Academic journal article International Public Health Journal

Sexual and Reproductive Health Education: A Case for Inclusion in the Curriculum of Primary Schools in the Caribbean

Academic journal article International Public Health Journal

Sexual and Reproductive Health Education: A Case for Inclusion in the Curriculum of Primary Schools in the Caribbean

Article excerpt

Introduction

Early sexual activity as noted by Duncan et al. (1) has a detrimental effect on the lives of young people leading to complications such as STIs and premature pregnancy. STIs and premature pregnancy in the young population adversely affects health, life expectancy and quality of life from personal, social and economic cost in the immediate and long term. It is therefore argued that sexual and reproductive health (SRH) education can be effective in making the young primary school population aware of the risks and prepare them for preventive strategies.

Children and adolescents are disproportionately vulnerable to adverse consequences of early sexual behavior when compared to adults (2). The increased vulnerability is critical during the period of biological, behavioral and emotional development. This is linked to biological and behavioral factors including hormonal changes at puberty, immature reproductive morphology, immunological naivety, sexual experimentation, imperceptions of risk, and alcohol and illicit drug use (3). Additionally, social factors including social disruption, economic deprivation and freedom of mobility, which reduces parental and adult supervision and unregulated behavior, are also among the determinants of STIs and premature pregnancy (3). These challenges also inhibit the educational opportunities and continued professional development for both sexes, which serves as an economic burden to the individuals, their families and society. The collective burdens of STIs and premature pregnancies as described by Johnson et al. (4) found that the burden attributed to STIs in South Africa included death, lost years of life and significant resource expenditure from living with STIs. The United Nations Educational, Scientific and Cultural Organization (5) summarize these socio-cultural challenges by stating:

Few young people receive adequate preparation for their sexual lives. This leaves them potentially vulnerable to coercion, abuse and exploitation, unintended pregnancy and sexually transmitted infections (STIs) including HIV.

The deficiency in SRH education noted by UNESCO (5) indicates the importance of measures to develop knowledge and skills to inform healthy behavior and practices towards SRH. This knowledge gap is also noted in the UNAIDS 2008 Report (6)on the Global AIDS epidemic where among the age group 15-24 years, including those from the Caribbean, 60% did not correctly identify HIV prevention strategies. Effective SRH education as a collaborative effort on the part of schools and their stakeholders including parents, teachers, Ministries of Education and Health, non-governmental organizations and the community according to WHO (7) can provide opportunities to inform attitudes and perceptions regarding their SRH and encourage the practice of healthy behavior concerning their sexual health. This education, according to UNESCO (5), would be required to reduce misinformation, increase correct knowledge, clarify and strengthen positive values and attitudes and enhance self-efficacy. The education can also serve to improve peer group and social norm perceptions while increasing communication with parents and the community. According to Glanz, Rimer and Lewis (8), both the Theory of Reasoned Action (TRA) and the Theory of Planned Behavior (TPB) focus on educational constructs to influence attitude, social normative perceptions and perceived control respectively to explain and inform behavior. Thus, with STIs and premature pregnancies described as being behavioral in nature, they become challenges in SRH that are now preventable if changes in behavior are targeted. Therefore, a cost effective, accessible and culturally oriented approach for combating STI's and premature pregnancies lies with effective and early education.

Sexual and Reproductive health education is defined by the WHO (9) as:

"Information that develops the capacity of people to understand their sexuality in the context of biological, psychological, socio-cultural and reproductive dimensions. …

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