Global Health Action (original) (raw)
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Global Health Action
Background : Adolescents' health is greatly influenced by social determinants, including gender norms. Although research has shown that there is an association between gender attitudes and adolescents' sexual behaviour, few studies have assessed this relationship carefully. The Attitudes toward Women Scale for Adolescents (AWSA) is widely used to assess gender attitudes among adolescents; however, to our knowledge it has not been applied in Latin America. Objective : To apply AWSA in Latin America for the first time, to perform a factorial validation of this scale and to assess the relationship of gender attitudes and sexual behaviour in Bolivian and Ecuadorian adolescents. Design : This cross-sectional study was carried out in 2011 among 14-18 year olds in 20 high schools in Cochabamba (Bolivia) and six in Cuenca (Ecuador) as a part of a larger project. Schools were purposively selected. A Spanish version of the 12-item AWSA was employed for this study. The assessed aspects...
Reproductive health, 2015
In February 2014, an international congress on Promoting Adolescent Sexual and Reproductive Health (ASRH) took place in Cuenca, Ecuador. Its objective was to share evidence on effective ASRH intervention projects and programs in Latin America, and to link this evidence to ASRH policy and program development. Over 800 people participated in the three-day event and sixty-six presentations were presented.This paper summarizes the key points of the Congress and of the Community Embedded Reproductive Health Care for Adolescents (CERCA) project. It aims at guiding future ASRH research and policy in Latin America.1. Context matters. Individual behaviors are strongly influenced by the social context in which they occur, through determinants at the individual, relational, family, community and societal levels. Gender norms/attitudes and ease of communication are two key determinants.2. Innovative action. There is limited and patchy evidence of effective approaches to reach adolescents with t...
Gender Differences in the Sexual Well Being of Mexican Adolescents Casique
International Journal of Sexual Health, 1919
Objective: This study examines the associations of gender roles and sexual power with the sexual wellbeing of Mexican adolescents. Particularly we look at the role played by adolescent’s attitudes toward gender roles and sexual power regarding three aspects of their sexual well-being: satisfaction with one’s sex life; consistent condom use; and the refusal of unwanted sexual contact with one’s partner. Methods: we used logistic regression models to analyze possible associations between attitudes toward gender roles, and sexual power, with the sexual well-being of adolescents, using a random and representative sample of 4,738 sexually active teenagers from three Mexican states. Results: egalitarian attitudes are positively associated to high sexual satisfaction for female adolescents, whereas for males they favor the refusal of unwanted sex. Sexual power shows significant associations with consistent condom use for both males and females, and it also significantly increases the likelihood of high sexual satisfaction and refusal of unwanted sex among females. Conclusions: the findings suggest the relevance of overcoming traditional sex roles to achieve adolescent sexual well-being. In this sense, health and population policies should direct more substantial efforts in the promotion of gender equality among the adolescents and in the development of critical attitudes towards traditional gender norms.
Gender differences on sexual behavior and school inputs: evidence from Bogota
This thesis explores the correlation between school factors and the differentiated results on sexual behaviour between boys and girls in Bogota. A school stratified propensity score matching was performed to match each boy of the sample with the most similar girls in individual, household and school characteristics. A regression analysis was performed to estimate the correlation between the five school factors evaluated with four main outcomes: have had sexual intercourse, condom use in the last sexual intercourse, incidence of teenage childbearing and age at first intercourse. Boysin relation to girls-begin earlier their sexual life, more of them reported have used condom in their last sexual intercourse and have a lower incidence of teenage childbearing. These differences are correlated with have reported the school as main source of knowledge about reproductive health and contraceptive methods, a larger proportion of teachers with a graduate or postgraduate degree, a larger proportion of teachers with a related pedagogy degree and to the average age of teachers in the school. The results suggest that the content of the message about sex that is delivered to girls at school is not complete or accurate and that the competences of the school teachers in charge of this task should be improved to reach equally boys and girls.
Gender differences on sexual behaviour and school inputs : evidence from Bogota
instname:Universidad del Rosario, 2013
This paper explores the correlation between school factors and the differentiated results on sexual behavior between boys and girls in Bogota. A school stratified propensity score matching was performed to match each boy of the sample with the most similar girls in individual, household and school characteristics. A regression analysis was performed to estimate the correlation between school factors and the main outcomes, namely sexual status, condom use in last intercourse, teenage childbearing and age at first intercourse. Boys-in relation to girls-begin earlier their sexual life, report larger use of condom and lower incidence of teenage childbearing. These differences are correlated with sex education at school, and teachers characteristics-age, education level and pedagogy degree. The results suggest that the content of sex education that is delivered to girls at school is not complete or accurate and that teachers play a key role to reduce this gender bias.
2006
This study describes the prevalence of risky sexual activities among Bolivian adolescents within the context of other behavioral factors that contribute to compromised health outcomes, unintended pregnancies, and sexually transmitted infections including HIV/AIDS. Data was collected from 576 adolescents, 13-18 years of age, from six schools in La Paz, Bolivia, using the Youth Risk Behavior Surveillance Survey. Findings indicate that males were more likely than females to report having ever engaged in sex, initiated sexual activity at age 14 or younger, and had two or more sexual partners within the three months prior to the survey. For both sexes, those who initiated sexual activity at an early age were more likely to engage in a variety of risk behaviors, with alcohol as the most significant risk factor. The likelihood of engaging in sexual activity is associated with age, low academic performance, substance abuse, violence, depression, and suicidal tendencies. The more frequent the occurrence of these risk factors, the higher the chances of engaging in sexual activity. Future research should examine efforts to simultaneously reduce multiple risk factors and to determine how adolescents' views on reproductive issues influence sexual initiation and patterns of sexual behavior over time.
Parents' contribution to sex education is increasingly receiving research attention. This growing interest stems from recognition of the influence that parental attitudes may have both on young people's sexual attitudes and behaviour, and on school-based sex education. Studies regarding parental attitudes towards sexuality are, however, still rare. The two main objectives of this study were to explore parental views about sexuality and to understand parental attitudes towards sex education. Four focus group discussions were conducted with parents from high schools in Cuenca, Ecuador. Data were analysed using thematic analysis. The study revealed that parents held a restricted view about sex education, grounded in traditional religious ideas about sexuality, which led parents to understand it as a morally and physically dangerous activity. Although parents expressed a willingness to make good quality sex education available to their children, they reported having insufficient personal resources to fulfil that objective. The results of this study provide important information about the need to develop and adapt sex education to each specific cultural context, thereby confirming the importance of knowing about the cultural traditions and religious beliefs that may form obstacles to effective sex education for young people in Ecuador.
Improving adolescent sexual and reproductive health in Latin America: reflections from an
2015
In February 2014, an international congress on Promoting Adolescent Sexual and Reproductive Health (ASRH) took place in Cuenca, Ecuador. Its objective was to share evidence on effective ASRH intervention projects and programs in Latin America, and to link this evidence to ASRH policy and program development. Over 800 people participated in the three-day event and sixty-six presentations were presented. This paper summarizes the key points of the Congress and of the Community Embedded Reproductive Health Care for Adolescents (CERCA) project. It aims at guiding future ASRH research and policy in Latin America. 1. Context matters. Individual behaviors are strongly influenced by the social context in which they occur, through determinants at the individual, relational, family, community and societal levels. Gender norms/attitudes and ease of communication are two key determinants. 2. Innovative action. There is limited and patchy evidence of effective approaches to reach adolescents with the health interventions they need at scale. Yet, there exist several promising and innovative examples of providing comprehensive sexuality education through conventional approaches and using new media, improving access to health services, and reaching adolescents as well as families and community members using community-based interventions were presented at the Congress. 3. Better measurement. Evaluation designs and indicators chosen to measure the effect and impact of interventions are not always sensitive to subtle and incremental changes. This can create a gap between measured effectiveness and the impact perceived by the targeted populations. Thus, one conclusion is that we need more evidence to better determine the factors impeding progress in ASRH in Latin American, to innovate and respond flexibly to changing social dynamics and cultural practices, and to better measure the impact of existing intervention strategies. Yet, this Congress offered a starting point from which to build a multi-agency and multi-country effort to generate specific evidence on ASRH with the aim of guiding policy and program decision-making. In a region that contains substantial barriers of access to ASRH education and services, and some of the highest adolescent pregnancy rates in the world, the participants agreed that there is no time to lose.