ARH in Cambodia (Phnom Penh and Sihanoukville municipalities and Battambang and Kampong Cham provinces). RAS/98/P12

In Cambodia, the International Planned Parenthood Federation, through the Reproductive Health (RH) Association of Cambodia, seeks to help strengthen the national capacity to deliver RH services and high-quality RH information, education and communication (IEC) materials for adolescents in four project areas. It also aims to increase the utilization of RH services by young people aged 12-25 years. Its strategies include providing back-up IEC services and specialist technical inputs to the production of radio shows, and sharing the family life education curriculum as a resource. The main activities of the project consist of: 1) meeting with stakeholders to encourage community participation and carrying out needs assessment; 2) organizing adolescent reproductive health services and providing special clinic facilities; 3) setting up of youth club activities and mobilizing, training and supporting youth volunteers to provide outreach, peer education and referrals to clinic services; and 4) training and disseminating IEC materials.     

Media education to improve adolescent sexual and reproductive health in Cambodia. RAS/98/P10

Through the use of interactive radio and other media, Health Unlimited through its implementing agencies, the Cambodia Health Education Media Services and Cambodia Health Education and Development is working towards increasing knowledge of reproductive and sexual health among Cambodian adolescents. It also seeks to promote the use of reproductive and sexual health services for the youth; improve youth involvement in developing information, education and communication (IEC) materials on reproductive health; and increase the capacity of nongovernmental organizations, government agencies and the private sector to develop IEC for the youth. The strategies being pursued include exploring the role of radio and using nongovernmental organization expertise in radio show production and sharing IEC messages with the media. The main activities being carried include the production of interactive radio magazine programs for the youth along with magazine supplements, training of health and media staff and providing them with work experience, and involving the youth in media production by using an interactive format and focus group discussion.     

Reproductive health for vulnerable children and youth in Cambodia. RAS/98/P14

In Cambodia, Mith Samlanh/Friends, through Pharmaciens Sans Frontier, is developing a project aiming to provide reproductive health (RH) information, education and care among vulnerable urban youth and children in squatter areas, pagodas and streets. The project also seeks to reintegrate vulnerable youth and correct abusive and risky behavior, introduce RH services in vulnerable communities, and to build the capacity of partner nongovernmental organizations in all aspects of the project. As its strategy, it works with vulnerable groups, including commercial sex workers and street children in Phnom Penh and Kampong Cham province, to teach them useful skills. A summary of the main program activities is presented.     

National news. Cambodia. The future of ARH

The escalating HIV/AIDS crisis in Cambodia underscores the importance of reproductive health programs aimed at adolescents. Although the Cambodian Government has not developed a strategy specifically aimed at reaching youth, it has initiated several related health promotion and HIV/AIDS prevention programs. Such programming is especially urgent in light of rapid economic changes in Cambodia and the growing influence of the mass media on urban youth. An in-country paper prepared by a staff member of the Youth Department of Cambodia's Ministry of Education, Youth, and Sports stressed the importance of four factors: 1) designation of young couples as a target for birth spacing campaigns and services, 2) realistic HIV/AIDS educational messages in the mass media, 3) incorporation of traditional practices in adolescent reproductive health campaigns, and 4) greater sensitivity to youth culture and habits.     

Reproductive health through community involvement with special attention to adolescents and clinical contraception. RAS/98/P63

This article outlines the objectives, strategies and main activities of Save the Children Fund/Bangladesh to increase reproductive health (RH) through community involvement with special attention to adolescents and clinical contraception. It is noted that the ways to increase the range of reproductive information and care available to adolescents are being explored, with a view to improving their sexual and RH knowledge and practices, and to increasing clinical contraception use. The following strategies are being implemented: 1) strengthen the capacity of local partners, which include the districts of Khulna, Moulavibazar, Cox's Bazar and Panchagarh; 2) conduct participatory workshops with adolescent groups; 3) promote advocacy for adolescents regarding their needs; 4) develop a platform for adolescent and adolescent-friendly clinics; and 5) promote community-based programs in RH and family planning, especially contraception. A summary of the main program activities of the project is given.     

Survey reveals slow strides in promoting adolescent reproductive health in Vietnam

This article presents the findings of a survey evaluating the adolescent reproductive health program by the Vietnamese Government. Conducted by the Population Research Consultants, survey findings revealed several setbacks of the adolescent reproductive health program; these included the following: 1) adolescents favor radio, television and newspapers as sources of reproductive health (RH) information; 2) adolescents have no knowledge of pregnancy, sexually transmitted diseases, and HIV/AIDS prevention; 3) the demand for RH information varies according to the sociodemographic characteristics of respondents; 4) while the majority of adolescents do not favor premarital sex and premarital pregnancy, their choice is to keep and deliver the baby in case of a premarital pregnancy; 5) adolescents give a poor rating to the quality of RH/family planning services at the centers; 6) adolescents need to further understand RH but not knowing its meaning, they cannot tell what type of information they require; 6) adolescents have poor knowledge of adolescent reproductive health; 7) friendship and love are often discussed among adolescents, but sexuality rarely is; and 8) adolescents have poor knowledge of RH and poor interest in RH/family planning service facilities.     

Strengthening access to improved reproductive health services through the Bangladesh Red Crescent Society. RAS/98/P64

This project aims to strengthen access to improved reproductive health (RH) services through the Bangladesh Red Crescent Society (BDRCS). Being the implementing agency, the facilities and technical and human resource capacity of BDRCS should be strengthened in order to manage quality RH services, especially clinical family planning and safe motherhood activities. In addition, strengthening of the BDRCS should be done to enhance Red Cross volunteer activities by mobilizing grassroots men and women to raise the demand for family planning and reproductive health services, with assistance from government health workers. To this effect, several strategies are implemented: 1) upgrade two BDRCS hospitals in Sylhet and Banglabazar; 2) provide postnatal counseling for clinical contraceptive by trainee paramedics and nurses; and 3) establish referral linkages with other RH international partners. Target groups include the Sylhet town and old parts of Dhaka City. An outline of the main activities of the project is given.     

AD/HD: The role of teachers in the assessment of children suspected of having AD/HD

In the light of recent guidance published by The National Institute for Health and Clinical Excellence (NICE) on the diagnosis and management of attention deficit disorders in children, young persons and adults, Gill Salmon, a consultant Child and Adolescent Psychiatrist based in Swansea, South Wales, and Amanda Kirby, Professor of Developmental Disorders in Education based at the University of Wales, Newport, give an overview of the rationale for involving teachers in the assessment of children with AD/HD and the development and implementation of subsequent educational interventions. They also review the resulting training implications; explore some of the obstacles to multi‐agency, multi‐disciplinary working; and examine how current special educational needs policy goes hand‐in‐hand with the tiered approach to provision of child and adolescent mental health services in offering a graduated response to these children.     

Expanding access of low-income women and men to reproductive health services in underserved urban / peri-urban areas. RAS/98/P62

This article outlines the objectives, strategies and main activities adopted by the Marie Stopes Clinic Society in expanding access of low-income women and men to reproductive health (RH) services in underserved urban/periurban areas. The overall objective of the project is to help increase the utilization of family planning and RH services among low-income men and women in the towns of Moulavibazar, Laxmipur, Narsingdi, and Keraniganj in Bangladesh. To achieve this, the strategies being pursued include: 1) establish four clinics in the towns; 2) enhance the capacity to organize RH service delivery and promote RH advocacy through information, education and communication materials and campaigns; and 3) establish linkages with RH international partners, other nongovernmental organizations, government health programs, as well as non-formal practitioners with the community. The main activities are enumerated and discussed.     

Promotion of adolescent reproductive health and healthy living. Malaysia

This article discusses a 3-year project, "Promotion of Adolescent Reproductive Health and Healthy Living," which was implemented by the Federation of Family Planning Associations, Malaysia. The project seeks to achieve the following: 1) development of a reproductive health of adolescent module (RHAM) for trainers and educators; 2) training of trainers; 3) sharing of adolescent reproductive health experiences in Asian countries; and 4) setting up three service models in Sabah, Selangor, and Terengganu to provide reproductive health (RH) care to adolescents and youth. The first part of the RHAM with the trainer's manual has been finalized and will be tested in a workshop. The second part, a teacher's guide, is under preparation. A series of training on the use of the RHAM will be conducted including a 5-day national workshop, which will be followed by several state level workshops. The three service models being set up have specific orientations. The Sabah model is putting up a youth clinic for adolescents within its clinic network. The Selangor model is developing a Youth Resource Center for training and youth involvement in RH activities. Lastly, the Terengganu family planning association (FPA) has developed a Youth Center web site, which features the history, mission, and activities of the Terengganu FPA.     

Maldives: empowering adolescents and women

In response to the special needs of Maldivian adolescents, who constitute 47% of the total population, the Maldivian government has targeted the group for social development programs. In the Health Master plan (1996-2005), interests of adolescents and women are highlighted. Health policies for adolescents emphasize the intensification of information, education and communication services, particularly special campaigns and the creation of conditions and environments that empower women and adolescents to share the responsibility for healthy living. In addition, there has been an integration of population education in existing subjects at the primary and middle school levels. The Non-Formal Education Centre has also implemented a population education program, a UNFPA bilateral project supported by UNESCO since 1994. Despite these initiatives, a major challenge remains--making sure that teaching and information dissemination methodologies are appealing and attractive to the adolescent target group.     

National news. Indonesia. Promoting ARH awareness

Limited availability of IEC materials is hindering efforts to promote adolescent reproductive health in Indonesia. This, in turn, reflects a lack of awareness on the part of policy makers and community leaders about the importance of interventions directed at young people. Two ongoing United Nations Population Fund projects seek to promote awareness of adolescent reproductive health needs in Jakarta, Yogyakarta, West Java, Bali, Lampung, and Riau. A coalition of governmental and nongovernmental agencies has been established to implement the project. By project end in 1999, government agencies and nongovernmental organizations are expected to have incorporated youth-oriented activities into their overall programming and formulated relevant policy guidelines. Another project (Strengthening Strategies to Improve Adolescent Reproductive Health through Materials Development), implemented by the Indonesian Planned Parenthood Association, is focusing on the development and distribution of reproductive health materials for specific target audiences.     

Resisting risky sexual activity: SHINE project shows how. Philippines

This article presents the Sexual Health Initiatives through Networking and Education (SHINE), an 18-month project on reproductive health for young adults 13-25 years old by CARE/Philippines. SHINE targets the two most likely places to effectively reach large numbers of youth: the school and the workplace. Completed in December 1999, the project has made significant achievements in increasing the youth's knowledge of important reproductive health issues and enabling them to make informed decisions about their reproductive life. In addition, it has established a referral network of service providers to ensure sustainable access to quality reproductive health services. During its implementation, it addresses cultural constraints in promoting adolescent reproductive health in the Philippines. The SHINE Project encourages the involvement of the youth, school and community through the parents and other concerned organizations/agencies. It enables the youth to increase their knowledge and to focus on values that would guide them in making the right decisions about their reproductive life. Moreover, it provides supporting structures for the young, including youth-friendly medical facilities that offer counseling and medical services.     

Riding the dragon: developing inter‐agency systems for supporting children

‘Better inter‐agency working’ has been the oft‐quoted remedy to many reviews of services to support vulnerable children and young people, and yet outside the realms of tightly focused specialist teams it seems to be very difficult to achieve. Georgina Glenny here reviews three case studies of interdisciplinary and inter‐agency working to examine some of the reasons for the difficulties and some of the factors that contribute to success. Her findings suggest that, however ‘loose‐knit’ they are, members of children's services can work together effectively if they feel themselves to be part of a common project served by an inclusive communication system. In the successful case studies the ‘common project’ was defined by an agreed central purpose to guide action within a defined geographical locality. Central to achieving this purpose was a carefully managed series of communication feedback loops to ensure good quality information was being shared at all levels. With this communication system in place the complex system of relationships and actions that resulted could be reflected upon and continually tweaked to ensure that ‘project purpose’ was achieved or at least ‘worked towards’ in a managed way.     

Career Guidance and Counselling for Youth: What Adolescents and Young Adults are Telling Us

The area of career guidance and counselling for youth is undergoing rapid change in light of evolving expectations of young people as members of society and rapidly changing educational and career opportunities. This article summarizes previous research describing the perspectives of adolescents and young adults, and concludes that there is a need to re-examine the assumptions underlying career advising, guidance, and counselling programs offered to young people; and also to re-develop these services to better reflect current economic, career, and social realities.     

Rural underpinnings for resiliency and linkages (rural): A safe schools/healthy students project

Rural Underpinnings for Resiliency and Linkages (RURAL) is an example of a Safe Schools/Healthy Students (SS/HS) project. RURAL provides services to children and families in a rural Kansas county. The county's rates of juvenile alcohol and illicit drug use are higher than state averages. The RURAL project was designed to enhance existing partnerships among three school districts, the local community mental health center, law enforcement, the regional prevention center, and Fort Hays State University. A significant number of evidence‐based strategies were implemented in the schools and community in a short period of time. Using a public health approach to increase school safety and promote healthy behaviors, RURAL introduced strategies designed to provide universal prevention for the school population, early intervention for at‐risk children and families, and intensive services for those with the greatest needs. Services were provided to students (preschool–young adults) and their families. School psychologists held key roles in the development, implementation, and management of the project. Preliminary evaluation findings are presented, and the importance of local process and outcome evaluation is discussed. © 2003 Wiley Periodicals, Inc. Psychol Schs 40: 531–547, 2003.     

Strengthening strategies to improve adolescent reproductive health through materials development. Indonesia

This article concerns a 3-year materials development project that was implemented by the Indonesian Planned Parenthood Association and the Bureau of Non-Physical Family Resilience. The project was developed in response to the need for improving adolescent reproductive health in Jakarta, Yogyakarta and West Java, where adolescent problems have been increasing during the last decade. The project's long-term goal is centered on raising the commitment of families to instill in their children a better understanding of adolescent reproductive health concepts and desirable family values. For its short-term objectives, the project seeks to develop a basic information, education and communication (IEC)/counseling strategy and policy in support of a family-centered approach to adolescent reproductive health; promote better understanding of reproductive health needs of adolescents among the policy-makers; and improving the IEC/counseling skills of personnel at the community level. The project used five strategies to achieve its goals; namely, 1) preparation of a media development and production plan; 2) conducting a needs assessment; 3) production of three types of materials; 4) implementation of three key activities; and 5) periodic monitoring of activities.     

Expanding access to quality reproductive health services in underserved outlying districts in Bangladesh. RAS/98/P65

In Bangladesh, the International Planned Parenthood Federation, through the Family Planning Association of Bangladesh, works to increase access to quality reproductive health (RH) care services among low- and medium-income groups in underserved outlying districts. The strategies being pursued are as follows: 1) expand RH services (with special emphasis on long-term methods) through special work units/upgraded clinics and mobile clinics; 2) develop and use information, education and communication materials for information and awareness raising; 3) hold community-based meetings for information dissemination, RH awareness and motivation, and clinical contraception; 4) conduct advocacy campaigns to increase demand for RH services; 5) organize adolescent school-based programs and peer group meetings on awareness raising and RH; 6) strengthen field units/local nongovernmental organizations and community based organizations through training and support; 7) promote inter-linkages with other RH information partners, government agencies and other nongovernmental organizations; and 8) establish a cost recovery process for sustainability. A summary of the main activities of the program is provided.     

Families,schools, individual characteristics,and young adults’ outcomes: Social and cultural group differences

A moderation-mediation model was developed to investigate relationships among adolescents’ family, school learning environments, individual characteristics, and measures of the academic, affective, and social outcomes of young adults from different cultural backgrounds. Data were collected as part of a longitudinal survey of Australian youth. The findings indicated that: (1) adolescents’ family backgrounds, family and school capital, and individual characteristics combined to have a large association with young adults’ educational attainment, a small relation to subjective well-being, and a medium association with social engagement, (2) adolescents’ family backgrounds moderated relationships between the intervening variables and young adults’ educational attainment and social engagement, (3) the intervening individual characteristic and social capital variables partially mediated the relationships between family background and measures of the young adults’ outcomes, and (4) after taking into account the other predictors in the model, young adults’ earlier educational attainment was related to their later attainment and social engagement.