Adolescents in Latin America are at major risk for unwanted pregnancies leading to unsafe
abortions and maternal health risks. Mostly, adolescent health programmes tend to focus on
unidirectional interventions aiming at a single determinant of adolescents´ sexual and
reproductive health. However, evidence exists that a complex health problem should be
addressed by an equally nuanced and multipronged response. Knowledge is lacking on how to
develop a comprehensive approach to promote adolescents' sexual health.
The CERCA study will conduct an implementation based on the hypothesis that a comprehensive
strategy of community-embedded interventions helps to improve the sexual health of
adolescents. We will test this hypothesis and describe the development, implementation and
testing of interventions in three Latin American cities: Cochabamba (Bolivia), Cuenca
(Ecuador) and Managua (Nicaragua).
The research methodology has been designed based on the methodological frameworks of action
research, community based participatory research and intervention mapping.
The interventions are complex addressing different target groups (adolescents, parents,
authorities and health providers) and focussing on various behaviours that are related to
communication about sexuality, information seeking, access to health care and safe sexual
For the evaluation of effectiveness a randomised and non-randomised controlled study was
developed for respectively Managua and the two other cities. Furthermore a process evaluation
This research will result in a framework that will contribute to the planning of
interventions that are effective and responsive to adolescents' sexual health needs.