Youth hotlines succeed in Guatemala and Colombia.

Early childbearing, unsafe abortion, HIV/AIDS, sexually transmitted infections (STIs), sexual violence, drug and alcohol addiction, family tensions, and psychological distress are all common problems among youth in Guatemala and Colombia.

PHONE HOTLINES

Youth phone hotlines were established in both of these countries in order to provide an anonymous and free point of first contact for adolescents in need of sexual and reproductive health information, counseling, and referral.

In Guatemala, the Asociacion Pro-Bienestar de la Familia (APROFAM) ran a phone counseling and referral service in Guatemala City for 16 years (1980-1996), fielding 40 to 100 calls a day, or 7,000 per year. In 1999, the organization sought to capitalize on this expertise and focus on adolescents, establishing a youth hotline with funding from The Netherlands Trust Fund.

In Colombia, PROFAMILIA has successfully operated a nationwide phone information service since 1991, with the annual call volume increasing from 15,600 to 132,000 in the first five years. Due to the growing demand among youth for this service as well as the need to provide them with free and confidential access to accurate information on sexual and reproductive health, PROFAMILIA launched a three-year Youth Hotline Project in 1996 with funding from the Hewlett Foundation.

PROJECT GOALS AND OBJECTIVES

The goal of the Guatemalan youth hotline was to improve adolescents' sexual, reproductive, and mental health by offering anonymous emergency counseling and referral to clinical and psychological services. In Colombia, the goal was to offer counseling to those adolescents with questions or problems related to sexual and reproductive health but without direct access to services, and to provide referral to appropriate services as needed. Both young men and women were served through the hotlines.

PROJECT ACTIVITIES

In Guatemala, APROFAM surveyed youth prior to implementation so that the project could be better tailored to youth needs and preferences. The service was offered nationwide and was free to anyone with a phone line. The hotline was staffed by two trained female psychologists who provided counseling and

referral to a wide range of agencies, such as drug and alcohol detoxification centers, Alcoholics Anonymous, cultural and sports clubs, and homeless shelters, as well as health clinics, including APROFAM's own youth clinic. The psychologists were also prepared to help victims of sexual harassment or domestic violence.

Marketing strategies were an important component of both projects. In Guatemala, the hotline was marketed through newspaper, television, and radio announcements, at kiosks, and on posters and flyers distributed at schools and youth hangouts. The project was also promoted through APROFAM's other youth projects, such as the organization's cyber center. Most of the callers indicated that they had heard about the service through friends (41 percent), schools (19 percent), flyers (19 percent), newspapers (10 percent), and radio (8 percent).

In Colombia, PROFAMILIA launched a widespread marketing campaign for the youth hotline on several fronts. Promotional materials were distributed through universities, high schools, community centers, health centers, and other places frequented by youth. The hotline number was printed on PROFAMILIA's letterhead, on all papers distributed to clinic users, and on posters hanging in PROFAMILIA facilities. The Youth Hotline also served as one of the sponsors of a nationwide youth meeting, making contacts with municipal authorities, youth groups, and local and national governmental agencies involved in health, education, and youth issues. T-shirts were printed with the hotline number and worn by PROFAMILIA staff at the event.

In addition, a radio marketing campaign was broadcast in numerous cities in and around Colombia with information about the youth hotline as well as informational spots on sexual and reproductive health topics, such as HIV/AIDS, STIs, adolescent pregnancy; family planning, condom use, sexual abuse, emergency contraception, and so forth. These radio spots were designed using young people's own language and the specific context of the geographical area in which they were to be aired. A special effort was also made to market the service directly to young men, since in the past 90 percent of youth callers to the hotline were female.

Youth hotline staff received training in sexual and reproductive health, including specialized information on adolescent health, as well as information related to accessing services at PROFAMILIA and other service providers within the Colombian health system.

KEY RESULTS

Guatemala's Youth Hotline project received a total of 954 calls during the initial 18-month period of the project, mostly from the Guatemala City metropolitan area. Youth called seeking information or counseling on a variety of concerns, including contraception (15 percent), abortion (13 percent), fear of pregnancy (12 percent), information about youth services (12 percent), HIV/AIDS/STIs (6 percent), self-esteem (4 percent), and emotional crisis (4 percent). Approximately 30 adults also called with concerns about adolescents.

According to the results of APROFAM's caller survey, all users were either very satisfied (50 percent) or satisfied (50 percent) with the hotline service. Some 90 percent of callers were referred to APROFAM's youth clinic, which registered 366 visits directly attributable to hotline referral (14 percent of all visits during the project period).

Colombia's youth hotline project also proved to be a success. Calls from adolescents increased 139 percent from a monthly average of 144 calls at the beginning of the project to 345 calls per month, and the average proportion of young male callers increased from 10 to 15 percent. Calls came from youth around the country, including large urban centers, smaller cities, and rural areas. Nearly 9,000 calls were received through the youth hotline during the three-year project period. The majority of requests for information were related to family planning methods, especially emergency contraception and injectables, pregnancy risk, STIs, and couple relations.

LESSONS LEARNED

These two projects have shown that youth hotlines can serve as an important point of first contact for youth seeking sexual and reproductive health information, counseling, and related services. Some of the key lessons learned were:

* Ongoing marketing is important. Radio campaigns proved especially fruitful for PROFAMILIA in Colombia.

* Strategic alliances with other organizations can help in the dissemination of information. PROFAMILIA in Colombia developed ties with a variety of youth-serving agencies that helped to promote the hotline.

* Adequate staffing is important in handling calls in an efficient manner. These calls can sometimes prove difficult and time consuming because young people find it hard to discuss issues relating to sexuality.

* Hotline staff must have access to current information on services available to youth. This is especially important when the hotline service is offered nationwide and young people need referrals to services in multiple areas.

* Hotline staff should receive training on a broad range of topics, such as adolescent development, sexual and reproductive health, drug and alcohol abuse, sexual harassment, and referrals.

* Since hotlines are usually free, organizations will find it difficult to operate without donor funding. They should consider cross-subsidization from clinical services as a possible strategy.