First event in the ICPD+5 review process
New York, 20 April (UNFPA) -- Most countries now acknowledge adolescents' right to be prepared to face reproductive and sexual health concerns, and many have made significant advances in meeting young people's needs for information and services.
But attitudes need to be changed and programmes better supported to sustain this progress, a group of experts and activists in the field concluded last week at a Round Table on Adolescent Reproductive Health and Rights organized by the United Nations Population Fund (UNFPA).
"There has been a sea change in attitudes towards adolescent reproductive health and rights," said Dr. Herbert Friedman at the close of the 14-17 April meeting. Since the 1994 International Conference on Population and Development (ICPD) in Cairo, he noted, "many people and countries are coming together to take action on the issue. Just a few years ago, there was mostly talk about the problems."
The meeting, held at the Ford Foundation's headquarters, was the first of four round tables scheduled as part of a review of progress in implementing the ICPD Programme of Action. The review will culminate next year in an International Forum in The Hague and a special session of the UN General Assembly.
The gains made at the ICPD must be protected and carried forward, UNFPA Executive Director Dr. Nafis Sadik said on 17 April. She told participants that their discussions and recommendations would inform both the Fund's programming efforts and the UN Secretary General's report to the General Assembly's special session.
Advocacy programmes, involving informed and articulate young persons and networks of non governmental organizations are necessary to protect those gains and to ensure that everybody hears about adolescent reproductive health and rights, she said.
"The hardest thing is to change the minds of those who feel that providing reproductive health services for young people leads to promiscuity," Dr. Sadik acknowledged. "We need to find ways to have a dialogue with those in opposition. Our position should be open, non-emotional and based on the facts and young people's needs. We won't get far if we become confrontational," she cautioned.
The round table was organized to review programme experiences and policy changes initiated since the Cairo conference, and to identify successful approaches and constraints faced by countries in responding to the reproductive and sexual health needs of adolescents.
To consolidate gains of the ICPD, Dr. Sadik said, the successes and failures of projects should be shared among development agencies or organizations, with the failures dropped. Successful programmes, on the other hand, should be made sustainable and lasting donor commitment secured.
The conclusions of this meeting on adolescent reproductive health would also be very relevant, she said, to the other three round tables: on reproductive rights, including women's empowerment, due in June in Uganda; on partnership with civil society in the implementation of the Programme of Action, in July in Bangladesh; and on population and macroeconomic linkages, in November, in Italy.
The 30 participants from two dozen countries included experts on sex education and adolescent health from governments, academia, NGOs and foundations, as well as a number of young people involved in advocacy for adolescents' sexual and reproductive rights.
Over the four days of the meeting, panel presentations were followed by group discussions on a wide range of topics, including:
- Improving accessibility and quality of reproductive and sexual health information and services for adolescents;Sociocultural and economic factors contributing to teenage pregnancy, and how to promote an "enabling environment" for adolescent reproductive health;
- The role of parents and of schools in providing sex education, how to reach young people who are not in school, and how to communicate effectively to change unhealthful behaviour;
- National laws and policies protecting the health and rights of youth, and how to remove obstacles to information and service provision;
- Involving communities and increasing the participation of young people in adolescent reproductive health programmes; and
- The mobilization of resources from the private sector and private foundations, and issues of programme sustainability; and recommendations for future actions.
Dr. Friedman, an expert on adolescent reproductive health formerly with the World Health Organization and the meeting's general rapporteur, summed up the group's main conclusions. He noted that countries now acknowledge that adolescent reproductive and sexual health is a matter of human rights, and have introduced national youth policies and extended reproductive health services to more adolescents.
There has been progress since the ICPD in integrating reproductive health with other services aimed at youth, and new materials methods and technologies are being used. There has also been greater collaboration between governments and the private sector, religious communities and non governmental organizations, as well as a variety of interventions and advocacy campaigns initiated or led by youth. In addition, he noted, there is an increased recognition of the need to improve the status of women in terms of education and social visibility.
Despite these achievements, Dr. Friedman continued, important constraints remain: Many policy makers and parents are reluctant to accept the idea of adolescent sexuality, and the number of youth-friendly services is limited. Health professionals often lack respect for young people, and the young often do not trust the professionals. There is still denial of the seriousness of the HIV/AIDS pandemic and widespread misunderstanding about the disease and its transmission. There is insufficient coordination between United Nations agencies and youth organization lack access to them.
The general rapporteur listed a number of actions recommended by the round table. Among others, adolescent reproductive health programmes should:
Involve diverse groups of young people in the development of programmes, youth friendly services and communications materials, and recognize that this will require adults to relinquish some control;
- Cooperate with a wide variety of NGOs and other partners;
- Encourage open discussion of sexuality;
- Involve key groups in the community including parents, and recognize that parents are a valuable resource;
- Train and support individual young persons to provide counselling to their peers;
- Provide young people with opportunities to serve as paid programme staff;
- Utilize a range of quality communication resources, including entertaining mass media materials, to effectively address young people's concerns;
- Train health care professionals on how to deal with adolescents;
- Develop indicators for evaluating non-physical aspects of adolescence, including those for social well-being and emotional health;
- Increase access of the young to the formal health sector, while recognizing the importance of the non-formal sector, including the family, NGOs, traditional healers, social marketing and the commercial sector; and
- Use the visibility of women's groups to promote young women's interests;
The meeting also called on United Nations agencies to strengthen their commitment to and funding for programmes aimed at youth.
Also addressing the closing session were two of the youth participants, Bjorg Thorsteinsdottir of Iceland, President of the International Federation of Medical Students' Associations; and Mala Bannerjee, of India. Dr. Claudio Stern, coordinator of research on adolescent sexuality and reproductive health at El Colegio de Mexico, spoke on behalf of participants from Latin America and the Caribbean; while Kwame Ampomah, a Director at Ghana's National Population Council, spoke for African participants.