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  1. 1
    Peer Reviewed

    What do we know about sexual and reproductive health of adolescents in Europe?

    Avery L; Lazdane G

    European Journal of Contraception and Reproductive Health Care. 2008 Mar; 13(1):58-70.

    Acceptance of sexual and reproductive health as fundamental to the sustainable development of societies has allowed for creation of new reproductive health programmes and policies. WHO sexual and reproductive health (SRH) strategies were developed in the WHO Regional Office for Europe (2001), as well as globally (2004). Adolescent SRH is important in both strategies. Despite these commitments, adolescents remain vulnerable to poor reproductive health. The goal of this paper is to analyse the current status of SRH of adolescents in Europe. Key reproductive health indicators were chosen. Information was obtained from published studies, databases and questionnaires sent to WHO reproductive health counterparts within the health ministries in the Member States of the WHO European Region. Pregnancy rate, age at first sexual intercourse, contraceptive use at first and last intercourse, contraceptive prevalence, HIV knowledge, and STI rates vary widely according to the population considered. Gender difference and lack of information pertaining to SRH of all adolescent populations are other key findings. While the SRH of most European adolescents is good, they remain a vulnerable population. Lack of standardized reproductive indicators and age specific aggregate data make it difficult to accurately assess the situation in individual countries or perform cross country comparison. (author's)
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  2. 2

    Working with adolescent boys: programme experiences. Consolidated findings from regional surveys in Africa, the Americas, Eastern Mediterranean, South-East Asia, and Western Pacific.

    World Health Organization [WHO]. Department of Child and Adolescent Health and Development

    Geneva, Switzerland, WHO, Department of Child and Adolescent Health and Development, 2000. [59] p. (WHO/FCH/CAH/00.10)

    The survey and this report seek to contribute to the understanding of working with adolescent boys in health and health promotion. Pursuant to this purpose, the consultants contacted programmes working in health promotion with adolescent boys in four regions of the world. These contacts did not aspire to include all of the programmes which are working with adolescent boys in these regions, nor do they necessarily represent a random sample of those programmes. Where possible, the survey included a relatively small but representative number of organizations working with adolescent boys in other regions. The organizations were identified via colleague organizations, WHO regional and local offices, the literature review, personal contacts of the survey authors and via non-governmental organizations (NGOs) working in health/health promotion. As detailed below, the survey sought to gather information in a dozen specific areas of interest by means of a questionnaire, which was translated into Spanish and Arabic. Programme staff were requested to fill out the questionnaire and return it to the consultants. (excerpt)
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  3. 3

    Research summary. Vulnerability of street and working children to HIV / AIDS.

    Venkatachalam Y

    Vadodara, India, Centre for Operations Research and Training [CORT], 2000. [2] p.

    Street children live and work in conditions that are not conducive for healthy development. They are exposed to the street subculture such as smoking, drug, alcohol and substance abuse, gambling, engaging in sexual activities or selling sex for survival. The few studies that exist on the sexual behaviour of street children show that these children are more prone to high-risk behaviour and are sexually active at an early age. Often such relationships start as abusive. The circumstances in which they live and work increase their vulnerability also to sexual exploitation and abuse and put them at a higher risk of unintended pregnancies, sexually transmitted infections and even HIV/AIDS. The problem is further compounded by the lack of access to reproductive health information and services. UNICEF, recognising the magnitude of the problem, has undertaken to promote programmes to reduce children's vulnerability to HIV/AIDS, to diminish its impact on children, families and community and to take care of orphans and people living with AIDS. The present study is a situation analysis of children and adolescents carried out CORT to inform programme planning. (excerpt)
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  4. 4

    A qualitative evaluation of the impact of the Stepping Stones sexual health programme on domestic violence and relationship power in rural Gambia.

    Shaw M

    [Unpublished] 2002. Presented at the 6th Global Forum for Health Research, Arusha, Tanzania, November, 2002. [6] p.

    The work presented here came from a preliminary evaluation and was followed up by several applications for funding to carry out a prospective community randomised trial. So far none have been accepted. This may be partly due to the fact that such an evaluation runs against current funding culture. Because of it's holistic approach and focus on core skills in couple communication, the Stepping Stones programme is neither just an HIV prevention or just a domestic violence prevention programme, but has something to contribute to both (and would see the two problems as inter-related). Funding on the other hand is often organised 'vertically' by problem, and evaluation criteria may differ from one problem to another. For example donors who fund evaluation of HIV prevention activities usually require a biological outcome, and hence concentrate on geographical areas with high HIV incidence where the epidemic is seen as most severe. Where sociological outcomes are used this tends to be either the use of quantitative tools to assist in risk factor analysis, or qualitative tools which can assist in replication of the intervention. As such they are usually considered secondary to the primary (biological) outcomes. The hope here is that these interventions may provide a 'blueprint' which can subsequently be applied in low prevalence areas. However by concentrating on proximal rather than distal determinants of infection these blueprints may only capture 'half the story', leading to locally inappropriate assumptions about which groups or behaviours HIV prevention programmes should target. An example would be the demand by some donors that interventions should have an exclusive focus on adolescents, when in a polygamous society adolescent's risk is often mediated by the older generation. On the other hand community interventions against domestic violence are forced to rely on self reported behaviour (perhaps backed up by participant observation) as an outcome. If the intervention is also a reflexive process then qualitative studies become essential to describe a process of change which contains empowerment, group dynamic and normative dimensions. The locally appropriate nature of such interventions is used to justify participatory interventions as being more effective than didactic approaches, but at the same time in the epidemiological-evaluation paradigm it can be seen as problematic, because (I would argue incorrectly) a participatory process is assumed to generate a wide spectrum of outcomes (low replicability), which mitigates against quantitative evaluation. (excerpt)
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