Sexual and reproductive health

Working to safeguard the health, well-being and human rights of adolescents with WHO guidelines

INTERNATIONAL DAY OF THE GIRL

11 October 2018: Many adolescents make the transition to and through adolescence in good health; many others do not. Every year, 1.1 million adolescents die, mostly from preventable causes. Tens of millions of adolescents experience illnesses and injuries that hinder their ability to grow and develop to their full potential. What is more, hundreds of millions of adolescents live in unhealthy environments and/or develop unhealthy habits or unequitable gender attitudes that will negatively affect their future health.

Adolescent girls participating in a workshop, Brazil
UN Women/Gustavo Stephan

To meet adolescents’ diverse and complex needs, which evolve over time and which relate to their personal circumstances and developmental stages, girls’ and boys’ healthy development needs to be promoted. This includes building their sense of self-worth and strengthening their links with the individuals and institutions in their communities. Adolescents also need to be supported to prevent health problems and to respond to such problems if and when they occur. Adolescents themselves have a role to play in this, as do their parents and other family members, the communities they grow up in, schools, clinics and other institutions that are designed to serve them, as well as the laws and policies of the countries they live in.

On the occasion of the International Day of the Girl, WHO has launched a compilation of all its current guideline recommendations on the evidence-based actions that can be used to address the principal sexual and reproductive health and rights issues affecting adolescents. It is at once a handy ‘all in one’ tool and a gateway to WHO information and guidelines.

“This tool is the first of its kind. Decision makers will now be able to easily find the latest evidence on what works to help improve adolescent sexual and reproductive health and secure their well-being.”

Dr Lale Say, Coordinator of the adolescents and at-risk populations team at WHO Department of Reproductive Health and Research and HRP

New WHO document

The new document supports the implementation of the Global Strategy for Women’s, Children’s and Adolescents’ Health 2016–2030, and is aligned with the WHO Global Accelerated Action for the Health of Adolescents (AA-HA!). It also upholds the values of the WHO Operational framework on sexual health and its linkages to reproductive health.

The tool compiles WHO recommendations on a breadth of sexual and reproductive health and rights issues including: comprehensive sexuality education provision; contraception counselling and provision; antenatal, intrapartum and postnatal care; safe abortion care; sexually transmitted infections (STIs) prevention and care; human immunodeficiency virus (HIV) prevention and care; violence against women and girls prevention, support and care; and prevention of harmful traditional practices such as female genital mutilation, in addition to early, forced, and child marriage. For each issue, it provides relevant definitions, rationale for addressing the issue in adolescents, the relevant WHO guidelines that exist, key concepts to consider, key complementary documents in addition to the WHO guidelines, and a real-life example of the guidelines’ application.

Accessible for people with or without expertise

The new WHO adolescent sexual and reproductive health and rights compilation tool has an easy-to-access and user-friendly format. It is aimed to be accessible for all people, whether or not they have expertise in sexual and reproductive health and rights of adolescents. Policy-makers and decision-makers in ministries of health, and members of international and national non-governmental organizations, and members of international organizations that provide technical or financial support for ASRHR work will likely find the tool particularly useful. It is not intended as a technical reference for frontline professionals such as health-care providers, teachers or community development professionals.

A call for holistic responses

Although the structure of this document sets out groups of interventions intended to contribute to specific health outcomes, such as preventing and responding to STIs, or to harmful traditional practices, both the determinants of health problems and the responses to them are closely linked.

Laws that require parental consent for legal minors to obtain health services hinder access to contraceptive information and services and to HIV testing and counselling. Social stigma can hinder care-seeking for intimate partner violence and STIs. Health worker bias can contribute to withholding of safe abortion services and contraceptive information services to unmarried adolescents, even if laws do not require health-care workers to do so. Programmatic responses are also intertwined.

“This compilation of WHO guidelines is intended to highlight... linkages and to press us to all to see adolescents’ needs and problems and respond to them in an holistic manner.”

Dr Venkatraman Chandra-Mouli, expert on adolescent health at WHO

When equitable gender norms are promoted through sexuality education, they can contribute to the prevention of gender-based violence, and to joint decision-making on contraception for couples. A caring and competent health-care worker can, for example, provide respectful care to a young single woman giving birth, and can also address the distress of a young woman living with the consequences of female genital mutilation.

Dr Venkatraman Chandra-Mouli, expert on adolescent health at WHO comments, “This compilation of WHO guidelines is intended to highlight these linkages and to press us to all to see adolescents’ needs and problems and respond to them in an holistic manner.”

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