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 do not have adolescent health policies in place and much remains to be done to ensure that adolescents can access appropriate sexual and reproductive health services. The authors of this volume present new perspectives and strategies to promote adolescent sexual and reproductive health. In particular, they make a unique attempt to bring together social and biomedical science and to disseminate concrete empirical evidence from existing programmes, carefully analysing what works and what does not at the local level.
he starting point for this guideline is the point at which a woman has learnt that she is living with HIV and it therefore covers key issues for providing comprehensive sexual and reproductive health and rights-related services and support for women living with HIV. As women living with HIV face unique challenges and human rights violations related to their sexuality and reproduction within their families and communities as well as from the health-care institutions where they seek care particular emphasis is placed on the creation of an enabling environment to support more effective health interventions and better health outcomes. This guideline is meant to help countries to more effectively and efficiently plan develop and monitor programmes and services that promote gender equality and human rights and hence are more acceptable and appropriate for women living with HIV taking into account the national and local epidemiological context. It discusses implementation issues that health interventions and service delivery must address to achieve gender equality and support human rights.
Promotion of the low risk "ABC" behaviors--Abstinence, Being faithful, and Condom use--has had only limited success in Africa. This book draws on a large qualitative study affiliated with an adolescent intervention trial to examine how ABC promotion can be improved. It evaluates the MEMA kwa Vijana sexual health program, which was implemented in 62 primary schools and 18 health facilities in rural Tanzania, scrutinizing its teacher-led curriculum, peer education, youth-friendly health services, youth condom distribution, and community mobilization components. The book examines how implementing such a low-cost, large-scale program involved many compromises, including those between national policies and international "best practice" recommendations, between the most desirable intervention design and one that was affordable and sustainable at a large scale, between optimal teaching methods and real-world teaching capacity, between ideal curriculum content and what was acceptable to the local community, and between adults' values and youths' realities. The program's impact is evaluated by triangulating findings from three person-years of participant observation, in-depth interviews, survey interviews, and biomedical tests. The book also provides in-depth case studies to examine the motivations and strategies of extraordinary young people who practiced ABC behaviors. It outlines broad principles for ABC promotion, including: acknowledging existing youth sexual relationships; promoting each low risk behavior in complexity and depth; working with preexisting, culturally compelling motivations; and intervening at individual, interpersonal, community, and structural levels. Many recommendations for the promotion of specific ABC behaviors are discussed, such as reducing pressures and incentives for girls to have sex; targeting male risk-perception and self-preservation; promoting alternative forms of masculinity than sexual conquest; strengthening premarital and marital relationships; tailoring fidelity programs for hidden couples, couples planning to marry, and monogamous and polygynous married partners; and addressing pleasure, trust, pregnancy prevention, and fertility protection in condom promotion. The book concludes with additional recommendations specific to school programs, and a review of promising complementary interventions for out-of-school youth, women, men, couples, and parents.
This book provides an overview of the current epidemiology of the HIV epidemic among young people in Eastern and Southern Africa (ESA) and examines the efforts to confront and reduce the high level of new HIV infections amongst young people. Taking a multi-dimensional approach to prevention, the contributors discuss the many challenges facing these efforts, in view of the slow progress in curbing the incidence of HIV amongst young people, focusing particularly on the structural and social drivers of HIV. Through an examination of these issues, chapters in this book provide valuable insights on how to mitigate HIV risk among young people and what can be regarded as the catalysts to mounting credible policy and programmatic responses required to achieve epidemic control in the region. The contributors draw on examples from a range of primary and secondary data sources to illustrate promising practices and challenges in HIV prevention, demonstrating links between conceptual approaches to prevention and lessons learnt from implementation projects in the region. Bringing together social scientists and public health experts who are actively engaged in finding effective solutions, the book discusses 'which interventions works', 'why they work', and the limitations and gaps in our knowledge to curb the pandemic amongst young people. As such it is an important read for researchers focusing on HIV/AIDS and public health. The Open Access version of this book, available at https://www.taylorfrancis.com/books/e/10.4324/9780429462818 has been made available under a Creative Commons Attribution-Non Commercial-No Derivatives 4.0 license.
The Human Sciences Research Council was commissioned by the WK Kellogg Foundation to develop and implement a five-year intervention project focusing on orphans and vulnerable children (OVC) in southern Africa. In collaboration with several partner organisations, the project currently focuses on how children, families, and communities in Botswana, South Africa, and Zimbabwe are coping with the impact of HIV/AIDS. The aim of the project is to develop models of best practise so as to enhance and improve support structures for OVC in the southern African region as a whole.
Promoting Adolescent Health: A Dialog on Research and Practice is a collection of essays that discusses the insights provided by professionals into the problems of encouraging adolescent health. The book presents the open dialog between the views of pediatrics, cardiologists, psychologists, health educators, sociologists, and nutrition scientists. The text gives discussions from a variety of perspectives on each of six problem areas: smoking, drugs and alcohol, sexuality, coronary risk factors, health-risk eating behaviors, and chronic disease. It also discusses the factors influential in smoking onset and describes the examination of health education and health promotion, adolescent medicine, developmental psychology, education, and research methodology. The book will provide valuable insights for anthropologists, psychiatrists, sociologists, students, and researchers in the field of adolescent behaviors.
The AIDS epidemic in Sub-Saharan Africa continues to affect all facets of life throughout the subcontinent. Deaths related to AIDS have driven down the life expectancy rate of residents in Zambia, Kenya, and Uganda with far-reaching implications. This book details the current state of the AIDS epidemic in Africa and what is known about the behaviors that contribute to the transmission of the HIV infection. It lays out what research is needed and what is necessary to design more effective prevention programs.
