Righting the mismatch between law, policy and the sexual and reproductive health needs of young people in the Asia-Pacific Region

Abstract

The context of sexual relations is changing in the Asia-Pacific. While the age of sexual debut remains the same, young people are generally marrying later and sex outside of marriage is increasing. The first systematic review of how laws and policies govern young people's access to sexual and reproductive health services was conducted in 2013. The study considered >400 national documents and held focus group discussions with >60 young people across three countries in the region. This paper examines the study findings in light of epidemiological data on young people's sexual behaviour and health, exposing a critical mismatch between the onset of sexual activity and laws and policies governing consent (to sex and medical treatment), and the restriction and orientation of services to married persons. An enabling legal and policy environment is an essential foundation for efforts to improve young people's sexual and reproductive health. This paper argues that international guidance and commitments (including the widely ratified Convention on the Rights of the Child) provide a framework for recognising young people's evolving capacity for independent decision-making, including in the realm of sexual and reproductive health. A number of countries in the region are using these frameworks to expand access to services, providing valuable examples for others to build on.

Knowledge, attitudes and peer influences related to pregnancy, sexual and reproductive health among adolescents using maternal health services in Ugu, KwaZulu-Natal, South Africa

“…There are also restrictive laws and policies concerning adolescent sexual and reproductive health [9]. Access to SRH in the Asia Pacific Region is dependent on age and the regulation of marital status [10, 11]. Customary and religious laws require persons under the age of 18 years to seek consent from parents or spouses to access SRH [10].…”

“…Customary and religious laws require persons under the age of 18 years to seek consent from parents or spouses to access SRH [10]. Healthcare providers may also be prohibited from delivering contraceptive services to unmarried persons [11]. The age that an adolescent is allowed to consent for sex often conflicts with the age that the adolescent is allowed to consent for medical interventions [10].…”

A Bioethics Framework for At-risk Child/Adolescent Access to Key Reproductive Health Services Without Parental Consent

“…Despite the decreasing trend of HIV infection and acquired immunodeficiency syndrome (AIDS)-related deaths, these rates are increasing in older adolescents (1). Studies in the Asia-Pacific countries show an increase in the age of marriage and a decrease in the age of sexual activity (6); nevertheless, the results of a systematic review indicate the inconsistency of sexual and reproductive health policies and laws in these countries (7).…”

Sexual Health Challenges in Iran and the Strategies for its Improvement

“…Thus, the preparation of standard training packages based on needs is recommended in order to empower them to choose healthy sexual behaviours [20]. Studies in the Asia-Pacific region also show a change in the sexual relations, an increase in the age of marriage and a decrease in the age of sexual intercourse [22]. The results of a study indicate that laws are inconsistent with the reproductive and sexual health policies and needs of young people in the Asia-Pacific region; However, in most of the countries, legislation has been or is being implemented to prohibit stigma and discrimination in the provision of reproductive and sexual health services to the adolescents and other groups with high-risk sexual behaviours [23,24].…”