Undoubtedly sports and physical activities are essential for our mental and physical wellbeing. But how can a sport help in addressing sexual and reproductive health issues of the youth, and social ills like sexual and other forms of gender-based violence? It looks somewhat incredible.
Well Grassroot Soccer, an adolescent health organization, seems to be doing exactly that. It has leveraged the power of soccer (football) to mobilise youth to become agents of change in their communities.
Grassroot Soccer was originally founded in Zimbabwe in 2002 to spread awareness on HIV/AIDS prevention and control amongst the youth. It used the services of professional soccer players as coaches working directly with the young people. But, since then it has broadened its base by including sexual and reproductive health and gender empowerment programmes for adolescents. It has reached 2.7 million young people from 62 different countries with its sports-based health promotion activities.
Using soccer as the hook, it engages adolescents in making healthy decisions through the 3C’s model: an adolescent-friendly and evidence-based health Curriculum, supportive influence of typically young (18-35 years), motivated and role model Coaches, and positive Culture – a fun-filled, inclusive, and positive play-based environment that the coaches create to ensure that adolescents feel safe and comfortable when discussing sensitive topics like sexual and other forms of gender-based violence as well as range of issues around sexual and reproductive health.
Grassroot Soccer uses this delivery model to achieve the 3A’s: strengthening young people’s Assets- their health knowledge and confidence to use it; increasing young people’s Access to youth-friendly health services; and ensuring that young people Adhere to treatment regimens and healthy behaviour and lifestyle.
During an online session of 10th Asia Pacific Conference on Reproductive and Sexual Health and Rights (APCRSHR10 Virtual), Nicole Banister, Partnerships Coordinator for Grassroot Soccer, shared some insights from Grassroot Soccer’s play-based approach in the Pacific Island country of Papua New Guinea, where Grassroot Soccer has been working since 2017.
Grassroot Soccer, in association with its partners, has developed a Relationship SKILLZ programme for Papua New Guinea, comprising 8 sessions (each 1 hour long) of sport-based interventions for sexual and reproductive health and rights (SRHR) and to tackle sexual and other forms of gender-based violence, which are designed for mixed sex groups of adolescents 13-19 years of age. The purpose is to help adolescents contribute towards ending sexual and other forms of gender-based violence by building their assets to make healthy choices, increasing access to comprehensive SRHR services, and promoting adherence to healthy sexual behaviours. The curriculum is evidence-based, and in the local context of Papua New Guinea and validated and approved by the young people as well. The programme and the curriculum is designed to be youth friendly and fun.
The coaches work in pairs – one female and one male coach – to co-facilitate the curriculum with mixed groups of 20 to 40 participants per practice. Key themes in the curriculum include rights and responsibilities, gender and power, healthy communication and relationship, forms of gender-based violence and where to access services and critical sexual and reproductive health and rights information, including puberty, menstruation, contraception, HIV and STIs prevention.
The coaches use plays, energisers, ice breakers and sports activities to create a safe space for both girls and boys to open up to the coaches about sensitive issues in their lives and be connected to health services.
For this particular project Grassroot Soccer analysed routine monitoring data of 628 participants 13-19 years of age (317 girls and 311 boys) collected from interventions conducted between January and September 2019 in Port Moresby (urban) and Mendi (rural) cities of Papua New Guinea. These included attendance registers completed by coaches at each session and a 13-item pre- and post-test questionnaire completed by participants assessing their sexual and reproductive health and rights knowledge, gender-equitable attitudes, self-efficacy, and justification of violence against women and girls.
91% participants had attended at least 6 of the 8 intervention sessions. Post intervention, many participants demonstrated positive change in their knowledge and attitudes across 10 out of the 13 items. Over 41% of participants showed positive change in their confidence in communicating effectively with the opposite sex. Nearly 40% of participants showed positive change in their knowledge of where to go if someone they know is abused. Also, 42% of participants showed positive change with regard to justification of violence against a partner though a lower proportion of men compared to women demonstrated this statistically significant change (37.2% of men vs. 46.7% of women).
Participants’ knowledge of where to report abuse, self-efficacy to report unwanted touching, and self-efficacy for communication with the opposite sex showed the largest positive changes from baseline to end line. Knowledge of unequal power as a risk for HIV, self-efficacy to say no to sex, and gender equitable attitudes also improved significantly over the course of the intervention.
However a significant negative change was observed on item 8 (sometimes a man may have a good reason to hit is girl friend or wife)-significant negative change in girls and slight negative change in boys. Very slight (insignificant positive changes were seen in items 10 (it is okay for a boy to threaten to hit his girl friend if he never physically hits her)-very slight positive change and 12 (it is okay to use violence with my partner if she or he makes me angry).
These negative changes are perhaps a reflection of the high prevalence of sexual and other forms of gender-based violence that seems to be socially acceptable in Papua New Guinea, where 66% of women estimated to have experienced physical or sexual violence, 41% of men admitting to perpetrating rape and two-thirds of women reporting to have experienced domestic violence.
“Grassroot Soccer’s programme is the first time they (adolescents) have learned about or ever discussed topics such as gender, power and gender based violence. So we do think there may have simply been some confusion. Regardless, it is absolutely critical to further investigate some of these surprising findings, given the very common experiences of violence in Papua New Guinea, and conduct additional training or implement changes to our tool”, says Nicole.
Overall the results indicate that Grassroot Soccer’s Relationship SKILLZ participants showed positive changes on many of the key programme outcomes. Coaches say that this programme has made a significant impact on how they liaise with members of the opposite sex and how they approach sexual relationships.
One participant recently shared, “Thank you Grassroot Soccer for coming to our school and teaching us about important values and issues affecting both genders, breaking down strong cultural barriers and how we can share responsibilities and help girls have a balance of respect.”
In the words of Nicole, “Many of our activities happen directly on soccer fields so that both boys and girls have equal access to sports, and to soccer in particular, which has historically been seen as a boys’ sport. We are trying to level the playing field, not only in terms of athletic prowess but also in terms of understanding around menstruation and contraception as well”.
The basic Grassroot Soccer model seems to be worth replicating by youth organizations in other countries as well. It need not necessarily be about football. The national or any popular sport of a particular country can be leveraged to advance sexual and reproductive health and rights for adolescents and gender equity through a sports-based approach.
Games are fun and their power can be used to create an environment of learning that is not preachy and yet can educate, inspire, and mobilize youth to take control of their lives and health, on the play field and off it and become agents for change in their communities.
Shobha Shukla is the founding Managing Editor of CNS (Citizen News Service) and is a noted health and gender justice advocate. She is a former senior faculty of Loreto Convent College and current Coordinator of Asia Pacific Media Network to end TB & tobacco and prevent NCDs.