scholarly journals Committing to comprehensive sexuality education for young people in Eastern and Southern Africa

2018 ◽  
Vol 26 ◽  
pp. 138
Author(s):  
Elizabeth Bruce

The Ministerial Commitment on Comprehensive Sexuality Education and Sexual and Reproductive Health Services for Adolescents and Young People in Eastern and Southern Africa (ESA), or the ESA Commitment, was affirmed December 7, 2013, by 21 countries located across this region during the 17th International Conference on AIDS and Sexually Transmitted Infections in Africa. The ESA Commitment speaks to the numerous practices and challenges of school age populations stemming from interplay among education, health, and contextual issues varying by country. Analysis of this policy is approached using methodology drawn from Bartlett and Vavrus (2014, 2017) and using a lens of policy borrowing, particularly focused on incorporating agency, process, impact, and timing (Steiner-Khamsi, 2000, 2010). This analysis seeks to understand the ESA Commitment and national curriculum subsequently implemented in Zambia by situating these actions among broader international, regional, and national discourse in the area of sexual and reproductive health and education for young people between 1994 and 2016. Through analysis considering its effectiveness in terms of implementation, scalability, and sustainability, its ability to enable progress towards improving the lives of young people, especially through increased knowledge of HIV/AIDS prevention, is examined and recommendations are presented.

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
V Déom ◽  
L Ben Abdelhafidh ◽  
N Annez ◽  
C Glorie ◽  
M Roland

Abstract Early pregnancies are often linked to precarious situations. Even if Belgium has seen a decrease in teenage pregnancies, in the former mining region of the Hainaut there are still twice as many births to young women under 20 compared to the national rate. Colfontaine is one of the poorest cities in Belgium. Last year, one of the local high schools counted 10 pregnant teenagers out of 450 students. Médecins du Monde was already present in the city at the time with a mobile health clinic called the Médibus. In response, we carried out a mapping of the local sexual and reproductive health actors. The lack of accessibility to social and health structures capable of welcoming teenagers anonymously and free of charge quickly emerged as a problem, the nearest family planning center being located 30 minutes away by bus. In September 2019, in partnership with 5 local health actors, we decided to reshape the Médibus into the Adobus in order to offer family planning consultations, health promotion and harm reduction activities at the high school once a week. In addition to offering health information services, we also aim to detect teenagers experiencing vulnerable situations such as addiction, violence, gender issues and refer them to appropriate services. Halfway through the project, we met 430 teenagers in 14 afternoons. The most common reasons for consultation (N = 310) were questions related to contraception for 29% and to sexually transmitted infections for 24,5%. 70,9% of teenagers received condoms and 13 girls were tested for pregnancy. One girl received a morning-after pill. 3 teenagers with addiction problems and 17 victims of violence were detected. The teams referred 18 teenagers to other services. The success of this outreach project confirms the need for information regarding sexual and reproductive health for teenagers living in precarious situations as well as the need to develop reachable and affordable sexual and reproductive health services in semi-rural areas. Key messages Outreach is an efficient approach to respond to teenagers’ needs in poor semi-rural areas. Outreach facilitated the detection of early pregnancies, addiction and violence issues among teenagers.


Author(s):  
Ingrid Lynch ◽  
Finn Reygan

Both significant progress and profound backlash have occurred in the inclusion of sexual and gender diversity across eastern and southern Africa. This includes the decriminalization of homosexuality in Mozambique in 2015 and the introduction of the Anti-Homosexuality Act (later annulled) in Uganda in the preceding year. Simultaneously there is increased pressure on Ministries of Education to engage more robustly with sexual and reproductive health and rights (SRHR) education in education systems across the region. Emerging regional research points to a narrow, heteronormative focus in comprehensive sexuality education; access barriers to sexual and reproductive health services; and pervasive school-related gender-based violence, including homophobic and transphobic violence. Civil society organizations (CSOs) play a key role in developing best practice in advancing the SRHR of sexual and gender minority youth and are therefore a valuable resource for government SRHR policies and programmatic responses. The regional SRHR education policy landscape is underpinned by two policy narratives: that of young people’s SRHR as a public health concern and a focus on young people’s human rights. These policy narratives not only underpin SRHR policy in the region but also in many instances are drawn on in CSO advocacy when positioning the SRHR of lesbian, gay, bisexual, transgender, queer, and intersex (LGBTQI) young people as an important policy concern. These two dominant policy narratives, however, have a narrow focus on young people’s risks and vulnerabilities, may inadvertently perpetuate stigma and marginalization of LGBTQI youth, and may limit youth voice and agency. These narratives also do not sufficiently engage local sociocultural and structural conditions that drive negative SRHR outcomes for young people in the region. Research, advocacy, and policy development toward the full realization of the SRHR of sexual and gender minority youth can address some of the limitations of health and rights-based policy narratives by drawing on a sexual and reproductive justice framework. Such a framework expands the policy focus on health risks and individual rights to include engagement with sociocultural and structural constraints on young people’s ability to exercise their rights. A sexual and reproductive justice framework provides a more robust toolkit when working toward full inclusion of sexual and gender diversity in regional school-based SRHR policy and programs.


Author(s):  
Lavanya Pillay ◽  
Jenni Smit ◽  
Mags Beksinska ◽  
Chelsea Morroni

Ensuring sexual and reproductive health and rights (SRHR) and empowerment of girls and women are essential to improving individual-level and population-level outcomes globally, and to achieving the Sustainable Development Goals (SDGs). Target SDGs for SRHR include access to a range of (SRH) services, reproductive rights, and ending discrimination and violence against women and girls. SRH services should be provided in a holistic and integrated package to ensure increased access to modern contraceptives, maternity care, prevention, and appropriate treatment of infertility, comprehensive sexuality education and the prevention, diagnosis, and treatment of sexually transmitted infections, reproductive tract infections, and HIV. Addressing these is particularly crucial for ending the HIV/AIDS epidemic, where women are at greater risk of infection compared to men due to a greater physical vulnerability, which is further compounded by gender inequality, poverty, and violence.


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