This article describes a review of 58 evaluation studies of programmes with men and boys in sexual and reproductive health (including HIV prevention, treatment, care and support); father involvement; gender-based violence; maternal, newborn and child health; and gender socialisation more broadly. While few of the programmes go beyond the pilot stage, or a relatively short-term timeframe, they offer compelling evidence that well-designed programmes with men and boys can lead to positive changes in their behaviours and attitudes related to sexual and reproductive health; maternal, newborn and child health; their interaction with their children; their use of violence against women; their questioning of violence with other men; and their health-seeking behaviour. The evidence indicates that programmes that incorporate a gender-transformative approach and promote gender-equitable relationships between men and women are more effective in producing behaviour change than narrowly focused interventions, as are programmes which reach beyond the individual level to the social context.
This paper contributes to understanding of young people's help-seeking behaviour. A conceptual framework is proposed that seeks to integrate differing sources of influence and their implications for policy and programme development. Data was collected by means of an international literature review followed by a purposive international survey of expert informants. Findings suggest that it is important to distinguish between individual and structural determinants of young people's help-seeking behaviour. Policy and programme influences also impact upon the demand for help and the supply of social support that is available. It is important to focus on the normative needs of young people as well as specific health needs and problems. Creating trust, rethinking adult attitudes toward young people, and reducing the stigma associated with seeking help are key to promoting helpseeking behaviour. Many young people are hindered from seeking help, or are not offered help because of social exclusion, violence, poverty, prejudice (including homophobia) and gender inequalities. Future actions to promote help-seeking and enhance social support must consider these structural barriers, making special efforts to reach and work with excluded populations.
Every year, an estimated 2.0-4.4 million adolescents resort to abortion. In comparison with adults, adolescents are more likely to delay the abortion, resort to unskilled persons to perform it, use dangerous methods and present late when complications arise. Adolescents are also more likely to experience complications. Consequently, adolescents seeking abortion or presenting with complications of abortion should be considered as a medical emergency. Issues requiring special attention in the management of abortion complications in adolescents are identified. Approaches to adolescent abortion should involve all levels of the health care system, as well as the community, and should include not only management of the consequences of unsafe abortion, but also post-abortion contraception and counseling. Prevention of unwanted pregnancy by providing information on sexuality, ensuring that reproductive health services are adolescent-friendly, creating a supportive environment, building young people's social and decision-making skills, and offering counseling in times of crisis are highlighted.
The rise in adolescent pregnancy in the 20th century has been influenced by declining age at menarche, increased schooling, delay of marriage, inadequate contraception and poverty. The main problems are preterm labor, hypertensive disease, anemia, more severe forms of malaria, obstructed labor in very young girls in some regions, poor maternal nutrition and poor breastfeeding. In many regions HIV infection is an important problem. The infants of adolescent mothers are more prone to low birth weight and increased neonatal mortality and morbidity. Antenatal care is often inadequate. The most important problem is the increased incidence of preterm labor and delivery, the youngest age groups running the highest risk. Technically, care of adolescents during labor need not differ from care of older women; most adolescents are not at increased risk during labor, although, they are more in need of empathic support. Generally, care of pregnant adolescents should be adjusted to their specific needs.
A community survey in the Shomolu area of Lagos Nigeria showed the incidence of induced abortion to be 5.6%. Most of the abortions were carried out under medical supervision, using a combination of methods. Reasons for the abortions suggest that many were carried out on pregnancies that could have been prevented.
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