Bangladesh: recognizing adolescents as a great resource

This article presents the initiatives undertaken by the government and other organizations to improve adolescent reproductive health in Bangladesh. The Health and Population Sector Programme under the 5-year Health and Population Sector Strategy (HPSS) of Bangladesh targeted married youth and soon-to-be-married adolescents. It has provided training of field workers so they can provide health services in an adolescent-friendly atmosphere. The Government has also collaborated with nongovernmental organizations and agencies that could help in the formulation of well-planned policy for adolescent health. These agencies include the UN International Children's Emergency Fund, UN Population Fund and WHO. In addition, on-going multisectoral coordination of various sectors, such as education, labor law and justice, youth and social affairs, has been developed and has contributed to the success of the Programme.     

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.     

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.     

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.     

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.     

青春期儿童父母性教育状况调查研究

青春期儿童的性教育是家庭性教育中的重要组成部分.青春期是儿童身体快速成熟的时期,生理和心理上发生的新变化会在生活和学习等方面给儿童带来一定的挑战.家庭性教育对于帮助他们顺利度过青春期,获得身心全面健康发展具有积极的促进作用.本文通过对处于青春期的儿童的父母进行性教育知识、性教育态度及家庭性教育开展状况调查,发现受访父母...     

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.     

Counselling skills training for adolescent health: A WHO approach to meet a global need

In recent years as public health measures such as improved sanitation, water supply, and immunization have taken effect in developing as well as economically developed countries, there has been an increase in attention to health problems arising from voluntary behaviour such as sexual activity and substance abuse rather than simply from passively acquired infection. This is of special relevance to adolescents who have generally been given lower priority in health services because they are relatively disease-free yet whose patterns of behaviour have great significance for their present and future health. However establishing or changing health behaviour during the dynamic period of adolescence can be difficult especially when the environment is rapidly changing too. This is especially so in developing countries where the traditional directive approach to guidance may need to give way to a somewhat more non-directive style of counselling in order to accommodate greater adolescent autonomy, without loss of fundamental cultural values. Because few people in developing countries are experienced in such techniques WHO has developed a module for training counselling skills for adolescent sexual and reproductive health which preserves culture specificity in a non-directive approach and uses behavioural techniques to train communication microskills.     

The Davao Teen Centre empowers the youth of Mindanao. Philippines

This article discusses the Development and Family Life Education for the Youth (DAFLEY) Project in Davao City, Philippines. The DAFLEY aimed to make the youth enlightened citizens of the future by educating them on reproductive health care services, gender equality, and responsible parenthood. It was established by the Family Planning Organization of the Philippines and is being carried out through the Davao Teen Centre (DTC), which provides reproductive and sexual health care services through counseling, face-to-face or by telephone. In an effort to reach out to more teenagers in Mindanao, the DTC introduced radio programs offering on-the-air advice to adolescents with problems ranging from boy-girl relationships and unplanned pregnancies to more complex and serious problems. Public response to the programs has been enthusiastic. The youth that have benefited from the DTC counseling refute a conservative belief that sex education leads to promiscuity and sexual experimentation. They state the respect they have for their bodies and their sense of responsibility as proof of the value of the reproductive health education and services that they have received.     

Attachment security and the school experience for emotionally disturbed adolescents in special education

Adolescents with disabilities are at increased risk for school failure, and those in special education as the result of emotional disturbances consistently have the highest dropout rate of any disability. This paper discusses the importance of feelings of security in relationships for these adolescents and the results of a study designed to determine the effects of these feelings on their educational experience. The impact of several relationships in the home and school life on the school experience of the emotionally disturbed adolescent is explored. These relationships include those with mother, father, teachers, social workers/therapists and peers. All of these figures are potentially ‘secure bases’ for adolescents, providing the experience of emotional safety necessary to engage in the challenges of the academic environment. The resources need to be provided to enhance feelings of emotional safety in the school setting, including the services of social workers and other mental health professionals.     

Health Literacy of Students with and without Individualized Education Programs: A Brief Report

While much is known about the educational, behavioral, and social needs of adolescents receiving school-based special education services, one critical domain, health literacy, has been largely unexamined. Given the impact of health and health management on the well-being of all persons, and the likelihood of additional challenges for students receiving special education supports, this study sought to examine and compare the health needs and transition preparedness of 341 adolescents with and without Individualized Education Programs (IEPs). Survey items were selected from widely used health literacy, health risk, and health related quality of life measures. Findings revealed that for students with IEPs, the risk for having limited health literacy was 128% higher than for their peers without IEPs. Students with IEPs were also significantly more likely to demonstrate risk across indicators of health related quality of life, health risk, and access. Limitations, research recommendations, and implications are addressed.     

Education and Social Services for Disabled Persons in Spain

DETAILED INFORMATION about education and social services for disabled children and adults, with emphasis on the hearing impaired population is provided. Information is derived from an extensive series of interviews conducted with representatives of government, international agencies, and private sector organizations, as well as health professionals, educators, and disabled persons. A broad discussion of policy and health services follows an overview of demographic and historical background. Spain's leaders recognize the nation's dependence on human resources to affirm its place in the international community and understand that an educated citizenry ensures the preservation of democracy and functions as an instrument for social transformation. These insights have driven major changes in service delivery to the disabled, including a national project for the integration of disabled children into regular classrooms. The National Centre of Resources for Special Education (NCRSE) is responsible for overseeing the national integration project; provision of inservices to teachers and other professionals; development, adaptation and distribution of curricular materials designed to improve the learning process; adaptation of evaluation instruments for students with special educational needs; and promotion of research in the field of special education.     

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.     

The use of selected theatre rehearsal technique activities with African-American adolescents labeled "behavior disordered".

The extensive literature on the overrepresentation of adolescent African-American male learners in classes for students identified as behavior disordered has essentially not addressed the problems caused by teacher reactions to adolescent conversational language use, the qualitative differences in language choices, or the impact of the conversational choices of adolescents on their educational treatment. This article explores how the dramaturgical perspective of selected Theatre Rehearsal Technique (TRT) activities can be used as learning experiences in communication with this student population. If these students gain quantifiable success in their social communication interactions, reassessment of their special education placement might facilitate their entrance into less restrictive educational environments.     

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.     

A critical consideration of ‘mental health and wellbeing’ in education: Thinking about school aims in terms of wellbeing

This paper examines ideas about mental health, wellbeing and school education to illustrate important issues in the relationship between mental health and education. The Covid crisis has amplified the pre-existing mental health problems of children and young people in England and recognition of the opportunities in schools to address these. The paper gives an overview of child and adolescent mental health services and how they position the role of schools. It examines prominent concepts of mental health and their relationship to wellbeing, setting this in a discussion of ‘mentally healthy’ schools, mental health in special educational needs and whole-school approaches. This analysis shows how the relationship between mental health and wellbeing has not been adequately worked out, using this as the basis for arguing for the dual-factor mental health model which separates mental illness/disorder from wellbeing as two related dimensions. The paper then translates the dual-factor model into a two-dimensional framework that represents the distinctive but related aims of school education (wellbeing promotion) and mental health services (preventing, coping, helping mental health difficulties). This framework involves a complex conception of wellbeing, with schools playing an important role in promoting wellbeing (beyond emotional wellbeing), tiered models and establishing school-wide social emotional learning. It is about a whole-school curriculum approach that involves considering what is to be learned and how it is taught. It contributes to a more nuanced concept of wellbeing that has a place for meaningful learning and challenge.     

Sexuality issues in adolescents with a chronic neurological condition

Substantial progress in the medical treatment of individuals with spina bifida (SB) has increased the numbers who survive into adolescence and adulthood. However, sexual health in this population has not received much attention. This study explored the knowledge (SB Sexuality Knowledge Scale), worries (SB Worries Scale), romantic appeal (from Harter's Self-Perception Scale), and access to sexuality information of a sample of 60 adolescents from a midwestern state. Study participants reported having sexual feelings like their peers, and they knew they could contract sexually transmitted diseases (STDs) if they were sexually active. However, only a moderate percentage was aware that women with SB are fertile, that adolescent women with SB should take a multivitamin with folic acid, and that latex-free condoms should be used by most adolescents with SB. They did not worry about their ability to make friends; however, these adolescents reported low levels of perceived romantic appeal and they worried about sexuality issues. These sexuality issues were not correlated to measures of SB neurological severity. Although over 50% reported having discussed sexuality with a health professional, 29% reported no one discussed sexuality and SB with them. Data from this study can affect the way health care providers and educators conduct sexuality education in health care and school settings.     

Examining the Experiences of a Short Break Scheme amongst Adolescents with Disabilities (Service Users) and their Parents

Globally, families who care for a child or adolescent with disabilities have been found to experience high levels of maternal ill health, stress, depression and family breakdown. In extreme cases, children and adolescents may have to move away from their family to a permanent residential placement. A potentially more appropriate and cost-effective approach is the provision of family support services; predominantly these have taken the form of short break schemes, whereby temporary (respite) care is issued to provide short-term relief for the family (e.g. regular afternoon care). This research reported the impact of a short break scheme from the perspective of the service users and their parents by conducting interviews with adolescents with disabilities and quantitative questionnaires with the parents, following a summer short break scheme.     

Pakistan: moving ahead. NGOs pilot adolescent reproductive health projects

In a study focusing on the views of Pakistani adolescent girls on contraception and family planning reveals that the majority of girls between the ages of 15 and 19 years have no knowledge of contraceptives. Many favor immediate pregnancy right after marriage. Only 4.8% of the total adolescent population opted to delay pregnancy and 1.5% expressed a desire to gain access to family planning aids to limit number of births. Nongovernmental organizations (NGOs) have responded to this adolescent reproductive health problem. Activities such as the Girl Child Programme, the Youth Project, and training in skills development concerned with the issue are being piloted by NGOs. In addition, non-formal education programs by the NGOs and community-based organizations have been initiated in response to the need for appropriate family life, adolescence and population education. Moreover, significant changes have been observed, brought about mainly by cultural and socioeconomic changes. Among these are the rise in the age at marriage from 16.9 to 21 years and a discernable career orientation of the education pursued by some women.