Adolescent Reproductive Health Programs Research Articles

Availability of Adolescent and Young Adult-Specific Sexual and Reproductive Health Programs and Resources: A Review of the Websites of National Cancer Institute-Designated Cancer Centers.

Adolescent and young adult (AYA) cancer survivors often search online for information about cancer-related sexual and reproductive health concerns. A review of the websites of National Cancer Institute-designated cancer centers (n = 9) and comprehensive cancer centers (n = 58) was conducted to identify the presence of AYA-specific sexual and reproductive health programming and resources. No AYA-specific sexual health programs were found. Oncofertility programs were presented on 56% (n = 5) of cancer centers and 50% (n = 29) of comprehensive cancer center websites. As the population grows, it is imperative that cancer centers provide services to meet AYAs' sexual and reproductive health needs and highlight these services on their websites.

Understanding the socio-demographic and programmatic factors associated with adolescent motherhood and its association with child undernutrition in Bangladesh

BackgroundWorldwide, a significant number of girls become mothers during adolescence. In Bangladesh, adolescent childbirth is highly prevalent and has adverse effects on children’s health and undernutrition. We aimed to identify the relationship between the undernutrition of children and adolescent motherhood, the factors associated with adolescent mothers’ age at first birth, and to examine the programmatic factors and gaps influencing children’s undernutrition in Bangladesh.MethodsWe analysed the ‘Bangladesh Demographic and Health Survey’ BDHS-17-18 data and desk review. To examine the factors associated with adolescent motherhood and its impact on child undernutrition, data from 7,643 mother-child pairs were selected. Child stunting, wasting, and underweight were measured according to the World Health Organisation (WHO) median growth guidelines based on z-scores − 2. Univariate, bivariate, simple, and multiple logistic regressions were used for analyse. We followed the systematic procedures for the literature review.ResultsApproximately, 89% of adolescents aged ≤ 19 years were married and 71% of them gave their first childbirth. Children of adolescent mothers (≤ 19 years) were significantly 1.68 times more wasted (aOR: 1.68; 95% CI: 1.08 to 2.64), 1.37 times more underweight (aOR: 1.37; 95% CI: 1.01 to 1.86) and either form 1.32 times more stunting, wasting or underweight (aOR:1.32; 95% Cl: 1.05 to 1.66) compared to the children of adult mothers (> 19 years) after adjusting potential confounders. The factors associated with mothers’ first childbirth during adolescence were the age gap between husband and wife 5–10 years (aOR: 1.81; 95% Cl: 1.57–2.10) and age gap > 10 years (aOR: 2.41; 95% Cl: 1.96–2.97) compared with the age group < 5 years, and husbands’ education (aOR: 1.29; 95% Cl: 1.04–1.61) compared with the uneducated husbands. In the literature review, we found potential gaps in focusing on the Adolescent Sexual and Reproductive Health (ASRH) program in Bangladesh, from thirty-two programmes only half of them focused on adolescents aged 10–19 years, and eleven programmes focused only on girls.ConclusionChildren of adolescent mothers are at risk of wasting, underweight, and any form of undernutrition. For effective policies and interventions in Bangladesh, it is important to emphasise delaying adolescent pregnancy and prioritising child undernutrition.

KAJIAN KEBIJAKAN IMPLEMENTASI PROGRAM KESEHATAN REPRODUKSI REMAJA UNTUK MENGHASILKAN MODEL PEMBERDAYAAN REMAJA

It is hoped that the existence of a youth posyandu will become a forum for empowering teenagers, especially those who have limited access or geographical barriers such as remote areas, island areas, outermost or isolated areas. The aim of this research was to examine the policy of the Adolescent Reproductive Health (KRR) program implemented by the community health center and develop a policy model for adolescent empowerment. This policy study research is a qualitative study using interviews and FGDs to examine the implementation of the KRR program and the results can develop strategic policies. The researcher then conducted a Focus Group Discussion. Total of 16 posyandu from 8 community health centers in Morotai Island Regency were chosen as research locations. Data collection during August 2023. Only 4 community health centers have active posyandu (Daruba, Sangowo, Morodadi, and Tiley), 1 community health center (Wayabula) has joined Posbindu, 3 youth posyandu are integrated with the School Health Unit (UKS) program implemented in junior and senior high schools. Data analysis was carried out using theme analysis. Facilities and infrastructure have not been met according to standards and guidelines are incomplete at the youth posyandu. Most teenagers are less active in using youth Posyandu if it is implemented in villages compared to implementation in integrated schools with the UKS program. In conclusion, the achievement of the KRR program objectives has not been optimal. The development of a youth empowerment policy model is carried out based on the resulting policy brief.

To what extent did implementing a community-embedded intervention align with the goals and roles of stakeholders in adolescent sexual and reproductive health?

Adolescents' sexual and reproductive health (SRH) needs are largely unmet due to poor access to SRH information and services. A multicomponent community-embedded intervention, comprising advocacy to policymakers and community leaders, training of health workers on the provision of youth-friendly SRH services, and establishment of school health clubs, was implemented in Ebonyi State, Nigeria, to improve access to SRH information and services for adolescents aged 13-18years in selected communities and secondary schools. This study explored the extent to which the intervention aligned with goals and roles of stakeholders in the State. Qualitative in-depth interviews (30) were conducted with key stakeholders in adolescent health programming in the State, and community gatekeepers (traditional and religious leaders) in the intervention communities. Sex-disaggregated focus group discussions (10) were conducted with health service providers, parents/guardians of adolescents. Data was analyzed deductively based on fit of strategy and two constructs of the Theoretical Framework for Acceptability - burden, and opportunity cost. The transcripts were coded in NVivo 12, and the subthemes that emerged from each construct were identified. Stakeholders perceived the ASRH intervention activities to align with their individual goals of sense of purpose from serving the community and organizational goals of improving the visibility of adolescent reproductive health programs and aligned with their routine work. Hence, implementing or participating in the interventions was not considered a burden by many. Although the delivery of the interventions constituted additional workload and time commitment for the implementers, the benefits of partaking in the intervention were perceived to outweigh the inputs that they were required to make. Some of the community health workers in the intervention felt that provision of financial incentive will help with making the intervention less burdensome. To participate in the intervention, opportunity cost included forgoing work and business activities as well as family commitments. Findings from the study show that the intervention aligned with individual/organizational goals of stakeholders. To improve acceptability of the ASRH interventions, interventions should leverage on existing programs and routine work of people who will deliver the interventions.

Implementasi Program Kesehatan Reproduksi Remaja melalui Posyandu Remaja: Studi Kualitatif

Utilization of youth information services is still low in several areas, including North Maluku. The low level of utilization of reproductive health services among adolescents is influenced by many factors. This research aims to analyze the implementation of adolescent reproductive health programs. Through the youth Posyandu in Juanga Village, the working area of the Daruba Community Health Center, South Morotai District. This research used qualitative methods, selecting subjects using purposive sampling and data collection techniques through observing the implementation of youth Posyandu, interviews, and focus group discussions on cadres. The research subjects were 14 informants, consisting of five cadres, five teenagers, two families, one health center officer, and one community figure. The findings show that there is no special training for adolescent Posyandu cadres, there is no incentive funding for cadres, the infrastructure and guidelines are incomplete, and there is still a lack of knowledge among adolescents regarding adolescent reproduction. It can be concluded that the current implementation of youth Posyandu has obstacles and problems which have an impact on implementation limitations, including the implementation process which still experiences obstacles in attracting youth participation and communication with related parties, as well as obstacles to funding incentives for youth cadres. It is recommended that there be a model of community empowerment, especially teenagers, in utilizing youth Posyandu, in an effort to reduce the high rate of premarital teenage pregnancies.

A qualitative approach to interrogating the age and gender divide in digital SRHR platforms in Kenya

Adolescent sexual and reproductive health and rights (ASRHR) programmes for 10–17-year-old adolescents in many African contexts are school-based and often aim to manage the risks associated with adolescent sexuality. Such programmes are critiqued for adopting pathologising, biomedical, moralistic and/or authoritarian approaches. Critiques of conventional ASRHR initiatives and technological advancements have resulted in an increased use of digital technologies to facilitate ASRHR. However, there is a gender and age divide whereby adolescent minors, particularly girls, remain excluded, unreached, or unable to exercise their agency. Despite the existence of a gender and age divide in digital SRH platforms, the divide remains uninterrogated. Data were collected in four phases from November 2019 to April 2022 using a qualitative mixed methods design that included review of online information and communication technology (ICT)-based sexual and reproductive health and rights (SRHR) websites and platforms, 18 interviews with implementers of the platforms, and seven focus group discussions with adolescent girls. Even though ICTs have demonstrated their ability to navigate socio-cultural tensions surrounding SRHR, an age and gender divide poses a barrier for them to achieve this anticipated potential as adolescent girls below the age of 18 have the least access in Kenya. Socio-cultural norms surrounding adolescent sexuality in Kenya continue to inform ASRHR policies and programmes that exclude 10–17-year-old girls, particularly those in low-income urban contexts. Such exclusionary norms permeate digital spaces, inhibiting the potential of digital spaces to offer comprehensive and holistic services to adolescent girls who are not legally adult.

Adolescent Reproductive Health, Sex and Sexuality Education Program in a Science-Based Approach for Junior High School Learners

This study was undertaken to determine the stakeholders’ perspective on the adolescent reproductive health (ARH), sex, and sexuality education with the purpose of developing a program using a science-based approach to provide age and developmentally appropriate information for junior high school learners. A descriptive-developmental research design was used to determine any significant difference on the perception of the three groups of respondents on the adolescent reproductive health, sex, and sexuality education. Moreover, it determined the significant relationship between the students’ evaluation of the designed program as to their profile and awareness on ARH, sex, and sexuality education. The results revealed a significant difference on the perception of the respondents on the adolescent reproductive health, sex, and sexuality education. Findings also revealed significant relationship between the students’ profile, except religion and family orientation, and the effectiveness of the designed program. Therefore, the null hypothesis is partially upheld. Likewise, students’ awareness is significantly related to the perceived effectiveness of the program on adolescence reproductive health, sex, and sexuality education. The research suggests that the designed program must be aligned to the holistic development of adolescents ensuring that the information is comprehensible and relevant to their stage of life.

Penyuluhan Kesehatan Pada Remaja Putri Tentang Kesehatan Reproduksi Remaja

Adolescence is a period of human development. Reproductive health in Indonesia which is prioritized only includes four components/programs, namely: maternal and newborn health, family planning, adolescent reproductive health, as well as prevention and control of sexually transmitted diseases (STDs) including HIV/AIDS. The community service that we will carry out refers to the adolescent reproductive health program. Adolescent Reproductive Health is a healthy condition that concerns the reproductive systems, functions and processes of adolescents. The definition of health here does not merely mean being free from disease or free from disability but also being mentally and socially and culturally healthy. Adolescents need to know about reproductive health in order to have correct information about the reproductive process and the various factors that surround it. With the correct information, it is hoped that teenagers will have responsible attitudes and behavior regarding the reproductive process. Adolescent reproductive health problems apart from having a physical impact, can also affect mental and emotional health, economic conditions and social welfare in the long term. Long-term impacts not only affect the teenagers themselves, but also their families, communities and the nation in the end.

Level and determinants of knowledge, attitude, and practice of risky sexual behavior among adolescents in Harar, Ethiopia

Adolescence is a transition period of advancement from a state of immature sexual characteristics to sexual and reproductive maturity; an improvement in the mental form progressing to the mental maturity of a grown-up adult; and a period of transition from total socioeconomic dependence to relative independence. An adolescent is defined as a person aged between 10 and 19 years. This study assessed the level and determinant factors of knowledge, attitude, and practice of risky sexual behavior among secondary school adolescents in Harar, Eastern Ethiopia, 2022. A school-based cross-sectional study design was employed. From the total population of adolescents, 387 respondents were sampled. A simple random sampling method was used to select study participants. The data was collected by using a self-administered questionnaire and analyzed using SPSS version 26. Among the participants, 47.3% had good knowledge of risky sexual behavior. 41.9% had a positive attitude toward risky sexual behavior. 36.1% of students had started sexual activity before they reached 18 years old. Out of 9.3% of respondents who have had sexual intercourse, almost 50% of them had multiple partners. Students who live in urban areas were three times (adjusted odds ratio: 3.3, 95% CI: 1.6, 6.6) more likely to have good knowledge about risky sex than their counterparts in rural settings. There is a significant number of risky sexual behaviors, such as having a different sexual partner and having unprotected sex with a non-regular partner. Being female, in urban residence, not having pocket money, and attending parties have significant associations with having good knowledge about risky sex. Harari Regional Educational and Health Bureau should provide repeated tailored information that can specifically address the attitude of the adolescents toward risky sexual behavior using different media, teachers, and school clubs in respect of sexual and reproductive health. The existing adolescent reproductive health program should be strengthened and evaluated to improve the sexual behavior of adolescents.

IMPLEMENTASI PROGRAM KESEHATAN REPRODUKSI PADA GURU SEKOLAH DI SUNGAI AMBAWANG

Background: The implementation of the School Health Business (UKS) program has not touched and accommodated all the problems that may be experienced by adolescents during puberty. Through teachers, young people must also be given information and teaching on how to protect themselves from various possible risks of reproductive health problems. The teacher's lack of understanding to answer practical problems related to reproductive health and the use of inappropriate vocabulary in explaining reproductive health causes teachers to lack confidence when explaining. Training of teachers and health service providers needs to be carried out, so that they feel confident about the topics to be discussed, support, not judge and are able to provide accurate and complete information. Objective: to improve adolescent reproductive health through optimizing the role of Puskesmas and teachers in schools by implementing reproductive health extracurricular programs in schools. Methods: Implementation of adolescent reproductive health programs by providing training to UKS teachers/officers, who will later serve as program facilitators/resources. Result: there is a significant difference in the knowledge aspect of pre-test and post-test with p = 0.000 (p &lt; 0.05). The mean difference between pre-test and post-test was 23.13 (95% CI: 20.82-25.45). Conclusion: Program implementation has been proven to increase the knowledge of UKS teachers/officers in understanding reproductive health and its implementation to the needs of primary and secondary school students (early adolescents).Keywords: Program implementation; Extracurricular; Reproduction health

A qualitative study regarding menstrual hygiene in a rural community of Haryana, India.

Adolescent girls face challenges in menstrual hygiene in routine patterns which impacts their education and health. A qualitative study was undertaken to assess the knowledge and practices regarding menstruation in a rural community of Haryana and to identify the barriers to menstrual hygiene. The study was conducted in the month of September 2019 among various stakeholders i.e. adolescent females, adolescent males, Accredited Social Health Activist (ASHA) workers, Anganwadi workers, school teachers and Medical Officers. The stakeholders were mapped with the help of a Multi-Purpose Health Worker and ASHA of the village. Interview guides for focus group discussion (FGD) and in-depth interview (IDI) were prepared from previous literature to understand menstrual health management among the stakeholders. After IDI and FGD, we found that there is a barrier to accessibility of regular sanitary pads, a lack of education on menstrual hygiene among adolescent girls. School absenteeism was a concern due to the unavailability of mechanisms for the disposal of sanitary pads in school and poor maintenance of toilets. Proper implementation of the Adolescent Reproductive Sexual Health program and Menstrual health education can improve the use and reduce stigma and ignorance. Free uninterrupted supply of sanitary pads through school and Anganwadi will help improving accessibility and separate toilets for girls would lead to a reduction in absenteeism.

Barriers and facilitators regarding the implementation of policies and programmes aimed at reducing adolescent pregnancy in Ghana: an exploratory qualitative study

ObjectivesThis study explored the perceived barriers and facilitators regarding the implementation of policies and programmes aimed at reducing adolescent pregnancy among health and education professionals (‘professionals’), grassroots workers and adolescent...

Relationship between childhood sexual abuse and attitudes toward premarital sexual permissiveness among middle school students in Luzhou, China

BackgroundIn recent years, the number of adolescents engaging in premarital sex has increased, and an increasing number of childhood sexual abuse (CSA) cases have been reported in China. Many studies have indicated that CSA has a well-established association with risky sexual activities. However, only a limited number of studies have explored possible reasons for this association among middle school students, a population that may engage in premarital sex, which is critical for the development of interventions to prevent risky sexual behavior. Based on random samples of middle school students from a Chinese city, this article investigated the relationship between CSA and students’ premarital sexual permissiveness (PSP).MethodsIn a cross-sectional study conducted between 2016 and 2017 in Luzhou, China, 2292 middle school and high school students aged 12–18 years were recruited by multistage random sampling. All students were administered anonymous questionnaires. Multiple linear regression and binary logistic regression analyses were conducted to analyze the relationship between CSA and PSP.ResultsThe prevalence of CSA was 15.4% (354/2292; 95% CI: 14–16.9%). A higher percentage of male respondents (18.2%) than female respondents (12.9%) had experienced CSA. A positive association between CSA and PSP was found among students. Respondents who had suffered CSA exhibited greater PSP, and this relationship was observed in the male sample, female sample and the total student sample in Luzhou (β = − 3.76, P < 0.05; β = − 2.79, P < 0.05; and β = − 2.84, P < 0.05, respectively). Respondents who had suffered CSA were also more likely to express a double standard about premarital sex (odds ratio [OR] =1.41, P < 0.05), especially among male students (odds ratio [OR] =1.63, P < 0.05).ConclusionsSex differences in CSA and the relationship between CSA and PSP were significant among this large sample of middle school students in Luzhou (China). The findings suggest that experiencing CSA may be closely related to youth attitudes toward premarital sex, especially among males. Therefore, it is important to emphasize the prevention of CSA and provide adolescent reproductive health programs to reduce the impact of CSA on sexual cognition and attitude, prevent premarital sex and promote positive attitudes toward sexual equality for middle school students.

Keterpaparan Program GenRe (Generasi Berencana) dan Perilaku Pacaran Remaja Jawa Timur, Indonesia

Background: According to Population and Family Planning Agency (BKKBN), adolescents are aged 10-24 years and are not married. Indonesian Basic Health Research (RISKESDAS) 2018 showed around 58.8% of adolescents aged 10-19 years had been married and had had a pregnancy. The Indonesian Demographic and Health Survey (SDKI) results revealed that risk behavior among male junior and senior high school students was around 8.06%, and female were 4.17%. This study aimed to determine the correlation between the Planning Generation (GenRe) Program knowledge and adolescents’ characteristics with dating experience in East Java Province. Method: This research was a cross-sectional study. Secondary data were collected from the 2019 Program Performance and Accountability Survey (SKAP) and were analyzed descriptively with cross-tabulation and chi-square tests. The risk estimate calculation was also carried out to identify the Odd Ratio (OR). The sample used was 5,300 adolescents in East Java Province after weighting. The research variables consisted of dating behavior in adolescents, age, gender, and adolescents' knowledge about GenRe, HIV/AIDS, drugs, and Sexually Transmitted Infections (STIs) and Adolescent Reproductive Health Program.Results: The results showed that 41.80% of adolescents in East Java had dated. There was a significant correlation between dating behavior with adolescents’ knowledge about GenRe, HIV/AIDS, drugs, and Sexually Transmitted Infections (STIs) and Adolescent Reproductive Health Program (P-Value = 0.00). Dating behavior also had a significant correlation with age (P-Value = 0.00) and gender (P-Value = 0.00). This study concluded that there was a correlation between dating behavior in adolescents in East Java Province with age, gender, and adolescents’ knowledge about GenRe, HIV/AIDS, drugs, Sexually Transmitted Infection (STIs), and Adolescent Reproductive Health Program. They were strengthening the GenRe program through the introduction, explanation of program activities, and the process of youth involvement. So far, teenagers only know the name of the GenRe program. This action needs to be applied to prevent negative effects caused by dating behavior, such as premarital sex, unwanted pregnancy, and early marriage.

Diversities of Sexual Activities and Correlates of Safe Sex Practices Among Adolescents in Plateau State, Nigeria.

Background: Unsafe sex, particularly, condomless sex exposes adolescents to sexual and reproductive health risks. This study aimed to assess the sexual experiences and to determine the most important covariates of sexual activity and consistent condom use among adolescents in Plateau State, Nigeria.Methods: A cross sectional survey was conducted among 428 adolescents selected from 6 LGAs through a multistage sampling technique. The data was analyzed using the IBM Statistical package for Social Sciences (SPSS) version 23, multiple logistic regression was conducted to determine the covariates of sexual activity and condom use.Results: About one third (38%) of the adolescents were sexually active, 5.7% had same sex partners, 70% had more than one sexual partner and majority (72.4%) were not consistently using condom during sex. Logistic regression results showed that older adolescents (OR = 5.73; CI = 3.72–8.12; p = 0.001) and out of school adolescents (OR = 2.68; CI = 1.79–4.00; p = 0.001) were more likely to be sexually active, while multivariable logistic regression analysis showed age (AOR = 0.33; CI = 0.12–0.90; p = 0.031) and gender as important covariates of being sexually active, (AOR = 6.29; CI = 3.18–12.44; p = 0.001). Inconsistent condom use was more likely among adolescents; with lower education, (OR = 2.14; CI = 1.19–3.85; p = 0.011), having sex with older partners (OR = 0.61; CI = 0.42–0.90; P = 0.013) and with low awareness of SRH issues (OR = 2.08; CI = 1.02–4.22; p = 0.044). The multivariable logistic regression however, showed gender, being male (AOR = 0.43; CI = 0.006–3.09; p = 0.023) as covariate of consistent condom use.Conclusion: Most sexually active adolescents had multiple sexual partners, some had same sex partners and majority were not consistently using condom. Older adolescents and those out of school were more likely to be sexually active. Awareness of SRH issues significantly influenced condom use while gender, specifically being male, was the independent covariate for being sexually active and for consistent condom use. We recommend sexual health intervention targeted at adolescents. In addition, gender should be mainstreamed into adolescent sexual and reproductive health programmes.

Determinants of change in the inequality and associated predictors of teenage pregnancy in Uganda for the period 2006–2016: analysis of the Uganda Demographic and Health Surveys

ObjectiveTeenage pregnancy has become a public health concern in Uganda because of its negative consequences to both the mother and child. The objective of this study was to examine the...

Implementation of adolescent health programs at public schools and religion-based schools in Indonesia.

Background: Adolescents are a vulnerable group who have great curiosity and need access to various adolescent health information. Therefore, the government has implemented a strategy through the implementation of Youth Care Health Services (YCHS). However, some of the stakeholders and youth have limited access to YCHS especially the ones delivered in schools setting. The purpose of this study was to investigate the implementation of adolescent health programs in schools especially public schools and religion-based schools.Design and methods: This study was an analytic observational quantitative study by using a cross-sectional design. This study was conducted in public schools and religion-based schools in North Surabaya Indonesia. The sample in this study consisted of 100 students through a simple random sampling technique.Results: There was a difference in the level of knowledge of adolescent reproductive health between public schools and religion- based schools (p=0.047). Student’s attitudes (p=0.000) and environmental influences (p=0.000) both related with reproductive health contents. However, there was no difference in adolescent’s attitudes about adolescent reproductive health programs (p=0.90) and adolescent’s exposure to adolescent reproductive health policies (p=0.196).Conclusion: The implementation of adolescent health programs in two types of schools (public and religion-based) were different. Adolescents should have the same rights to obtain knowledge about adolescent health as the prelude for forming a positive attitude. Therefore, stakeholders need to conduct regular monitoring and evaluation on the implementation of standardized adolescent health programs in all types of schools. Significance for public health Adolescents are the nation's next-generation in which the rapid development of technology can cause various problems for their health especially reproductive health which is one of the major challenges for public health among adolescent. One of health programs conducted by stakeholder in Indonesia is YCHS. This program was designed to improve adolescent health through school approach. Nevertheless, there are some problems in the implementation such as unequal access to get information of adolescents health between public schools and religion based schools, the lack of stakeholders support, and the lack of students’ involvement in health adolescents programs. Through this study, we will find how the implementation and the effect of YCHS program regarding adolescents’ knowledge, attitudes, and the exposure about the policy of adolescent health. So, it can contributes to the public health.

Socio-demographic determinants of pregnancy termination among adolescent girls and young women in selected high fertility countries in sub-Saharan Africa

BackgroundMost of the unintended pregnancies that occur among adolescent girls and young women (AGYW) in sub-Saharan Africa (SSA) end up in pregnancy termination. In this study, the socio-demographic determinants of pregnancy termination among AGYW (aged 15–24) in selected countries with high fertility rates in SSA were examined.MethodsThis was a cross-sectional analysis of data from the most recent Demographic and Health Surveys of nine countries in SSA. The countries included are Angola, Burkina Faso, Burundi, Chad, Gambia, Mali, Niger, Nigeria, and Uganda. A total of 62,747 AGYW constituted the sample size for the study. Fixed and random effects models were used to examine the determinants of pregnancy termination with statistical significance at p < 0.05.Results Higher odds of pregnancy termination were found among AGYW aged 20–24, those who were cohabiting and married, those who listened to radio and watched television at least once a week and those who lived in communities with high literacy level. Conversely, the odds of pregnancy termination were lower among AGYW with three or more births and those with secondary/higher education.ConclusionThe socio-demographic determinants of pregnancy termination among AGYW in this study were age, level of education, marital status, exposure to radio and television, parity, and community literacy level. The findings provide the needed information for designing health interventions to reduce unwanted pregnancies and unsafe abortions in countries with high fertility rates in SSA. It is recommended that governments and non-governmental organisations in these countries should enhance sexuality education and regular sensitization of adolescent sexual and reproductive health programmes targeted at AGYW who are at risk of pregnancy termination.

Social policy with tunnel vision: problems of state efforts to curb adolescent pregnancy in post 1988 Brazil

ABSTRACT The current moralistic take on adolescent sexuality in Brazil raises the importance of sexual citizenship when examining adolescent fertility policies. Literature on the capacity contract lends a useful lens for understanding the ramifications of the construction of adolescents as sexual citizens. This paper investigates how the conceptualisation of adolescents within the capacity contract may relate to the problematisation of adolescent pregnancy in Brazil. To investigate this, I conduct a Foucauldian discourse analysis of federal level documents. These pertain to adolescent sexual and reproductive health programmes, guidelines and a campaign between 1989 and 2020. To examine the visibility of adolescents and adolescent pregnancy, I conduct a content analysis of health indicators and surveys from health registries from the same period. My evidence shows that adolescents found themselves in contradictory and dynamic positions within the capacity contract. Notably, when adolescents were attributed less agency, they were governed more paternalistically. Their choices and vulnerabilities regarding fertility seemed then more likely to be ignored. I conclude that this way in which adolescents were constructed as sexual citizens may have hindered a holistic policy approach to adolescent pregnancy. This highlights how the capacity contract falls short of protecting those deemed incapable.

Predisposing, Enabling and Reinforcing Factors Associated with Sexual Intercourse Intention among Indonesian Young Men

Premarital sex among young men is more acceptable than young women. The Indonesian Demographic and Health Survey data consistently shows that the percentage of sexual experiences in young men is higher than that of young women and is increasing every year (6% versus 1% in 2007 and 8% versus less than 1% in 2012). This study aims to investigate which factors influence sexual intercourse intention among young men in Indonesia. This study obtained data from the 2012 Indonesian Demographic and Health Survey, especially the Adolescent Reproductive Health component with a total number of respondents of 9,109 young unmarried men. Data were analyzed descriptively and inferentially using the chi-square test and the Mann Whitney test. There are 21.1% of young men who intend to have premarital sex. Predisposing factors such as knowledge and attitudes on reproductive health, enabling factors such as dating behavior, as well as reinforcing factors such as sources of reproductive health information (peers, siblings/relatives, health service providers, religious leaders and the media) were found to be associated with the intention to have sexual intercourse. These findings indicated the need to strengthen the role of peer educators and health service providers as well as the involvement of religious leaders, and the media in adolescent reproductive health programs.