Seychelles has made remarkable progress in its health development—achieving impressive healthcare indicators and ensuring that universal health coverage (UHC) is a constitutional right. It is globally recognized as a country that is most likely to achieve Sustainable Development Goals and has demonstrated strong political commitment to doing so through endorsement of a national Sustainable Development Strategy (2011-2020) that integrates public health within all policies. Despite significant advancements towards health equity, Seychelles still faces challenges in the quality and delivery of adolescents’ sexual and reproductive healthcare (SRH) services.These challenges are reflected in increasing adolescent fertility rates (pegged at 94/1000 in 2018), a growing percentage of pregnancies ending in abortion (22%–26%) that occur among women in the age category of 20–29 years and escalating rates of teenage pregnancies with two-thirds of all first pregnancies occurring in the age category of 15–24 years.

To address these challenges, Seychelles set a target to reduce teenage pregnancies by 50% in its National Health Strategic Plan (2016–2020) and has been implementing measures accordingly. However, persistent gap sexist including low contraceptive use and high rates of unintended pregnancies and abortions among adolescents. In recognition of these challenges, WHO’s Country Office in Seychelles (WCO) has been supporting Seychelles’ Ministry of Health (MoH) to improve SRH outcomes and health-seeking behaviour among adolescents. To encourage evidence-based practices, WCO facilitated national-level surveys and research on adolescent reproductive health in 2019.

WCO then leveraged emerging findings to develop an integrated Reproductive, Maternal, Neonatal, Child, Adolescent Health and Nutrition (RMNCAH+N) strategy, and monitoring and evaluation framework. In 2020, through policy guidance and technical support from WCO, MoH conducted a national workshop designed to build agreement around the RMNCAH+N strategy among various stakeholders within the health system, thus enabling implementation. The national workshop secured participation from other bilateral agencies and development organizations working towards related health outcomes, including UNFPA, UNESCO, Doctors4Doctors, Alliance of Solidarity for the Family( ASFF). Bringing together representatives from relevant MoH programs and departments—Health Policy Development program, Youth Health Centre, Pharmaceutical Unit,and the Agency for the Prevention of Drug Abuse and Rehabilitation—WCO was able to secure nation-wide buy-in for proposed RMNCAH+N interventions. Recognizing that implementing newly designed, high-impact, adolescent-friendly interventions would require increased capacities among healthcare workers(HCWs), WCO also facilitated training programs for HCWs across the country. These training programs sensitized HCWs on various barriers that adolescents face when accessing SRH information and services; gaps identified through WCO-led, deep-dive national-level research in 2019. To address this challenge, WHO’s Regional Office for Africa,in collaboration with the Department of Sexual Reproductive Health and Research in Geneva, conducted capacity building workshops for over two dozen healthcare workers on providing comprehensive abortion care services. WCO-led training programs thus built alignment with and adherence to WHO recommendations and clinical guidelines on integrating adolescent-and youth-friendly services within the health system, among HCWs across Seychelles.

Photo caption: Healthcare worker in Seychelles provides post-natal care under WHO-supporter integrated Reproductive Maternal Neonatal Child Adolescent Health and Nutrition.

Photo credit: WHO