Promoting sexual and reproductive health among adolescents: What works?

The purposes of the study was evaluate the impact of a school-based gender-sensitive sexuality education program on adolescents’ sex-related knowledge, attitudes, and self-efficacy in Lanzhou, northwest China. We used data (N = 1,126) from a quasi-experimental intervention research conducted among students in four high schools. Gender-sensitive sexuality education was provided to all 10th grade students in the intervention group from October 2011 to June 2012. 1222 students enrolled at baseline, and 94.2% of them were followed up at posttest.
Results showed that students in the intervention group had better knowledge and less permissive attitudes toward sexual double standards than those in the control group. Boys in the intervention group also had less stereotypical attitudes toward gender roles than those in the control group. Girls in the intervention group showed significantly more increase in self-efficacy related to sexual decision-making skills relative to those in the control group. The findings demonstrated that gender-sensitive, critical thinking sexuality education approach has advantages over mainstream medical-oriented and abstinence sex education. The study has important implications for developing more effective intervention programs to improve adolescent’s sexual and reproductive well-being.

Inadequate comprehensive efforts towards meeting the demands for sexual and reproductive health needs among adolescent and young people, intensifies the menace of loosing away the progress achieved towards the MDGs over last one decade, particularly in the context of developing countries including India. Using data from DLHS-3, this research evaluated the demographic and socioeconomic differentials in access to family life/sex education (FLE) among unmarried young women in India. Additionally, using the adjusted multiple logistic regression models, the association between access to FLE and attitudes towards range of sexual and reproductive health matters among unmarried women were investigated. Only 48% of unmarried women received some form of FLE. Importantly, the likelihood of possessing positive attitudes towards reproductive activities, knowledge and discussion of contraceptive methods, precise awareness about pathways of RTIs/STIs and HIV/AIDS were significantly higher among women who had access to the FLE. Present study underscores protective role of FLE towards improving the sexual and reproductive life experiences of young people. Henceforth, it emphasizes need for implementing a culturally appropriate and comprehensive programme of FLE to address the sexual and reproductive health needs of the younger cohort in India.

According to 2010 population census, the size of 15-24 age group is about 228 million in China. There is a large potential unmet need among this group regarding reproductive health service, especially among young migrants (about 70 million). Sexual and reproductive health projects focusing on young adults in China have been carried out for more than a decade, from several pilot sites in early 2000s to a larger scale in recent years. Efforts have been made to empower young workers with approaches such as life skill training and peer education. This paper will first review experiences and lessons learnt from youth reproductive health projects among migrants in urban China, then we will introduce a most recent case study in three sites based on site visits, focus group discussion, and in-depth interview, to analyze reproductive health needs among young migrants, service available and gaps. Experiences from different sites imply that approaches should be specifically designed to fit the local situation and to serve different sub-groups, and participation of youth is one of the important factor to support the program be effective. However there is still a big challenge for the existing service system work with youth, especially unmarried ones. This paper will propose more specific approaches for each site to address different needs.

In the course of transition to adulthood, adolescents are exposed to sexual and reproductive health risks. India, being a traditional society, somehow inhibits its adolescents in redressing their queries and thus many of them lack correct knowledge to make informed sexual and reproductive decisions. The study aims at understanding the attitude of adolescents towards sexual matters; involvement in sexual activities and exploring their experiences of pre-marital sex (PMS) or extra marital sex (EMS) through qualitative and quantitative analysis. The study has used data from Youth Study, 2006-07 focused on unmarried and married men and women in the age group of 15-29 years in rural and urban settings. The study highlights that substantial percentage of adolescent considered hugging or kissing acceptable but at the same time they did consented PMS or EMS. Adolescents do involve in romantic relationships and sometimes get engaged in PMS or EMS; however these are widely under cover. As Indian society is in transitional phase, there is need to provide culturally appropriate sex education to cater the adolescents sexual and reproductive health needs to prevent them from perversion’ for taking advantage of demographic dividend in India.

The study examines the sexual behaviour of adolescents living in two urban poor areas in two municipalities in the Brong-Ahafo region of Ghana – to ascertain the extent of sexual activity in the two areas and whether condom is patronized at high risk sex. Using systematic sampling, a total of 501 questionnaires were administered to adolescents in the two municipalities. Bi-variate and multi-variate statistical methods are used to examine the results. A logistic regression model is used to examine the correlates of adolescents’ sexual behaviour. Odds ratio was calculated for adolescents’ sexual behaviour. After calculating the odds ratios, a command ‘listcoef, percent help’ was run in STATA and this provide us with the percent increase per a unit change in a variable. The results show that male adolescents were having sex 0.8 years earlier than their female counterparts. First sexual intercourse among the adolescent was mostly planned. The results revealed that multiple sexual relation was uncommon among the adolescents. Logistic regression results shows that age had a direct and significant relationship with adolescents’ sexual behaviour. For instance, at .001, there was more than 519 percent increase in the likelihoo

Adolescent sexuality constitutes one of the most unattended aspects of young people’s development in Nigeria. Consequently, reproductive health mishaps such as sexually transmitted infections, unplanned pregnancies, abortion, maternal morbidity and mortality are common features among different categories of young women. This study which anchored on Social Action and Rational Choice Theories investigated sexuality education among out-school female adolescent house-helps in Ibadan as a way of understanding the culture of silence that characterises young people’s sexual orientation. Data were collected through 1020 questionnaires, 27 in-depth interviews and 2 case-studies. Findings reveal that although a large majority of adolescents do not receive sex education from parents and guardians, house-helps are disproportionately more disadvantaged. Some house-helps are given sexuality education not primarily for their personal benefit but as a means to indirectly educate guardians’ biological children since these employers’ comfort levels are low to personally undertake the activity. Prioritising sexuality education among adolescents and house-helps in particular will go a long way in demystifying unnecessary insensitivity that pervades sexuality discourses among Nigerian youths.

In sub-Saharan Africa, the transition of adolescent girls to first sexual intercourse is increasingly occurring before marriage. Yet sexual initiation and union formation continue to be analyzed separately, even though it is well-established that social and economic changes have simultaneously affected the timing of marriage and the context of sexual initiation in this region. In addition, most of the existing studies are plagued by the limitations of non-representative cross-sectional data, the only ones generally available. This paper fills this gap by using rich cross-sectional, retrospective data from nationally-representative surveys of adolescents. We analyze simultaneously the factors associated with sexual initiation before and within the first union for adolescent girls age 12-19 in four sub-Saharan African countries: Burkina Faso, Ghana, Malawi and Uganda. Within the framework of event history analysis, we describe the different patterns of sexual behavior among adolescent girls in these countries. We then analyze the factors that shape adolescents’ life-courses during their transition to adulthood by modeling sexual initiation before and within the first union in a competing risks framework. Findings show that parental control has the straightforward effect of delaying sexual initiation before the first union.

Role of teachers is particularly central in the school context: teachers bring their own ideas about gender to the classroom; they may treat students differently based on their own or the student's gender, communicate different expectations for students, assign chores based on sex, and monitor or discipline students differently. This study explores the gender-stereotyped beliefs and perception of secondary school teachers’ in classroom practices. A total of 257 teachers’ participated in this study conducted by International Center for Research on Women (ICRW), as a part of ongoing Gender Equity Movement in Schools (GEMS) Project. A self-administered questionnaire was used to generate responses from teachers on how gender-stereotypes are played out in their classroom practices. Results indicate that most of the teachers surveyed directly or indirectly promote gender-stereotypes. Data reveals that female teachers are more gender equitable than male teacher, regression result depict that female teachers are significantly 3.7 times more gender equitable than their counterpart male teacher. The study recommends that teacher’s education curricula for both pre-service and in-service must be permeated with opportunities to acquire gender sensitivity knowledge, skills and develop attitudes in classroom layout.

Early marriage as well as early child bearing is rampant in India. Early child bearing has adverse effect on the mother and the newborn. In spite of global influence on the paradigm shift in reproductive health approach, no population in the world has yet met the goals set at the ICPD, and the predicaments are particularity acute in developing countries. This paper examines the relation between age at initiation of child bearing and utilization of maternal health care services among currently married women in India. The 3rd round of District Level Household and Facility Survey 2007-08 is the data source of the study. The study employed bi-variate and multivariate analysis. Insofar as the ANC, safe delivery and PNC is concerned the pattern of its utilization varies across the different segments of the society. The findings of the study reveals that the women who initiate child bearing before the age of 18 have a very low level of maternal health care services utilization than the women who initiate child bearing after the age 18. This difference is persistent in the subsequent birth order and across the background characteristics.
(Key Words: Child bearing age, maternal health, India)

Attitude of today’s youth is changing from romantic relationship to casual sex. West influenced societal norms & liberal sexual culture in metros offers varied avenues for sexual experiences adding opportunity for sexual liaisons. Findings derive from study in slum of Mumbai with randomized cluster sample of 1239 men age 18-29 using in-depth interviews and survey. Results show, 80% of romantic relationships are translated in sex. 10% of respondents reported multi-partner behavior in last one year and 1/5th of respondents reported their “girlfriend” as married. Study reveals that peer network, self assessment as sexual partner and perceived relational satisfaction with girlfriend are significantly affecting the safe sexual behavior and coercive sex. The multi-partner behavior is affecting condom use negative whereas is catalyzing alcohol use and also coercive sex. Findings facilitate understanding of changing sexual culture & behaviors and highlights need to fully informed and equipped youth to make safe choices.