Reaching Adolescents with Health Services in Nepal: Sexual and Reproductive Health Services for Adolescents Are Being Rolled out in Nepal, but Many Young People Have Yet to Benefit
Notice bibliographique
Résumé
Radha (not her real name), a 15-year-old resident of Kathmandu, the capital of Nepal, read about sexual and reproductive health in her school textbook, but it did not answer all of her questions. When she asked her parents, they did not want to discuss this traditionally taboo topic. Radha's story is typical, says Amit Timilsina, who heads nongovernmental organization YUWA (youth in Nepali) that is helping to provide young people like Radha with sex education and reproductive health information. Adolescents are shy about asking questions and learning about sexual and reproductive health in the classroom, and they don't always receive support at home to seek out the information and services they need, Timilsina says. About 22% (6.38 million) of Nepal's 28.5 million population (government projection for 2016) are adolescents aged 10-19 years. The legal age of marriage in Nepal is 20 years. Despite that, 48.5% of women aged 20-49 years were married by the age of 18 and 15.5% aged 15-49 were married by the age of 15, according to the Nepal Multiple Indicator Cluster Survey 2014 (NMICS 2014). Childbearing also begins early, especially in rural areas. Almost a quarter of women in Nepal give birth before the age of 18 and nearly half before they are 20 years old, according to the Nepal demographic and health survey 2011 (NDHS 2011) although the numbers of teenage pregnancies have reduced in recent years, as shown by NMICS 2014. Early childbearing can have negative health consequences for teenage mothers and their infants. Moreover, it greatly reduces girls' education and employment opportunities. High rates of adolescent marriage and the pressure to bear a child--preferably a son--right after marriage are often cited as key factors holding back economic development, helping to make Nepal one of the poorest countries in the world. In a bid to better meet the health needs of adolescents, the Nepali government launched a national programme in 2010 to provide adolescent-friendly sexual and reproductive health services as part of its five-year health sector plans. The National Adolescent Sexual and Reproductive Health Programme aims to serve all adolescents. Although launched in the era of the Millennium Development Goals that ended in 2015, the programme is in the spirit of the sustainable development goals (2015-30) that stress universal access to health care and leaving no one out. The programme is complemented by sex education. Between 2002 and 2006, with the support of the United Nations Population Fund (UNFPA), Nepal introduced what is known as comprehensive sexuality education in schools as part of the national curriculum. The approach stresses human rights and gender equality, and helps adolescents develop the life skills they need to cope with puberty and weigh the risks of early marriage and pregnancy. We are working with the Ministry of Education to empower teachers and students with training and information on this important topic, says Manju Karmacharya, the Adolescent Sexual and Reproductive Health Programme Officer with UNFPA in Kathmandu. NGOs also play a role. YUWA has been complementing this school-based intervention with peer education in 14 districts. Young people may feel inhibited discussing these issues in the classroom, so other ways of delivering sexuality education are needed, Timilsina says, adding that his NGO plans to provide such support via mobile phone applications from April. Since the National Adolescent Sexual and Reproductive Health Programme was launched, services--including counselling, provision of contraceptives and screening for sexually transmitted infections --have been rolled out at 1134 health facilities in 63 of Nepal's 75 districts. The remaining districts will be covered by 2021, according to Ghanashyam Pokharel, former chief of Adolescent Sexual and Reproductive Health and Family Planning from the Family Health Division in the health ministry. …
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| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,003 |
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| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,004 | 0,001 |
| Communication savante | 0,004 | 0,005 |
| Science ouverte | 0,001 | 0,005 |
| Intégrité de la recherche | 0,002 | 0,006 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,009 | 0,001 |
Scores machine (provisoires)
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