Parallel 1 - Abstract presentations (Oral-007 - Oral-009)

Background
The World Health Organisation had estimated that 21 million adolescent girls get pregnant every year in developing countries, and of this, 3.9 million of them would undergo an unsafe abortion. It is apparent that adolescents face a significant health risk if not specifically targeted by interventions that can empower them to maintain safe and healthy sexual lives. to this end, Marie targets adolescents with sexual and reproductive health services through multiple service delivery channels.

Materials and methods
Secondary data on family planning services provided by Marie Stopes Nigeria were obtained from the organisation's management information system. Analyses to show frequencies and trends for contraceptive uptake among adolescents in Nigeria were conducted.
Results
In 2021, 30% of all clients served by the Marie Stopes Nigeria Country Programme were adolescents. This adolescent reach was attributed to its Outreach and Marie Stopes Ladies (MS Ladies) operations: 35% of MS Ladies clients and 29% of Outreach clients were adolescents. Moreso, almost all (97%) of these girls lived in rural areas. On average, each "itinerant" (door-to-door) MS Lady provided services to 20 adolescents per month, whereas each "stationary" (PPMV) MS Lady served an average of 5 adolescents per month.

Conclusions
Contraceptive use among adolescent in Nigeria can be consolidated and scaled particularly in rural communities through the use of age estimation tool for clients who are unsure of their age, youth-friendly approach to counselling and service delivery. Word of mouth by satisified clients can raise, motivation and referrals among adolescents.

Background: Adolescents make poor decisions about their sexuality due to religious-social-cultural beliefs and poor parental involvement. These pose threats to their transition from this delicate phase of life to adulthood resulting poor health outcomes. Marie Stopes Nigeria trained private health providers located in communities with high unmet need on youth friendliness in the delivery adolescent sexual and reproductive health (SRH) service using the values clarification and Attitudinal Change tool. This was balanced with the training of adolescents as demand creation agents to target in-and out-of-school adolescents with SRH Information, Education and Communication (IEC) to access SRH services marie supported private health facilities at subsidized cost. 
Methods: The study focused on 57 Private health Facilities in Mariestopes Blue Star Network operational in the South-east region between 2017 to 2020. Routine service data generated in the facilities were abstracted from Marie Stopes internal database. The data was analysed descriptively.
Results: The adolescent's mobilization strategy had a multiplier effect on adolescent reach in family planning services. These satisfied users courageously raised awareness about contrception among in-and-out of school adolescents, referred them to the youth friendly providers. This led to significant increase in contraceptive service uptake in te focal facilities. The proportion of adolescent clients served increased from 4.6% in 2017 to 18.9% in 2020 following the introduction of the adolescent-focused strategy in 2017.
Conclusion: The use adolescents peer-to-peer demand creation strategy reinforced with IEC has positive impacts on the adolescent client footfall in the private health facilities for contraception. The use of VCAT to enhance youth friendly service delivery should be scaled to other private health providers.

ABSTRACT
Background: The early sexual debut of adolescents predisposes them to unplanned pregnancy, maternal mortality, VVF, STIs and HIV/AIDS. Early marriages, school dropout, sexual abuse are also some common negative outcomes. Lack of awareness, access, fear of stigma, and backlash are common barriers to Adolescent contraception. The need to create social support and safe spaces where adolescent girls can be mentored as advocates of contraception among their peers is important.
Objectives: To determine effectiveness of peer-to-peer group network strategy in driving adolescence contraception in Benue State, Focusing on data from DHIS from May-December 2021 and January-August 2022. 
Materials and Methods: Community Reproductive Health Service Center was established for continuous engagement of adolescent girls as a sustainability strategy. Health education teachers in 3 secondary schools at Gwer-West LGA were trained as advocates for Family Planning. The messages were specifically tailored to suite in-school adolescents. Health clubs, peer groups and social media channels were set up to connect students from various schools under the supervision of Health Teachers with Facility Service Providers serving as Matrons. ORION and Client Record Forms (CRF) were tools used to gather and evaluate data.
Results: Prior to implementation of strategy, the baseline showed a trend of 7.8% to 22.2% service uptake from May to December 2021, after the intervention there was a significant increase in the percentage number of adolescents from 8.8% to 31.9% from January to August 2022.
Conclusion: Networking peer groups across school communities has proven to be an effective strategy in scaling contraceptive awareness with in-school adolescents.
Keywords: Adolescent, Contraception, awareness, peer-to-group, networking