Discussions
Four key action areas are proposed to best promote and protect
adolescent sexual and reproductive health in the Pacific. They are
complementary and intersecting (14,15) and should involve the
participation of young people . Pacific nations have the opportunity to
review their current situations, and build national programs based on
what interventions work best in their own settings. ASHRHR programmes
must develop to become large scale and sustainable. This requires
greater attention and investment.
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Creating an enabling environment for ASRHR
Children and adolescents spend the greatest amount of time at home and
schools; therefore parents and teachers must provide the enabling
environment that builds trusting relationship for information sharing,
communication, mentoring and counseling (14). Programmes to support
parents, guardians and teachers are required. Churches, NGOs and
community support groups play a critical role in this process.
Programmes should also empower young people so that they can exercise
their human rights, with special attention given to younger adolescents,
10-14 years of age.
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Comprehensive Sexuality Education (CSE)
Children and adolescents need to build knowledge, skills and attitudes
on gender norms, power imbalances, traditions and practices, respect
for people in line with traditional structures. CSE should start as
early as the beginning of primary school and integrated into standard
school curriculum. This requires that teachers training institutions
teach CSE for pre-service teachers while practical arrangements are
made for in-service teachers. CSE should reach all adolescents,
including the most vulnerable and marginalised (14,15). In countries
where primary school enrolment is low, CSE programmes for
out-of-school should be developed to engage churches, NGOs and other
community-based institutions. CSE should strongly address gender based
violence and other forms of violence. This is particularly relevant in
the Pacific where the prevalence of gender violence is one of the
highest in the world.
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Adolescent Health Services and Demand Creation
Programmes must address both establishing adolescent services and
creating demands for services. Increased adolescent uptake of SRH
services has been shown to include a combination of training and
support of health workers; improving adolescent-friendliness of health
facilities; and information outreach through multiple channels
(14,15). The relevance of innovative initiatives such as school-based
clinics can be explored in schools that will also develop and teach
CSE.
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ASRHR as an integral part of SDGs programmes
ASRHR programs must be implemented on a large national scale as part
of government programmes within the framework of SDGs. Large-scale
programmes can facilitate collaborative work across sectors to gain
greater impact. EG: Increased utilization and greater demands for
adolescent health services will occur if education and empowerment
programmes for change behaviours are also implemented. Small scale and
short-term projects are not sustainable and investing in such should
be avoided (14,15).
In summary the key action areas outlined above should link sexuality
education and reproductive health (SRH) services; build awareness,
acceptance, and support for youth-friendly SRH education and services;
and address gender inequality in terms of beliefs, attitudes, and norms;
and target early adolescents, where appropriate. Implementers should
adopt some key principles for improved results such as:
adolescent-focused, political support, community participation,
multi-sectoral engagement, partnerships, results-based and working
towards sustainability.