Anne Kuster, headshot
Annie Kuster, MAIDP Class of 2020

Annie Kuster, MAIDP Class of 2020, and her research partner Sara Surani have developed a multifaceted proposal to reduce adolescent pregnancy in Peru that is a finalist in the international “Map the System” challenge sponsored by Oxford University. Scheduled to be held and judged virtually June 15-17, the competition will include 31 teams globally from such universities as Harvard, University of Cape Town, Northwestern, Vanderbilt, University of British Columbia, and Oxford, among others.

“We wanted to figure out where we could most efficiently share our ideas,” Kuster says of entering the competition, which provides an award of 4,000 British pounds to the winners. “It is much less for the award itself, and much more for the chance to further develop our understanding of this nuanced space and bring about needed social change in Peru.”

They were the top finishing Harris team among 14 and were selected to represent the school at Oxford. Kuster and Surani hope to implement their program proposal after graduation. They bring a depth experience to this project based on interviews and quantitative research as Fulbright Scholars in Peru in 2018-19.

A photo of someone from behind wearing a hat, and text saying that girls born in rural Peru are 6x more likely than global averages to get pregnant as a teen.
Annie Kuster, MAIDP Class of 2020, and her research partner Sara Surani have developed a multifaceted proposal to reduce adolescent pregnancy in Peru that is a finalist in the international “Map the System” challenge sponsored by Oxford University.

“It’s incredibly exciting that people care about our work and see potential in it like we do,” Surani says. “It feels very assuring and gives us hope that other people see potential in working to reduce adolescent pregnancy in Peru.

Kuster and Surani spent a combined 29 months in Peru living among and getting to know teenage girls who had become pregnant before the age of 15, in settings ranging from the mountains, to the cities, to the Amazon jungle.

“A lot of these young women have this power inside of them, they have their story and have their voice, but so many people haven’t thought to listen to it,” Surani says. “It set a fire inside of us.”

Their work is grounded in more than 50 interviews with adult stakeholders in government, nonprofits, and international and community healthcare resources as well as over 80 conversations with adolescents themselves. They reviewed government legislation, studied academic and international reports, and delved into all available data to make their proposal as strong as possible.

“It’s incredibly exciting that people care about our work and see potential in it like we do,” Surani says. “It feels very assuring and gives us hope that other people see potential in working to reduce adolescent pregnancy in Peru.

The “Map the System” moniker refers to the competition’s focus on identifying multiple solutions, major gaps, and key stakeholders that can be leveraged to bring about needed social change, says Ron Gibbs, Faculty Advisor for Social Entrepreneurship at Harris.  “It’s not just about finding a single, solve-everything solution – these are complex, intractable problems.”

Current policy approaches in Peru, according to Kuster and Surani, are aimed at increasing access to healthcare and sex education, and improving socioeconomic status. But these tend to give short shrift to political will and cultural issues, they argue.

The pair identified five “levers of change,” all inter-connected, as vital to advancing progress: female labor market participation; access to healthcare; a reset of power dynamics between the genders; comprehensive sex education; and decentralization of programming.

A photo of a young girl, Flora, 4 years old, and colorful circles listing the components of their proposal.
Annie Kuster, MAIDP Class of 2020, and her research partner Sara Surani have developed a multifaceted proposal to reduce adolescent pregnancy in Peru.

Surani and Kuster believe a “systemic overhaul” is in order, eyeing reforms like expanding cash transfer programs to focus specifically on women and girls, reallocating funding to regional government, and  mobilizing community health workers to provide access to reproductive healthcare and education in rural communities.

“A lot of these young women have this power inside of them, they have their story and have their voice, but so many people haven’t thought to listen to it,” Surani says. “It set a fire inside of us.”

Kuster sees the recommendation about decentralizing the funding mechanisms as particularly important, noting that the national health ministry only spent 42% of its budget last year.

“It is our hope that the regional governments can make decisions on how to spend that money in ways that are more culturally sensitive,” she says. “The journey that a girl in the jungle has to take to get to the health clinic involves a canoe, and making sure she’s home before dark.  Sometimes she has to travel a full day to reach a clinic only to find herself rebuffed by the doctor for not having parental consent. We therefore have to think about breaking down not only financial barriers to healthcare access, but geographic and cultural ones as well.”

A diagram showing the probable outcomes for teen mothers which the team studies in their project
“A lot of these young women have this power inside of them, they have their story and have their voice, but so many people haven’t thought to listen to it,” Surani says. “It set a fire inside of us.”

Ultimately, Kuster and Surani seek to support partners, stakeholders, and most importantly, community members to design solutions to work towards breaking the cycle of adolescent pregnancy.  Their experiences point toward setting up a nonprofit organization that they plan to call Nayaraq, a Quechua word that means “one with many dreams.” They plan to use Nayaraq to implement their recommendations once they both finish graduate school.

“We’re focused on the question of when and how, vs. if, we are going to try to launch that,” Kuster says.

Gibbs sees great potential for their work. “They have a connectivity and commitment to wanting to solve this problem, which shows their passion in wanting to make a difference,” he says. “Their proposal is a very well thought out road map and strategic approach for reducing adolescent pregnancy in Peru.”