. Proposed strategies include reaching young men and boys with SRHR services outside Primary Health Care settings; facilitating dialogue to support female partners; and promoting community advocacy. 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.