Strengths and challenges of a school-based sexual and reproductive health program for adolescents in Chile

A scoping review of strategies for adolescents' sexual and reproductive health role modelling

BACKGROUND

 Individuals strive to maintain their sexual and reproductive health (SRH) by being exposed to correct information, having access to contraceptives, and promoting safe sex practices. Adolescent SRH promotion efforts should consider the influence of role models. This review explored the availability and nature of strategies and programmes on adolescents' SRH role modelling and described them using a scoping review.

METHODS

 Studies were retrieved from four databases and grey literature through a search of 223 studies. The databases included EBSCO-host, Medline, Sabinet, and Pubmed. Data extraction was guided by a data-extraction tool adapted from the JBI Manual for Evidence Synthesis. The characteristics of the selected studies were recorded in a Microsoft spreadsheet. Eleven studies published between 2014 and 2022 were included for the final review and analysed using thematic analysis.

RESULTS

 Selected articles focused on adolescents' SRH; however, only two studies focused particularly on role modelling. Nonetheless, some aspects of the findings and recommendations presented could be extrapolated to adolescents' SRH role modelling. This includes adolescent-parent communication on SRH, community engagement, mentoring, positive role modelling, and information sharing through media campaigns.

CONCLUSION

 There is a lack of literature on SRH role modelling because most studies did not focus on role modelling as an aspect of SRH. Therefore, research needs to be conducted on strategies and programmes focusing on SRH modelling.Contribution: The findings of this scoping review may encourage the development and implementation of strategies and programmes targeting adolescents' SRH throughout diverse communities to promote adolescent SRH.

Knowledge and attitudes regarding contraceptive methods and sex education in students and parents of eight Colombian schools 2020-2021: a mixed methods study

Background

In Colombia, the average age of first sexual intercourse is between 14 and 15, and it has one of the highest fertility rates among adolescents in Latin America, which reflects poor access to health services and a lack of knowledge about contraception. Some laws support comprehensive sex education as a learning process that families and schools should provide. The objective of this work was to assess the frequency of adequate knowledge and attitudes of acceptance towards contraception in students, their associated factors, sexual behaviours in sexually active students, and experiences with sex education.

Methods

Mixed methods study consisting of an analytical cross-sectional study and a qualitative hermeneutic phenomenological study. The former included students who completed a questionnaire with sociodemographic variables, surveys on knowledge and attitudes toward contraception, and questions about sexual behaviour. Focus groups were used in the qualitative study to evaluate students' and parents' sex education experiences.

Findings

827 students were surveyed, of whom 52.3% had adequate knowledge about contraceptives and 80.1% had attitudes of acceptance. Talking with parents about sex education, receiving sex education, and being in the eleventh grade increased the likelihood of having adequate knowledge. Each year of age, being male, being a victim of forced displacement, and studying in a public school were associated with lower possibilities of attitudes of acceptance. Using condoms, compared to other contraceptives, was associated with less adequate knowledge and attitudes of acceptance (p < 0.05). Experiences with sex education, contraception, and sexual and reproductive rights were three emerging categories in the focus groups.

Interpretation

In a group of Colombian high school students, half of them had adequate knowledge, eight out of 10 had attitudes of acceptance about contraception, and both were associated with having received sex education. Nevertheless, different types of barriers to sexual education were identified at home and in schools. The results will allow the generation of educational policies that modify the educational model as well as new strategies by health professionals to raise awareness about responsible sexuality.

Funding

This project was financed by internal research of the Fundación Universitaria de Ciencias de la Salud-FUCS (DI-I-0392-20).

An analysis on the roles and involvements of different stakeholders in the provision of adolescent sexual and reproductive health services in Southeast Nigeria

Introduction

Sexual and reproductive health of young people involve a lot of stakeholders, traverse different sectors, and cut across all levels of government. For a clearer understanding of the activities of these stakeholders in adolescent sexual and reproductive health (ASRH) services, this paper was designed to explore the positions, attitudes and involvements of government/public institutions and non-governmental organizations (NGOs) in ASRH policy-making processes and implementations in Ebonyi State, Nigeria.

Methods

The evidence was generated from a cross-sectional qualitative study, with data collected through in-depth interviews and focus group discussions from 81 and 59 stakeholders in adolescent sexual and reproductive health, respectively. A mapping tool was used for the stakeholder analysis.

Results

The State Ministry of Health (MOH) was identified as playing a major role in ASRH policy development and so was categorized as a ‘savior’. However, out of nine public institutions, four were categorized as ‘trip wire’ because they had non-supportive attitudes, weak powers and passive interests in ASRH policies and programs. All the NGOs were categorized as ‘friend’, because of their weak, but favorable disposition to ASRH policy-making processes. Regarding the implementation of ASRH programs, most public institutions were categorized as ‘savior’. Similarly, most of the institutions were classified as ‘trip wire’ at the local government level, in relation to ASRH policy development. Only, the offices of traditional rulers/village heads and local government administrative secretaries were regarded as ‘friend’, while the public schools were classified as an ‘acquaintance’. Concerning the implementation of ASRH programs at this level, public secondary schools, the offices of local government administrative secretaries and local government focal persons on ASRH were categorized as ‘savior’, while town union/ward development chairmen were considered ‘friend’. Few stakeholders, including, religious leaders were classified as ‘savior’ regarding engagement with local authorities on ASRH matters.

Conclusion

Although key stakeholders appear to play supportive roles in the implementation of ASRH programs in Ebonyi State, many of the relevant government and non-government institutions are not involved in the policy-making process. There is a need for more intentional and active involvement of relevant stakeholders in policy-making for better ownership and sustainability of ASRH interventions.