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    Feasibility of operating adolescent clinics.

    Dominica. Ministry of Health; Tulane University

    In: Operations research family planning database project summaries, [compiled by] Population Council. New York, New York, Population Council, 1993 Mar. [2] p. (DMA-02)

    Teenage pregnancies have been a major health concern in Dominica. Although fertility rates were declining overall, 26% of all live births in 1984 were to teenagers 19 years old and under, the majority of whom were unmarried. Family planning (FP) services were available on request to teens at most clinics but the Ministry of Health (MOH) initiated plans to make contraception more accessible to this age group by establishing youth clinics in collaboration with the UNFPA and the International Planned Parenthood Federation. Tulane University was asked to design and implement an operations research study to test the feasibility of operating these clinics with the objective of reducing teenage pregnancy by providing sex education and making contraceptives readily available. The project was designed at a cost of US $17,326 to test 2 alternative strategies in 6 communities. One rural and one urban community were assigned to each of 2 treatment groups, and another urban community and rural community formed the control group. Treatment group 1 had a separate youth clinic facility established, open 2 days a week to teen clients. Services provided included family life education, FP counseling, distribution of contraceptive methods, and general health care. Group 2 had youth clinics which operated from the existing health centers, with different hours for the teen clients. In the control group, there were no special services provided for the younger age group, although FP services were provided at the local health center or clinic. Although the 4 clinics were established, there was official reluctance to publicize the fact that contraceptives were among the services available. As a result, the project was terminated early. Using a quasi-experimental design, the study was to be based on pre/post-intervention surveys and the collection of service statistics. The baseline survey indicated that knowledge about the reproductive process was higher among older teens, but 90% of all respondents did not know the most fertile time for a woman. Knowledge of FP methods increased with age among both males and females. Over 90% of all teens knew at least one contraceptive method. 78% of males claimed to have had sex as did 46% of females. The reported use of contraceptives during first sexual encounter was significantly higher for females than males. Over 50% of the males who claimed to have had sex said they disapproved of premarital sex, as did nearly 66% of the females. More than 75% of respondents wanted more information on sexually transmitted diseases and contraceptive methods and thought sex education should be taught in schools.
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