Promoting Adolescent Health and Development through Research and
Social Action: The COMNET Initiative, Ile-Ife, Osun State, Nigeria
Introduction and Problem Statement
Young people in Nigeria face enormous developmental challenges, of which reproductive
health (RH) issue ranks very high. According to the 1999 Nigerian Demographic and
Health Survey (NDHS), 21.9 percent of teenage girls between the ages of 15 and 19 years
have had begun childbearing1. Most of the teenage pregnancies are unwanted and out-ofwedlock, and consequently many young people resort to unsafe abortion with grave
consequences for their health and well being in both short and long terms. About twofifth of pregnancies among teenagers end up in induced abortion2. The implication of
teenage pregnancy for overall personal and national development, particularly through its
role in school discontinuation of females, is also grave. In 1999, more than one-third of
females who dropped out of secondary school in Nigeria cited pregnant and related
family-life issues as their reasons1. HIV/AIDS has also been increasing at an alarming
rate among Nigerian youths, with a seroprevalence rate of 8.1 % and 4.9 % recorded for
ages 20 – 24 years and 15 – 19 years respectively in 19993. Evidently, these reports
showed that a high proportion of Nigerian adolescents have early sexual and unprotected
exposure. Field-based experiences as well as epidemiological pattern of HIV/AIDS
infection indicate that many young girls are sexually involved with older men, usually
enticed by material gains. A rise in the incidence of other risky health behavior such as
cigarette smoking, alcohol intake, and other drug abuse has also been documented 4.
These behaviors have been associated with poor quality of life by youths themselves5.
Factors identified as being associated with risky adolescent health behaviors in Nigeria
include low level of health knowledge and poor life skills. The culture of silence which
traditionally surrounds RH issues, and limited ability of parents and other care givers to
communicate with young people on sexuality-related issues have contributed to the
vulnerability of young people, and leave them at the mercy of incorrect information
offered by their peers and the negative influence of sex-saturated media. The absence of
significant adults, meaningful activities and facilities have also been associated with
health risky behavior among young people as the evening period, between the end of
school hours and the return of parents from work, has been associated with higher
incidence of adolescent risk behavior6. Poor community perception of gender, which
ascribes lower social status to females, also play a part in poor adolescent reproductive
health (ARH) status. As a result of inadequate response to the adolescent reproductive
health and related behavioral challenges on the part of government as well as civil
society, most young people are alone in their developmental struggles, as they lack access
to appropriate programs and supportive social structures. Ile-Ife, a major town in Osun
state, for example, lacks the presence of any youth-focused development program. With
Osun state documented as the hotspot for HIV/AIDS in Southwest Nigeria2, and Ile-Ife
itself being a major center for violent inter-communal clashes, young people in the
environ stands as one of Nigeria’s most vulnerable groups. The presence of a number of
higher institutions in Ile-Ife, including a university and school of medical laboratory
sciences, also widens the possible sexual network of adolescents in the town.
Adesegun Ola. Fatusi
1
Project Overview and Strategy
The Community Network for Promotion of Adolescent Development (COMNET)
initiative aims at mobilizing community-based resources in support of adolescent health
and development (AHD). Based on the “conceptual framework for adolescent risk
behavior”7 (derived from the problem-behavior theory), the project approach is based on
the following principles:
 Risk behaviors in adolescents are inter-related;
 There is an interplay of both risk and protective factors in adolescents’ health
behavior; and
 The social environment plays a salient role in adolescents’ risk behavior
Thus, the project would target risk behaviors in the context of a “syndrome”, and focus
not only on the adolescents, but also on the significant others (individuals and
institutions) in their social environment. In this regard, five groups of community-based
organizations/institutions are recognized as important within the framework of the
initiative: schools; healthcare institutions; faith communities (churches and mosques);
youth groups (such as the scout, and boys and girls’ brigade); and private voluntary
organizations (PVOs)/social clubs (for example, Rotary and Lions Club). This proposal
covers the first year period, and essentially the start-up level of the initiative.
The one-year project consist of three phases of activities:
Phase 1: Provide a comprehensive analysis of adolescent health and development (AHD)
situation through qualitative and quantitative studies
Phase 2: Develop an advocacy package targeting each of the five specified groups, based
on the result of the analysis
Phase 3: Use advocacy package (and research result) to promote social action aimed at
increasing access of young people to relevant services.
Overall, the project would involve the following strategies:
 Research: To gain better understanding of knowledge, attitude and behavior
relating to AHD at individual and community level, and to inform effective
programming.
 Information, Education, Communication (IEC) and Counseling: To promote
improved knowledge, attitude and practice among young people on health-related
risk behavior.
 Sensitization and Advocacy: To promote involvement of major community-based
groups and institutions in AHD efforts.
 Partnership Formation and Coalition Building: To enhance the synergy of efforts
of various stakeholders, and ensure greater overall effectiveness.
Project Goals and Objectives
Broadly, the COMNET initiative aims to contribute to improvement of health,
development, and quality of life of adolescents in Ile-Ife, Osun State, Nigeria.
Adesegun Ola. Fatusi
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The specific objectives of the project are as follows:
1. To determine the level of health knowledge and pattern of health-risk behaviors,
and correlates, among adolescents (10-19 years) in Ile-Ife
2. To determine the level of health knowledge and attitudes of secondary school
teachers to the provision of reproductive information to students through the
school system
3. To assess the opinion of religious leaders on adolescent health and development
issues and the role the faith community could play in addressing associated
challenges.
4. To increase awareness about AHD situation among leaders of five communitybased institutions: secondary schools; healthcare facilities; faith communities;
youth groups; and social groups/PVOs.
5. To mobilize the above-stated community-based institutions to each organize at
least one activity aimed at promoting ADH within the project period.
Project Activities
The COMNET project would address health and related challenges of young people in
the context of action research and community social action. Primary beneficiaries of the
program are adolescents (10 – 19 years) in Ile-Ife, Osun State, Nigeria, particularly inschool youths. The project will feature three phases.
Phase 1:
Comprehensive Analysis of AHD status and community-based resources
Baseline assessment would be carried out by means of both qualitative and quantitative
approaches. The results of the assessment would provide baseline information that would
be useful for the design of behavioral interventions, development of activities for the
youth resource center, and as a basis for subsequent evaluation. The methodology that
would be involved in the baseline assessment is described below.
A. Quantitative survey.
Survey, involving the use of questionnaires, would be carried out on three schoolrelated groups – students, teachers and parents. Multistage sampling method would be
used to randomly select students from six schools, who will participate in the survey.
At the first stage of the sampling, the list of all secondary schools in the town would
constitute the sampling frame. The list would be obtained from the local school
authority, and the schools would be stratified into two groups – private and public
schools. Three schools would be selected randomly from each of the two groups. For
the public schools, the selection would be carried out through a further stratification
to ensure that the three types of school system – boys’ only, girls’ only, and mixed
sex schools – are represented in the survey. Such classification would not be
necessary for the private schools as they are all mixed-sex schools. It is necessary to
ensure that both public and private schools are equally represented in the survey, as
there are socioeconomic differentials between the students that attend them. Thirty
Adesegun Ola. Fatusi
3
students would be selected from each of the six class arms (junior secondary 1 to
senior secondary 3) of each of the six schools. This approach, and the total number of
1,080, would make it possible to carry out detailed statistical analysis of various
determinants of health behavior among adolescents.
The questionnaire for students would cover demographic characteristics and RH
issues such as knowledge of HIV/AIDS and other sexually transmitted infections
(STI), attitude to condom use, perceived degree of self-efficacy, and sexual practices.
It would also cover use of alcohol and tobacco and other substances, as well as gender
issues including sexual harassment and dating violence. Questions would also be
asked about respondents’ sources of information on RH issues (sources regarded as
most important, presently, and those really preferred), and communication with
parents on sexuality issues. The questionnaire would also inquire about the
adolescent’s perspective on their concept and perceived personal state of quality of
life. Thus, this survey would adopt a more holistic quality-of-life perspective rather
than the narrower traditional concepts in AHD surveys5,8.
One-third of parents of the students surveyed (360 parents), and two hundred and
forty teachers would be randomly chosen to be involved in the study. The parents’
questionnaire would focus on such information as pattern of sexuality communication
with their children, and perspectives on AHD and program needs for young people.
Questions for teachers would relate, among others, to their perception on adolescent
sexuality issues, self-efficacy on sexuality communication with young people, and the
type of school-based health-enhancement program they desire. The questionnaires
would be designed in English language, but that of the students and parents would
also be translated to the native Yoruba language for students in junior classes (who
may prefer such) and for parents who are not literate in the English language. The
questionnaire for teachers and students shall be self-administered, although
interviewers shall be present in the classroom to assist students who may need help.
Questionnaire for parents would, however, be interviewer-administered, to ensure that
the perspective of illiterate parents are captured in the survey. The administration of
such questionnaire would be in the home settings. Translation shall be undertaken
through a two-way process (forward and backward translation between the two
languages) and be undertaken by graduate students in Yoruba language. The three
sets of questionnaires would undergo pre-testing before their finalization.
B. Qualitative studies
To gain better understanding of attitudinal issues and underlying psychological
constructs, which are critical but are often inadequately captured by quantitative
survey, focus group discussions (FGD) would be carried out separately for students,
parents, and teachers. Each FGD session will have the benefit of an experienced
facilitator and a recorder, and a discussion guide prepared by the project. Each focus
group will consist of 6 – 10 people, from similar socioeconomic background. Each
FGD session will also be recorded on audiotapes and subsequently transcribed and
analyzed by relevant social science experts.
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4
For students, FGD would provide opportunity for greater exploration of. Eight sets of
FGD shall be organized for the students, each comprised of. The eight would be as
follows:
- Male senior secondary schools students (SSS1 to 3) in public schools
- Female senior secondary schools students (SSS1 to 3) in public schools
- Male senior secondary schools students (SSS1 to 3) in private schools
- Female senior secondary schools students (SSS1 to 3) in private schools
- Male junior secondary schools students (JSS1 to 3) in public schools
- Female junior secondary schools students (JSS1 to 3) in public schools
- Male junior secondary schools students (JSS1 to 3) in private schools
- Female junior secondary schools students (JSS1 to 3) in private schools
Four sets of FGD would be conducted for parents: two for females (one for literate
group and the other for an illiterate group) and two similarly for males. Four sets of
FGD would be conducted for teachers: two for females (one for science-related
subjects, and the other for art/social science subjects), and two similarly for males.
In addition, key informant interview would be conducted for selected individuals
from the following stakeholders’ groups:
 Government healthcare facilities: 3 people from each of the 4 public facilities
 Private health providers: five doctors and five nurses, and ten operators of
chemist/dispensary stores.
 Social organizations: two leaders of four
 Youth groups: 2 leaders of four youth groups
 Faith communities: five Christian leaders and five Islamic leaders
 Local Government Area (LGA) office: 4 people, including the Supervisory
Councilor for Health and the Medical Officer of Health.
Selection of participation for the in-depth interview will be by purposive method.
Discussion in the FGD would include issues of access of young people to relevant
services, factors affecting their healthcare utilization pattern, and attitude of service
providers to adolescents request for such services as contraception.
Phase 2: Development of Advocacy Package
Based on the result of baseline studies, advocacy packages targeting various
stakeholders group would be developed. The advocacy package would include
summary of the study results and targeted messages. The summary of the findings
would be prepared in an easily understandable form, and involve appropriate use of
charts and other graphical images. The targeted messages would be in form of “action
sheets” for each stakeholders group: educational authorities; health facilities; faith
communities; youth groups; and social groups. Advocacy materials will be presented
and distributed at a Stakeholders’ Dialogue Forum, which will also serve as
dissemination workshop for the baseline studies. Representatives of various interest
groups as well as officials of the Local Government Area will all be invited to the
Stakeholders’ Forum.
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5
Table 1: Overview of approaches for the comprehensive health study on AHD
Interview Group
Study Approach
Information desired
Students

Survey

KAP on AHD issues
perception of quality of life

FGD

Further exploration of attitudinal issues
& related psychological constructs

Survey

KAP on AHD issues; Self-efficacy in
teaching sexuality topics; Preferred
school-based health program

FGD

Further exploration of attitudinal and
perceptive issues

Survey

Awareness of, and attitude to AHD;
Parent-child
communication
on
sexuality
issues;
and
desired
community-based AHD programs

FGD

Further exploration of attitudinal and
perceptive issues
Teachers
Parents
and
self-
Health workers
Key Informant
Interview
Perspective on AHD, available services, and
factors affecting utilization by young people
Religious leaders
Key Informant
Interview
Awareness on AHD and attitude to
sexuality education, available youthtargeted services, and potential for actions
by faith communities
LGA officials
Key Informant
Interview
Perception on AHD challenge;
government’s roles, and AHD activities
Phase 3: Promotion of Community Social Action
On the strength of the phase two activities described above, each group of stakeholders
will be encouraged and supported to develop simple and specific action plan that they can
initiate or implement within their resources. Technical support for the development of the
action plan will be made available through the Project Coordinator (myself) and another
colleague who have been involved in adolescent initiatives at national level. The focus
shall be on relatively affordable and actionable plan, which could be included in on-going
activities of the specific groups. These could include: organizing debates on sexuality
Adesegun Ola. Fatusi
6
issues in schools; inviting experts to give talks on parent-child communication during a
regular meeting of social clubs; health fairs; presentation of a talk on HIV/AIDS at a
youth group meeting; or campaign against the practice of “sugar daddies” (whereby older
and relatively affluent men lure young girls to beds with promises of material gain).
As part of community social action, a youth resource center (YRC), “The Lighthouse”,
would be established from private funds. The center would provide an operational base
for the initiative, and for future AHD initiatives. The center will maintain a collection of
AHD resource materials (both print and audiovisual), and provide these and other
technical resources in support of various AHD activities. On the other hand, the YRC is
would provide IEC and counseling services directly to young people. The center would
be opened for fours hours after school period on weekdays (2.00 p.m. – 6.00 p.m.) and
six hours on Saturdays (12 noon – 6 p.m.). Thus, the center would also provide a “safe
haven” for young people in the after-school hours. Relevant national guidelines9,10 and
instruments would guide the services to be offered at the center. A Program Coordinator
(myself) and an administrative assistant would manage the day-to-day affairs of the YRC.
Volunteers (including young people) would also be recruited to offer various services.
Project inputs, Outputs and Outcomes
The following inputs would be required for the project implementation.
 Personnel: Coordinating persons, survey personnel, volunteer youth workers, and
representatives of stakeholders’ groups

Print materials: These will include questionnaires and guides for the qualitative
studies; national documents for adolescent health service provision and program
planning; handbills, books and magazines for IEC and counseling.

Audio and audiovisual equipment and materials: Television and video for health
educational interventions, and as library materials.

Office space: This would serve as the Youth Resource Center. As indicated
above, funding for the office space and furnishing will be privately provided.
The outputs and outcomes are reflected in the implementation section and the logframe
(see figure 1).
Project Impact
The project would increase the access of young people to relevant and factual
information, counseling support, and other relevant supportive and youth-friendly
resources. These, in turn, would be expected to result in improved knowledge and attitude
on health-related issues, and ultimately impact on their behaviors. The project would
also increase the awareness of various stakeholders on AHD issues and mobilize
community resources to address identified problems. Through the approach described
above, the project is expected to create a critical mass of actors, whose activities would
Adesegun Ola. Fatusi
7
have synergistic effect and greater impact on the communit. Such would also have a
positive effect on the environment in terms of health programming, and to discourage
social practices that are of deleterious effects on adolescents’ development such as the
“sugar daddy” syndrome and gender disparities.
The impact of the project would include improved adolescent health status through
decrease in the incidence rate of teen pregnancy, induced abortions, HIV/AIDS and other
STIs. The project would also contribute to overall development of the young people, their
future families and the larger society through higher school completion rate (by decrease
in pregnancy-attributable school-dropout rates). Decrease in the rate of substance use,
including cigarette and alcohol, would also result in improved well-being of adolescents.
By affecting the lives of young people positively in the manner mentioned, the project
would also touch on the lives of parents and youth handlers positively with reduced level
of worry and anxiety about their wards and their future success and well-being. On the
whole, the project would contribute to improved quality of life of young people and their
parents in the community.
Evaluation and Indicators of Success
In addition to the monitoring of project activities, which shall be carried out periodically
through interactions with stakeholders and young people, evaluation would be carried out
at the end of the project period. The evaluation will use mostly qualitative processes. The
evaluation would be from a development approach, and participatory in nature. The
evaluation team would include at least two adolescents (male and female). Among others,
the evaluation will examine the degree to which various community-based groups had
been able to promote AHD, and the functioning of the YRC (the logframe – figure 1 –
shows the full list of indicators). The process and outcomes of the project would be
widely disseminated through dissemination workshops and publications (including peerreview journals).
Follow-up and Sustainability Issues
The external funding (from PLP) is directed mainly at baseline assessment, which is a
one-time activity. Funds for other activities would be available through private sources,
mainly community-based resources. With this arrangement, sustainability is likely to be
assured. The establishment of a youth resource center that serves as a nerve center of
present and future activities would provide stability and institutional memory for
continuation of project. With successful implementation of the first year of activities, the
initiative would be in a position to seek for and secure external funding to support future
expansion of programs.
Budget
A total of four thousand dollars is expected from the Population Leadership Program of
the University of Washington to support the project (Table 2). In-kind contributions and
local funds would also be available to support other relevant activities.
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Leadership Skills Required to Complete Project
Leadership skills required for completion of the project include the following:









Environmental-political mapping and advocacy
Negotiation and conflict-resolution skills
Coordination skills
Personnel management skills
Financial and budgetary management skills
Research skills
Communication and public speaking skills
Counseling skills
Advocacy and writing skills
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9
TABLE 2: THE COMNET INITIATIVE, ILE-IFE, OSUN STATE, NIGERIA: IMPLEMENTATION PLAN
PROJECT ACTIVITIES
BASELINE ASSESSMENT
Design Plan and Instruments for Baseline Assessments
Train Interviewers
Conduct Baseline Studies
Data Entry and Management
DEVELOPMENT OF ADVOCACY PACKAGE
Preparation of research results in audience-friendly formats
Design of stakeholders-specific advocacy messages
Printing of Advocacy packages
Conduct Sensitization/Advocacy & Research Dissemination Meeting
Preparation of Manuscript for publication in a peer-review journal
COMMUNITY SOCIAL ACTION
Development of Stakeholders' Action Plan
Establishment of Youth Resource Center
Operationalization of the Youth Resource Center
Staging of AHD activities by stakeholders' groups
MONITORING AND EVALUATION
Conduct Participatory Evaluation
Preparation and Dissemination of Project Evaluation Report
Adesegun Ola. Fatusi
1
2
3
X
X
X
X
4
5
X
X
X
X
PROJECT MONTH
6
7
8
9
10
11
12
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
10
FIG. 2: IMPLEMENTATION OF COMMUNITY-BASED YOUTH GROUPS AND PEER EDUCATION PROGRAMS
PROJECT STRUCTURE
Adesegun Ola. Fatusi
INDICATORS
MEANS TO VERIFY
ASSUMPTIONS
11
PROJECT STRUCTURE
INDICATORS
MEANS TO VERIFY
ASSUMPTIONS
Increase in proportion of young people
free from STD/HIV risks by 5 % point.
Decrease in proportion of female
adolescents who dropped out of school
due to teenage pregnancy by 10 % point
Decrease in pregnancy-related morbidity
and mortality rates among females
adolescents by 10 % point
Decrease in cigarette smoking rate by 20
% point
Knowledge, Attitude and
Practice (KAP) survey
reports, and Nigeria
Demographic and Health
Survey (NDHS)
Sustained reduction in health
risk behavior and increased
health-enhancing behavior
will improve quality of life
of adolescents
At least 10% point increase in number of
AHD-related IEC activities carried out by
each of the following:
o Schools;
o Health workers;
o Youth groups;
o Faith communities;
o Social groups/PVOs
Increase in the number and types of AHD
services available in the community
Surveys
Number of adolescents who utilize youth
resource center per month
Number of adolescents who participated
in AHD activities organized by
stakeholders’ groups
Project report, Youth
Center management
Information System
Goal
To contribute to improved health and
quality of life of adolescents in Ile-Ife




Project Objective

Increased availability of
community-based AHD-related
activities



Increased access of adolescents to
AHD-related services
Adesegun Ola. Fatusi


Increased availability of,
and access to services
would result in improved
health behavior
Survey
12
PROJECT STRUCTURE
Project Outputs

Conduct baseline assessment of
adolescent health and development
situation

Develop youth-related community
resource profile

Develop advocacy packages on
AHD for 5 stakeholders: schools;
health services; faith communities;
youth groups; social/private
voluntary organizations


Develop Stakeholders’ AHD
action plans
Establish youth resource center
Adesegun Ola. Fatusi
INDICATORS
MEANS TO VERIFY
ASSUMPTIONS

Availability of baseline needs assessment
report
Report of baseline
assessment (survey and
qualitative studies)
Baseline assessment would be
of high quality to inform
appropriate programming

Availability of youth-related community
resource profile
Youth-focused
community profile file,
project report
Youth-related community
resource will provide services
appropriate to adolescents’
needs

Number of stakeholders’ group for which
advocacy packages are available
Advocacy packages
Observation, project
report
Advocacy packages would
stimulate positive AHD
action by stakeholders

Availability of action plans.
Action plans, Project
report
Action plans would be
implemented

Presence of a functioning youth resource
center
Youth resource center,
Project report
Youth resource center will
attract patronage of young
people
13
PROJECT STRUCTURE
Project inputs
INDICATORS
MEANS TO VERIFY
ASSUMPTIONS

Personnel: Project Coordinator,
administrative assistant, youth
mentors, unit leaders and volunteer
youth workers.

Number and types of personnel involved
in the initiative
Project report.
Project personnel would be
available and function
satisfactorily

Audiovisual equipment and
materials

Numbers and types and of audiovisual
equipment and material available
Project report
Anticipated resources would
be available for purchase of
materials

Print materials, including
counseling texts

Numbers and types and of print materials
available for use
Project report.
Anticipated resources would
be available for purchase of
materials

Office space

Availability of office space
Project report
Anticipated resources would
be available for purchase of
materials; and suitable office
space would be timely
available for rent
Adesegun Ola. Fatusi
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TABLE 3: THE COMNET INITIATIVE, ILE-IFE, OSUN STATE, NIGERIA: BUDGET
A. PLP Funding
Activity
Cost
1. Baseline Research and Analysis
1.1. Materials
1.2. Design and Translation of Instruments
1.3. Recruitment and Training of Interviewers, and Pre-testing
1.4. Intervewers' Fieldwork (6 pers. x 10 days x $10)
1.5. Personnels for Qualitative Assessments (4 pers x 3days x $30)
1.6. Focus Group Discussions sessions
1.7. Analysis
Sub-total (baseline research)
250
150
80
600
360
200
1,100
2740
2. Production of Advocacy Packages & Resource files
750
3. Sensistization/Advocacy & Research Dissemination Meeting
110
4. Participatory Evaluation
400
Total
4000
B. In-kind Contributions: Establishment & Operation of Youth Resource Center
1. Office space
2. Furniture
3. Personnel
4. Audiovisual equipment
5. Library resources
Adesegun Ola. Fatusi
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REFERENCES
1 Nigeria Population Commission. Nigeria Demographic and Health Survey 1999. Abuja: NPC
and IRD/Macro International Inc; 2000.
2 Campaign Against Unwanted Pregnancy (CAUP). Abortion in Nigeria. Lagos; CAUP. 1999.
3 Federal Ministry of Health. HIV/Syphilis sentinel Sero-Prevalence Survey in Nigeria Technical
Report. National AIDS/STD Control Programme. Federal Ministry of Health, and Department
For International Development. November 1999.
4 United Nations Development System in Nigeria (UNDS). Nigeria Common Country
Assessment. Lagos: UNDS; 2001.
5 Topolski TD, Patrick DL, Edwards TC, Huebner CE, Connell FA, Mount KK. Quality of life
and health-risk behavior Among Adolescents. Journal of Adolescent Health 2001; 29: 426-435.
6 Flannery DJ, Williams LL, Vazsonyi AT. Who Are They with and What Are They Doing?
Delinquent Behavior, Substance Abuse, and early Adolescents’ After-School Time. American
Journal of Orthopsychiatry 1999: 69; 247 – 253.
7 Jessor R. Behavior in Adolescence: A Psychological Framework for Understanding and
Action. Journal of Adolescent Health 1991; 12: 597 – 605.
8 Fatusi AO. Quality Of Life In Adolescents: Association with Health-Risk Behaviors, and
Implications for Adolescent Health Program Management. Independent Study (Unpublished).
Seattle: University of Washington; 2002.
9 Fatusi AO, Segun BO, Odujinrin O, and Adeyemi AA: National Training Manual for
Adolescent Health and Development in Nigeria. Abuja: Federal Ministry of Health; 2001.
10 Adekunle AA, Onwudiegu U, Fatusi AO, Segun BO, and Adeyemi AA: Clinical Service
Protocol and Service Guidelines for Adolescent Development in Nigeria. Abuja: Federal
Ministry of Health; 2001.
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