The World Bank Tackling Teenage Pregnancy by Enhancing Youth Socioeconomic Opportunities in Nicaragua (P163364) COMPLETION REPORT Tackling Teenage Pregnancy by Enhancing Youth Socioeconomic Opportunities in Nicaragua (ID: P163364) Nicaragua (LATIN AMERICA AND CARIBBEAN) 1. Summary Information Project ID Product Line P163364 Advisory Services & Analytics Short Name Full Name Tackling Teenage Pregnancy by Enhancing Youth Socioeconomic Tackling Teenage Pregnancy in Nicaragua Opportunities in Nicaragua Project Status Completion Fiscal Year Active 2020 Region Country, Region or World LATIN AMERICA AND CARIBBEAN Nicaragua Responsible Unit Team Leader GPV04(9336) Jorge Luis Castaneda Nunez Practice Area (Lead) Contributing Practice areas Poverty and Equity Education, Health, Nutrition & Population 2. Context Nicaragua stands out as one of the countries with the highest adolescent fertility rate in the region. Although there has been a decline over the last 15 years, around 25% of women of ages 15-19 have been pregnant at least once. In effect, teenage pregnancy has pervasive impacts particularly on the children of young mothers, as they are more likely to exhibit lower human capital development and poorer outcomes in the labor market. The Government of Nicaragua is addressing teenage pregnancy to reduce the negative impacts in young women’s development through multiple yet decentralized initiatives, including socioemotional and values development programs from the Ministry of Education ( Consejería de Comunidades educativas and Aprender, Emprender y Prosperar). The team proposed designing and delivering a set of sessions in existing academic spaces to foster a growth mindset, perseverance, self-efficacy, goal setting, and planning skills for students with the goal of providing psychological tools to change the mindsets and increase young females educational and professional aspirations. Guatemala faces similar challenges related to high rates of teenage pregnancy (20.7% childbearing rate for teenagers 15-19 and 24.3% for rural areas, DHS 2014-15) and its consequences, such as low rates of female labor force participation and low quality, vulnerable jobs for women who opt to join the labor force. The activities proposed in Nicaragua can easily be transferred to Guatemala, given that: i) the activities are well aligned with the Bank portfolio in Guatemala and could be scaled up under an eventual project in either the education or social protection sector, and ii) co-financing from the CMU, which is a requirement of the grant, could also be used in Guatemala. May 08, 2019 Page 1 of 5 The World Bank Tackling Teenage Pregnancy by Enhancing Youth Socioeconomic Opportunities in Nicaragua (P163364) 3. Development Objective The development objective is to contribute to the prevention of teenage pregnancy by generating evidence on the use of multisectoral and behaviorally informed interventions to increase socioeconomic opportunities for young girls in a low-middle income setting. Specifically, this work aims to: i) road test evidence at the country level on innovative multisector approaches to stimulate behavior change in adolescent girls to increase their likelihood of staying in school and/or developing skills for productive labor force participation; and ii) be a catalyst for investment in frontier issues by facilitating knowledge exchange on successful programs for at-risk youth populations that apply behavioral insights to prevent teenage pregnancy (10 to 19 years old) and have potential to be replicated in the Nicaraguan context. 4. Activity Summary The proposed activities respond to a request from the Government of Nicaragua for WB’s support to explore new approaches to tackle teenage pregnancy by enhancing the likelihood that adolescent girls will stay in school and develop skills for productive labor force participation. a. Design, validate and test a small batch of ‘soft-skill’ training/education modules aimed at triggering behavior change (focused on at-risk youth) (65%). Learning from the successful implementation of innovative programs such as Becoming a Man (BAM) and Working on Womanhood (WOW), a Chicago Public Schools counseling program successful at motivating young women to graduate and make positive life choices, the focus of this activity is to design and implement a few ‘soft-skill’ modules that would support continued development of emotional intelligence and a change in worldview, with the greater goal of preventing teenage pregnancy and fostering skills critical to education and employability. Some possible modules could include: i) agency and voice (with focus on female modules); ii) visionary goal setting; iii) self-awareness/emotional intelligence, and iv) healthy relationships. The validation would be carried out with youth groups, institutional actors and specialists, and community volunteers working in current youth interventions. These modules could complement the educational materials under “Social Science: Skills for Life� already in use in school or in conjunction with services identified under Activity 2. Alternatively, they could potentially be implemented as a package in key youth programs. Feasibility of including this activity under the World Bank education project currently under preparation will be explored. b. Knowledge exchange of evidence on programs for at-risk youth that apply behavioral insights to support the prevention of teenage pregnancy (35%). Given the growing body of experience related to behaviorally informed interventions, there is scope to learn from regional/global experiences in designing and implementing behavior change interventions for at-risk youth, particularly related to preventing teenage pregnancy. The team would review existing national policies, programs, and services for adolescents and youth, and consult stakeholders to identify opportunities to implement behaviorally informed policies with proven success elsewhere. This activity would explore opportunities for practitioner-to-practitioner learning by facilitating a dialogue with implementers of programs identified by country counterparts as having the potential for replication of multisectoral approaches in their country setting. Nicaragua has implemented its social assistance flagship Programa Amor through a multisectoral platform to address early-childhood development and wants to explore how to continue using this platform for teenage pregnancy prevention. Assess opportunities to modify or supplement ongoing interventions to increase the potential impact on preventing teenage pregnancy. Government programs to prevent teenage pregnancy include, among others: Community Adolescents Counseling (Ministry of Health), Family Counseling (Ministry of Family, Children and Youth), Community Counseling (Ministry of Education), integrated effort of the Ministries of Health and Education on training teachers on sexual reproductive health, and preventive work at the community level (such as the work of volunteers in Maternal Homes and community educational interventions of Programa Amor). There is also potentially scope to share preliminary challenges and successes in the development and application of soft-skill modules in Nicaragua. May 08, 2019 Page 2 of 5 The World Bank Tackling Teenage Pregnancy by Enhancing Youth Socioeconomic Opportunities in Nicaragua (P163364) 5. Tasks and outputs The team successfully initiated and coordinated a multisector engagement between WB HD and EFI teams with relevant Government counterparts, for the design of an innovative intervention to increase aspirations for young women. Additionally, during this initial engagement, the team contributed to the knowledge exchange and preparation of materials for the development of a socio-emotional education curriculum with teams in charge of curriculum development, teacher preparation and training, and skills development from the Ministry of Education. a. Preliminary review: i) desk review of literature on behavioral change and teenage pregnancy prevention, ii) survey data analysis, iii) meetings with HD country teams and initial engagement with Government (MIFAN) to look for entry points. b. Fieldwork and diagnostics document: fieldwork preparation, group discussions, and visits to health centers, community centers and schools, and debriefing with counterparts (MHCP, MINED, MIFAN, MINSA). c. Workshop: full day workshop on behavioral insights for policy design with an emphasis on the prevention of teenage pregnancy and targeting Government officials from MINED, MIFAN, MINSA, MITRAB, and MINJUVE. d. Masculinity literature review: a literature review on experimental evidence targeting masculinity norms to prevent teen pregnancy, gender violence, and sexually transmitted infections with a focus on experimental evidence for the region. e. Socio-emotional development module design: i) review of SE interventions for teenagers delivered through the school system in the region, ii) coordination of a multi-sector dialogue between World Bank HD and POV teams and teams from MINFAM and MINED in charge of curriculum development, teacher preparation and training, and skills development, iii) proposal preparation of a socio-emotional development intervention in schools. However, given the current political unrest in the country and the reduced involvement of the WB, the planned activities for the implementation of socio-emotional development modules in schools were interrupted from February 2018 onwards. The team has proposed to transfer the funds to Guatemala, a country with a similar context and programmatic agenda. The following steps have been planned: a. Begin engagement with WB teams in Guatemala and relevant counterparts to identify entry points for the implementation of a socio-emotional development intervention connected to the prevention of teenage pregnancy. b. Prepare a plan for the implementation of a socio-emotional development intervention, adapted to the Guatemalan context. c. Implement the activities, including exploratory fieldwork, intervention design, material preparation, data collection, training, and pilot delivery. 6. Main findings The main findings summarized below were drawn from fieldwork activities and a literature review on masculinity: a. Young women with a support system, access to reliable information, and clear goals to pursue further education and to become financially independent, are more likely to take pro-active steps to avoid teen pregnancy than those who have not developed academic or professional aspirations. b. Having children is still associated with high sexual potency and masculinity and are thus desirable for men, especially from the family perspective. Thus, men usually don't carry the financial, psychological and social consequences of fathering at a young age. May 08, 2019 Page 3 of 5 The World Bank Tackling Teenage Pregnancy by Enhancing Youth Socioeconomic Opportunities in Nicaragua (P163364) c. The reduced use of contraception by youth is partially due to social norms that prescribe that women should be passive when using protection and stigmatize sexual activity and access to reliable communication about planning methods. d. Interventions aim to prevent teenage pregnancy by questioning and replacing masculinity norms have been effective at increasing usage of family planning methods when delivered through classroom and interactive education sessions, as well as family planning counseling. These findings provided inputs for client engagement. Concretely, the diagnosis notes and activities carried out during the field visit generated several requests from the Government of Nicaragua, including i) a request from the MINFAM to provide technical assistance to the formulation of the policy framework for teenage pregnancy prevention and ii) a request from the MINED to support the design of the national socio-emotional development curriculum. From this latter request, the project and WB education teams initiated policy dialogue to support the design of a socio- emotional development curriculum for the entire country. As one of the main conclusions from the fieldwork, the team highlighted the need to provide psychological tools and socio-emotional skills for young females to change their mindsets about education and increase their aspirations regarding career options as a successful approach to improve educational outcomes and, consequently, avoid pregnancy as the single life path of choice. It is unclear whether MINED will be able to move forward with the implementation of the socio-emotional development curriculum under the current political environment. 7. Risks and Issues The political unrest led to the interruption of all activities in Nicaragua funded by the grant with a high probability of not being able to resume and finalize the implementation of the project in the foreseeable future. In order to mitigate this risk, the team evaluated the possibility of transferring the activities to Guatemala, given that i) this latter country faces a similar pressing challenge of addressing its high rate of school dropout and adolescent pregnancy, particularly for women in rural areas, ii) the grant activities are well aligned with the Bank portfolio in the country and could be scaled up under an eventual project in either the education or social protection sector; and ii) co-financing from the CMU, which is a requirement of the grant, can also be executed in Guatemala. The team proposed and discussed to transfer the grant activities to Guatemala with the TF managers, the Director of Strategy and Operations, the Regional Vice Presidency, and the CMU. Agreement and approval were obtained. Lastly, the Trust Fund responsibility has been transferred from Tania Dmytraczenko (GHN3, previously in LCC2C) to Jorge Luis Castaneda (GPVGE) following approval from the TF managers, the LCC2C CMU, and unit managers. Thus, the funds will now seat on the Poverty and Equity Global Practice. 8. Deliverables Name Completion Date Processing Type Status a. Validated socioemotional skills training modules to be 05-Dec-2018(P) DR Not Required Canceled implemented in at-risk youth populations b. Roll out small-scale validation of the soft skills modules 07-Mar-2018(P) DR Not Required Canceled c. Design soft skill modules 18-Oct-2017(P) DR Required Canceled d. Note on Module Development & Pilot 24-Jan-2019(P) DR Required Canceled e. Completion Report Document 17-May-2019(P) DR Required Planned May 08, 2019 Page 4 of 5 The World Bank Tackling Teenage Pregnancy by Enhancing Youth Socioeconomic Opportunities in Nicaragua (P163364) 9. Schedule and budget Planned ACS at AIN Sign- Age to-Date (in months) Revised planned ACS Time elapsed since last PR off 23 28-Feb-2019 30-Jun-2020 NA Cumulative Budget Current FY (2019) Actual Actual vs. Activity Expenditure WPA Burn Source of Fund Activity Plan Expenditure WPA Plan Plan (%) Plan (YTD) Rate (%) to Date Bank Budget 40 15,180 *50 10 0 0 0 Bank Trust Fund 124 14,348 *71 54 0 2,673 0 2018 2019 Source of Fund Total Direct Cost 2017 (Current FY) Grand Total Direct Cost 164 0 100 64 Bank Budget 40 0 30 10 Bank Trust Fund 124 0 70 54 10. Documents and materials attached a. Preliminary review 1. Behavioral Diagnostics presentation d. Masculinity Literature Review 2. Behavioral Diagnostics note 1. Masculinity Intervention Inventory 3. Survey Review 2. Masculinity Literature Review b. Fieldwork and diagnosis e. Socio-Emotional Development module 1. Fieldwork Guide (Spanish) 1. SED Presentation MinEdu (Spanish) 2. Diagnostics Note 2. SED Proposal MinEdu (Spanish) 3. Diagnostics Note (Spanish) f. Other c. Workshop 1. Grant Reporting and Monitoring (GRM) Report 1. Handout Workshop (Spanish) for Gender Trust Fund (GENTF) 2. Presentation Workshop (Spanish) May 08, 2019 Page 5 of 5