FHI - May 30, 1997

Protecting Adolescent Reproductive Health -- May 30, 1997

RESEARCH TRIANGLE PARK, NC -- Teaching adolescents about the biology of reproduction, options for preventing pregnancy and how to avoid risky sexual behavior is an effective way to help them preserve their reproductive health, experts say.

Several studies show that sexual health education can delay first intercourse for adolescents who are not already sexually active. For those who are active, including married young people, education encourages correct and consistent use of contraception and ways to prevent sexually transmitted diseases (STDs). A recent World Health Organization (WHO) review of 1,050 scientific articles on sex education programs concludes that "if any effect is observed, almost without exception, it is in the direction of postponed initiation of sexual intercourse."

"Sex education programs may be the only place that young people can learn accurate information about reproductive health," says Dr. Cynthia Waszak, a Family Health International (FHI) researcher who specializes in adolescent reproductive health, in the current issue of FHI's quarterly bulletin, Network. "Sex education programs may offer the only setting in which young people can practice the skills necessary to maintain good reproductive health."

Worldwide, young women and men suffer a disproportionate share of unplanned pregnancies, STDs including HIV, and other serious reproductive health problems. About half of all HIV infections worldwide occur among people under the age of 24, while more than 10 percent of all births worldwide are among teenage mothers, ages 15-19. Many youth who become sexually active do so without accurate information about reproductive health, placing them at a greater risk of unplanned pregnancies or STD infections.

A crucial consideration for any reproductive health service for adolescents is the fact that young people are typically less informed, experienced or confident about sexual matters than older adults. Also, older adults who provide services tend to be more judgmental of youth. Better ways to make services more accessible include addressing the attitudes and training of providers, says Dr. Waszak. "Young people need advocates. And providers need special training to serve youth," she says.

When planning reproductive health services for adolescents and young adults, several key components contribute to success. Identifying and understanding the group to be served, involving youth in designing programs, working with community leaders and parents, and finding better ways to make services accessible are commonly cited as important considerations.

Understanding the specific group to be served includes knowing their age range, school and marital status, and other social factors. Involving youth in several stages of developing a reproductive health program can be helpful, from the initial program design to implementation, and even in the training of providers.

The cultural and traditional values of a community are important factors. Community leaders, parents, teachers and others should be involved in developing these programs. "People promoting health need to pay attention to the values of society," says Dr. Herb Friedman, recently retired director of WHO's Adolescent Health and Development Programme. Making services more accessible will involve different approaches in different communities, but generally should create a "youth-friendly" environment that appeals to adolescents who may be embarrassed or intimidated in seeking services or may have practical obstacles such as lack of transportation.

Understanding the psychological and social pressures that adolescents and young adults face can help in serving this age group. Some problems adolescents face are psychological. For example, many adolescents are afraid, embarrassed or unwilling to take precautions against STDs. Cultural values, such as an emphasis on early marriage, can affect reproductive health.

See Also:

Protecting Adolescent Reproductive Health -- May 30, 1997