Promoting adolescent sexual and reproductive health in East and Southern Africa

In Africa, as in many parts of the world, adolescent reproductive health is a controversial issue for policy makers and programme planners. Adolescents are particularly vulnerable to HIV and AIDS and to a host of other problems such as sexually transmitted infection, unwanted pregnancy, unsafe abortions, sexual abuse, female genital mutilation and unsafe circumcision. Yet many countries don't have adolescent health policies and much remains to be done to ensure that adolescents can access appropriate sexual and reproductive health services. Articulating new perspectives and strategies to promote adolescent sexual and reproductive health, the authors of this volume, comprise a network of researchers working in east and southern Africa. They make a unique attempt to bring together the social and biomedical sciences and to disseminate concrete empirical evidence from existing programmes, carefully analysing what works and what doesn't at the local level. The chapters are built on the premise that sexual and reproductive health behaviour is multifaceted and that interventions must operate on several levels - individual, organisational and governmental - and must reach young people in schools, communities, workplaces, and health-care institutions. Cognisant of recent research and the ethical difficulties facing researchers, the authors provide practical guidance for practitioners and policymakers wishing to promote adolescent sexual and reproductive health at the policy and institutional levels and in local communities.Contents: Part I. Policy and Theory Informing Practice -- 1. Public Policy: A Tool to Promote Adolescent Sexual and Reproductive Health / Yogan Pillay & Alan J. Flisher -- 2. Social Cognition Models and Social Cognitive Theory: Predicting Sexual and Reproductive Behaviour among Adolescents in Sub-Saharan Africa / Leif E. Aarø, Herman Schaalma & Anne Nordrehaug Åstrøm -- 3. Health Education and the Promotion of Reproductive Health: Theory and Evidence-Based Development and Diffusion of Intervention Programmes / Herman Schaalma & Sylvia F. Kaaya -- 4. Ethical Dilemmas in Adolescent Reproductive Health Promotion / Gro Th. Lie -- Part II. Contextual aspects of adolescent Sexual and reproductive Health -- 5. From Initiation Rituals to AIDS Education: Entering Adulthood at the Turn of the Millenium / Graziella Van den Bergh -- 6. Illegal Abortion among Adolescents in Dar es Salaam / Vibeke Rasch & Margrethe Silberschmidt -- 7. Adolescent Sexuality and the AIDS Epidemic in Tanzania: what Has Gone wrong? / Melkizedeck T. Leshabari, Sylvia F. Kaaya & Anna Tengia-Kessy -- 8. To Risk or not To Risk? Is It a Question? Sexual Debut, Poverty and Vulnerability in Times of HIV: A Case from Kigoma Region, Tanzania / Graziella Van den Bergh -- Part III. Addressing the Needs of adolescents: arenas for action -- 9. Peer Education for Adolescent Reproductive Health: An Effective Method for Program Delivery, a Powerful Empowerment Strategy, or Neither? / Sheri Bastien, Alan J. Flisher, Catherine Mathews & Knut-Inge Klepp -- 10. Adolescent-Friendly Health Services in Uganda / John Arube-Wani, Jessica Jitta & Lillian Mpabulungi Ssengooba -- 11. Quality of Care: Assessing Nurses’ and Midwives’ Attitudes towards Adolescents with Sexual and Reproductive Health Problems / Elisabeth Faxelid, Joyce Musandu, Irene Mushinge, Eva Nissen & Mathilde Zvinavashe -- Part IV. Evaluation and review of Interventions in Sub-Saharan Africa -- 12. Evaluating Adolescent Sexual and Reproductive Health Interventions in Southern and Eastern Africa / Alan J. Flisher, Wanjiru Mukoma & Johann Louw -- 13. A Systematic Review of School-Based HIV/AIDS Prevention Programmes in South Africa / Wanjiru Mukoma & Alan J. Flisher