ADOLESCENT SEXUAL AND REPRODUCTIVE HEALTH SERVICES

ACCORDING to the World Health Organisation, “sexual health is a state of physical, mental and social well-being in relation to sexuality” whilst, sexual and reproductive health (SRH) services are those that promote safe pregnancy and birth, prevention and treatment of sexually transmitted infections, provision of family planning, contraceptives, including information and healthcare, treatment of other diseases or illnesses concerning the reproductive organs e.g. fibroids, cancers etc.

During puberty, adolescents experience SRH problems that call for a responsive health system and skilled health workers in adolescent health.

The human brain undergoes rapid development that influences the thinking, feeling and behaviour of adolescents in many ways.

The American Academy of Child and Adolescent Psychiatry confirms that the part of the brain that controls reasoning, abstract thinking and self-regulation (executive control) is not fully developed during adolescence, but, the component that is responsible for aggression and gut reaction that dominates the reasoning in the heat of the moment.

Because adolescents are not fully grown-up adults, they may have difficulties in making responsible decisions and do not think about the consequences of their actions.

“…lack of executive functions can result in teen risky behaviour. And lack of emotional self-regulation skills can affect teen mental health,” reports Newport Academy.

A good example of such an apparent irrational decision is engaging in unplanned and risky sexual behaviour as adolescents consider themselves invincible and not at risk of HIV/STI infection or pregnancy.

The latest Zambia Demographic and Health Survey reported that comprehensive knowledge about HIV in girls and boys were 40.5 percent and 38.6 percent respectively.

Since over 50 percent of adolescents do not know how HIV is acquired and its prevention measures, the majority are at risk of infection.

Programmes concerning HIV/AIDS/STI, sexual and reproductive health, gender-based violence (GBV), non-communicable diseases (NCDs), alcohol and drug use and adolescents with special needs exist.

The goal is to address high cases of teenage pregnancy which stands at 29.2 percent as reported in 2018 Zambia Demographic and Health Survey.

GBV, alcohol and substance use in adolescents can facilitate teenage pregnancy and Sexually Transmitted Infections including HIV because of power imbalances in sexual relationships and impaired judgement respectively, hence their inclusion on the list of programme priority areas to be tackled using a multi-intervention and multisectoral approach.

Schools and health facilities are formal structures through which adolescents enhance their SRH literacy and life skills. While the mandate of the Ministry of Education is to provide accurate and age-appropriate information on human development, family, culture, relationship, reproduction, values, attitudes and skills etc. through Comprehensive Sexuality Education (CSE) imbedded in carrier subjects, the Ministry of Health offers sexual and reproductive health services which speak to basic human rights.

The Ministry of Health promotes delayed sexual debut to avert devastating effects of premature sexual intercourse in adolescents. As one researcher explained, “early initiation of sexual intercourse is a proxy measure of the onset of young people’s exposure to HIV infection, multiple lifetime sexual partners and vulnerability to reproductive health problems.”

The ministry utilises multi-media platforms to enhance SRH literacy levels among adolescents. Working with implementing partners, the Adolescent Health Unit has developed materials on teenage pregnancy and its risks, benefits of abstinence, HIV, Gender-Based Violence, alcohol and drug use.

HIV testing, Human Papilloma Virus (HPV) vaccination in among 14-15 year olds to prevent cervical cancer and Voluntary Medical Male Circumcision ( VMMC) are among other services offered.

Efforts by the ministries of Education and Health to promote SRH must be complemented by parents, religious, civic and traditional leaders who play a critical role in shaping the environment young people grow in to establish a positive trajectory.

Improved intergenerational dialogue to impart values and morals in adolescents, enforcement of by-laws to deter young people from accessing brothels, alcohol and drugs, providing young people with education and economic empowerment to avert transactional sex that leads to HIV/ STIs, unintended pregnancies and associated unsafe abortions are strategies that can improve Sexual and Reproductive Health outcomes.

Young people with disabilities and those in religious settings facing social/financial challenges should also be reached with support, health messages and services to ensure that no one is left behind.

Be alert. Stay safe always. ___________________________

The author is a Senior Health Promotion Officer

Ministry of Health- Headquarters

Dept: Health Promotion, Environment and Social Determinants

Unit: Health Promotion

Phone No.: +260 953 268090