Sexual and reproductive health

Overcoming barriers to adolescent health education and services

An educator showing teens how to use a condom, Dominican Republic
Helen Hawkings/Photoshare
An educator facilitates a family planning workshop with young peer educators. Dominican Republic

What is relevance of this area to Adolescent Sexual and Reproductive Health (ASRH) ?

In many countries sound national ASRH strategies exist. However, they are not implemented, or are only weakly implemented. Many factors contribute to this.

One key factor is lack of comfort in dealing with sensitive issues, and biases emanating from attitudes and values that are either personally held or grounded in religion on tradition act as potent barriers in preventing evidence-based recommendations from shaping policies, and in translating sound policies and strategies into action on the ground. Another is lack of capacity in planning, implementing and monitoring activities on adolescent health among government staff, and especially those in positions of authority at sub-national levels e.g. provincial and district levels.

When national ASRH strategies are not implemented effectively, adolescents and young people are unable to obtain the sexuality and reproductive health education they need in their schools and communities, and sexual and reproductive health services they need from health facilities in their communities. The result is unwanted pregnancies, unsafe abortions and STIs including HIV infection.

What is WHO's reading of the need in this area ?

There is a need for community-based research to identify forces that support and oppose the provision of sexuality education and sexual and reproductive health services, and education/health system research to identify managerial and technical bottlenecks. This needs to be followed by implementation research to overcome community resistance and education/health systems weaknesses, using tailored approaches

How is WHO responding to this need ?

The Department of Reproductive Health and Research (RHR) is supporting countries to assess their laws and policies using a rights framework, and to then formulate/reformulate laws and policies to respond to the needs and fulfill the rights of adolescents. RHR is also developing and testing the feasibility and effectiveness of delivering a complementary package of health interventions with the HPV vaccine. RHR intends to widen its portfolio of implementation research in this area.

Alongside the research and development work, RHR is contributing to wider efforts to support countries in moving from small scale, time limited projects to large scale and sustained programmes.