Improving adolescent sexual and reproductive health in Latin America: reflections from an International Congress

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• 作者：Kathya Córdova Pozo (1)
  Venkatraman Chandra-Mouli (2)
  Peter Decat (3)
  Erica Nelson (4)
  Sara De Meyer (3)
  Lina Jaruseviciene (5)
  Bernardo Vega (6)
  Zoyla Segura (7)
  Nancy Auquilla (6)
  Arnold Hagens (1)
  Dirk Van Braeckel (3)
  Kristien Michielsen (3)
  
  1. South Group ; C. Ecuador O-138 ; Edificio Holanda ; A-3A ; Cochabamba ; Bolivia
  2. Reproductive Health and Research ; World Health Organization ; 20 Avenue Appia ; CH - 1211 ; Geneva 27 ; Switzerland
  3. International Centre for Reproductive Health (ICRH) ; Ghent University ; De Pintelaan 185 6?K4 ; 9000 ; Gent ; Belgium
  4. Center for Social Science and Global Health ; University of Amsterdam ; Nieuwe Achtergracht 166 ; 1018 WV ; Amsterdam ; The Netherlands
  5. Department of Family Medicine ; Lithuanian University of Health Sciences ; Kaunas ; 44307 ; Lithuania
  6. University of Cuenca- Facultad de Ciencias Médicas ; Avenida 12 de abril S/N sector El Paraíso ; Cuenca ; Ecuador
  7. Instituto Centroamericano de la Salud ; Reparto Los Robles ; Restaurante La Marsellaise 1 c. al norte 1 c. al este ; casa # 77 ; Managua ; Nicaragua
  
• 关键词：Adolescents ; Latin America ; Sexual and reproductive health ; Policy ; Intervention strategies ; Teenage pregnancies
• 刊名：Reproductive Health
• 出版年：2015
• 出版时间：December 2015
• 年：2015
• 卷：12
• 期：1
• 全文大小：66 KB
• 参考文献：1. Decat P, Nelson E, De Meyer S, Jaruseviciene L, Orozco M, Segura Z, / et al.: Community embedded reproductive health interventions for adolescents in Latin America: development and evaluation of a complex multi-centre intervention. / BMC Public Health 2013, 13:31. doi:10.1186/1471-458-3-1 10.1186/1471-2458-13-31 CrossRef
  2. Proyecto CERCA: / Declaración de Cuenca. URL: . Accessed on November, 20th de/915" class="a-plus-plus">http://www.codajic.org/node/915
  3. PAHO: / Salud en las Américas: edición de 2012. Panorama regional y perfiles de país. Washington D.C: PAHO; 2012. ISBN 978-2-5-1691-
  4. LAC and World Bank: / Embarazo Adolescente y Oportunidades en América Latina y el Caribe Sobre las Decisiones de Fecundidad Adolescente, la Pobreza y los Logros Económicos. Washington, DC: WB; 2012.
  5. Blanc AK, Windrey W, Ross J: New findings for maternal mortality age patterns: aggregated results for 38 countries. / PLoS Collections PLoS One 2012,8(4):e59864-. doi:10.1371/journal.pone.0059864 CrossRef
  6. Ganchimeg T, Ota E, Morisaki N, Laopaiboon M, Lumbiganon P, Zhang J, / et al.: Pregnancy and childbirth outcomes among adolescent mothers: a World Health Organization multicountry study. / BJOG 2014,121(Suppl 1):40-. CrossRef
  7. Chen XK, Wen SW, Fleming N, Demissie K, Rhoads GG, Walker M: Teenage pregnancy and adverse birth outcomes: a large population based retrospective cohort study. / Int J Epidemiol 2007,36(2):368-3. 10.1093/ije/dyl284 CrossRef
  8. Restrepo-Mendez MC, Barros AJ, Santos IS, Menezes AM, Matijasevich A, Barros FC, / et al.: Childbearing during adolescence and offspring mortality: findings from three population-based cohorts in southern Brazil. / BMC Public Health Vols BMC Public Health 2011, 11:781. doi:10.1186/1471-458-1-81 10.1186/1471-2458-11-781 CrossRef
  9. Women on waves: / Abortion laws worldwide. 2014. Retrieved from URL: Accessed on November, 20th, 2014 de" class="a-plus-plus">http://www.womenonwaves.org/en/page/460/abortion-laws-worldwide
  10. De Meyer S, Jaruseviciene L, Zaborskis A, Decat P, Vega B, Cordova K, / et al.: A cross-sectional study on attitudes toward gender equality, sexual behavior, positive sexual experiences, and communication about sex among sexually active and non-sexually active adolescents in Bolivia and Ecuador. / Global Health Action 2014, 7:24089. CrossRef
  11. Jaruseviciene L, De Meyer S, Decat P, Zaborskis A, Degomme O, Rojas M, / et al.: Factorial validation of the Attitudes toward Women Scale for Adolescents (AWSA) in assessing sexual behaviour patterns in Bolivian and Ecuadorian adolescents. / Global Health Action 2014, 7:23126. CrossRef
  12. Borile M: / Adolescencia: La necesidad de su abordaje integral, Presented at International Congress Promoting Sexual and Reproductive Health. Cuenca, Ecuador: .; 2014.
  13. Chandra-Mouli V, Greifinger R, Nwosu A, Hainsworth G, Sundaram L, Hadi S, / et al.: Invest in adolescents and young people: it pays. / Reprod Health 2013, 10:51. 10.1186/1742-4755-10-51 CrossRef
  14. Curi-Halal R: / Participación Comunitaria y salud, Presented at International Congress Promoting Sexual and Reproductive Health. Cuenca, Ecuador:
• 刊物主题：Reproductive Medicine; Public Health;
• 出版者：BioMed Central
• ISSN：1742-4755

文摘

In February 2014, an international congress on Promoting Adolescent Sexual and Reproductive Health (ASRH) took place in Cuenca, Ecuador. Its objective was to share evidence on effective ASRH intervention projects and programs in Latin America, and to link this evidence to ASRH policy and program development. Over 800 people participated in the three-day event and sixty-six presentations were presented. This paper summarizes the key points of the Congress and of the Community Embedded Reproductive Health Care for Adolescents (CERCA) project. It aims at guiding future ASRH research and policy in Latin America. 1. Context matters. Individual behaviors are strongly influenced by the social context in which they occur, through determinants at the individual, relational, family, community and societal levels. Gender norms/attitudes and ease of communication are two key determinants. 2. Innovative action. There is limited and patchy evidence of effective approaches to reach adolescents with the health interventions they need at scale. Yet, there exist several promising and innovative examples of providing comprehensive sexuality education through conventional approaches and using new media, improving access to health services, and reaching adolescents as well as families and community members using community-based interventions were presented at the Congress. 3. Better measurement. Evaluation designs and indicators chosen to measure the effect and impact of interventions are not always sensitive to subtle and incremental changes. This can create a gap between measured effectiveness and the impact perceived by the targeted populations. Thus, one conclusion is that we need more evidence to better determine the factors impeding progress in ASRH in Latin American, to innovate and respond flexibly to changing social dynamics and cultural practices, and to better measure the impact of existing intervention strategies. Yet, this Congress offered a starting point from which to build a multi-agency and multi-country effort to generate specific evidence on ASRH with the aim of guiding policy and program decision-making. In a region that contains substantial barriers of access to ASRH education and services, and some of the highest adolescent pregnancy rates in the world, the participants agreed that there is no time to lose.