Teenage Sexuality.pdf

Population-focused Nursing: Teenage Health & Wellbeing Kurnia Rachmawati School of Nursing, Lambung Mangkurat University

Remaja…. • Usia 10-19 tahun (WHO) • Usia 10-18 tahun (Permenkes RI No. 25 tahun 2014) • Usia 10-24 tahun dan belum menikah (BKKBN)

Why adolescent?

Alcohol and drugs in adolescent

Alcohol and drugs in adolescent

Adolescent high risk sexual behaviours & problems Unsafe abortion Adolescent (unintended) pregnancy

Child marriages

STD

Sexual activity

Teenage VS sexuality Where do teenagers/adolescents get information on sexuality?

Source: Pusat data dan Informasi Kementerian Kesehatan RI, 2015

Quick survey amongst 353 respondents.. Darimana kalian sebagai remaja mendapat informasi seputar seksualitas?

15% 4%

Internet

44%

24%

Ibu/Bapak Dosen/Guru Pemuka Agama Teman

13%

2010 VS 2017

Problems VS effective interventions How do we get highly reliable source of information in reproductive health? High quality evidence for effective interventions in adolescent sexuality?

The WHO Reproductive Health Library (RHL) is a curated collection of highquality evidence in reproductive health, published by the World Health Organization

Highly reliable source for health care professionals!

Evidence gaps • Systematic data about the lives of adolescent sexual behaviours, problems & interventions in developing countries (incl. Indonesia) are scarce. • High quality research were found in Jamaica, Kenya, Uganda, Malawi, South Africa, Senegal, Zimbabwe, India, Mexico, Colombia and China

What the evidence say.. • Interventions to Prevent Unintended and Repeat Pregnancy Among Young People in Low- and Middle-Income Countries (Hindin, Michelle J. et al., 2016) • Interventions for preventing unintended pregnancies among adolescent (Cochrane review) • Outcomes : reducing pregnancy rates & sexual activities

Cont..

Cash transfer programmes

Education & life skills curricula

Provision of contraception interventions

Cont.. • Case study in Indonesia

What the evidence say.. • Interventions to Prevent Child Marriage Among Young People in Low- and Middle-Income Countries (Kalamar, Amanda M. et al., 2016) • Outcomes: reduced proportion of girls married, increasing age at marriage

Cont..

Cash transfer programmes (esp. at parents)

Life skills programme

Education

What the evidence say… • Interventions to Prevent Sexually Transmitted Infections, Including HIV, Among Young People in Low- and Middle-Income Countries (Kalamar, Amanda M. et al., 2016) • Outcomes: Declines in STI diagnoses & symptoms, declines in risky sexual behaviours, increases in abstinence

Cont..

Health Education (curriculum, peer, health care)

Mass media campaign

Conclusion • More research is urgently needed • Evidence translation is important in our settings • Evidence should informed policy makers

Kesehatan Reproduksi…

Tujuan program kespro remaja Mencegah dan melindungi remaja dari: • Perilaku seksual beresiko: • • • • •

Seks di luar nikah Kehamilan yang tidak diingikan Aborsi Pernikahan dini Perilaku seksual berganti2 pasangan à STD

• Perilaku beresiko lain yg berdampak pada kesehatan reproduksi: • NAPZA • Gizi buruk à anemia

Program Kesehatan Reproduksi Remaja • Pelayanan Kesehatan Peduli Remaja (PKPR) • Bentuk kegiatan:

• Konseling • Pendidikan Keterampilan Hidup Sehat (PKHS)

• Perlu jejaring (lintas program, lintas sektor, swasta, NGO) • Pelaksana :

• Di Puskesmas diutamakan promotif & preventif (penjaring khusus, konseling, laboratorium, gizi, imunisasi TT, dll) • Di RS lebih diutamakan pada kuratif & rehabilitatif

• Tugas tenaga kesehatan dalam PKPR:

• Memperoleh data dasar kespro remaja di wilayah kerjanya • Konseling & pelayanan kesehatan dgn memperhatikan etika, empati, menjaga privasi, tdk menghakimi, menghormati pendapat & mendorong klien mengambil keputusan sendiri stlh diberi informasi yg benar.

Program Kesehatan Reproduksi Remaja • Karakteristik kebijakan PKPR: • Adil & kesetaraan gender dlm penyediaan pelayanan • Tidak mensyaratkan persetujuan orang tua • Tidak menghalangi pemberian pelayanan & produk kesehatan u/ remaja • Tidak membatasi sasaran plynn berkaitan dgn status.

Program Kesehatan Reproduksi Remaja • Karakteristik Petugas kesehatan PKPR: • Petugas yg memiliki kompetensi dlm m’berikan plynn kesehatan remaja • Peduli, memahami & tertarik pd mslh remaja • Menghormati privasi & kerahasiaan klien • Memiliki waktu yg cukup untuk berinteraksi sec. baik dgn klien dpt dihubungi sewaktu2 • Tersedianya konselor sebaya

Program Kesehatan Reproduksi Remaja • Karakteristik prosedur pelayanan: • • • •

Klien dapat berkunjung sewaktu2 tanpa perjanjian Waktu tunggu harus sesingkat mungkin Biaya pelayanan terjangkau Ada kaitan dengan pelayanan sosial lainnya

Program Kesehatan Reproduksi Remaja • Karakteristik parisipasi remaja: • Remaja terpapar informasi mengenai keberadaan pelayanan dan memanfaatkannya • Aktif berpartisipasi dalam perencanaan, pelaksanaan dan evaluasi dari pelayanan

Program Kesehatan Reproduksi Remaja • Karakteristik lingkungan pelayanan • • • • •

Tidak ada stigma Lokasi terjangkau dan nyaman Waktu pelayanan sesuai Material KIE cukup Privasi ruang periksa, ruang konseling dijamin

Program Kesehatan Reproduksi Remaja

Program Kesehatan Reproduksi Remaja • Program Generasi Berencana (GenRe) BKKBN • Pendekatan : • remaja à PIK R/M (Pusat Informasi Konseling Remaja/Mahasiswa) • keluarga dengan remaja à Bina Ketahanan Remaja (BKR)

• Bentuk kegiatan: pemilihan duta mahasiswa, seminar remaja, poster, jambore kreativitas remaja, temu kader BKR

Posyandu remaja

References •

Pictures

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https://thinkprogress.org/new-pro-life-law-could-literally-kill-women-who-attempt-to-obtain-an-abortion-ab41287065a8

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http://www.telegraph.co.uk/news/health/news/9497270/Sex-education-doesnt-cut-teen-pregnancy-rate-claims-academic.html

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http://mief.in/child-marriage-in-india/

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http://www.allenglandbadminton.com/10310-2/

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http://teknologi.news.viva.co.id/news/read/192915-10-ponsel-terlaris-november-2010

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https://inet.detik.com/fotoinet/d-3283240/ini-dia-10-ponsel-terlaris-di-indonesia/10/#photos

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https://criminallawsvirginia.com/virginia-beach-reckless-driving.html

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https://en.wikipedia.org/wiki/Adolescence

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https://m.kiblat.net/2013/12/01/ratusan-ormas-gelar-aksi-tolak-pekan-kondom-nasional/

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http://www.fsrmm.com/2013/12/visi-dan-misi-pemerintah-yang.html

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http://www.kompasiana.com/farid_wadjdi/kemenkes-dikadali-kondom-jupe_55289ab6f17e61d3698b4594

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https://www.icrw.org/publications/making-change-with-cash-impact-of-a-conditional-cash-transfer-program-on-age-of-marriagein-india-3/

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http://www.unfpa.org/comprehensive-sexuality-education

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http://iawg.net/areas-of-focus/voluntary-contraception/emergency-c/

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http://wvi.org/bangladesh/article/keeping-girls-school-stopping-child-marriages

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http://www.creativeassociatesinternational.com/news/morocco-usaid-life-skills-training-deters-child-marriage/

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http://ponabana.com/water-and-sanitation/healthy-villages-and-schools/?lang=en

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http://www.kompasiana.com/cardalola/perlukah-pelajar-membawa-kendaraan-pribadi-ke-sekolah_5517dcb0a33311af07b66131

References • Hindin, Michelle J. et al. Interventions to Prevent Unintended and Repeat Pregnancy Among Young People in Low- and Middle-Income Countries: A Systematic Review of the Published and Gray Literature. Journal of Adolescent Health , Volume 59 , Issue 3 , S8 - S15 • Kalamar, Amanda M. et al. Interventions to Prevent Sexually Transmitted Infections, Including HIV, Among Young People in Low- and MiddleIncome Countries: A Systematic Review of the Published and Gray Literature. Journal of Adolescent Health , Volume 59 , Issue 3 , S22 - S31 • Kalamar, Amanda M. et al. Interventions to Prevent Child Marriage Among Young People in Low- and Middle-Income Countries: A Systematic Review of the Published and Gray Literature. Journal of Adolescent Health , Volume 59 , Issue 3 , S16 - S21 • https://extranet.who.int/rhl/topics/adolescent-sexual-andreproductive-health • http://www.who.int/reproductivehealth/topics/adolescence/en/