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The App That Will Help Dominican Youth Protect Their Health

Project HOPE’s 5 Star Youth program is working to reduce the number of teen pregnancies in the Dominican Republic by reaching adolescents with the education they need — including a mobile app to help manage their health.

By Emma Schwartz

The Dominican Republic has one of the highest rates of adolescent pregnancies in Latin America. According to the National Health Service, adolescents account for around 23% of all pregnancies in the country every year.

Three of every four of these pregnancies aren’t planned.

“We usually see between 15 and 20 pregnant adolescents each day,” says Ruth Zettouri, head of the Department of Adolescents and nurse at Hospital El Almirante in Santo Domingo. “The biggest challenges are how they will care for themselves during pregnancy — including nutrition — and how they will care for the baby after giving birth. For non-pregnant patients, the biggest challenge is addressing the taboos they have regarding family planning. Many do not know much about the subject.”

When teens become mothers, the social costs are steep. They’re more likely to drop out of school, have fewer job opportunities, and face a more limited horizon of possibilities. Their emotional development and mental health are put to the test, and they are often ostracized from their social circles.

woman holding small child
The Dominican Republic has one of the highest rates of adolescent pregnancy in Latin America. “The biggest challenges are how they will care for themselves during pregnancy — including nutrition — and how they will care for the baby after giving birth,” says Ruth Zettouri, a nurse in Santo Domingo. All photos by Marie Arago for Project HOPE, 2022.

“Pregnant teens feel rejected,” says María Guillén, a nurse at Hospital Municipal Mata Hambre. “Early pregnancies generate depression, self-esteem problems, lack of motivation, and school desertion. They are victims of bullying.”

The physical risks are also huge. Young women between 15 and 19 are twice as likely to die during pregnancy and childbirth than those over 20 — and their newborns are at significantly greater risk of death, too.

Through the 5 Star Youth program, Project HOPE is working to improve health education and care for the Dominican Republic’s youth. In health facilities in the provinces of Santo Domingo, La Vega, and La Altagracia, we’re training health workers on sexual and reproductive health and contraception protocol in adolescents. And in public high schools in La Vega, we’ll soon be leading lectures on goal setting, decision making, delaying sexual relationships, and family planning. We’ll also be rolling out a mobile app to reach youth across the country with the information.

“The hope is to inspire teenagers to identify their dreams, set goals, build plans to achieve them, and be able to increase their knowledge to make informed, healthy, and age-appropriate decisions,” says Adriana Wanderlinder, program manager for Project HOPE.

man holding tablet
The 5 Star Youth program is adapted from the 5 Star Mother program, which helps mothers in the Dominican Republic manage their health during and after pregnancy.

All of this work is possible thanks to the financial support of Organon and the Elsa and Peter Soderberg Charitable Foundation and will be carried out in close collaboration and consultation with the Ministry of Health, National Health Service, and various local partners.

“I loved the training,” Zettouri says. “We learned a lot of things we didn’t know. What I liked the most is that we are going to be able to work with adolescents in their environment, through technology and digital applications. I want them to learn to be able to take care of themselves.”

Guillén, a nurse at Hospital Municipal Mata Hambre, will be applying the training in many different areas of her life.

“I’m also a university teacher and I am going to include elements of the training in my classes,” she says. “Even on a personal level, I will apply the knowledge because I have a 5-month-old granddaughter. I have always had a lot of empathy for my patients, but now I am going to have more because I understand how important it is to connect with adolescents.”

pregnant woman
Alexandra, 18, used the 5 Star Mother app while pregnant with her daughter, Yvonne. “I learned how to take care of myself,” she says. Project HOPE’s new 5 Star Youth program will go into high schools and health facilities to help more young people set goals, delay pregnancy, and manage their health.

The 5 Star Youth program is an adaptation of the 5 Star Mother program, an existing Project HOPE initiative focused on patient education and improving the quality of reproductive, maternal, newborn, and child health services offered at primary care levels in the Dominican Republic. The 5 Star Mothers app is used by health professionals and mothers nationwide and helps mothers’ complete essential health milestones during and after pregnancy, from infancy to age 5.

The promotion and adoption of this strategy has depended on a nationwide network of skilled and dedicated health workers. The same will be true for the 5 Star Youth program.

“Committed health personnel can make a great difference in the mindset of adolescents,” Wanderlinder says. “My wish is that the doctors, nurses, and psychologists who receive the training become multiplying agents of change.”

>> Click here to learn more about Project HOPE’s work in the Dominican Republic

>> Learn more about maternal health work in the Dominican Republic

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