In February 2014, an international congress on Promoting Adolescent Sexual and Reproductive Health
(ASRH) took place in Cuenca, Ecuador. Its objective was to share evidence on effective ASRH intervention
projects and programs in Latin America, and to link this evidence to ASRH policy and program
development. Over 800 people participated in the three-day event and sixty-six presentations were
Adolescents in Latin America are at high risk for unwanted and unplanned pregnancies, which often result in
unsafe abortions or poor maternal health outcomes. Both young men and women in the region face an
increased risk of sexually transmitted infections due to inadequate sexual and reproductive health
information, services and counselling. To date, many adolescent health programmes have targeted a single
determinant of sexual and reproductive health.
To improve ASRH services within primary healthcare institutions in three Latin American countries, primary
healthcare providers call for focusing on improving the youth-friendliness of health settings. To facilitate this,
they suggested engaging with key stakeholders, such as parents, schools, and decision-makers at the
When I first arrived in the Cuenca, Ecuador, tobegin ethnographic fieldwork as part of an adolescent sexual
and reproductive health project (CERCA), my colleagues at the University of Cuenca Medical School
assured me that talking about sex with young people, their parents, or anyone else in this predominantly
Catholic city would be difficult.