Democratic reform paves the way for new reproductive health strategy and advocacy. Mongolia

Ms. Munkhuu, senior adviser to the Reproductive Health Advocacy Project in Mongolia, reports the implementation as well as the impact of its National Adolescent Health Program. She relates the program's beginnings with the adoption of the National Program in Reproductive Health in 1997, which made adolescent reproductive health issues a public concern. Through the program, formal health education was incorporated in the secondary school curriculum. Other developments of the program were the training of trainers, publication of a quarterly newspaper called the Uerkhel--Love for adolescents, creation of educational radio and television programs on adolescent sexuality, and the establishment of a hot line service. In conclusion, Ms. Munkhuu emphasizes the need to make the program more effective and responsive by improving the country's information system and by increasing reproductive health awareness among policy-makers and the general public. Advocacy training should also be actively pursued.     

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.     

H is for "homeroom". The Philippines' Revitalized Homeroom Guidance Programme (RHGP). Davao's teen center. FAD's approach is preventive

The Davao Teen Chapter (DTC), a component of the Family Planning Organization of the Philippines, has a 10-year history of work among youth around issues of reproductive health, gender equality, and responsible parenthood. DTC's counseling service provides face-to-face counseling to about 25 teens each week and telephone counseling to another 125 callers a month. The chapter's most recent activity has been production of two radio programs. The first, "Love Letters from Your Heart," provides listeners with advice on peer pressure, boy-girl relationships, unplanned pregnancies, parent-child communication problems, and other problems commonly experienced by teenagers. The second, "Love, Sex, Marriage, and Career," focuses on more complex issues such as homosexual relationships, HIV/AIDS and other sexually transmitted diseases, rape, and abortion. As a result of the popularity of these programs, DTC plans to introduce the format to other radio stations.     

Programme guidelines. How effective are sex education programmes? Findings

Adolescent reproductive health program promotion in Asia and Oceania has been hindered by a lack of appreciation on the part of parents, educators, policy makers, and development planners of the benefits of sex education. Concerns persist that sex education encourages adolescent promiscuity. However, a World Health Organization review of 1050 studies on sex education failed to provide any support for this position. In fact, the research shows that sex education can actually help to delay first intercourse among teens who are not already sexually active and promotes consistent contraceptive use among those who are sexually active. A comprehensive literature review commissioned by the US Agency for International Development as well as a US Centers for Disease Control study corroborated this finding. Cross-national comparisons have indicated adolescent pregnancy rates are lower in countries with liberal policies in terms of sex education programs and the provision of adolescent sexual health services.     

Bhutan: impressive strides in health and education

This article reports the important developments in adolescent health and education status in Bhutan. These developments consist of a change in the focus of Bhutan's UNFPA-supportive reproductive health services. The country has also included adolescents as a primary target of reproductive health services. Adolescent girls have become the beneficiaries of a school health program developed by the Division of Education, and a comprehensive youth guidance program is under development by the Youth Guidance and Counseling Section of the Education Division. This change is a response to the increasing youth population; over 58% of the total population is aged under 25 years, and over 15% is aged under 15 years. Although initiatives to improve youth status has been undertaken, some problems still remain. These include malnourishment, pregnancy complications, and rise of sexually transmitted diseases, which raises the potential for the spread of HIV/AIDS.     

Nepal: positive trends in ARH

This article records the Nepalese Government's adoption of a strategy, which is consistent with Nepal's second long-term health plan (1997-2017). The primary health care system would deliver an integrated reproductive health package, which gives emphasis on gender perspective, community participation, equitable access and intersectoral collaboration. In addition, some of the appropriate interventions being pursued are the formulation of national policies, provision of counseling and sex education and information, supplying contraceptives, and delivering youth-friendly reproductive health services. However, serious problems hindering efforts to implement effective adolescent reproductive health programs include limited access to food and health care; high infant and maternal mortality rate due to early and frequent pregnancies; low level of contraceptive use and increasing frequency of sexually transmitted diseases cases among adolescents; and low level of literacy, particularly among girls.     

Sri Lanka: a holistic approach to reproductive health

In response to the request of Sri Lankan adolescents in the provision of family planning knowledge prior to marriage, a holistic approach to reproductive health education program supported by the UN Population Fund/Dutch multi-bilateral assistance was adopted. This program is jointly coordinated by the Social Science Department of the National Institute of Education and the Department of Science and Health. It conducts counseling by peers and teachers and educating parents concerning adolescent health. In addition, the Government invited nongovernmental organizations and private sectors to assist in the development of a national policy concerning reproductive and adolescent health. Policy statements were recognized by the public and programs at the community level were implemented by a task force. The government initiated preventive strategies through the counseling center network of the National Youth Services Council and the vocational training centers of the Vocational Training Authority. Reactions of Sri Lankan adolescents to these initiatives have been positive. They have demonstrated favorable attitude towards reproductive health and are receptive to family planning concerns. However, there is still a need to provide an organized service delivery program to ensure the availability and provision of contraception to adolescents.     

Developing a program for sexually abused adolescents: The research-service partnership

This paper outlines the process of developing and implementing a new community service program for sexually abused adolescents and highlights the advantages of a functional research-service agency partnership in shortening the planning phase and sharpening the focus on such key factors as program components, site selection, and evaluation approaches.Data have been presented at the mid-point of the demonstration program's operation that show the program to be achieving its purposes in terms of impacting the rate of reporting and confirmation of child sexual abuse in the community.Other data indicate that the program is, in fact, being utilized as intended primarily by adolescents and that the incidence of reported and confirmed adolescent sexual abuse in particular is rising as a result.Impressions concerning the overwash effects of the program upon the community—and surrounding communities—have also been presented.The ultimate value of a continuing research-service agency partnership will perhaps be best determined by the quality of the final report on the program to be prepared in March, 1979. We expect chat the research emphasis upon accuracy in the data and the service interest upon interpreting their practical import will yield an honest assessment of the program's impact and its usefulness to other communities in meeting the needs of adolescent victims of sexual abuse.     

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.     

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.     

Giving adolescent reproductive health and population issues a world view. Sri Lanka

This article reports on the production of 52 video programs addressing reproductive and sexual health and reproductive rights issues by the Colombo-based Worldview International Foundation. The UN Population Fund (UNFPA) and relevant NGOs and institutions chose the themes. Following the production, the video programs will be broadcast through Young Asia Television, which covers 18 countries in Asia and reaches over 385 million viewers, and other channels. This advocacy program is under the Television Advocacy Program for Adolescent Reproductive Health and Population Issues project, which complements special strategies under the European Commission/UNFPA Initiative for Reproductive Health in Asia. By promoting the global dissemination of information and education, the Worldview project aims to 1) strengthen young people's participation; 2) advance TV media advocacy; 3) advocate the inclusion of population, gender, sexual and reproductive health issues; 4) provide extended knowledge of adolescent reproductive health to all concerned groups; 5) encourage positive attitudes towards preventive methods among the target groups; 6) promote the importance of incorporating gender perspectives and child abuse issues; and 7) establish close cooperation among organizations at the national, regional and international levels.     

The impact of birthweight and adolescent health on educational attainment

This article examines the relationship between birthweight, adolescent health (general health and psychological distress) and high school completion in Norway, using survey data linked to longitudinal registry data (n?=?5,354). The findings show that the positive association between birthweight and high school completion can be attributed to socioeconomic status. General adolescent health is explained by socioeconomic status combined with risk- and protective behavior. Psychological distress is mediated by having a close relationship with family and friends among the most affluent students, but not among the lower-income students. Among the lower-income students it was, instead, absence from school and feeling comfortable in class that mediated the association between psychological distress and high school completion, net of other factors.     

Programme guidelines: effective and ineffective school-based sex and HIV / AIDS education programmes

In several countries, despite considerable opposition to sex and HIV/AIDS education programs, school-based reproductive and sexual health education is gradually gaining ground. It has expanded to include adolescent and sexual health. There exist positive trends and evident changes in the delivery of school-based reproductive and sexual health education. Among these are the following: 1) systemic and deliberate incorporation of adolescent reproductive and sexual health issues in the school curriculum in countries that have UN Population Fund population programs; 2) inclusion of reproductive and sexual health issues in different subjects, which paves the way for their incorporation into the curriculum; 3) continuous improvement in the delivery, content, methodologies and activities of population education, particularly the inclusion of topics concerned with reproductive and sexual health and greater emphasis on the behavioral and skills development; and 4) the growing nongovernmental organization involvement in the provision of reproductive and sexual health education and training. Numerous factors ensure the success of the programs; they are the use of social learning and cognitive behavioral theory and clear mission statements, communication and negotiation practical exercises, values formation, interactive strategy development, effective training, behavior change--particularly with regard to risk-taking behavior, and provision of a supportive environment.     

The Core Competencies for Adolescent Sexual and Reproductive Health

The Adolescent Sexual Health Work Group commissioned the development of core competencies that define the knowledge, skills, and attitudes necessary for all providers of adolescent sexual and reproductive health. This article describes the background and rationale for this set of competencies, the history and use of competencies, and the process involved in creating the core competencies. It explores the ways that educators can use them to strengthen classroom instruction and improve outcomes for adolescents in the area of reproductive health. Several additional tools that guide the application of the competencies to human resources, self-assessment, performance assessment, professional development, and program evaluation are described.     

Engaging school personnel in making schools safe for girls in Botswana,Malawi, and Mozambique

Girls are vulnerable to HIV in part because the social systems in which they live have failed to protect them. This study evaluates a program aimed at making schools safe for girl learners in order to reduce girls’ vulnerability to HIV in Botswana, Malawi, and Mozambique. In addition to an extensive process evaluation with school personnel program participants, program facilitators, and community members, a cross-sectional post-intervention survey was conducted among adolescent girls in the three countries. The total sample size was 1249 adolescent girls (ages 11–18). Bivariate and multilevel, multivariate analyses were conducted to assess the association between school participation in the intervention and a decrease in teachers offering sex in exchange for academic favors. In Botswana, girls who attended an intervention school, as compared to girls who attended a non-intervention school, were significantly more likely to report a reduction in teachers offering sex in exchange for favors. Communication interventions that both challenge and empower school personnel to create safer environments for schoolgirls can have positive effects, particularly in settings with sufficient resources to support change.     

Service needs of adolescent parents in child welfare: Is an evidence-based,structured, in-home behavioral parent training protocol effective?

SafeCare is an evidence-based behavioral parent training intervention that has been successfully implemented in multiple state child welfare systems. A statewide implementation in Oklahoma established the effectiveness of SafeCare with a diverse group of parents, which included adolescent parents under 21 years of age, a particularly at-risk group. The current study examined whether SafeCare is also effective for this subsample of 294 adolescent parents with regard to child welfare recidivism, depression and child abuse potential, and attainment of service goals. Post-treatment adolescent parent ratings of program engagement and satisfaction were also examined. Among the subsample of adolescent parents, the SafeCare intervention did not result in significantly improved outcomes in terms of preventing recidivism or reduction in risk factors associated with child abuse and neglect as compared to child welfare services as usual. Further, no significant differences in program engagement and satisfaction between SafeCare and services as usual were detected. These findings shed light on the potential differences in program effectiveness between adolescent and adult parents, and the need for future research to rigorously evaluate the effectiveness of behavioral parenting programs with adolescent parents.     

未婚青年生殖健康现状及对计生服务的需求

采用问卷调查方式，调查内容包括未婚青年生殖健康现状、对婚前性行为、人工流产的态度与看法、对计生服务的需求状况与期望；结果表明：1、农村未婚从业青年婚前性行为、人工流产有明显增多趋势，人流经历确实造成了身心伤害；2、未婚青年迫切需要生殖健康与避孕节育措施服务；3、计划生育部门应有效转变观念，拓宽服务领域，提高服务质量。     

Throwing the baby out with the bathwater: Changing requirements for a successful business education program

There are centrally mandated graduation, promotion, or curriculum requirements for the public schools in all fifty states. Most focus on academic rigor, and this focus has serious implications for programs of vocational education. One such program, a work-study program based on a public education/private industry partnership called the Philadelphia Business Academy, is undergoing significant modifications in response to new state promotion requirements. These modifications are altering many of the program's unique features, particularly its culture, and seem to be causing fundamental changes in the program's nature, operations, and effectiveness.     

Next time somebody asks: "Is it good for young people to watch TV?" say YA TV,the Young Asia Television: the eyes and ears of young Asians

This article presents a profile of the Young Asia Television (YATV) initiative by the WorldView International Foundation. The YATV channel brings news and analysis of Asia-focussed environmental concerns, current affairs, population and reproductive health issues, social problems including poverty and illiteracy, arts and culture, and other topics. In addition, it broadcasts programs produced by different countries on reproductive and sexual health, including AIDS and sexually transmitted disease prevention, and youth/adolescent awareness of sexual health. It was launched by the Foundation with a thrust stating that "television must encourage dialogue and debate; advance the creativity of people, especially the younger generation who will be the leaders of the future." In order to reach many more millions of viewers, YATV programs are networked with the Asian Broadcasting Union and 1000 other organizations through the Foundation's own NGOs network. This network provides the medium for value-based broadcasts in an entertaining fashion. The International Office of Worldview International Foundation in Colombo monitors the program activities on a continuing basis and uses the information gathered for impact assessment and long-term planning.     

Umbrella project for Bangladesh: strengthening NGO capacity and linkages to improve reproductive health service and information. RAS/98/P55

In Bangladesh, the UN Population Fund is working to strengthen nongovernmental organization (NGO) capacity and linkages to improve reproductive health services and information. Specifically, the aim is to strengthen the technical and human resource capacity of participating NGOs and the functional linkages between national NGOs and relevant government agencies to help harmonize and standardize the delivery of reproductive health information and services. This umbrella project collaborates with RHI-participating NGOs in a policy paper on adolescent reproductive health, and will maintain contact with the regional dimension project to collaborate its activities. Programs implemented by partner NGOs are being reviewed and monitored, and linkages among national NGOs and government agencies are being developed. The main activities of the project are enumerated.