• Subject Name : Nursing

School-Based Sex Education and Neuroscience

Table of Contents

Background.

Effective Strategies.

Working with parents.

Partnering with schools.

Mobilizing non-governmental organizations (NGO)

Building government commitment

Building life skills.

Engaging religious organizations.

Collaborating with media.

Supporting peer interactions.

Exploring collaboration in workplace.

Connecting at youth gathering places.

Monitoring and Evaluation.

References.

Background of Strategies for Adolescent Sexual and Reproductive Health

Adolescence is the period of social and reproductive health behaviour changes, where young people are more prone to sexual behaviours of health, which can be harmful at such ages. These harms include sexually transmitted diseases, unsafe abortions, sexual violence, early pregnancy and many more (Liang et al., 2019). The target population of this essay covers the young people of ages 10-24 years. According to the World Health Organization (WHO), ages are divided into three groups: adolescents (10-19 years), young people (10-24 years) and youth (15-24 years). However, this could be highly dependent on the socio-cultural and economic sector in which an individual lives. Responsibilities of any person are categorized by their gender and rate of development or growth. Epidemiological needs of people of young ages signify the status of women in society, sexual intercourse, use of contraception, childbearing, age of marriage etc., which could directly affect the reproductive health of people (Sedgh et al., 2015). This can lead to cause infertility, abuse, disability, sexual violence, and maybe a death in some young people. Current and next-generation people may have harmful effects on their reproductive health due to drug abuse, tobacco, alcohol consumption like lifestyle behaviours, nutritional status, access to reproductive health services and educational opportunities etc (Plourde et al., 2016).

Globally, the current situation of young people suffering from reproductive health issues includes several complications, such as HIV (Human Immunodeficiency Virus) infections, RTI infections, cervical cancer among women, anaemic, sexual abuse, violence, inevitably drop out of schools when got pregnant, gender impairment, in-utero exposure to tobacco etc. Over 7000 young people were found each day to be infected by HIV, which is about half of all new HIV cases. Moreover, in every 1 out of 20 younger ones contracts a curable RTI. Both HIV and RTI are more prone to get infected in women’s as compare to men’s, because of their wider mucosal surface exposed during sexual intercourse. Especially young women are more likely to be affected due to the immature cervix line, which can cause cervical cancer at later stages of their life. In developing countries, young girls will face problems of diabetes and hypertension due to their nutritional status (Ganchimeg et al., 2014). Anaemia is also another common issue, which may get exacerbated when women got pregnant. Sexual abuse, violence, and victimization occur at high rates due to the low status of women or defenceless young girls, which will eventually lead to an increased rate of suicide. Access to education is also problematic in many areas of South Asia and Africa, where young girls were dropped out of school if they get pregnant (Santhya & Jejeebhoy, 2015). There is no chance of their further social or economic development. Girls education has a low emphasis and under-investment schooling as compared to boys, which indicates the gender gap. According to ‘education for all-conference’, gender parity is more important in education. Many young women have a lack of knowledge about RTI and because of no symptoms, they are unaware of their health issues. Due to these untreated infections, their health gets affected and it may lead to ectopic pregnancy and infertility as well. Moreover, in-utero exposure to tobacco and exposure through breast milk have harmful effects on babies and may cause low birth weight and an increased tendency to upper respiratory tract infections. This may lead to a 30% higher risk of adolescent mothers get underweight and malnourished child (Salam et al., 2016).

This essay aims to improve the young people’s reproductive health behaviour and conditions, by the help of a variety of strategies that can be effective in maintaining their reproductive health issues. Towards this end, this essay seeks to address objectives or strategies, such as working with parents, partnering with schools, reorientating health services in and out of schools, building government commitment, mobilizing non-governmental organizations, engaging religious organizations, building life skills, supporting peer interactions, collaborating with the media, exploring collaboration in the workplace, and connecting at youth gathering places. Strengthening of a health system is required all over the world with special emphasis on the rural areas where people are less educated or the developing countries where this is becoming the normal lifestyle of people. It is important to provide them with sexual and reproductive health services for the strengthening of the healthcare system. Gender and age of an individual signify his/her reproductive health, for an instance, 86% males and 75% females at age of 19 have their sexual intercourse and many of them have multiple partners. During first sexual intercourse, most of the people are less educated about reproduction, sexuality, contraceptives or the protection used for reproductive tract infections (RTI) (Chandra-Mouli et al., 2014). This may lead to unwanted pregnancies or unsafe abortions, which can also cause infertility, disability or even death. In young women of 18-24 years age, death occurs due to early pregnancy and childbirth is 2-5 times more (Bitzer et al., 2016).

The meaning of adolescent or young people varies in terms of the policy context and legislative boundaries. In many countries, a law or policy is enforced that those who are in the category of ‘minors’ must consent from their parents or adults before taking any healthcare advice. Whereas some countries permit ‘health services for minors act’, under which minors can also access to health services without anyone consent, and some countries have passed ‘emancipated minor’ by which financially strong adolescents can give their consent (Davis, 2020). Sometimes law excludes young or unmarried people to get access for their reproductive healthcare services, because of which diagnosis, treatment and control of sexually transmitted diseases are more difficult. Moreover, there is also fear among people of being asked about their sex lives. According to the International Conference on Population and Development (ICPD), the government should recognize and promote the rights of adolescent requirements for reproductive healthcare information. They also seek to involve young people in the planning and implementation of reproductive healthcare. However, currently, many of the developing countries do not believe these services and policies (Chandra-Mouli et al., 2019).

The known social and cultural challenges and boundaries majorly include the fear of humiliation among young generations. They become fearful of how to answer the unpleasant question arise by society, which can reduce their privacy, confidentiality, as well as their respect. Other challenges they may face during their sexual and reproductive health needs includes, judgemental behaviour of health workers, laws and policies restriction, lack of education and training, inappropriate understanding of people. This essay will further propose some strategies to address the reproductive health issues faced throughout the world by younger people. However, it is equally important to address the socio-economic factors, along with the education, and roles and responsibilities of an individual, without this success cannot be achieved. This is commonly seen in South Asia and some regions of America and Europe (Leung et al., 2019).

Effective Strategies

The proposed strategy is to maintain the reproductive and sexual health concerns among young people, which includes community actions, individual skills, supportive environments, and health services and policies. Young generations were greatly influenced by the opinions of their friends, families and people whom they contact daily. Policies, regulations, economic concerns, cultural and religious factors also affect their environment (Curry & Holter, 2015). So, it is necessary to take views of families, policymakers and other leaders to support the younger ones. Strategies are based on the understanding of younger one’s cultural beliefs and lifestyle as well as behavioural factors. If education and support are provided to young people then they are likely to get adopt it in healthy behavioural patterns. Moreover, they are supposed to actively participate in the planning process of programmes to build up their sense for support and sustainability. Other major components cover the information about RTI, HIV infections, early sexual relationships joys and dangers, advice for early marriage consequences, and proper guidance and support. These activities will enhance the reproductive health behaviours by the employment of new behavioural and healthy skills (Salam et al., 2016). 

These targets or strategies are successful with the target population of this study because they are the most effective strategies and promote sexual and reproductive health activities as proposed in various researches. Reproductive health requirements varied according to each individual and multiple strategies will work best to overcome the health issues. Lessoned learned by this essay is to promote healthy activities, education, behavioural aspects, enhanced sexual and reproductive health activities, and skills of an individual. Moreover, health services that are provided should be of good quality, confidential, and affordable as well as accessible by young generations. Training and education will increase the consistency of protocols and guidelines followed. Health personnel must meet the human suffering from health issues, and not just have faith in their categories. By communicating the individuals, they can better identify the needs of young people (Plourde et al., 2017). Multiple strategies are provided by the researchers to address a common goal about the adolescent sexual and reproductive health issues and provide ways to improve their health outcomes and behaviour. These strategies are mentioned below:

1. Working with Parents:

Parents are the closest person to the younger people, and they have the rights to take action for the betterment of their health and development. Involvement of parents is an essential part of healthy sexual development of any child. Their guidance and values make the child more positive in his/her beliefs (Wang et al., 2014). If the parents and their children talked openly and honestly about their sexual and reproductive health concerns, then it will be very effective in maintaining the health needs of younger ones. Parents and families needed to be guided and assisted to interact comfortably with their child regarding these matters. Moreover, the father’s involvement in child-rearing will improve the emotional and social health of children, and minimize the stress of the financial burden faced by women. Thus, it is clear that education for parents about parenthood and maternal health can makes their children health well and also leads to healthy family life (Althabe et al., 2015).

2. Partnering with Schools:

It is advantageous to work with schools and communicate with staff, school structure, resources etc., for the betterment of the younger ones. The young people will more likely to get educated at their schools only, so it is a better way to promote positive behaviour and attitude among them. By communicating and interacting with school staff and students, reproductive or sexual health issues can be easily identified, like violence. It will also help in enhancing the confidence of teachers to talk with their students about sex education, and its pros and cons on their health (Suleiman et al., 2015).

3. Mobilizing Non-Governmental Organizations (NGO):

In the implementation of reproductive health programmes, NGO’s are very helpful. They provide services to all individuals along with maintaining their confidentiality. Counsellors are important to give advice to young people about their sensitive issues and refer them to appropriate health services. NGO work with both rural and urban areas and promote strategies and outcomes. NGO’s are open for new strategies and approaches to build up the cultures for knowledge transfer. They are free form any kind of political or legal predicaments (Storeng et al., 2018).

4. Building Government Commitment:

National youth policy establishment is one of the best possible ways to support the reproductive health of young people. This policy is meant to develop high-level commitments to younger people for their health support and development. Political leaders also endorse specific policies and laws to promote their reproductive health. It provides opportunities for young people to access and protect their health services Implementing policies empowers young generation to contribute to the development of their country and themselves. Policies, laws and legislations are the areas which endeavour the health programs for young people (Pizzarossa, 2018).

5. Building Life Skills:

To improve self-esteem and enhance the self-awareness of any person, personal values are examined by the help of certain skills. By increasing the self-assessment, they will be able to understand their body features and their rights to protect it, that is building confidence to say no to sex or have safe sex. Improvement in communication skills, refusal, coping, and conflict management will eventually make them comfortable to discuss these things with their peers, and improve relations with them. Improved skills will help in powerful decision-making by monitoring the consequences of having sexual intercourse at a young age. It may also help in reducing the violent behaviour of individual; use of drugs, alcohol, smoke, tobacco; high-risk sexual activities which may cause early pregnancies, HIV and RTI infections, harassment and emotional disorders (Ng’Eno et al., 2018).

6. Engaging in Religious Organizations:

To provide well-structured activities for young people, religious organizations play a vital role. They provide spiritual guidance and values, which can help them to feel part of the community. This will eventually lead to their own spiritual and moral development, and they will initiate contributing to their community. Some organizations will focus on young peoples along with their families. These organizations will provide counselling to people, which make them realize the importance of health services in the community and their referral at the correct time (Carter & Boehm, 2019).

7. Collaborating with Media:

Media acts as a powerful tool to promote social practices, and it greatly impacts adolescents. This will help in the encouragement of novel behavioural patterns, by the help of cultural elements or ideas through which young people can relate themselves. For an instance, popular actors, singers will take the help of media to promote their drama or role play, in a similar way media can help in creating awareness among the young generation. By enhancing the media access to reproductive and sexual health issues, their collaboration and support a be achieved, by which they can implement reproductive health awareness among their ongoing programmes. They can broadcast it by television or radio or multimedia messages, and help multiple people by providing opinions on reproductive health (Jones et al., 2014). 

8. Supporting Peer Interactions:

For younger ones, peer interactions are really useful and they also depend on their advice and guidance for any work. Peer interaction can provide young one’s support and guidance, which is more diverse and intense as compared to other people. Peers have already experienced the struggle that their young generation will face, so they can empathize them in a better way. They make them learn about the healthy psychosocial environment and spread positivity to keep the young people motivated. In communities, schools, or youth clubs, peer counselling has been undertaken for youth empowerment (Salam et al., 2016).

9. Exploring Collaboration in The Workplace:

Globally approximate 73 million young people are working currently in different countries. Many of them work in the tourist sector, factories, or trade zones, where dangerous sexual behaviour risk is high. By exploring the collaboration in workplaces, the major benefit is to manage the needs and support the arguments by improving the health of young people. Training is offered at the workplace to improve their parenting skills and interventions by extending services to their families as well. It also provides information about health requirements, counselling, skills maintenance, and other healthcare services (Plourde et al., 2016).

10. Connecting at Youth Gathering Places:

It is important to reach young people at their gathering places. By identifying these places, it would become much easier to help them out on their grass, where they might feel more comfortable. These places can be anything, like parks, bars, clubs, street corners etc. Most of the children if not attending schools, go to a place where they frequently gather. These children are at high stake of getting RTI, HIV, teenage pregnancies, or any other sexual relations (Maravilla et al., 2017). It is really important to reach them out especially where they gather at night and taught them about physical education and sexual relations. Several youth groups and school clubs often provide skills training to young children to build their self-esteem, self-confidence, social development, and self- expression. 

Monitoring and Evaluation

In the current scenario, young people will get mature early both emotionally, socially and physically. This can be due to many reasons, such as, freedom, new information sources, enhanced nutrition etc, which can lead to more experiments done by young generations, particularly in the sexual domain. Sexual activities and maturation now occur at much younger ages as compared to past times. If this will be rising this way, then being sexually active at age of 16 will become a trend in future. The monitored impact of this sexual and reproductive health activities justifies the fact that young people are bound to face the consequences of mortality and morbidity, only if their respective societies or countries take action towards them. Therefore, it is required to promote the education about decision-making, protection and planning for health outcomes, and socio-economic sustaining, which also supports young people to value their own choices (Azzopardi et al., 2019). The strategies mentioned in this essay are proven to be useful by various researchers, and they are also adolescent-friendly. Emphasis has been given to gender equality between the role of men and women. Sharing power, respect, understanding, decision-making will mostly depend on gender equality. Moreover, sex education, interaction with family and friends, partnering with schools, building skills, media collaboration, etc., is discussed which is also important to maintain the sexual and reproductive health of young people. However, it is to be noted that these strategies do not need to work out every time, so implementers should be ready to monitor for the efforts made and aware when to change their directions. Finally, future implications are to take a note of these strategies to follow, because current generation young people will get matured early and engage in sexual relations and unknowingly face its consequences on their reproductive health (Weiss et al., 2019).

References for School-Based Sex Education and Neuroscience

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Azzopardi, P. S., Hearps, S. J., Francis, K. L., Kennedy, E. C., Mokdad, A. H., Kassebaum, N. J., . . . Patton, G. C. (2019). Progress in adolescent health and wellbeing: Tracking 12 headline indicators for 195 countries and territories, 1990–2016. The Lancet,393(10176), 1101-1118. doi:10.1016/s0140-6736(18)32427-9

Bitzer, J., Abalos, V., Apter, D., Martin, R., & Black, A. (2016). Targeting factors for change: Contraceptive counselling and care of female adolescents. The European Journal of Contraception & Reproductive Health Care,21(6), 417-430. doi:10.1080/13625187.2016.1237629

Carter, E. W., & Boehm, T. L. (2019). Religious and spiritual expressions of young people with intellectual and developmental disabilities. Research and Practice for Persons with Severe Disabilities,44(1), 37-52. doi:10.1177/1540796919828082

Chandra-Mouli, V., Ferguson, B. J., Plesons, M., Paul, M., Chalasani, S., Amin, A., . . . Engel, D. M. (2019). The political, research, programmatic, and social responses to adolescent sexual and reproductive health and rights in the 25 Years since the international conference on population and development. Journal of Adolescent Health,65(6). doi: 10.1016/j.jadohealth.2019.09.011

Chandra-Mouli, V., Mccarraher, D. R., Phillips, S. J., Williamson, N. E., & Hainsworth, G. (2014). Contraception for adolescents in low- and middle-income countries: Needs, barriers, and access. Reproductive Health,11(1). doi:10.1186/1742-4755-11-1

Curry, K. A., & Holter, A. (2015). The influence of parent social networks on parent perceptions and motivation for involvement. Urban Education,54(4), 535-563. doi:10.1177/0042085915623334

Davis, M. (2020, May 19). Emancipated Minor. Retrieved September 27, 2020, from https://www.ncbi.nlm.nih.gov/books/NBK554594/

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Jones, K., Eathington, P., Baldwin, K., & Sipsma, H. (2014). The impact of health education transmitted via social media or text messaging on adolescent and young adult risky sexual behavior. Sexually Transmitted Diseases,41(7), 413-419. doi:10.1097/olq.0000000000000146

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Liang, M., Simelane, S., Fillo, G. F., Chalasani, S., Weny, K., Canelos, P. S., . . . Snow, R. (2019). The state of adolescent sexual and reproductive health. Journal of Adolescent Health,65(6). doi: 10.1016/j.jadohealth.2019.09.015

Maravilla, J. C., Betts, K. S., Cruz, C. C., & Alati, R. (2017). Factors influencing repeated teenage pregnancy: A review and meta-analysis. American Journal of Obstetrics and Gynecology,217(5). doi: 10.1016/j.ajog.2017.04.021

Ng’Eno, B. N., Kellogg, T. A., Kim, A. A., Mwangi, A., Mwangi, M., Wamicwe, J., & Rutherford, G. W. (2018). Modes of HIV transmission among adolescents and young adults aged 10–24 years in Kenya. International Journal of STD & AIDS,29(8), 800-805. doi:10.1177/0956462418758115

Pizzarossa, L. B. (2018). Here to stay: The evolution of sexual and reproductive health and rights in international human rights law. Laws,7(3), 29. doi:10.3390/laws7030029

Plourde, K. F., Fischer, S., Cunningham, J., Brady, K., & Mccarraher, D. R. (2016). Improving the paradigm of approaches to adolescent sexual and reproductive health. Reproductive Health,13(1). doi:10.1186/s12978-016-0191-3

Plourde, K. F., Ippoliti, N. B., Nanda, G., & Mccarraher, D. R. (2017). Mentoring Interventions and the impact of protective assets on the reproductive health of adolescent girls and young Women. Journal of Adolescent Health,61(2), 131-139. doi: 10.1016/j.jadohealth.2017.03.002

Salam, R. A., Das, J. K., Lassi, Z. S., & Bhutta, Z. A. (2016). Adolescent health and well-being: Background and methodology for review of potential interventions. Journal of Adolescent Health,59(4). doi: 10.1016/j.jadohealth.2016.07.023

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Sedgh, G., Finer, L. B., Bankole, A., Eilers, M. A., & Singh, S. (2015). Adolescent pregnancy, birth, and abortion rates across countries: Levels and recent trends. Journal of Adolescent Health,56(2), 223-230. doi: 10.1016/j.jadohealth.2014.09.007

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Suleiman, A. B., Johnson, M., Shirtcliff, E. A., & Galván, A. (2015). School-based sex education and neuroscience: What we know about sex, romance, marriage, and adolescent brain development. Journal of School Health,85(8), 567-574. doi:10.1111/josh.12285

Wang, B., Stanton, B., Deveaux, L., Li, X., Koci, V., & Lunn, S. (2014). The impact of parent involvement in an effective adolescent risk reduction intervention on sexual risk communication and adolescent outcomes. AIDS Education and Prevention,26(6), 500-520. doi:10.1521/aeap.2014.26.6.500

Weiss, H. A., & Ferrand, R. A. (2019). Improving adolescent health: An evidence-based call to action. The Lancet,393(10176), 1073-1075. doi:10.1016/s0140-6736(18)32996-9

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