Transcript Delivery strategies for sexual health in Cambodian

Westfield Scholarship 2007
• Delivery strategies of Adolescent
Reproductive Health (ARH) programs in
Cambodian Schools, remote communities
and to At Risk Youth, and associated
programming to assist with intervention
ideas aimed at improving ARH standards
for Australian Indigenous Youth.
An overview.
There are significant similarities between
Australian indigenous cultural sensitivities and
the Cambodian (Khmer) equivalent in terms of
Adolescent Reproductive Health (ARH) and how
this is delivered into schools.
In Cambodia a considerable number of NGO’s are
currently researching, developing and
implementing innovative adolescent
reproductive health programs.
Overview: condensed program
These program outcomes address sexuality
education topics with specific issues facing
secondary aged Cambodian students including:
• The interface between new and old cultural
ideas.
• The influence on risk taking behaviours.
• Attitudes and practices of community leaders.
• The relationship between STI vulnerability and
social factors.
Research: Ethnography• An ethnography is a description and
interpretation of a cultural or social group
or system.
• The research examines the group’s
observable and learned patterns of
behaviour, customs and ways of life.
Research
The research has centred around ethnographic principles, however a
combination of both quantitative and qualitative methods were used.
Participant observation and data collection techniques included •
Direct first hand observation of both teachers and students in
schools where ARH courses are delivered.
• Conversation and detailed interviews/survey with students and other
youth not attending school.
• Comparison of what Khmer teachers consider effective programs
and how this relates to actual NGO developed programs.
Research..
Literature search included –
• Detailed investigation of the NGO
developed programs including research
used to create these programs.
• Investigation of delivery methods into NT
communities.
Method
• To access as many relevant NGOs as
possible.
• To build on links previously made when
visiting Cambodia.
• Structured and informal interviews.
• Observations: classroom/community
programs.
• Data collection: NT and Cambodia.
• Focus groups.
Current situation
• Substantial information about ARH issues
exists/is available amongst Khmer and
Indigenous youth.
• Positive behaviour change in terms of
ARH has been minimal.
• There is a continuing disregard for the
sexual and reproductive rights of young
women, from within communities.
Needs
• Sustainable behaviour change, underpinned by
changes in values and attitudes towards ARH.
• Promotion of a rights based approach that
addresses gender based violence and respect
for the ARH rights of young girls and women.
• Using appropriate and appropriately trained
people to deliver ARH messages.
• Deliver messages effectively.
Key points
• Overcoming the stigma associated with talk
about sexual health is vital.
• Peer teaching is a highly effective way of
delivering ARH messages.
• Access to pornography and drugs are accepted
as part of the male youth experience.
• The above are clearly linked to inappropriate
sexual behaviour.
• An ill prepared teacher will render any ARH
program ineffective.
• ARH can be delivered across the curriculum.
Effective practice 1
• Community teams made up of people from a
broad range of backgrounds, can effectively
deliver ARH messages.
• Community teams should be trained together.
• Communities/Elders resisting ARH delivery
should be approached directly and regularly to
enable changes to traditional viewpoints on
ARH.
• Culture should be seen as a changing and
evolving phenomena.
Effective practice 2
• Promotion of ARH messages through the Arts is
a proven effective avenue for message delivery.
• Street theatre, play groups, peer leader lead
activities, music, art, dance and especially
community youth radio programs are highly
effective.
• Mobile video units, puppet theatre, television
and radio spots are very effective mediums of
delivery.
• Radio soap operas and call-in radio shows have
enabled positive ARH messages to reach over
90% of Khmer youth.
Effective practice 3
• Promotion of international and national
days such as International Youth Day
using ideas in Effective Practice 2, provide
an effective base from which to deliver
ARH messages.
Effective practice 4
• Development of an effective condom
promotion, distribution and social
marketing program.
• Countries in the Asia-Pacific region where
STI infection rates have been lowered,
have programs that teach detailed condom
use and promote this publicly.
• NT STI rates are increasing.
Recommendation 1
• Creation of a Travelling Sexual Health
Road Show.
• Use mediums such as Drama, Role Play,
Comedy, Dance, Film etc.
• Model on the Science Roadshow and Bell
Shakespeare Roadshow.
Recommendation 2
• Development of a Lifeskills for ARH Peer
Education Program.
• A participatory training process provides
Teams with information about ARH
orientation necessary to train and engage
other youth.
• Empowering young people in ARH
programming is a proven way of delivering
ARH messages.
Recommendation 3
• That communities establish Youth Centres that
focus on providing a safe environment in which
ARH messages are delivered along with
activities appealing to sustainable youth
activities.
• Centres should be open and staffed during late
evenings when there is a high number of
unsupervised youth on the streets.
• Establishment of Men’s and Women’s safe
areas within these Centres.
Recommendation 4
• Development and implementation of a
radio based youth program – to be aired
on local radio (possibly Radio Larrakia).
• 1. Situational Comedy Show using local
indigenous youth that delivers a ARH
message.
• 2. Youth Sexual Health Talkback Program.
Recommendation 5
• Development of a Beginning Teacher ARH
Package.
• To be used as a way of incorporating ARH
issues across the curriculum.
Recommendation 6
• Development of an effective Condom Use
Strategy for implementation indigenous
community level.
• If condom use is positioned as a harm
minimisation strategy then it is a proven
way of preventing unwanted pregnancy
and STI transmission (Smith et al 2000).
These are major issues for indigenous
youth.
Government Reports
• All recommendations are linked to
concepts presented in the following
Reports:
• The Little Children are Sacred Report.
• The Indigenous Education Strategic Plan
2006-2009.
• Transforming Indigenous Education.
Contact
• For further information on this project
contact:
David Armstrong at the Northern Territory
Open Education Centre.
[email protected]