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RHO archives : Topics : Adolescent Reproductive Health

Annotated Bibliography

This is page 2 of the Adolescent Reproductive Health Annotated Bibliography. This page contains:

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Youth-friendly clinic services

Armstrong, B. et al. Involving men in reproductive health: the Young Men's Clinic. American Journal of Public Health 89(6):902-905 (June 1999).
This article presents and discusses a model for delivering reproductive health services to young men. Located in a predominantly Dominican population in northern New York City, the Young Men's Clinic works to inform male clients that their reproductive health needs are important. The program also emphasizes that men are vital in efforts to promote the reproductive health of both women and men. The report discusses reasons why young men wait before seeking reproductive health services, and presents data gathered from routine clinic visit forms. The report concludes that the clinic's experiences suggest that complementing existing family planning services with services designed specifically for men is feasible and highly acceptable to young men. The authors recommend that their program should serve as a model for health care delivery to adolescents and young adult males.

Ginsburg, K. et al. Adolescents' perceptions of factors affecting their decision to seek health care. Journal of the American Medical Association 273(24):1913-1918 (June 28, 1995).
The objective of this study was to receive input from adolescents about characteristics of health care providers and sites that affect their decision to seek health care. Acknowledging that adolescents' decisions to seek health care services, especially preventative services, might be heavily influenced by subjective issues, the study asked school students in Philadelphia to describe the effect of 31 factors on their decision to seek care. The characteristics identified as most likely to influence their decisions were provider hand washing, clean instruments, honesty, respect toward adolescents, cleanliness, know-how, carefulness, experience, equal treatment of all patients, and confidentiality. The study showed little variation in order of items by sex, race, or socioeconomic status. These results indicate that adolescents are more concerned about provider characteristics than specific site, service, or outreach characteristics. The study results offer providers straightforward, modifiable factors that can influence adolescents' decision to seek care.

Senderowitz J et al. Clinic Assessment of Youth-Friendly Services: A Tool for Improving Reproductive Health Services for Youth. Watertown, MA: Pathfinder; 2003. This tool will help program managers and clinicians determine the extent to which their current reproductive health services are youth-friendly. Results from the tool can be used to tailor services to better meet the needs and preferences of young people. Under the African Youth Alliance (AYA) Project, Pathfinder conducted baseline assessments in Botswana, Tanzania, Uganda, and Ghana using this tool.

Senderowitz, J. Making reproductive health services youth friendly. FOCUS on Young Adults. Research, Program and Policy Series (February 1999). Available at: This paper discusses the premise that whether services are offered in a clinic or youth center, through outreach, at a workplace or informal venues, certain youth-friendly characteristics are essential to effective adolescent reproductive health care services and programs. The paper addresses adolescents' need for specialized services, the types of services needed by adolescents, how services can be delivered to them, why they avoid existing services, and components of youth-friendly services. Provider, health facility, and program characteristics are outlined. Finally, specific country program efforts to institute youth-friendly services are presented, offering real-life examples of a broad spectrum of youth-friendly programs.

Webb, S. ed. Insights from adolescent project experience, 1992-1997. Watertown, Massachusetts: Pathfinder International (1998).
This report presents a review of reproductive health programs for young adults supported by Pathfinder International between 1992 and 1997. It presents a broad range of programs, and explains how they were undertaken, how they evolved, what their effects have been, and what has been learned from them. Output data are presented along with qualitative and descriptive impact information gathered from project reports. Several evaluations of adolescent programs located in Kenya and Bangladesh are presented.

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Providing information and services

Israel, R. and Nagano, R. Promoting reproductive health for young adults through social marketing and mass media: a review of trends and practices. FOCUS on Young Adults Research Series (July 1997). Available at:
During the past decade, modern marketing and mass communication techniques have been used with increasing success to promote the reproductive health of young adults in different countries. This paper reviews these social marketing approaches to strengthen reproductive health practices. It summarizes the analytical literature and lessons learned from relevant projects; describes key elements of successful project design, implementation, and evaluation; and identifies critical research questions that need to be addressed to enhance the effectiveness of future interventions.

Johns Hopkins University Center for Communication Programs (JHU/CCP). Reaching Young People Worldwide: Lessons Learned from Communication Projects (1986-1996). (September 1995). Available at:
For more than a decade, the United States Agency for International Development (USAID) has provided major support to the Johns Hopkins/Population Communication Services, a component of the Center for Communication Programs (JHU/CCP), to support more than 30 communication programs around the world that help young people protect their health. This 50-page publication reviews these projects and presents the lessons that JHU/CCP has learned. Lessons apply to designing programs, gaining support for programs, and evaluating program efforts. Chapters present lessons learned; an overview of projects from Africa, Asia, Latin America, the Near East, and the Newly Independent States; and additional activities that benefit youth, such as worldwide communication and advocacy. An extensive set of references also is included for further research.

Piotrow, P. et al. Health Communication: Lessons from Family Planning and Reproductive Health. Westport, Connecticut: Praeger Publishers (1997).
This book presents lessons learned from 15 years of experience developing family planning communications. During this time, the Population Communication Services (PCS), a program of the Center for Communication Programs at Johns Hopkins School of Hygiene and Public Health, has been involved with national family planning programs in 50 developing countries. This book presents many examples of reproductive health communication programs aimed at adolescents, including the Enter-Educate approach used in Latin America, the Philippines, and Nigeria to deliver sexual behavior messages such as "Wait until you are ready for sexual relations, marriage, or pregnancy." The "Nine Ps" of Enter-Educate (pervasive, popular, personal, participatory, passionate, persuasive, practical, profitable, and proven effective) are described and documented.

Senderowitz, J. Reproductive health outreach programs for young adults. FOCUS on Young Adults Research Series (May 1997). Available at:
The delivery of reproductive health information, counseling, and services to young adults is a new and emerging area. Reaching out to young people presents many challenges, especially when they are reluctant to use services, are unaware of available services, or are not part of mainstream youth life or activities. This paper presents a comprehensive review of efforts to reach youth made by youth centers, peer-promotion programs, outreach programs, and reproductive health projects developed by youth-oriented organizations. The discussion of the lessons learned addresses strategic considerations; target-audience identification; needs assessments; youth, parental, and community involvement; evaluation; training; and use of peer promoters. The discussion of key program elements includes a wide range of topics, including program design and development, peer programs implementation, and key characteristics of successful peer programs. The publication also includes an extensive reference list and critical research questions.

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Contraception for adolescents

Blumenthal, P.D. and McIntosh, N. Pocket Guide for Family Planning Service Providers. Baltimore, Maryland: JHPIEGO (1995).
This guide for family planning service providers is designed to provide clinicians with practical, clinically oriented information for use in family planning services. It includes a brief chapter on adolescents that addresses factors relevant to the use of specific contraceptive methods in this population, including their tendency to have unplanned, unprotected intercourse and the resulting need for access to emergency contraception. The guide provides information on serving clients with special needs (such as women who may need emergency contraception) and clients who need information about specific contraceptive methods. Information on the mechanism of action, benefits, limitations, and precautions for use is provided for each contraceptive method along with instructions for management of common side effects and related problems. Information on counseling, assessing clients, and providing educational materials also is provided, as are chapters on infection prevention and genital tract infections.

Brooks, T.L. and Shrier, L.A. An update on contraception for adolescents. Adolescent Medicine 19(2):211-219 (1999).
After presenting an overview of pregnancy, birth, and abortion rates among adolescents, this article discusses the efficacy and appropriateness of various types of hormonal and barrier contraceptives used by adolescents including oral contraceptive pills, emergency contraception, injectables, condoms, and IUDs. A table used to illustrate these methods provides the expected and typical failure rates during the first year of use. The authors emphasize the importance of considering and discussing contraception with both male and female adolescents before the onset of sexual activity. They also discuss the importance of assuring confidentiality, making services adolescent-friendly, and taking individuals' preferences and concerns into account before prescribing any method of contraception.

FOCUS on Young Adults. Adolescent reproductive Q's & A's. Available online at
This online list of questions and corresponding answers provides information requested by individuals concerned with adolescent reproductive health including youth, adults working with young people, and representatives of international organizations. The questions cover a range of young adult reproductive health issues and interests including counseling, contraception, growth and development, and sexual behavior and decision making. This material is designed for health and population professionals working with youth 10 to 20 years old.

PATH. Improving contraceptive access: WHO reviews eligibility criteria for contraceptive use. Outlook. 1995;13(4):1-8.
WHO Eligibility criteria for contraceptive use: combined injectables and sterilization. Outlook. 1996;14(1):1-8.
This two-part series summarizes the World Health Organization's (WHO) revised medical eligibility criteria for initiating use of contraceptive methods. It is particularly helpful in providing age guidelines for use of the various contraceptive methods.

Stewart, K.J. and Guilkey, D.K. Factors predicting contraceptive use among adolescents in Zimbabwe. [Unpublished.] (April 1995).
This study presents the results of a cross-sectional analysis of data collected on 963 nonpregnant women age 15 to 19 years living in Zimbabwe to determine factors of contraceptive use. Results indicate that the presence of a community-based distribution worker was the most significant community variable predicting contraceptive use. Presence of a community-based distribution worker increased the probability of contraceptive use when adolescents had limited or no education. The study's findings suggest that community-based distribution programs may be a good way to reach adolescents, usually a population with poor access to family planning information and services.

Sucato G, Gold M. New Options in Contraception for Adolescents. Current Women’s Health Reports. 2001;1:116-123.
Several recent advances in the contraceptive methods available to adolescents are reviewed. Some of these contraceptives may be more adolescent-friendly and may improve compliance.
Some of the new contraceptives reviewed are the monthly injectables, very low dose pills, continuous cycling of oral contraceptives, and emergency contraceptives.

World Health Organization (WHO). Emergency Contraception: A Guide for Service Delivery. WHO/FRH/FPP/98.19. Geneva: WHO (1998).
This guide presents a comprehensive overview of the history and role of emergency contraception in family planning services. It provides detailed information about the use of emergency contraceptive pills and copper-releasing IUDs, including their modes of action, efficacy, side effects, and eligibility criteria, as well as counseling and patient follow-up issues. Throughout the publication, the need to prevent unwanted pregnancies and unsafe abortion, particularly during adolescence, by increasing access to emergency contraception is emphasized. The booklet also provides guidelines for involving both clinicians and the community in introducing emergency contraception in reproductive health programs, and for providing appropriate information to clients. Common misconceptions—such as the potential of emergency contraception to cause abortion, promote irresponsible behavior, or lead to a decrease in condom use—are addressed in detail.

WHO. Improving Access to Quality Care in Family Planning: Medical Eligibility Criteria for Contraceptive Use. Geneva: WHO (1996).
This document summarizes the main recommendations of two scientific working-group meetings held at WHO in March 1994 and May 1995 on the medical eligibility criteria for use of various contraceptives. It includes numerous tables clarifying how age, various health conditions, and behaviors should be considered when providing contraceptives. These meetings concluded that adolescents are a special population at risk of unwanted pregnancy, unsafe abortion, and, in some settings, STIs. In general, adolescents are healthy and eligible to use any method of contraception. Program barriers that limit adolescents' access to and use of safe and effective contraception need to be addressed. This document is designed for use by policy makers, family planning program managers, and the scientific community in the preparation of guidelines for service delivery of contraceptives.

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