Amsterdam 2015
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| Abstract #2260 - Needs and interventions for school-aged populations | ||||
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Session: 19.3: Needs and interventions for school-aged populations (Parallel) on Wednesday @ 16.30-18.00 in C103 Chaired by Mark Orkin, Larry Brown Authors: Presenting Author: Dr Najma Shaikh - Kheth' Impilo, South Africa |
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| Additional Authors: | ||||
| Aim: Access to Sexual Reproductive and Rights (SRH&R) services for adolescents is a priority policy objective in South Africa, given the increasing number of adolescents affected and infected by HIV/AIDS. Although HIV programs and school health programs highlight adolescents as requiring specific attention, their needs are not being addressed in a multi-sectoral manner. The goal of this programme was to reduce the burden of HIV /STI infections, unintended pregnancies and to improve SRH&R services for high school attenders through the use of a multi-sectoral approach. The underlying objective was to provide these services within schools to overcome many of the existing barriers to access for this cohort. We describe an innovative school-based and clinic-linked SRH&R service model for high-school students in rural SA that is based on the needs of the SAG ISHP. | ||||
| Method / Issue: The programme involved establishing an integrated school health support pod forming part of the continuum of HIV prevention, treatment, care and support. The school was supported by a Kheth’Impilo team, an NGO that provides HIV treatment, care and support, in collaboration with various departments such as education, welfare and health. Social workers, social auxiliary workers, Nurses and health care staff deliver SRH&R Counseling, education and services for the adolescents. The school team refers learners from the school-based Prevention SRH&R service to a primary health facility, offering youth friendly SRH&R. Learners are also referred to social and welfare and protection. A cross sectional anonymous study was conducted as part of the baseline assessment of the school prior to the implementation of the programme. | ||||
| Results / Comments: Baseline assessment of a sample of 210 learners showed that 62% were sexually active, median age of sexual debut at 16 years(range12-20years), 10% having sex <15 years. Sexual behavior occurs within a context of significant gender-based violence and coercion, with significant differences by gender on the first sexual debut being their own choice(22% females vs 50% of males(P=0.000). 3% of girls reported having been raped. There was relatively low uptake of contraception(48%), with high rates of self-reported pregnancy amongst girls(29%) and 12% of boys having impregnated a partner. In terms of utilization of services, despite a fairly positive uptake of 56% of learners having attended the clinics, only 31% of learners sought contraceptive services and 32% for STI, none requested TOP. Since the implementation of the programme however, uptake increased significantly with 80% of learners having sought services at the school through self-referral. Basic knowledge of HIV/AIDS was high – although relative uncertainty around treatment and “cure” for HIV remain. A key value-add of the study though was that the learners ‘SRH&R health challenges are exacerbated by significant geographic, socio-economic, and nutritional disadvantage. The households that these learners reside in are female headed households(70%), often food insecure (33%), with 58% of learners going to school hungry. 68% walk to school for 40-60 minutes, with 30% feeling tired and unsafe(20%). However 78% of learners benefit from the school feeding scheme. Over 60% of households receive state social grants. | ||||
| Discussion: Conclusions These findings highlight the need for an integrated approach to the delivery of SRH&R programmes, that are context specific and require interventions across multiple layers of need ranging from food security, safe environments, transport, social assistance, health education, water, sanitation - in addition to basic health services. | ||||
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