Adolescent Sexual and Reproductive Health:Report on an Assessment and Review of Training Materials

Young people in Tanzania face a range of serious reproductive health risks – from early unwanted pregnancy and unsafe abortion to sexually transmitted infections, including HIV/AIDS. These reproductive health problems do not only have an immediate impact on the lives and well being of young people, but also contribute to long-term pattern of high fertility, poverty, dependency and poor socio-economic development. In recognition of the extent of adolescent health problems, the Government of Tanzania has initiated an effort to address young people’s needs for reproductive health information, counseling and services. To guide improved adolescent sexual and reproductive health programming, the Reproductive and Child Health Section (RCHS) of the Ministry of Health, with technical assistance from Family Care International (FCI) and financial assistance from the United Nations Population Fund (UNFPA), launched an effort to assess and review training curricula and related resource materials that are available in Ta nzania and internationally. Specific objectives of the Assessment were: To provide an overview of adolescent sexual and reproductive health (ASRH) training curricula that is available in Tanzania and at the international level. To identify priorities for curriculum development in Tanzania. To recommend training materials that could be used as models for developing national training curricula for various target audiences. Through interviews with key ASRH stakeholders in Tanzania and literature reviews, a \ud range of training materials were identified and reviewed. Materials were analyzed by target user and audience as well as by content and depth of coverage. The Assessment and Review served to illuminate critical ASRH issues that need to be addressed through training programmes for those working with youth. In addition, the Assessment highlighted key gaps in available curricula. Based on the Assessment findings, priorities for curriculum development include. An in-service training curriculum for orienting health service providers. The Assessment revealed that there are few materials for orienting service providers to youth friendly service delivery. Therefore, a standardized curriculum is needed to guide in-service training of facility-based health staff, as well as school-based health workers, outreach workers, lay counselors and other community-based providers in adolescent sexual and reproductive health counseling and service delivery. A comprehensive peer education training manual. Many organizations working with peer educators have developed training curricula, and there is considerable variety in the content and quality of these resources. To ensure the content and quality of peer education programmes for youth, it is recommended that a comprehensive peer education manual be developed, which could be used for training various types of peer educators and youth counselors (i.e. those working with in-school adolescents, those working with out-of-school adolescents, etc). Curricula and teaching aids for primary and secondary schools. Although the Ministry of Education and Culture has begun developing syllabi to guide implementation of the Family Life Education Programme in primary and secondary schools, teachers need more detailed curricula, reference materials and teaching aids to successfully carry out this important education programme. In developing the above curricula, it is recommended that special emphasis be placed on designing training resources comprised of separate training modules – modules that can be used either separately or together, depending on the specific training needs of various audiences. For example, the curriculum for service providers should include separate modules on adolescent sexual and reproductive health, information and counseling, and service provision to young people. While all tree modules would be used in training service providers, select modules could be used to train lay counselors and outreach workers. Similarly, the comprehensive training manual for peer educators should include separate modules on topics, such as adolescent sexual and reproductive health, facilitation and peer education skills, and working with different target audiences – in school adolescents, out-of-school youth, and parents and other adults – to ensure that peer education programmes could use the specific modules that are appropriate to their outreach efforts.The Assessment revealed that a large number of training curricula and related materials exist to support adolescent sexual and reproductive health initiatives in Tanzania. Although none of these resources is precisely suited to meet the above-mentioned gaps,many of the existing materials contain excellent content, which should be used as the basis for developing standardized national curricula

New findings from intervention research: Youth reproductive health and HIV prevention

On September 9, 2003, FRONTIERS/Population Council, Horizons/Population Council, and YouthNet/Family Health International co-sponsored a technical meeting in Washington, DC, “New Findings from Intervention Research: Youth Reproductive Health and HIV Prevention.” Approximately 150 HIV/AIDS, reproductive health, and youth development experts from a diversity of organizations and backgrounds participated. The purpose of the meeting was to disseminate newly available research findings on how to change youth reproductive health/HIV knowledge, attitudes, and behaviors in developing countries. The meeting also sought to stimulate discussion on lessons learned, best practices, and recommendations for future youth programs and research. This meeting report summarizes the presentations and discussions at the meeting, following the meeting agenda

Building a better future for youth: Learning from experience and evidence

On June 6–9, 2006, the World Health Organization’s Department of Reproductive Health and Research, the Frontiers in Reproductive Health Program of the Population Council, and the YouthNet Program of Family Health International sponsored a regional forum on critical issues in youth reproductive health and HIV programs in sub-Saharan Africa. The objectives of the Africa Regional Forum on Youth Reproductive Health and HIV were to: share the latest research results and program evidence; share findings and methodologies of promising interventions for youth and identify new programs and techniques; identify gaps in existing research, programs, and policies in youth reproductive health and HIV prevention; and explore monitoring and evaluation methodologies and desired outcomes for youth programs. The three organizations engaged a broad range of participants to ensure that technical issues were interpreted and viewed from a diversity of perspectives. Approximately 90 national, regional, and international researchers, donors, program managers, youth, and policymakers from nine African countries participated in the forum. This report summarizes the key content of presentations and indicates the breadth of participant discussion

Best practices in CBD programs in sub-Saharan Africa: Lessons learned from research and evaluation

Community-based distribution (CBD) is the use of nonprofessional local distributors or agents to provide family planning (FP) methods—typically condoms, pills, and spermicides—and referral for other services. FP programs in Africa, Asia, and Latin America have implemented CBD programs for the past 30 years. There is a large body of evidence on the effectiveness, cost, and sustainability of CBD models. Most evidence supports using CBD where appropriate conditions exist. However, major changes have taken place in the context in which programs operate, including the onset of the HIV/AIDS pandemic, enhanced access to FP services, and increased demand for related reproductive health care. These changes call for a review of CBD’s relevance—particularly in sub-Saharan Africa. This seminar was organized by the Population Council’s Frontiers in Reproductive Health Program, Family Health International, and Advance Africa and attended by participants of the U.S. Agency for International Development and collaborating agencies. Key issues reviewed are detailed in this document

Why Family Planning and Reproductive Health are Critical to the Well-Being of Youth

An unprecedented number of young people are entering their reproductive years, most of whom live in the developing world. U.S. policy makers should assist in effortS to ensure that youth worldwide are able to make informed decisions about their sexuality and receive the family planning and reproductive health care that they require. The U.S. should support these efforts by providing adequate funding for international family planning and reproductive health programs. Young people's access to family planning and reproductive health is a fundamental right. The international community recognizes that youth must have access to comprehensive, evidence-based, scientifically accurate, and youth friendly family planning and reproductive information, services, and supplies. The 1994 International Conference on Population and Development (ICPD) Programme of Action endorsed by 179 countries identifies young people's reproductive rights as a priority. Youth were also a key consideration in the 2009 review of the ICPD

Family medicine training in Sub-Saharan Africa : South-South cooperation in the Primafamed project as strategy for development

BACKGROUND. Health-care systems based on primary health care (PHC) are more equitable and cost effective. Family medicine trains medical doctors in comprehensive PHC with knowledge and skills that are needed to increase quality of care. Family medicine is a relatively new specialty in sub-Saharan Africa. OBJECTIVE. To explore the extent to which the Primafamed South–South cooperative project contributed to the development of family medicine in sub-Saharan Africa. METHODS. The Primafamed (Primary Health Care and Family Medicine Education) project worked together with 10 partner universities in sub-Saharan Africa to develop family medicine training programmes over a period of 2.5 years. A SWOT (strengths, weaknesses, opportunities and threats) analysis was done and the training development from 2008 to 2010 in the different partner universities was analysed. RESULTS. During the 2.5 years of the Primafamed project, all partner universities made progress in the development of their family medicine training programmes. The SWOT analysis showed that at both national and international levels, the time is ripe to train medical doctors in family medicine and to integrate the specialty into health-care systems, although many barriers, including little awareness, lack of funding, low support from other specialists and reserved support from policymakers, are still present. CONCLUSIONS. Family medicine can play an important role in health-care systems in sub-Saharan Africa; however, developing a new discipline is challenging. Advocacy, local ownership, action research and support from governments are necessary to develop family medicine and increase its impact. The Primafamed project showed that development of sustainable family medicine training programmes is a feasible but slow process. The South–South cooperation between the ten partners and the South African departments of family medicine strengthened confidence at both national and international levels

The Population Problem: A Third World Reaction

Dr. Mascarenhas is Consultant in Community Health and Family Planning at the Family Welfare Center in Bangalore, India. Until April, 1975, she was Head of the Department of Preventive and Social Medicine at St. John\u27s Medical College in Bangalore and was actively involved in the first Village Health Cooperative program sponsored by the College. She is the author of a recently published book entitled Population Education for Quality of Life. The following article is the text of a paper presented at the XI General Assembly of the International Federation of Catholic Universities

Work-based assessment within Malta’s specialist training programme in family medicine

The Specialist Training Programme in Family Medicine (STPFM) – Malta was drawn up by the Malta College of Family Doctors in 2006, approved by Malta’s Specialist Accreditation Committee, and launched in 2007 by the Primary Health Care Department and the Malta College of Family Doctors. This article regarding the work-based assessment of specialist training in family medicine in Malta was prepared by consulting various local / international documents and publications that are related to general practice / family medicine and its teaching, appraisal and assessment. Assessment of family doctors should consider their actual performance of different tasks in diverse settings of daily practice; this is carried out on-site by direct observation of the practitioner at the work-place (work-based assessment) using different methods.peer-reviewe

Meeting the Development and Health Needs of 215 Million Women: U.S. International Family Planning Goals

U.S. international family planning assistance is one of the great success stories in the history of U.S. development assistance. In 2007, 56.5 million women in the developing world were using modern contraception as a direct result of U.S. support. Many millions more have benefited indirectly from service improvements resulting from the guidance and technical expertise of the U.S. Agency for International Development (USAID). Unfortunately a large and growing need for family planning remains in many developing nations. While the world population continues to grow by 79 million people annually, 215 million women in developing countries seek to postpone childbearing, space births, or stop having children, but are not using a modern method of contraception. The United States can lead international efforts to meet the unmet need for family planning by appropriating $1 billion annually. The$1 billion figure is the U.S. fair share of developed country contributions necessary to address unmet need in the developing world and would also fulfill our historic commitments to the U.N. Millennium Development Goals

Strengthening the Bank's population work in the nineties

This paper argues that the Bank should give renewed priority to population matters and accelerate the current upward trend in lending for family planning programs in the 1990s. It is timely for two reasons. First, the need for bank action in population will increase in the 1990s as a result of growing unmet demand for family planning and stagnant bilateral assistance levels. Second, there is evidence that the initial effects of the 1987 World Bank reorganization have been to strengthening the potential for population work by integrating it more fully with economic analysis and overall country programming, but some further adjustments would assure that the potential could be realized. As the largest and most influential international development organization, there is an important leadership role for the Bank in promoting population policy analysis, dialogue, and in financing family planning programs.Adolescent Health,Health Monitoring&Evaluation,Agricultural Research,Reproductive Health,Early Child and Children's Health