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Adolescent and youth reproductive health . Issues, Programmes & Operational barriers. Authors: Aparnaa Somanathan, Vindya Eriyagama, Ruwanthi Elwalagedara. Health Policy research Associates http://www.hpra.lk. Key questions.

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adolescent and youth reproductive health

Adolescent and youth reproductive health

Issues, Programmes &

Operational barriers

Authors: Aparnaa Somanathan, Vindya Eriyagama, Ruwanthi Elwalagedara

Health Policy research Associates http://www.hpra.lk

key questions
Key questions
  • What are key RH issues affecting adolescents and youth in Sri Lanka?
  • How have the government and NGO sector responded to the needs of adolescents?
  • What are the barriers to ensuring that adolescents have adequate access to ARH services and information?
  • What are some ways of improving government health policy towards A&YRH services?
who are adolescents
Who are Adolescents
  • Adolescence?

A transitional period from childhood to adulthood

outline
Outline
  • Background
  • RH issues affecting adolescents and youth
  • Existing programmes and policies on A&YRH
  • Operational barriers to A&YRH
  • Policy recommendations
outline5
Outline
  • Background
  • A & YRH issues in Sri Lanka
  • Existing programmes and policies on A&YRH
  • Operational barriers to A&YRH
  • Policy recommendations
background
Background
  • In 2002 19.7% or 3.7 million of Sri Lankan population were adolescents
  • It is estimated that the number will decrease to 3.1 million by 2021
  • Focus on A & YRH is important in SL context.
  • Knowledge and services will allow adolescents and youth to make informed decisions relating to sexual & RH matters
profile of adolescents in sl
Profile of Adolescents in SL
  • Education
  • Employment
  • Marriage
slide9

Years of Education completed 2003/04 (percent) (Ages 15-24)

Source: The consumer finance and socio economic survey report 2003/2004.

Central Bank of Sri Lanka

slide10

Employment by sex, 2003 ('000) (Ages 15-24)

Source: Labor force survey 2003. The Department of Census and Statistics. Sri Lanka

risk taking period sri lanka
Risk Taking Period: Sri Lanka

1901 Age at Age at

Menarche Marriage

2000

4yrs

14yrs

18yrs

14yrs

12yrs

26yrs

outline12
Outline
  • Background
  • A & YRH issues in Sri Lanka
  • Existing programmes and policies on A&YRH
  • Operational barriers to A&YRH
  • Policy recommendations
a yrh issues
A & YRH Issues
  • Early, High risk pregnancy
  • Unwanted pregnancy

unwanted pregnancy among adolescents in SL is exceptionally low by international standards

  • Abortion

Illegal, unsafe, on the rise (150,000-175,000 performed annually)

  • HIV/AIDS/STDs

On the rise, and primarily a concern because of poor awareness among high risk groups (i.e. workers in free trade zones, in tourist industry, commercial sex workers, displaced persons)

  • Sexual abuse

About 10% of early adolescents and 14% of mid and late adolescents admitted to have been sexually abused

outline14
Outline
  • Background
  • A & YRH issues in Sri Lanka
  • Existing programmes and policies on A&YRH
  • Operational barriers to A&YRH
  • Policy recommendations
a yrh programmes
A&YRH programmes
  • School – based health education
  • Community – based interventions
  • National Youth Campaign
  • Telephone hotlines
  • Peer education
slide16
NGO programmes
  • Operations research
  • Programs beyond health
outline17
Outline
  • Background
  • A & YRH issues in Sri Lanka
  • Existing programmes and policies on A&YRH
  • Operational barriers to A&YRH
  • Policy recommendations
operational barriers to a yrh
Operational Barriers to A & YRH
  • Lack of knowledge and public awareness

about ARH issues

REASONS:

    • Lack of human resources with necessary skills and experience on RH issues
    • Cultural factors have limited open discussion of issues  difficult for “safe” channels of information to develop
inability to obtain services
Inability to obtain services
    • There are very few, if any, reproductive clinics or centres from which adolescents can obtain services.
    • Public provision of contraceptives targets married couples almost exclusively

REASONS:

  • Lack of public awareness  lack of understanding of the gravity of the issue in the community  little impetus for strong policy action
  • General lack of resources in the health sector
lack of research
Lack of research
  • Lack of research on A&YRH and the needs of adolescents and youth, particularly among underserved and minority groups

CONSEQUENCES:

  • Scarce data and knowledge  severity of A&YRH issues is not known to public  weak political commitment for coherent policy initiatives
outline21
Outline
  • Existing programmes and policies on A&YRH
  • Operational barriers to A&YRH
  • Policy recommendations
policy recommendations
Policy recommendations
  • A more holistic approach to A&YRH : health and education sectors + legislative action to influence risk taking behaviour
  • Capitalizing on political support in establishing programmes that support A & YRH services.
  • Provision of information to adolescents: Importance of school-based programmes cannot be overstated
  • Improve pre-marital counselling
  • Work through the pharmacy network
  • Conduct research on sexual behaviour and special population groups
references
References
  • De Silva, W.I., Somanathan. A., and Eriyagama. V. 2003. “ Adolescent and youth reproductive health in Sri Lanka. Status, Issues, Policies and Programs”
  • Hardee K, Pine P, Wasson, L T. 2004. ”Adolescent and youth reproductive health in the Asia and Near East Region. Status, Issues, Policies and Programs”
  • Thalagala N.I. , Rajapakse L. 2004 National Survey on emerging issues among adolescents in Sri Lanka. UNICEF Colombo.
  • Department of Census and statistics Sri Lanka. Sri Lanka demographic and health survey. 2000, LFS 2003.
  • Central Bank of Sri Lanka. 2003/2004. The consumer finances and socio economic survey report
  • Family health Bureau, Ministry of Health Sri Lanka. Annual report and other publications.