Background Early adolescence (ages 10–14) is a critical period of physical, cognitive, social and emotional development, which affect sexual and reproductive health and rights (SRHR). Yet, little is known about positive or healthy aspects of sexuality development during this period of life, especially in South East Asia where sexual norms remain restrictive. The objective of this study is to assess the prevalence and correlates of sexual wellbeing among early adolescent girls and boys ages 10–14 years in Indonesia. Methods Data for this cross-sectional study were collected as part of the Global Early Adolescent Study via a school-based survey in three Indonesian urban sites in 2018 (N = 4309). We assessed the prevalence of multiple indicators of sexual wellbeing (e.g. SRHR knowledge and communication, gender attitudes, body satisfaction, self-efficacy, freedom from violence) and tested for differences by sex using Chi-square, Student t-test, and Wilcoxon rank-sum test. Multivariable logistic regression models were used to assess the adjusted odds ratio of selected indicators in relation to sociodemographic factors, romantic relationship status, and sexual activities. Results The mean age of students was 12 years (53% girls); 90% had started puberty. SRHR knowledge and communication was low overall, but higher among boys than girls. Boys were more likely than girls to report high body satisfaction, less feelings of guilt in relation to sexuality, but also to have experienced physical peer violence. In contrast, girls were more likely to hold gender equal attitudes, greater perceived self-efficacy to say ‘no’, and to report being bullied by boys. In multivariable models, romantic relationship experiences, perceived voice (boys and girls) and decision-making (girls) were associated with three or more indicators of sexual wellbeing. Conclusions While young adolescents in Indonesia score high on some aspects of sexual wellbeing, misconceptions, feelings of guilt and uncertainties related to sexuality are common, with clear gender differences. These findings confirm the need for comprehensive sexuality education that begins early in adolescence.
PurposeThis article seeks to summarise the recent publication, Turning the Tide: A Vision Paper for multiple needs and exclusions by Revolving Doors and Making Every Adult Matter. It addresses the significant financial and social costs of society's failure to support the 60,000 adults facing multiple needs and exclusions in England today and how this damage can be prevented.Design/methodology/approachIn total, six qualitative evidence seminars and a series of individual meetings were held, with 60 stakeholders consulted. The paper draws on the expertise of member agencies, partners, and the members of Revolving Doors' service user forum who have direct experience of multiple needs and exclusions.FindingsPeople facing multiple needs and exclusions experience several problems simultaneusly, have ineffective contact with services and, as a result, live chaotic lives. They are a small group but impose disproportionate costs on themselves, families, communities and the public purse. The paper sets out the vision that in every local area people facing multiple needs are supported by effective coordinated services. It argues that to achieve this, a new approach is needed from national government. Five building blocks to achieving the vision are examined in detail.Originality/valueDrawing on a wide evidence base, the paper shows how politicians, local leaders, and commissioners can act to make coordinated services for people facing multiple needs and exclusions the norm. It is of relevance to service managers/providers who can act now to tackle multiple needs by building partnerships, taking proposals to commissioners, and supporting elected members to develop new approaches.
Background: Early adolescence (ages 10-14) is a critical period of physical, cognitive, social and emotional development, which affect sexual and reproductive health and rights. Yet, little is known about positive or healthy aspects of sexuality development during this period of life, especially in South East Asia where sexual norms remain restrictive. The objective of this study is to assess the prevalence and correlates of sexual wellbeing among early adolescent girls and boys ages in Indonesia.Methods: Data for this cross-sectional study were collected as part of the Global Early Adolescent Study via a school-based survey in three Indonesian urban sites in 2018 (N=4309). We assessed the prevalence of multiple indicators of sexual wellbeing (e.g. sexual and reproductive health knowledge and communication, gender attitudes, body satisfaction, self-efficacy, freedom from violence) and tested for differences by gender using Chi-square, Student t-test, and Wilcoxon rank-sum test. Multivariable logistic regression models were used to assess the adjusted odds ratio of selected indicators in relation to sociodemographic factors, romantic and sexual experiences. Results: The mean age of students was 12 years (53% girls); 90% had started puberty. Sexual and reproductive health knowledge and communication was low overall, but higher among boys than girls. Boys were more likely than girls to report high body satisfaction, less feelings of sexual guilt, but also to experience physical peer violence. In contrast, girls were more likely to hold gender equal attitudes, greater self-efficacy to say no, and to report being bullied by boys. In multivariable models, romantic experiences, perceived voice (boys and girls) and decision-making (girls) were associated with three or more indicators of sexual wellbeing. Conclusions: While young adolescents in Indonesia score high on some aspects of sexual wellbeing, misconceptions, feelings of guilt and uncertainties related to sexuality are common, with clear gender differences. These findings confirm the need for comprehensive sexuality education that begins early in adolescence.
This paper presents the results of an implementation research of a pilot intervention, mainstreaming meaningful youth participation in a health care management system in Western Kenya with the aim to address adolescent sexual and reproductive health and rights (SRHR). This qualitative case study included 29 key informant interviews and 13 focus group discussions conducted in five community health units across four counties. The results demonstrate positive attitudes towards the principle of youth participation, yet, also a mismatch between the aspirations of young people to be active decision-making agents and the actual roles and responsibilities assigned to them. This paper further identifies factors that inhibit and enable effective youth participation at multiple levels; individual (such as education, discipline, migration, gender); organisational (such as guidelines and structures, financial support, and political interference) and societal (norms seeing SRHR as taboo and young people as unequal to adults), and formulates recommendations to address these.
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