Reproductive Health Knowledge Research Articles

Factors influencing sexual and reproductive health perceptions among mountainous adolescents in Vietnam

ABSTRACT This cross-sectional study aimed to assess the knowledge and perceptions of sexual and reproductive health (SRH) and factors influencing perceptions among adolescents living in Son La, a mountainous region in Vietnam. A total of 382 adolescents participated in the study, with 59.7% girls and 40.3% boys. Findings revealed that the level of knowledge of SRH among adolescents in Son La is markedly different among girls and boys, where girls exhibited higher knowledge compared to boys in all aspects surveyed. The average SRH perception score was moderate (21.7 ± 8.05; maximum score = 33). Adolescents’ understanding of sexual intercourse, misconceptions related to first-time sexual experiences, and awareness of contraceptive methods were significantly associated with SRH perception scores. These findings underscore the need for targeted health education interventions in mountainous areas, emphasizing the importance of enhancing SRH knowledge and awareness among all adolescents, with gender-specific needs. Such efforts can contribute to improved SRH outcomes among adolescents in these regions.

Using the consolidated framework for implementation research to identify challenges and opportunities for implementing a reproductive health education program into sickle cell disease care.

As survival rates for individuals with sickle cell disease (SCD) increase, calls have been made to improve their reproductive healthcare and outcomes. The research team created a web-based program entitled Fertility edUcaTion to Understand ReproductivE health in Sickle cell disease (FUTURES). The study aim was to use the Consolidated Framework for Implementation Research (CFIR) during pre-implementation to identify challenges and opportunities from the individual to systems level of implementation to ultimately optimize the integration of FUTURES into clinical practice. Semi-structured interviews were conducted with clinicians, research team members, and adolescent and young adult (AYA) males with SCD and their caregivers who participated in pilot testing. Interviews (N = 31) were coded inductively and then mapped onto CFIR domains (i.e., outer setting, inner setting, characteristics of individuals, and intervention characteristics). Research team interviews indicated the lack of universal guidelines for reproductive care in this population and gaps in reproductive health knowledge as key reasons for developing FUTURES, also highlighting the importance of collaboration with community members during development. Clinicians reported intraorganizational communication as essential to implementing FUTURES and discussed challenges in addressing reproductive health due to competing priorities. Clinicians, AYAs, and caregivers reported positive views of FUTURES regarding length, engagement, accessibility, and content. Suggestions for the best setting and timing for implementation varied. Using CFIR during the pre-implementation phase highlighted challenges and opportunities regarding integrating this program into SCD care. These findings will inform adaptation and further testing of FUTURES to ensure effective implementation of this novel education program.

THE RELATIONSHIP OF KNOWLEDGE AND ATTITUDES ABOUT REPRODUCTIVE HEALTH BY BEHAVIOR PRE MARITAL SEX

Background: According to the World Health Organization (WHO), reproductive health is a state of complete physical, mental and social health, not merely free from disease or disability related to the reproductive system, function and process. Knowledge of reproductive health for teenagers is very important, this aims to provide prevention and self-protection from risky sexual behavior and other risky behavior that can affect reproductive health and prepare teenagers to live a healthy and responsible reproductive life. Purpose of writing: to determine "The relationship between knowledge and attitudes regarding reproductive health and pre-marital sexual behavior among STIKes Abdi Nusantara Jakarta students". Research Method: This research design uses a cross sectional approach. With a sample collection technique using a questionnaire using the total sampling technique. The analysis used in this research was univariate and bivariate and used the chi-square test. With a total sample of 50 respondents who met the inclusion and exclusion criteria. Results: There is no significant relationship between the level of knowledge about reproductive health and premarital sexual behavior among STIKes Abdi Nusantara students in 2023 (p=0.94). There is no significant relationship between attitudes about reproductive health and premarital sexual behavior among STIKes Abdi Nusantara students (p=0.87). Conclusions: There is no relationship between knowledge and premarital sexual behavior among Stikes Abdi Nusantara students and there is no relationship between attitudes about reproductive health and premarital sexual behavior among STIKes Abdi Nusantara students.

Will Science Alone Save Your Fertility?

This paper highlights the pressing need for increased awareness and education regarding reproductive health and fertility issues in the Maltese Islands. Despite living in the age of information, misconceptions and misinformation persist, particularly surrounding basic reproductive health knowledge. To address this gap, two conferences on fertility awareness were organized in Malta and Gozo as part of ‘The 3 Missions’ Project, in collaboration with the Malta Council for the Voluntary Sector and Dar Guzeppa Debono Association. The conferences brought together various stakeholders including healthcare professionals, policymakers, and educators to discuss topics such as normal reproductive cycles, infertility treatments, and the legal framework surrounding assisted reproductive technologies (ART). International perspectives were also provided, shedding light on perceptions and practices in other European countries. Key recommendations emerged from these discussions, emphasizing the importance of standardized terminology, user-friendly information dissemination, and the destigmatization of infertility. Furthermore, the paper underscores the need for preconception parenthood preparation and highlights the psychological and social implications of infertility and parenthood. Overall, the conferences served as a platform to raise awareness and initiate collaborative efforts to address fertility-related challenges in the Maltese community.

Engaging and (the Illusion of) Learning? Examining the Relationship Between Different Social Media Activities and Reproductive Health Knowledge

Social media have become fundamental platforms for learning about health, including reproductive health knowledge. However, little is known about what specific user activity is conducive to learning about reproductive health and by what means. Drawing upon the cognitive mediation model, this study examines how different social media activities function in terms of elaboration and knowledge gain. Our hypothesized model was largely supported by a nationwide online survey with 1,000 Chinese women residing in both rural and urban areas. The results revealed the crucial role of information elaboration in bridging different social media activities with both subjective and factual reproductive health knowledge. Interestingly, public reposting of reproductive health information was found to be positively related to subjective knowledge but negatively related to factual knowledge, suggesting the emergence of an illusion of knowing among our participants. Multigroup SEM analyses revealed that the positive roles of scanning and private sharing in encouraging elaboration were more pronounced among users with lower levels of need for cognition. The findings are expected to contribute to a more nuanced understanding of health learning based on users’ social media activities and intrinsic motivations for learning.

The impacts of NGOs and SHGs on learning reproductive health information of Vietnamese women with physical disabilities

Researchers have drawn attention to people’s perceptions of reproductive health in Vietnam. Disabled people in Vietnam have been shown to have particularly low awareness and knowledge of reproductive health, in particular, women with disabilities have varied reproductive health knowledge because some of them have access to better reproductive health information than others. In this situation, non-government organizations (NGOs) and self-help groups (SHGs) contributed great value and provided a great resource for people with disabilities. This article explores the important roles of NGOs and SHGs, as they provide reproductive health information to people with disabilities. This article is concluded with some recommendations and directions for future research.

Maternal and Child Health: The Key to a Better South African Future

South Africa, a country rich in history and natural beauty, also faces serious challenges in the health sector, especially maternal and child health. Maternal and infant mortality rates are still high, inequality in access to health services, low levels of education and knowledge of reproductive health, as well as problems of malnutrition and HIV/AIDS are the main focus of discussion. Although the government has launched programs to improve maternal and child health, funding challenges and disparities in health resources between regions still hinder the achievement of equitable health coverage. This article highlights the importance of increasing health budget allocations, building first-level health facilities, improving the skills of health workers, reproductive health education, nutritional interventions, and multi-stakeholder cooperation to overcome these health challenges.

Exploring Reproductive Health Knowledge and Practices of Female Students under 24 Years: A Study at the University of Dschang Main Campus

Context: Reproductive health encompasses people’s freedom and ability to procreate and have a sexual life that is not only safe but also satisfying. Identifying factors related to the under-utilization of reproductive health services among young girls could help reduce the incidence of reproductive health problems affecting them. Methods: This was a cross sectional study carried out from January to July 2022 among the female students aged 24years and below of the University of Dschang’s main campus. The sampling method was proportionate stratified sampling. Categorical and continuous variables were expressed as frequencies and means respectively. Multiple logistic regression was used to assess the relationship between dependent and independent variables. Results: A total of 395 participants were recruited, with a mean age of 20.6 years and a reported high level of knowledge about reproductive health at 88.9%. Furthermore, 56.2% of the respondents were already sexually active, with the average age at first sex being 18.8 years. However, 30.6% of the participants had made use of reproductive health services. Being aged 21-22 years and being of a religion other than Christianity were some of the predictors of the participants' knowledge and practices towards reproductive health services. Conclusion: This study highlights the low use of reproductive health services among female students and provides new grounds for implementing interventions that will not only improve their reproductive health status but will also be culturally appropriate.

192 Developing a community laundromat intervention to increase reproductive health literacy outreach

OBJECTIVES/GOALS: The project goal was to conduct formative work using community-based participatory research (CBPR) to inform the development of a laundromat-based reproductive health literacy intervention (LI)informed by Passhe-Orlow and Wolf’s Conceptual Model. We provide insights to support the development of similar health literacy interventions. METHODS/STUDY POPULATION: In Phase I, we recruited female patrons over the age of 18 living in DC from 4 community laundromats. Participants completed a survey with validated measures to assess reproductive health knowledge, self-efficacy, and intentions to seek care. Open-ended questions assessed participants’ experiences accessing care, communication with health providers, and laundromat use. Data informed the development of a 2-3 minute reproductive health literacy intervention (LI) storyboard. In Phase II, in-depth interviews were conducted with reproductive health providers (midwives, obstetricians-gynecologists, women’s health registered nurses, women’s health nurse practitioners) working in the communities where the laundromats are located. LI acceptability and appropriateness were explored. RESULTS/ANTICIPATED RESULTS: For Phase I, we recruited 60 patrons. Participants (68.3%) expressed interest in a laundromat-based reproductive health literacy intervention (LI). Identified reproductive knowledge gaps included: unaware of fertile days (50.0%); believe prenatal care should begin after 2nd trimester of pregnancy (50.0%); unclear about pregnancy spacing (85.0%); unable to identify use for folic acid (91.7%); believe once a cesarean always a cesarean (53.3%). In Phase II, all 14 providers supported increasing community accessibility to health information: “we have to move beyond doing public health education in a provider’s office. That’s very outdated.” Providers identified the LI as an approachable, informative, and accessible way to disseminate health information. DISCUSSION/SIGNIFICANCE: Patron and provider input informed our choice of content, style, and delivery of the reproductive health literacy intervention. An essential aspect of our CBPR approach, this research will inform effective, appropriate reproductive health education despite barriers presented by access, transportation, and work schedules.

Minerals and the Menstrual Cycle: Impacts on Ovulation and Endometrial Health.

The role of minerals in female fertility, particularly in relation to the menstrual cycle, presents a complex area of study that underscores the interplay between nutrition and reproductive health. This narrative review aims to elucidate the impacts of minerals on key aspects of the reproductive system: hormonal regulation, ovarian function and ovulation, endometrial health, and oxidative stress. Despite the attention given to specific micronutrients in relation to reproductive disorders, there is a noticeable absence of a comprehensive review focusing on the impact of minerals throughout the menstrual cycle on female fertility. This narrative review aims to address this gap by examining the influence of minerals on reproductive health. Each mineral's contribution is explored in detail to provide a clearer picture of its importance in supporting female fertility. This comprehensive analysis not only enhances our knowledge of reproductive health but also offers clinicians valuable insights into potential therapeutic strategies and the recommended intake of minerals to promote female reproductive well-being, considering the menstrual cycle. This review stands as the first to offer such a detailed examination of minerals in the context of the menstrual cycle, aiming to elevate the understanding of their critical role in female fertility and reproductive health.

"Ripping Off the Band-Aid": uncovering future health care Professionals' "Fractured Knowledge" about sexual and reproductive health.

Research has shown the role of identity on future health professionals' confidence and competence in addressing the sexual and reproductive health (SRH) needs of their patients. While there has been some work in increasing the sexual health literacy of future providers via various curricular approaches and comprehensive clinical-based training, there are research gaps on how social differences around identity impact future healthcare professionals' knowledge and practices around SRH. This article presents research findings on the experiences of US undergraduate students attending a campus that provides training in the health sciences and health professions. Our study aims to understand the perspectives of these students as they pertain to their future career choices in healthcare, with a focus on how their past experiences learning about sex, sexuality, and reproduction impact their current and future professional trajectories. We present a qualitative analysis from 40 in-depth interviews with U.S. undergraduates. The interview questions were designed in collaboration with undergraduate researchers interested in sexual health education. These student researchers collected all the interview data and worked with senior researchers to analyze some of these data. The themes that emerged from the interviews were around experiences with what students perceived as "fractured" sexual and reproductive health (SRH) knowledge they received as children and adolescents. This knowledge shaped essential aspects of their identity as young adults and future healers. Data indicated unique processes implicated in how past as well as present socialization experiences learning about sex, sexuality, and reproduction positions undergraduates in health professions to see young adulthood as a journey of "catching up" on sexual knowledge but also as an ongoing experience of anticipation and planning influencing their career-building journey. The importance of sexual health literacy among healthcare professionals cannot be overstated, as it is vital in providing patient-centered and non-judgmental sexual and reproductive health (SRH) care and services. To date, there is a shortage of studies looking at the impact of sexual health knowledge on healthcare professionals. More research is needed on educational strategies that could be implemented at the intra-personal level to assist college-aged young adults in healthcare career tracks to "catch up" or "fill in the gaps" in their sexual education journey.

Relationship between Reproductive Health Knowledge and Early Marriage Pregnancy in Adolescent Girls: A Study in Kepung, Kediri District

Adolescent girls who marry at a young age are vulnerable to reproductive health risks, especially premarital pregnancy, which can have serious impacts on their future. The high prevalence of premarital pregnancy among young married teenagers is a serious concern in the context of public health, especially in rural areas such as Kepung District, Kediri Re-gency. This study aims to determine the relationship between reproductive health knowledge among young married women and the incidence of premarital pregnancy in the area. The research method used is descriptive quantitative with an analytical design and cross-sectional approach. The research population was 58 young married women in Ke-pung District, Kediri Regency, while the sample consisted of 49 respondents who met the inclusion criteria. Data collection was carried out using a questionnaire, and data analysis included univariate and bivariate analysis using the chi-square test. Research findings show that there is a significant relationship between the level of reproductive health knowledge among young married women and the incidence of premarital pregnancy in Kepung District, Kediri Regency.

Knowledge and Perceptions of Adolescent Girls on HIV/AIDs and Family Planning

Nepali adolescent girls face distinct challenges in HIV/AIDS and family planning, necessitating a nuanced understanding. Global concerns for adolescent reproductive health and rights, emphasized in international conferences, apply to Nepal’s struggle with HIV/ AIDS, particularly among young people. In this context, this studyaims to investigate knowledge and perceptions of adolescent girls on HIV/AIDS in Nepali context. Moreover, this study concerns on exploring cultural norms and social determinants that affect family planning among adolescents in Nepal. The researcher has employed survey research design of quantitative research by taking data from 111 late adolescent girls (15-19 years) through questionnaires in Sindhuli. Findings reveal age-related influences on reproductive health knowledge and perceptions. While family planning awareness is widespread, specific method knowledge disparities exist. Despite challenges, most exhibit positive perceptions and behaviours towards people living with HIV/AIDS. This research contributes evidence-based interventions, emphasizing the need for context-specific strategies to address the reproductive health needs of adolescent girls in Nepal.

Unveiling Silent Struggles – A Qualitative Study on Perception of Subfertility in Rathnapura District, Sri Lanka

Introduction: This qualitative study explores the perception of subfertility in the Rathnapura district of Sri Lanka. Subfertility is a public health issue with profound socio-cultural, psychological, and economic consequences for affected individuals and couples. Understanding the social constructs and perceptions of subfertility is essential for addressing the unique challenges individuals face within the social framework.
 Methods: A qualitative study was conducted through Focus Group Discussions (FGDs) and Key Informant Interviews (KIIs). The sample size was determined by theoretical saturation. Purposive sampling was used for FGDs, resulting in six groups of subfertile couples, and KIIs comprised 30 key informants from several subfertility service provider categories and relatives of subfertile couples. Data were collected by the trained research team, ensuring methodological rigour. Thematic analysis was conducted to extract meaningful insights from the gathered information.
 Results and Discussion: The findings of this study described the multifaceted perceptions related to subfertility, including significant emotional effects, societal stress, and stigma associated with subfertility. The desire for children was reflected as a source of happiness and achievement, with a preference for male offspring. Participants had varied beliefs about the causes of subfertility, including biological factors and supernatural influences. Accessing treatment options was challenging due to limited facilities, financial constraints, and cultural trusts. Additionally, religious and spiritual faiths influence the interpretation of subfertility, creating a complex interaction of cultural, social, and psychological factors. Cultural views and traditional norms play a significant role in shaping the perception of subfertility.
 Conclusion and Recommendations: The perception of subfertility is deeply influenced by cultural beliefs, societal norms, and gender roles. The stigmatisation associated with subfertility places considerable emotional strain on affected individuals and couples. Recognizing these social dynamics is crucial for developing effective interventions that address the unique challenges faced by individuals experiencing subfertility in this context. Sexual and reproductive health knowledge should be increased in the community, and culturally sensitive interventions are required to challenge prevailing societal norms and educate the public about subfertility.

(175) Knowledge, Attitude, and Practice on Sexual and Reproductive Health among Adolescent in Malaysia: A Systematic Review

Abstract Introduction A good sexual and reproductive health (SRH) encompasses dimensions of physical, emotional, mental and social-wellbeing in relation to sexuality; it is not merely the absence of disease, dysfunction, or infirmity. A proper curriculum is needed to ensure that all adolescents have a good grasp of knowledge of SRH to have proper attitudes and the right practices in SRH. Objective Currently, it is believed that there is no improvement in status of knowledge, attitude and practice of SRH among adolescents in Malaysia, despite the introduction of sexual and reproductive health topics in the school curriculum. No systematic or proper evaluation to evaluate the effectiveness of the said improved SRH curriculum. This review aims to investigate the status of level of knowledge among adolescents since the introduction of SRH curriculum. Methods A systematic literature review in the form of narrative review was used to investigate the status of knowledge, attitude, and practice of SRH. 109 potential articles were found through Medline, PubMed, Google Scholar and Google. Articles removed due to duplications within and between databases. 109 potential articles were found but only 29 articles met the inclusion/exclusion criteria. Selected articles were read through based on the 8 key concepts in the International Technical Guidance on Sexuality Education, 2018. Results The results reported that the knowledge of sexual health among adolescents was just above the average, while poor knowledge in reproductive health. They have a positive attitude towards introducing SRH curriculum as early as primary school. It was found that these adolescents have poor information-seeking behavior, and main resources of information are from peers, internet, and magazine. Parents and teachers were the least chosen as reference. Conclusions There is the need to re-evaluate the current SRH curriculum, and to integrate the healthcare personnel as educator to the adolescents, trainers to the teachers and parents to ensure a holistic approach to a proper SRH education following the CSE guideline. Disclosure No.

CyberRwanda's Pathway to Impact: Results From a Cluster-Randomized Trial of Adolescent Family Planning Knowledge, Beliefs, Self-Efficacy, and Behavior

PurposeCyberRwanda is a digital health intervention designed to increase knowledge of family planning and reproductive health (FP/RH) and access to youth-friendly services in Rwanda. MethodsSixty schools in eight districts were randomized 1:1:1 to one of two CyberRwanda implementation models—self-service (tablet-only) or facilitated (tablet, activity booklet, peer facilitators)—or to control. Students aged 12–19 years were randomly selected to participate. Baseline and 12-month midline surveys assessed intermediate (secondary) outcomes of FP/RH and HIV knowledge, attitudes/beliefs, self-efficacy, and behavior. Prevalence differences (PDs) were estimated using generalized linear mixed models. ResultsThere were 5,767 midline participants (51% female, mean/median age: 16 years, 29.9% sexually active). Those in CyberRwanda schools had higher knowledge of emergency contraception (57.3% vs. 47.5%, PD: 0.09, 95% confidence interval [CI]: 0.05–0.13); greater confidence in providing consent (73.3% vs. 68.1%, PD: 0.05, 95% CI: 0.01–0.08), negotiating partner's contraceptive use (88.3% vs. 85.0%, PD: 0.03, 95% CI: 0.01–0.06), and accessing/using contraceptive services (95.6% vs. 91.8%, PD: 0.03, 95% CI: 0.02–0.05); and more favorable views on FP/RH services (54.5% vs. 48.5%, PD: 0.06, 95% CI: 0.02–0.11) and condoms (76.9% vs. 71.3%, PD: 0.06, 95% CI: 0.03–0.08) compared to control. No significant differences in HIV/fertility knowledge, confidence in accessing HIV testing, or condom use were observed. DiscussionCyberRwanda increased FP/RH knowledge, supportive attitudes/beliefs, self-efficacy, and behavior at 12 months. The 24-month endline analysis will reveal whether CyberRwanda's benefits on intermediate outcomes result in changes to the primary outcomes, including contraception use and childbearing.

Studying Mothers' Knowledge and Perceptions of Adolescent Reproductive Health

Background: Reproductive health education is obtaining information and forming attitudes and beliefs about sex, sexual identity, relationships, and intimacy. Mothers are the primary caregivers and have an essential role in providing reproductive health and sexual education to adolescents. Parents' lack of reproductive health education triggers deviation; therefore, parents, especially mothers, can provide comprehensive reproductive health education to prevent free sexual behaviour and sexual crimes in adolescents. Purpose: To measure the knowledge and perception of mothers about adolescent reproductive health Methods: This is a cross-sectional study with a descriptive design. The study involved 135 respondents who were selected using a purposive sampling technique. Analysis using descriptive, T-test and Pearson correlation. Results: More than 50% of respondents answered that adolescents' reproductive health education should be parents' responsibility and education should begin during elementary school. There was a correlation between mothers' knowledge and perception of adolescent reproductive health (r=0.44, p<0.001). Most mothers were afraid of providing sex education due to their ignorance of teaching methods and their lack of knowledge, and mothers wanted to learn about adolescent reproductive health from experts. Conclusion: Mothers want to learn more about sex education from experts or health workers. They were interested in male/female sexual structure and sexual physiology. Open communication between mother and child on sex-related issues is essential. Providing accurate and up-to-date sex education information to parents is vital to effectively educating their children at home.

A DESCRIPTIVE STUDY TO ASSESS THE HEALTH SEEKING AWARENESS AND UTILIZATION OF ADOLESCENCE REPRODUCTIVE HEALTH SERVICES AMONG SCHOOL ADOLESCENTS IN RURAL COMMUNITY

Introduction: Reproductive health may be a vital area of concern in adolescent health. However traditional Indian society regards talks on such topics as taboos and discourages open discussions on reproductive health. Objective: This study assess the health seeking awareness and utilization of reproductive health services and determines the association between health seeking awareness and utilization of adolescence reproductive health service with selected demographic variables. Method: The descriptive study with non-experimental research design was used the analysis and interpretation was done using SPSS version 18 and excel 2010. Result: More than half (54.65%) adolescence boys and girls knew correctly about male and female reproductive system and more than half (46.94%) adolescence knew incorrectly about STD, contraception, pregnancy and abortion. However only (5%) of adolescence had ever used reproductive health services and majority of 74.2% adolescence had never used these services. Reproductive health knowledge was significantly associated with fathers qualification, fathers occupation and source of information. Reproductive health services utilization was significantly associated with age, class, source of information. Conclusion: This study clearly depicted that more than half adolescents were not utilizing the services. Lack of adolescent reproductive friendly clinics, fear/embarrassment and concealed service were reasons for not utilizing the service.Fear of social value and being embarrassed, misconception of adolescents about pregnancy, unsafe sex, shortage of supply, harmful traditional practices and lack of school based adolescent reproductive health services.

A Community-Based Reproductive Health Care Model Effectively Enhances Reproductive Health Among Lahu Women in Northern Thailand.

Inadequate and delayed access to sexual and reproductive health services among the Hill Tribe population can be attributed to the intersection of socioeconomic challenges and distinct cultural practices. To address this limitation and create a tailored model capable of addressing it, this study assesses the effectiveness of the Community-Based Reproductive Health Care Model (CRHC) in enhancing reproductive health knowledge, attitudes, and practices among Lahu women, a prominent hill tribe population in Northern Thailand. Implementing the CRHC model includes training programs for community influencers and subsequent education for Lahu women using culturally adapted courses. The effectiveness of the model is assessed through pre-test and post-test comparisons of knowledge, attitudes, and practices related to reproductive health care and analyzed using paired t-tests and repeated ANOVA. The scores for knowledge, attitudes, and practices among Lahu women changed from 8.92 ± 2.02, 52.99 ± 5.54, and 27.76 ± 6.67 to 10.47 ± 2.32 (p < 0.001), 56.61 ± 5.54 (p < 0.001), and 29.47 ± 6.76 (p = 0.030), respectively. Significant improvements are observed in these areas, particularly in maternal health practices among pregnant Lahu women (n = 11). This study additionally evaluates the model's impact on the healthcare system by analyzing changes in government performance indexes, showing increased access to high-quality antenatal care and contraceptive usage. This study highlights the challenges faced by hill tribe populations in accessing healthcare, emphasizing the need for tailored reproductive health education and the importance of addressing health insurance barriers. The CRHC model's success illustrates the potential of community-based, culturally sensitive interventions in improving reproductive health outcomes, providing valuable insights for similar interventions in other indigenous or marginalized communities.

TINGKAT PENGETAHUAN TALASEMIA, PENYAKIT MENULAR SEKSUAL DAN KESEHATAN REPRODUKSI PADA REMAJA USIA SEKOLAH MENENGAH PERTAMA

This PKM Activity aims to determine the level of knowledge of adolescents about thalassemia, sexually transmitted diseases, and reproductive health. The method used in this PKM is material presentation/ counseling and direct interviews using a questionnaire linked to the Google Form application. The results of this PKM activity were obtained as follows; The source of information that plays a dominant role in conveying sexually transmitted infections-HIV/AIDs is the internet, namely 57(53.4%). As many as 76(70.4%) students did not know about thalassemia. Surveys on sexually transmitted diseases/AIDs show that the average junior high school teenager has sufficient knowledge, namely above 50%. Surveys on reproductive health knowledge show that the average junior high school teenager has good knowledge about the physical changes that occur during puberty, including; 1) an Increase in muscle mass (30%), 2) a change in voice (71.8%), 3) hair growth on the face and pubic area (95%), 4) increased sex drive (33.6%). 5) enlarged breasts (17.3%), 6) menstruation started (40.9%). A survey limited to female respondents showed that the level of knowledge about the female reproductive cycle related to the fertile period in junior high school teenagers was around 24 (43.3%) respondents, but 30 (50%) respondents did not know this. The level of knowledge about the fertile period and the possibility of pregnancy occurring in that period are: 1) the response of not knowing was 26 (43.3%), people, 2) immediately after menstruation ended 14 (23.3%), 3) in the middle between two menstruations as many as 14 (23.3%). From the results obtained, it can be concluded that the level of knowledge of junior high school adolescents regarding thalassemia is still very poor, while for sexually transmitted infections and reproductive health, it is at an average level. It is hoped that after participating in PKM, teenagers will have a better level of knowledge than before.