Salam Rehana A, Faqqah Anadil, Sajjad Nida, Lassi Zohra S, Das Jai K, Kaufman Miriam, Bhutta Zulfiqar A
Division of Women and Child Health, Aga Khan University, Karachi, Pakistan.
Robinson Research Institute, University of Adelaide, Adelaide, Australia.
J Adolesc Health. 2016 Oct;59(4S):S11-S28. doi: 10.1016/j.jadohealth.2016.05.022.
Adolescents have special sexual and reproductive health needs (whether or not they are sexually active or married). This review assesses the impact of interventions to improve adolescent sexual and reproductive health (including the interventions to prevent female genital mutilation/cutting [FGM/C]) and to prevent intimate violence. Our review findings suggest that sexual and reproductive health education, counseling, and contraceptive provision are effective in increasing sexual knowledge, contraceptive use, and decreasing adolescent pregnancy. Among interventions to prevent FGM/C, community mobilization and female empowerment strategies have the potential to raise awareness of the adverse health consequences of FGM/C and reduce its prevalence; however, there is a need to conduct methodologically rigorous intervention evaluations. There was limited and inconclusive evidence for the effectiveness of interventions to prevent intimate partner violence. Further studies with rigorous designs, longer term follow-up, and standardized and validated measurement instruments are required to maximize comparability of results. Future efforts should be directed toward scaling-up evidence-based interventions to improve adolescent sexual and reproductive health in low- and middle-income countries, sustain the impacts over time, and ensure equitable outcomes.
青少年有特殊的性与生殖健康需求(无论他们是否有性行为或已婚)。本综述评估了旨在改善青少年性与生殖健康的干预措施(包括预防女性生殖器切割/环切 [FGM/C] 的干预措施)以及预防亲密暴力的影响。我们的综述结果表明,性与生殖健康教育、咨询以及提供避孕药具在增加性知识、避孕药具使用以及减少青少年怀孕方面是有效的。在预防女性生殖器切割/环切的干预措施中,社区动员和女性赋权策略有可能提高对女性生殖器切割/环切不良健康后果的认识并降低其流行率;然而,需要进行方法学上严谨的干预评估。关于预防亲密伴侣暴力干预措施有效性的证据有限且尚无定论。需要开展设计严谨、长期随访以及使用标准化和经过验证的测量工具的进一步研究,以最大限度地提高结果的可比性。未来的努力应致力于扩大基于证据的干预措施,以改善低收入和中等收入国家青少年的性与生殖健康,随着时间推移维持其影响,并确保公平的结果。