Santiago, Chile

The Global Early Adolescent Study is partnering in Chile with the Faculty of Medical Sciences of the University of Santiago de Chile, and the community of San Bernardo, a district in the southern area of the capital city, Santiago. The district is divided for administrative and political purposes into 68 neighborhood units. According to the district poverty assessment report (developed this year with data from the survey of socio-economic characterization (CASEN) 2017), the multidimensional poverty rate affects 22% of its population, with less than 2% of the population living in the rural sector and less than 1,000 foreign inhabitants with permanent residence. The National Census (2017) indicates that 301,212 people live in the district, with 22,029 being adolescents between 10-14 years old (51.07% men, 48.92% women). These data are similar to national averages.

The Faculty of Medical Sciences has developed a public engagement approach, supporting a local health adolescent clinic; the Comprehensive Adolescent Health Center Rucahueche. This Health Center belongs to the network of health services of the Corporation of Education and Health of the district of San Bernardo (CORSABER), which has a Memorandum of Understanding with University of Santiago. The Rucahueche Center has a multidisciplinary team focusing in adolescent population estimated in 5,500 attentions, considering 43,000 attentions in its 10 year of existence.

The Rucahueche Center develops five programs with adolescents:

Comprehensive outpatient health preventive program, developing different biopsychosocial strategies to prevent, treat and repair promoting health and wellbeing.
Health education and counseling program, focusing in mutual care/selfcare participatory process, with gender focus, and change agents in their environment:
Community Program, with actions in school environments with students and teachers;
Teaching program, for university students in health,
Research program in adolescent wellbeing,

In developing the study, the association with CORSABER, the local government’s Health and Educational areas, has been crucial: The CORSABER coordinates the activities of 41 public educational establishments: 27 elementary schools, 6 middle-high schools and 10 schools that have both, elementary and high school education.

The GEAS Chile study will begin with a formative phase to test the instruments, language, survey items, and methodology; given that Chile was not among the original Phase I sites. This testing will be conducted among 100 students between 10-14 years who visit the Comprehensive Adolescent Health Center Rucahueche in San Bernardo, along with their parents; both will be excluded from Phase II. The latter will compare longitudinal changes in perceptions of gender norms and subsequent effects on adolescent health outcomes over time. A cohort of 1,500 adolescents beginning at ages 10-14 and their parents will be followed over a period of four years. Participants will be drawn from low-income communities in the San Bernardo district of Santiago, attending public municipal and private subsidized schools. Currently, there are ten public schools with these characteristics, all of which will participate in the study.

The qualitative evidence of the global GEAS Phase 1 has proved that gender norms patterns and structure of male and female behaviors among other factors; reinforce the dynamics of unequal power between genders during early adolescence. This process operates across several cultures and helps maintain patriarchal systems. These normative beliefs predispose adolescents to gender-based violence, sexually transmitted infections, early pregnancies, school dropout, depression and a number of negative results in well-being and, specifically, sexual and reproductive health. It is crucial to develop a longitudinal approach to establish the strength of these associations, and to explore these processes over time and across cultures. The results will help to improve local government adolescent policies and programs, aiming to improve the quality of life and increasing the well-being of early adolescents within a gender equity approach.