CULTURAL AND SOCIAL BARRIERS LIMITATIONS IN ACCESS TO COMPREHENSIVE SEXUALITY EDUCATION LIMITATIONS IN ACCESSING SEXUAL REPRODUCTIVE HEALTH SERVICES ENABLING ENVIRONMENT FOR YOUTH International Comparisons Know the Facts What is UNFPA Doing?
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LIMITATIONS IN ACCESSING SEXUAL REPRODUCTIVE HEALTH SERVICES
The health system in Sri Lanka, while being very robust is based on a mother and child health approach. At the community level, public health midwives provide information, services and referrals on reproductive health. The public health midwife provides her services mainly to families either legally married or living together where the woman is between 15 to 49 years of age and/or having a child less than 5 years of age often referred to as the ‘eligible family’. A family with a pregnant or cohabiting woman irrespective of marital status and age and women who are widowed, divorced or separated are also recognized as an eligible family. This works well in theory, however this kind of administrative system in reality places restrictions on unmarried young people to access services due to issues such as confidentiality and social stigma.
What needs to be done?
  • Young people have reproductive rights. Thus, to honour their rights, they should have access to the sexual reproductive health services that they require to lead a healthy and responsible life free of sexually transmitted infections, unwanted pregnancy, sexual abuse, and coercion.
  • Accessibility of out-of-school youth to sexual reproductive health services needs to be ensured.
  • The provision of sexual reproductive health services for vulnerable groups, including street children, internally displaced youth and commercial sex workers need to be addressed.
What is Behaviour Change
Communication?
Behaviour change communication means working with individuals and their communities to:
1. Promote positive behaviour that fit their circumstances
2. Provide a supportive environment which will enable people to initiate and sustain positive behaviour
Teenage Pregnancies
  • In Sri Lanka it is estimated that 6.5% of girls are pregnant or have given birth before their 19th birthday.
  • Between 2007 and 2009 there has been a general decline but teenage pregnancies remain high in certain districts. For example, Trincomalee district had 12.9% of teenage pregnancies in 2009.
Why do teenage pregnancies
continue to occur?
  • A high level of unmet need for family planning due to myths about practicing family planning
  • Lack of accessibility to reproductive health services
  • Non-use of any family planning methods due to lack of knowledge and opposition from ‘spouse’
  • Opting not to seek the services of public health midwives
  • Social, cultural and economic issues
Sexually Transmitted
Infections & HIV/AIDS
  • There is very low prevalence of HIV/AIDS among young people aged 15-24.
  • The first Sri Lankan with HIV infection was reported in 1987.
  • In 2012, a cumulative total of 1,649 HIV infections were reported by the National STD/AIDS Control Programme. 981 were males, 668 females.
  • 80% of the reported HIV positives were between 18-49 years of age.
  • Sexually transmitted infections are low among youth.
  • Infectious syphilis and genital herpes are the most common sexually transmitted infections among youth.
  • Youth with comprehensive correct knowledge of STIs and HIV/AIDS is low.
  • Given the current low prevalence of STI and HIV/AIDS there is still an opportunity to educate young people on these to curtail the spread of STIs and HIV/AIDS.