Reproductive Health: WHO defines reproductive health as “...a state of complete physical, mental and social wellbeing, and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its functions and processes.”
Common SRH Problems of AY
Unwanted Pregnancy:
About 16 million girls aged 15 to 19 give birth every year;
High unwanted pregnancy proportions among 15-19-year-old
Too-Early Childbearing:
Worldwide, more than 10% of all births are to AY
In the least developed countries, teen pregnancy accounts for 17% and 13% in Ethiopia
The 40% of girls in Ethiopia married before the age of 18 years.
Unsafe Abortion:
Abortions performed illegally, under hazardous conditions, and/or by unskilled practitioners
Pregnancy related complications:
Increased complications from pregnancy, childbirth, and unsafe abortion resulting in higher maternal mortality
STI/HIV:
More than half of all new HIV infections occur in those under 25 AYs
More than two-thirds of STI infections occur in developing countries and a relatively low prevalence of HIV/AIDS in the 15-19 age group is lower (< 1%), in Ethiopia.
Sexual Relations and Expressions during Adolescents and Youth
Sexual relations during adolescence are not always consensual The practice of contraception and condom use is often erratic, and Ages of sexual debut for adolescent and youth are generally decreasing. Multiple premarital sex mainly due to arlier age of puberty, combined with the delayed age of marriage
Adolescent and Youth Sexual Health Risk/Protective Factors
Characteristics of SRH information
Adolescent and youth shouldn’t be passive participant in SRH but take part in organizing, delivering and evaluating SRH education e.g. Peer educators,
SRH education and information should be delivered in an interactive way,
SRH education and information is delivered in a continuous way, since the development of SRH is a lifelong process,
Continuity of SRH education and information can be ensured by interacting with different partners in and out of schools,
SRH education and information closely interconnected with the learner’s environment and context
SRH education and information establishes a close cooperation with parents and community in order to build a supportive environment,
SRH education and information is based on gender responsiveness to ensure that different gender needs and concerns are adequately addressed.
AYSRH client assessment
In order to conduct a developmentally adequate sexual and reproductive health assessment, it is important to follow the HEEADSSS
The assessment should also enquire about any protective practices against
pregnancy and STI,
measure the level of sexual risk taking and
any experience with the sexual and reproductive health service
AYSRH assessment questions
Protective practices
Which forms of protection against pregnancy and STIs have you used?
(Context) What, why, when and how was its use or non-use decided?
Sexual risk taking
To what extent do you think about any risks involved with sex?
Have you ever asked a partner to have a test? Why? Why not?
Do you consider yourself to be at risk? Why? Why not?
Have you ever paid someone for sex? Have you ever been paid for sex?
Use of services
Awareness of services, Personal usage, Personal experience of the 1st, 2nd, etc. services visited
How have you found out about the services? Family, friends, youth center, school etc.
Have you ever been to any services for help and advice about relationships, contraception, STIs, sex etc.?
Can you remember how old you were the first time you went there?
WHO Matrix for srh education and information
It is a framework from which the trainer or educator can pick topics from.
This is contextualized for use.
Each theme is categorized to
Knowledge/information: (Reproductive organs and function…)
Skills : (Condom demonstration, communication skill…)
Attitudes: (Menstrual Hygiene Management…)
Counselling for family planning( unmarried adolescents)
Adolescent and youths
Seeks information and cues about sexual life from a variety of sources
Are less informed despite the right on facts about sexual health.
Health-care provider –the source of accurate information Can present them with facts, Respond to their questions and provide reassurance
Menarche and Menstrual Hygiene
The mean age at menarche showed a substantial decline in most countries The age at menarche and menstruation are strongly associated with girls’ sexual debut.
Studies have shown that girls get married before they started experiencing menstruation particularly in rural Ethiopia.
There are misunderstandings of and myth and taboos associated with menstruation among boys and the society at large Studies have shown that girls are discriminated, insulted and isolated as result of menstruation, often associated with absenteeism from school.
Girls in rural and poor urban communities are less likely to obtain and use sanitary pads
Adolescent health literacy must include menstruation and menstrual hygiene
Outcomes of Sexual Education
Behavioral parameters
◆Delay of age of first intercourse
◆Reduction in number of partners
◆Improve in the use of condoms
Biological Parameters
◆Reducing prevalence of STIs
◆Reducing teenage pregnancy
Summary
Sexual and reproductive health rights are basic human rights for Adolescents and Youth
Providers and planners should understand this right of the adolescent to access SRH information and services to have an informed decision Adolescence is the period during which sexual activity is initiated in a substantial proportion of individuals Significant number of Adolescents and youth aged 10 to 24 die each year in the world, mostly due to preventable causes including SRH problems
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