Adolescents’ Access to Reproductive Health and Family Planning Services in Dakar (Senegal)

Christine Nare, Karen Katz, Elizabeth Tolley

Abstract

This paper analyses the issue of adolescents’ access to family planning services and information on reproductive health. The data used in this paper are a part of a broader study conducted in 1995 in Dakar (Senegal) by the Committee for Studies on Women, Family and Environment in Africa (COSWFEVA/ CEFFEVA) and Family Health International. The findings present information on adolescents’ perceptions of premarital sexual activity and contraceptive use and the different types of barriers to access to family planning, using data obtained primarily from focus group discussions with adolescents 16 to 20 years old and a mystery client study. In this approach, 12 of the adolescents participating in the focus group discussions visited clinics as clients and requested contraceptive methods or information. The results indicate that adolescents did not approve of premarital sexual relations, were less likely to approve of contraceptive use by adolescents than by married men and women, and felt embarrassed to go to the services. They were also disappointed by the providers’ reception and response to their needs. The content of the counselling offered by the providers was moralistic, encouraging girls to abstain from having sexual intercourse until marriage. The discussions of the findings related adolescents’ and providers’ attitudes to the socio-cultural context in which adolescent sexuality takes place. In this context, sexuality is closely linked to marriage and childbearing, which affects the impact of classical programs on adolescent health. Alternative solutions such as the life skills development approach could be promoted in order to reach both in-school and out-of-school adolescents. (Afr I Reprod Health 1997; 1(2): 15—25)

KEY WORDs: Adolescents, family planning, contraceptive use, reproductive health, Dakar, Senegal

Full Text:

PDF

References

Gage-Brandon Al, Meekers, D. Sexual activity before marriage in sub-Saharan Africa. Soc Biol

;41 ( 1—2):44--60.

Population Reference Bureau. Les adolescentes en Afrique sub-Saharienne graphique sur le manage et la procreation. New York: Population Reference Bureau, 1992.

Kuhn H. Adolescent pregnancy in Africa: a programmatic focus. Soc Sci Med 1988;26(7):727-35.

Sane K. Comportement sexuel des adolescents en milieu diola. Bien Etre 1994;(6):6—8.

Renne EP. Changes in adolescent sexuality and the perception of virginity in a southwestern Nigerian village. Health Trans Rev 1993;(suppl 3): 121—33.

Anonymous. A visit to the village of Saye (Burkina-Faso). People and the Planet 1992;1(1,2):24.

Barker G. Adolescent fertility in sub-Saharan Africa: strategies for a new generation. Report based on the proceedings of the international forum on adolescent fertility. Arlington, Virginia, September 1990.

Buga G, Amoko D, Ncayiyana DJ, et al. Adolescents’ sexual behavior, knowledge and attitudes to sexuality among school girls in Transkei, South Africa. East Afr Med I 1996;73 (2) :95—100.

Buga G, Amoko D, Ncayiyana DI, et al. Sexual behavior, contraceptive practice and reproductive health among school adolescents in rural Transkei. South African MJ 1996;86(5):523—7.

Lagarde E, Pison G, Enel C, et al. A study of sexual behavior change in rural Senegal. I Acquir ImmuneDeficSyndr 1996;11(3):282—7.

Kapiga SH, Hunter DJ, Nachtigal G, et al. Reproductive knowledge and contraceptive awareness and practice among secondary school pupils in Bamoyo and Dar-Es Salam, Tanzania. Cent Afr I Med 1992;38(9):375—80.

Agyei W, Epema E, Lubega M, et al. Contraceptive use and prevalence of STDs among adolescents and young adults in Uganda. IntJEpidemiol1992;2 1 (5):981—8.

Flisher AJ, Ziervogel CF, Chalton DO, Leger PH, Robertson BA. Risk taking behavior of Cape Peninsula high-school students, part VIII: sexual behavior. South African MI 1993:83:495—7.

Abdool Karim S, Abdool Karim Q, Preston- White E, Sankar N. Reasons for lack of condom use among high school students. South African MJ 1992;89:107—10.

Mbizvo M, Kasule I, Gupta V, et al. Reproductive biology knowledge, and behavior of teenagers in east, central and southern Africa: the Zimbabwe case study. Cent Afr I Med 1995 ;4 1( 11) : 346—54.

Orr D, Langefeld CD, Katz B, et al. Factors associated with condom use among sexually active female adolescents. I Pediatr 1992; 120:311—7.

Brooks J, Furstenberg F. Adolescent sexual behavior. Am Psychol 1989;44(2):249—57.

Hugard L, Ndoye B, Saccharin C. Chiamydia trachomatis in a urogenital practice: 435 specimens collected at a Senegalese hospital. Med Trop 1995;55(3):23 1—4.

Brabin L, Kemp J, Obunge 0, et al. Reproductive tract infections and abortion among adolescent girls in rural Nigeria. Lancet 1995:345(8945): 300—4.

Gorgen R, Maier B, Diesfeld H). Problems related to school girls pregnancies in Burkina Paso. Stud Fam Plann 1993;24(5):283—94.

Pouye A. La sexualité des adolescents: aspects psycho-sociaux. Bien Etre 1 994;(6) :4—7.

Barker G, et a!. Serving the future: an update on adolescent pregnancy prevention programs in developing countries. Washington DC: Center for Population Options, 1991.

Abdool-Karim S, Preston-White E, Abool-Karim 5, et al. Teenagers seeking condoms at family planning services: a user’s perspective. South African MJ 1992;82:356—9.

Abdool Karim Q, Adbool Karim S, PrestonWhite E. Teenagers seeking condoms at family planning services: providers’ perspectives. South African Mi 1992;82:360—2.

Briggs L. Post primary school teachers’ viewpoint on reproductive health, specifically, their attitude towards contraceptive practice among sexually active school girls in Port Harcourt, Nigeria. J Royal Soc Health 1994;114(5):235—9.

Naré C, N’Diaye P. Les barrières a l’utilisation des services de planification familiale par les femmes et les adolescent(e)s de Dakar. New York: Population Council, 1995.

Kirby D, Short L,Collins J, et al. School-based programs to reduce sexual risk behaviors: a review of effectiveness. Public Health Rep 1994; 109(3):339—60.

Senanayaka P. Positive approaches to education for sexual health with examples from Asia and Africa. Soc Adolesc Med 1992; 13(5) :350—4.

Barker G, Rich S. Influences on adolescent sexuality in Nigeria and Kenya: findings from recent focus-group discussions. Stud Fam Plann 1992;23(3): 199—210.

Naré C. Etude de milieu: projet de Sante Communautaire a Dakar et a Rufisque. Senegal and Netherlands: CARITAS and CEBEMO, 1995.

Weiss H, Whelan D, Gupta GR. Adolescents and HIV/AIDS in the developing world. Washington, DC: International Center for Research on Women, 1996.

Bailie R, Steinberg M. The focus group method in a formative evaluation of a South African high school sexuality education programme. BrJFam Plann 1995;21(2):71—5.

Sow I. L’approche de la sexualité par les jeunes peulhs. Bien Etre 1994(6):8.

Farghaly A, Kamal M. Study of the opinion and level of knowledge about AIDS problems among secondary school students and teachers in Alexandria. I Egypt Public Health Assoc 199 1;66(1-2):209—25.

KenneyA, Guardado 5, Brown L. Sex education and AIDS education in the schools: what states and large school districts are doing. Fam Plann Perspect 1989;21(2):56—64.

Darroch J, Silverman J. What public school teachers teach about preventing pregnancy, AIDS and sexually transmitted diseases. Fam Plann Perspect 1989;2 1 (2):65—72.

Kane T, Debuysscher R, Taylor TT, Smith T,Jeng M. Sexual activity, family life education and contraceptive practice among young adults in Banjul, The Gambia. Stud Fam Plann 1993;24( 1): 50-61.

Klepp K, Ndeki 5, Seha AM, et al. AIDS education for primary school children in Tanzania: an evaluation study. AIDS 1994;8(8):1 157—62.

Pillai V, Yates D. Teenage sexual activity in Zambia: the need for a sex education policy. I Biosoc Sci 1993;25(3):41 1—4.

Ebong R. Sexual promiscuity: knowledge of dangers in institutions of higher learning. I R Soc Health 1994;14(3):l37—9.

l. Wilson DJ, Lavelle S, Hood R. Health knowledge and beliefs as predictors of intented condom use among Zimbabwean adolescents in probation! remand homes. AIDS Care 1990;2(3):267—74.

Ascroft J, Muturi N. Health education for third world school-age children. Compiled by: Harvard Center for Population and Development Studies. The African school-age health research initiative volume II: school-age health. Boston, MA: Harvard Center for Population and Development Studies, 1995.

Leighton K, Sonenstein F, Pleck JH. Factors influencing first intercourse for teenage men. Public Health Rep 1993;108(6):680—91.

World Health Organization. Health of school children treatment of intestinal helminths and schistosomiasis. Compiled by: Harvard Center for Population and Development Studies. The African school-age health research initiative volume II: school-age health. Boston, MA: Harvard Center for Population and Development Studies, 1995.

Vincent ML, Clearie AF, Schuchter MD. Reducing adolescent pregnancy through school and community-based education. JAMA 1987; 257(24) :3382—6.

Wilson DJ, McMaster, Armstrong M, et al. Intergenerational communication within the family: implications for developing STD!HIV prevention strategies for adolescents in Zimbabwe. Washington, DC: International Center for Research on Women, 1995.

Refbacks

  • There are currently no refbacks.