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A Review of Literature and Projects 2005 the skills to deal with sensitive subjects. Such situations are lost opportunities because schools have the resources and facilities to make educational programmes work. (2) Informal (out-of-school) education Several other agencies, in both the government and non-government sectors, have started programmes to address adolescent health. These are carried out through youth activities, the majority of which are community-based. Under the AIDS Prevention Programme, there is a special activity targeting young people on how to live a life free from HIV/AIDS using peer education. Other agencies involved in developing and implementing training modules related to adolescent health are NPFDB, the Muslim Religious Council, the Malaysian AIDS Council, FFPAM and other nongovernmental organizations. Education materials produced by religious government agencies do not cover topics related to sexuality and do not mention sexual harassment. The products of nongovernmental organizations are often more creative and explicit when compared with those produced by government agencies. There is concern about the availability of materials in multiple languages, including Braille and sign language, to ensure balanced coverage for all ethnic groups and the disabled. Another concern is the training of teachers, trainers, facilitators and counsellors to deliver effective sexuality education. Several training modules have been developed for health care workers, including one on health problems commonly encountered among adolescents and how to manage them, a module focusing on mental health of young people, and another on counselling techniques. There is also a document on standard operating procedures for managing adolescents’ clinics. More innovative approaches have been designed for education on sexual and reproductive health. For example, the FFPAM has developed the electronic Reproductive Health of Adolescents Module (e-RHAM), which will enable wider coverage and a more current mode of learning. 3.4.2. Services Adolescents need a wide range of services, especially health services. While health care is the core function of the Ministry of Health, other government agencies also provide health care to young people. In addition, many nongovernmental organizations provide adolescent health services. 49
Sexual and Reproductive Health of Adolescents and Youths in Malaysia (1) The providers Several government ministries are actively involved in activities related to adolescent sexual and reproductive health, including the Ministry of Health, the Ministry of Education, the Ministry of National Unity and Welfare Services, the Ministry of Women and Family Development, and the Ministry of Youth and Sport. The police and local authorities are also involved. The FFPAM is a nongovernmental organization that provides family planning and reproductive health services to everyone, including young people. With branches in all the states, FFPAM provides static, as well as outreach reproductive health services throughout the country. Other active nongovernmental organizations include the Women’ Action Society Malaysia, the Women AIDS Organization (WAO), and the Malaysian AIDS Council. The private sector provides curative and rehabilitative care at private hospitals and doctors’ offices for those with illnesses related to sexual and reproductive health. (2) The approach and principles The review found several key principles of adolescent health, most detailed in the Ministry of Health’s National Adolescent Health Policy, including: • responding to the real needs of adolescents and young people; • availability of and access to youth-friendly services; • active participation by adolescents in health-related activities; • intersectoral collaboration to address the spectrum of biological, social, economic, cultural and political factors that affect adolescents’ sexual and reproductive health; • community participation; • consideration of cultural sensitivity; and • encouraging research to improve services. (3) The content Much of the reviewed literature emphasizes that services related to contraception are only available for married young people through the family planning services offered by the respective agencies. However, it is probable that unmarried young people avail of such services from the private sector and also from nongovernmental 50
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