ADOLESCENTS
-
In order to protect and
promote the right of adolescents to the enjoyment of the highest attainable standards of
health, provide appropriate, specific, user-friendly and accessible services to address
effectively their reproductive and sexual health needs, including reproductive health
education, information, counselling and health promotion strategies. These services should
safeguard the rights of adolescents to privacy, confidentiality and informed consent.1
- Full attention should be given to the promotion of mutually respectful and equitable gender relations and particularly to meeting educational and service needs of adolescents to enable them to deal in a positive and responsible way with their sexuality.2
- Ensure that adolescents, both in and out of school receive the necessary information on prevention, education, counselling and health services to enable them to make responsible and informed choices regarding their sexual and reproductive health in order, inter alia, to reduce the number of adolescent pregnancies.3
Adolescents should be a particular target group of reproductive and sexual health programmes. This is due to their vulnerability to health risks associated with unsafe sexual activity: early pregnancies, STIs; as well as their encountering of numerous obstacles in exercising their reproductive rights; for example in access to services and information on family planning.
However, in countries of Central and Eastern Europe, there is no sufficient attention given to adolescents’ reproductive health needs. Specialised services for young people are very rare, if any. Service providers often present bias towards adolescents accessing reproductive health services. Anecdotal data shows that there are many cases where providers refuse to prescribe contraceptives or to counsel young people on contraceptive options. Many providers assume a paternalistic attitude towards youth and do not observe confidentiality.
Another serious problem is the lack of comprehensive and widely available sexual education for young people. Sex education is not provided at schools on systematic basis. Curricula on sex education do not give adequate attention to topics of birth control, contraception and protection from STIs as well as the promotion of safe sex practices and equitable gender relations. Teachers frequently do not have adequate training in this field.4 Manuals present stereotypical attitudes to human sexuality and gender roles.
The result is a low awareness on issues of protection against STIs and unwanted pregnancies among youth. As a consequence, the CEE region experiences high levels of unwanted pregnancies and large prevalence of STIs, including AIDS, among adolescents. Vulnerability of young people to contracting STIs is heightened due to the increasing number of young people, who do not complete secondary education and cannot find employment, and thus, are prone to joining special risk groups: drug addicts or sex workers.
The incidence of pregnancy among women under age 20 in Russia has
increased over the last 30 years from 28,4% to 47,8%. In 1995 it was reported that 1500
children were born to girls under 15 years, 10 thousands to those under 16 years and more
than 30 thousands to those under 17 years.5
In Moldova, in 1997 less than 14% of unmarried women aged 15-24 used
modern methods of contraception at first intercourse.6
In Serbia, the research found that 54,3% of adolescent girls
use withdrawal (coitus interruptus) as a method of fertility regulation.7
In Russia, 75% of the 33 000 registered cases of HIV were
young people aged 15-29.8 At the same time, of those having sexual
contacts: 25% think there is no risk of STIs involved, 15% cannot even say whether there
is a risk and 37% think this risk is very small.9
In Poland, following the restrictions in access to abortion, in
1998, the Parliament abandoned the requirement that sex education be part of the school
curriculum. It can be introduced to schools as part of the “pro-family” curriculum.
However, in practice, the curricula and manuals for schools are influenced by the Catholic
Church’s views on human sexuality and gender roles and do not provide adequate, neutral
and accurate information on sexuality, contraception, protection of sexually transmitted
diseases and other important reproductive health issues.10
Albania is an exception with mandatory sex education carried
out in schools. However, sex education is planned for only 9 hours per school year.11
EXAMPLE OF GOOD PRACTICE
In Lithuania, on the initiative of an NGO – Family Planning and Sexual Health Association of Lithuania – five youth health centres were opened in 1998, where young people provided reproductive health consultations to their peers.12 Such initiatives, however, are still limited in scope and often unsustainable without the government commitment.
REFERENCES:
1 “Cairo Plus Five”, supra note 13, par. 73 (a).
2 “Cairo Programme of Action”, supra note 1, par. 7.3.
3 “Cairo Plus Five”, supra note 13, par. 73 (e).
4 UNICEF (1999), “Women in Transition”, supra note 7, p. 143.
5 The CRLP and Open Dialogue for Reproductive Rights (ODRR) “Reproductive Rights of Young Girls and Adolescents in Russia. A shadow report” September 1999, p. 6.
6 V. Moshin et al., ”Abortion in Moldova” in Choices Sexual and Reproductive Health and Rights in Europe, vol. 28, No. 2, Autumn 2000, p. 24.
7 K. Sedlecki, “Sexual activity among young people is on the rise in Serbia” in Entre Nous No. 52 – 2002, p. 4.
8 S. Jejeebhoy, ”Filling the gaps in what we know” in Entre Nous No. 50 – 2001, p. 9.
9 E. Ketting et al., ”Being young and in love in Russia” in Entre Nous No. 52 – 2002, p. 12.
10 FWFP, “The Anti-abortion Law in Poland”, supra note 20, p. 27-29.
11 CRLP, “Women of the World”, supra note 10, p. 26.
12 See id. at p. 94 and 193.