When people decide to work together, things happen. A perfect example of this is the Campaign to End Teen Pregnancy in San Ramón, a collaboration between ten different organizations, including ourselves. We’re pooling our resources to confront this serious health problem in San Ramón.

And when I say it’s serious, I mean serious. So far this year, 30% of pregnancies in San Ramón have been in teens and adolescents. As of right now, there are 162 pregnant girls from 10 to 19 years old, and of those 162, 20 are between 10 and 14 years old. Studies in teen and adolescent pregnancy in Nicaragua show that the most common factors are sexual abuse, traditional “machista” beliefs about gender roles that lead to early marriage, lack of education (particularly sex ed), and lack of knowledge and access to contraception. In all of Nicaragua, San Ramón has one of the highest rates of teen pregnancy.

Teen pregnancy is a very difficult problem to combat because it is rooted in social norms and long-held beliefs about gender roles. While access to contraception is important, it doesn’t solve the problem. As any health worker can tell you, you can give out condoms all day, but that doesn’t mean folks will use them. Changing the way people think means teaching them to think differently, and that takes a lot of time and effort. There are lots of non-profits that have education initiatives, but more often than not they work in isolation, working in one small community in the hope of making their budget stretch far enough to see a real impact, albeit on a micro-scale.

That’s where San Ramón and the organizations that work there stand out. Last year, I was invited to a meeting called the “Local Partners” meeting, where once a month public institutions and non-profits meet to talk about the problems we face in San Ramón and how to combat them. Some of the state institutions who participate are the Ministry of Health, the public defender’s office, and the police department, and among the non-profits there are Medicos del Mundo, ODESAR, World Vision, El Movimiento Comunal Nicaraguense, Grupo de Mujeres Sacuanjoche, ANESVAD, CESESMA, and of course, SCSRN.

It was decided last year to focus on combating teen pregnancy in San Ramón, and since then the different organizations involved have hosted a series of health fairs, public marches against domestic violence and sexual abuse, and public campaigns to educate people in rural communities about the risks involved with teen pregnancy and how to prevent it. They also formed “teen circles” in 11 different communities, where once a month over 40 participating teenagers receive sexual ed and life skills training that they replicate in their communities with other teens. Perhaps the most ground-breaking have been the trainings with groups of men titled “They’ll know me for the example I set.” Male community leaders meet to learn about how to recognize and stop domestic violence and sexual abuse. They also have learned about the importance of contraception and doing their part to prevent teen pregnancy.

Teen leaders participating in sexual and reproductive health workshop, led by Grupo de Mujeres Sacuanjoche

Each month, the organizations get together to see what each can contribute to the month’s activities. Some contribute the health workers and trainers; others the materials, workspace, or lunches for the workshops. We’ve provided our truck for transportation. With each group contributing something small, the program has been a success. We’ve seen significant change in the attitudes of the participants, and since they are leaders in their communities, we can see the impact they’re having on their neighbors.

For some reason, there is a spirit of collaboration in San Ramón that is seldom seen in other rural counties of Nicaragua. Communities are more organized; the public and the private sectors are more open to dialogue. Maybe it has something to do with the history of San Ramón, which was the center of a lot of clandestine organization before the revolution. Whatever the reason, there is something special about San Ramón, and we’re proud to be a part of it!